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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ10087317
Regular
Apr 11, 2016

Clark Fowler vs. Lompoc Unified School District

This case involves a worker's compensation appeal by Lompoc Unified School District challenging a 5% permanent disability award for applicant Clark Fowler. The employer argued the award was unsubstantiated due to the applicant's failure to undergo diagnostic testing. The Workers' Compensation Appeals Board denied reconsideration, upholding the award. The Board found the employer failed to prove applicant refused any evaluation and that even if one component of the disability rating was excluded, the applicant would still qualify for the same award based on another unimpaired physical function.

Workers' Compensation Appeals Boardpermanent disabilitysubstantial medical evidencediagnostic testingPetition for ReconsiderationFindings and Awardadministrative law judgeaccepted industrial injuryprimary treating physiciancarpal tunnel syndrome
References
Case No. LAO 0829008
Regular
Apr 01, 2008

CHRISTINA D. SALCEDO vs. COUNTY OF LOS ANGELES

The Appeals Board dismissed the defendant's petition for reconsideration as the WCJ's order denying invasive diagnostic tests was not a final order. However, the Board granted removal due to potential due process issues and the need to fully develop the record on causation. The decision deferred the issue of diagnostic tests, affirming other aspects of the WCJ's order and returning the case for further proceedings.

Workers' Compensation Appeals BoardReconsiderationRemovalDiagnostic TestsInvasiveCompelUrological InjuryCompensable ConsequenceDue ProcessMedical Proof
References
Case No. ADJ8118127
Regular
Apr 24, 2015

JUANA PONCE DE MAULEON vs. HARRIS WOOLF CALIFORNIA ALMONDS, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior finding. The WCAB determined that EMG/NCS diagnostic testing requested by the applicant's primary treating physician constitutes medical treatment. Therefore, this testing is subject to Utilization Review (UR) and subsequent Independent Medical Review (IMR), rather than being classified as a medical-legal expense adjudicated by the WCAB. The employer's petition for reconsideration was granted on this basis.

Workers' Compensation Appeals BoardUtilization ReviewIndependent Medical ReviewElectromyographyNerve Conduction StudyPrimary Treating PhysicianMedical TreatmentMedical-Legal ExpensesFindings & OrderPetition for Reconsideration
References
Case No. ADJ7587936
Regular
Oct 16, 2012

KAREN GODDARD vs. MARIE CALLENDER'S, ESIS, INC. C/O ACE INSURANCE COMPANY

The Appeals Board dismissed the applicant's petition for reconsideration. They granted removal on their own motion, rescinded the WCJ's order striking the PQME's report, and returned the matter for further development of the record. This action was taken because the record was unclear as to who performed diagnostic testing, potentially violating Labor Code section 4628. The Board directed parties to first obtain a supplemental report from the PQME to clarify this issue.

WCABPQMEAMEIMELabor Code 4628Nerve Conduction StudyMedical Record DevelopmentPetition for ReconsiderationRemovalFindings Order Opinion
References
Case No. ADJ6708293
Regular
Apr 04, 2013

Derrick Ransom vs. Jacksonville Jaguars, ACE Insurance, Arizona Cardinals, Travelers Indemnity Company, Gulf Insurance, Kansas City Chiefs, TIG Insurance, Risks Enterprise Management

This case concerns a workers' compensation claim filed by Derrick Ransom, a former professional football player. The Jacksonville Jaguars, through their insurer, petitioned for reconsideration of a finding that ordered them to pay for diagnostic testing and travel expenses before a jurisdictional determination. The Appeals Board found that ordering payment before establishing jurisdiction was improper. Therefore, the previous award was rescinded, and the matter was returned to the trial level to first determine if the Appeals Board has jurisdiction over the Jaguars.

Workers' Compensation Appeals BoardReconsiderationJurisdictionJacksonville JaguarsACE InsuranceArizona CardinalsTravelers Indemnity CompanyKansas City ChiefsTIG InsuranceQualified Medical Evaluator
References
Case No. ADJ14099837; ADJ18327322
Regular
Aug 21, 2025

ROBERT SCHLIESMANN vs. SOLAR OPTIMUM DESIGN AND ELECTRICAL, STATE COMPENSATION INSURANCE FUND

The applicant, Robert Schliesmann, sustained an injury to his lumbar spine, lower extremities, left leg, and bilateral feet while employed as a solar tech. The case was initially dismissed due to the applicant's perceived inaction. However, the Workers' Compensation Administrative Law Judge (WCJ) vacated the dismissal, finding that the defendant failed to comply with the Qualified Medical Evaluator's (QME) requests for diagnostic testing and documents, thereby impeding the QME process. The Appeals Board affirmed this decision, emphasizing the constitutional mandate for substantial justice and the defendant's duty to conduct a reasonable and timely investigation of claims.

PQMEAdjudication NumbersFindings and OrdersPetition for ReconsiderationReport and RecommendationLabor Code Section 5803Good CauseOrder of DismissalPetition to ReopenRescind
References
Case No. ADJ1972610 (AHM 0128733) ADJ2694708 (AHM 0123434)
Regular
May 28, 2013

ANTONIO MEDINA vs. MATRIX INDUSTRIES, INC.; TIG SPECIALTY INSURANCE administered by RISK ENTERPRISE MANAGEMENT

The WCAB granted reconsideration to StatMedical Diagnostics, Inc., a lien claimant, overturning a prior decision that denied their lien. The Board held that diagnostic services provided by the lien claimant to enable a physician's opinion on causation are recoverable medical-legal expenses. Even though the applicant was ultimately found not to have sustained an industrial injury, this does not negate the lien claimant's right to reimbursement for these services. The Board awarded the lien claimant the full amount of its lien.

Medical-legal expensesLien claimantIndustrial injuryCausationDiagnostic testsPrimary treating physicianReconsiderationJoint Findings and OrderLabor Code section 4620Mantel v. Workmens' Comp. Appeals Bd.
References
Case No. ADJ6764237
Regular
Feb 10, 2012

FRED MCCRARY vs. SAN DIEGO CHARGERS, TRAVELERS INDEMNITY successor in interest to GULF INSURANCE CO.; SEATTLE SEAHAWKS, ATLANTA FALCONS; BERKLEY SPECIALTY UNDERWRITING MANAGERS; NEW ENGLAND PATRIOTS

The Workers' Compensation Appeals Board (WCAB) dismissed Travelers Indemnity Company's Petition for Reconsideration because the WCJ's order regarding further medical testing was not a final order. The WCAB also denied Travelers' Petition for Removal, finding no showing of significant prejudice or irreparable harm. The WCJ had ordered Travelers to pay for additional medical evaluations and diagnostic tests, with the ultimate liability to be determined later. The Appeals Board adopted the WCJ's reasoning for denying removal.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalMinute OrderPanel QMEMedical Legal ExaminationsAuthorization for TestingSubstantive RightsIrreparable HarmAdministrative Law Judge
References
Case No. ADJ3941863
Regular
Feb 13, 2009

BETTY AMRIKHAS vs. ROBINSON-MAY DEPARTMENT STORES, NATIONAL FIRE & MARINE INSURANCE COMPANY

This case concerns defendant's petition to reconsider a WCJ's award of $\$3,159.00$ for diagnostic MRI services provided to the applicant. The Appeals Board granted reconsideration, reversing the WCJ's decision. The Board found the diagnostic tests were part of applicant's self-procured medical treatment for non-industrial conditions, not reasonable or necessary medical-legal costs to prove or disprove her contested claim. Since applicant's industrial injury claim was denied, defendant is not liable for these expenses.

WCABPetition for ReconsiderationFindings of FactAwardLien claimantsDiagnostic servicesMRIsMR arthrogramCumulative trauma injurySelf-procured medical treatment
References
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