CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. ADJ10033983 ADJ11112700
Regular
Jul 08, 2019

PABLO PEREZ vs. TAYLOR FARMS, ZURICH NORTH AMERICA INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted applicant Pablo Perez's Petition for Removal, rescinding the prior finding that a Functional Capacity Evaluation (FCE) was not a reasonable and necessary medical-legal expense. The WCAB found that an FCE, recommended by Panel Qualified Medical Evaluator Dr. Ali Soozani to assess permanent impairment, provides crucial objective data not fully captured by subjective complaints or a standard physical examination. The Board reasoned that while a physical therapist conducts the FCE, this is permissible under Labor Code section 3209.5 for medical treatment and does not violate Labor Code section 4628 when viewed as a distinct diagnostic tool supporting the QME's overall evaluation. Consequently, the WCAB issued a new Finding of Fact and Order deeming the FCE reasonable and necessary.

Functional Capacity EvaluationMedical-Legal ExpensePanel Qualified Medical EvaluatorPermanent ImpairmentActivities of Daily LivingSubstantial EvidenceAlmaraz/GuzmanLabor Code Section 4628Diagnostic ToolMedical Opinion
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. ADJ10275844
Regular
Apr 26, 2018

MARIA RIVERA vs. WELMORE TOOL & ENGINEERING, OLD REPUBLIC INSURANCE

The Workers' Compensation Appeals Board granted reconsideration of a prior decision in Rivera v. Welmore Tool & Engineering. This action was taken because a settlement has been reached during the pendency of the reconsideration. Consequently, the prior decision is rescinded, and the case is returned to the trial level for the WCJ to consider the proposed settlement. The WCJ will either approve the settlement or reinstate the original decision, with the option for either party to seek further reconsideration.

Petition for ReconsiderationGrant ReconsiderationRescind DecisionReturn to Trial LevelProposed SettlementWorkers' Compensation Appeals BoardWCJ DecisionAdministrative Law JudgeFurther ProceedingsDecision After Reconsideration
References
Case No. ADJ8967877
Regular
Apr 16, 2015

TEOFILO ALVAREZ vs. WETMORE TOOLS AND ENGINEERING, OLD REPUBLIC, GALLAGHER BASSETT NOVA CASUALTY, YORK

This case concerns a Petition for Reconsideration filed by the applicant, Teofilo Alvarez, against Wetmore Tools and Engineering and their insurers. The Workers' Compensation Appeals Board (WCAB) dismissed the petition because it was filed more than 25 days after the Administrative Law Judge's decision was served. The WCAB emphasized that the filing deadline is jurisdictional, meaning the Board lacks authority to consider untimely petitions. Had the petition been timely, it would have been denied on its merits.

Petition for ReconsiderationUntimely FilingJurisdictional Time LimitService by MailWCJ ReportAppeals BoardDismissed PetitionLabor CodeCalifornia Code of RegulationsProof of Mailing
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. 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. ADJ3086260
Regular
Feb 05, 2018

Mario Aviles vs. ARS ELECTRONICS, STATE COMPENSATION INSURANCE FUND

This case involved a lien claimant, TMS Diagnostics, seeking payment for medical treatment provided to applicant Mario Aviles. The original administrative law judge found the treatment unnecessary and disallowed the lien. After TMS petitioned for reconsideration, the parties engaged in mediation and reached a settlement. The Workers' Compensation Appeals Board approved the agreement, amending the decision to reflect a $\$ 1,100$ payment to TMS Diagnostics in full satisfaction of its lien claim. This resolution avoided further litigation.

Workers' Compensation Appeals BoardReconsiderationLien ClaimMedical Treatment NecessityFindings and OrderWCJPetition for ReconsiderationMediationSettlement AgreementSCIF
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
Case No. ADJ4334969 (LAO 0885524) ADJ2096143 (LAO 0885598)
Regular
Apr 10, 2012

RYAN ROMERO vs. RALPHS GROCERY COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration and reversed the prior award to lien claimant Neurolink Medical Corporation (NMC). NMC failed to meet its burden of proving that the diagnostic procedure it performed on November 16, 2010, was reasonably required to cure or relieve the applicant's industrial injury. Crucially, there was no evidence that the applicant's primary treating physician ever received or commented on the results of this repeat diagnostic test, which had previously yielded normal results. Therefore, NMC's lien claim was denied for lack of substantial evidence.

Workers' Compensation Appeals BoardRyan RomeroRalphs Grocery CompanyNeurolink Medical CorporationPetition for ReconsiderationJoint Findings And AwardAdministrative Law JudgeLien ClaimIndustrial InjuryLow Back Injury
References
Case No. ADJ8022679, ADJ7722045
Regular
Apr 22, 2013

CARRIE PARKER vs. ENTERTAINMENT PARTNERS, CHARTIS CLAIMS, INC.

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior Findings and Award, and returned the matter for further proceedings and a new decision. Defendant argued the award should have been for cumulative trauma, sought credit for EDD reimbursements against the temporary disability cap, and contended the PQME reports and awarded neck surgery were not substantial evidence. The Board agreed that the prior award needed to be rescinded for further clarification on the PQME's findings regarding the necessity of surgery and specific diagnostics. They encouraged further medical evaluation, potentially through an Agreed Medical Evaluator, to clarify treatment recommendations for the applicant's cervical spine injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardTemporary Disability IndemnityPanel Qualified Medical EvaluatorNeck SurgeryDiagnosticsCumulative Trauma InjurySpecific InjuryApportionment
References
Showing 1-10 of 165 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational