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

Case No. ADJ3293125 (SAC 0368540)
Regular
May 29, 2012

AMY ELDER SOUZA vs. MOTHERLODE HOLDING COMPANY, EVEREST NATIONAL INSURANCE

This case involves a Compromise and Release (C&R) agreement that the Administrative Law Judge (ALJ) initially disapproved because it provided no benefit to the applicant while attorney fees were paid. Both parties petitioned for reconsideration, but the Appeals Board dismissed these as the disapproval order was not a final order. Treating the petitions as requests for removal, the Board rescinded both the disapproval and subsequent approval orders. The matter is returned to the trial level for the ALJ to determine the C&R's adequacy, specifically addressing the alleged overpayment of temporary disability.

Compromise and ReleaseDisapproved C&RReconsideration PetitionRemoval PetitionWCAB Rule 10859WCAB Rule 10882Future Medical TreatmentNew and Further DisabilityTemporary Disability CreditOverpayment
References
Case No. ADJ164815 (SAL 0049263)
Regular
Apr 01, 2020

Pamela McGowne Willoughby vs. Hoge, Fenton, Jones \u0026 Appel, American Home Assurance

The Workers' Compensation Appeals Board (WCAB) reconsidered an administrative law judge's (ALJ) disapproval of a Compromise and Release (C&R). The ALJ found the C&R unlawful due to an alleged assignment of liability, citing Labor Code section 4900. The WCAB clarified that while an injured worker cannot assign their claim, a structured settlement where a third party pays the insurer's obligation with the worker's consent is permissible. After reviewing the financial stability of the annuity provider, the WCAB found the settlement adequate and in the applicant's best interest, thus rescinding the disapproval and approving the C&R.

Compromise and ReleaseMedicare Set AsideStructured SettlementAssignment of LiabilityLabor Code Section 4900Matthews v. Liberty Assignment Corp.WCAB Rule 10700Financially SoundPeriodic PaymentsAnnuity
References
Case No. SFO 0492831
Regular
Jan 23, 2008

ELIAS MONTOYA vs. ASTON BARNES, INC., STATE COMPENSATION INSURANCE FUND

The Board granted reconsideration to clarify the application of Labor Code section 4656 regarding temporary disability indemnity limits. The Board held that "new and further" disability does not extend the 104-week limit under section 4656(c)(1), nor do spinal disc excisions and bone grafts qualify as "amputations" under section 4656(c)(2)(C). Consequently, the applicant is entitled to temporary disability indemnity only up to two years from the date of the first payment.

Workers' Compensation Appeals BoardElias MontoyaAston Barnes Inc.State Compensation Insurance FundSFO 0492831Opinion and Decision After ReconsiderationTemporary Disability IndemnityIndustrial InjuryThoracic SpineChest Injury
References
Case No. ADJ17371801; ADJ18218517
Regular
Oct 10, 2025

MARIO PALACIOS vs. PLAN B ADVANTAGE, INC.; STATE COMPENSATION INSURANCE FUND

Applicant Mario Palacios petitioned for removal from a WCJ's order mandating in-person appearances for himself and two witnesses to verify signatures on a Compromise and Release (C&R). He also sought clarification on electronic signatures and challenged a prior C&R disapproval. The Workers' Compensation Appeals Board granted the petition for removal, rescinding the August 4, 2025 order and allowing Palacios to appear remotely to verify his signature. The Board declined to issue an advisory opinion on electronic signatures but referenced relevant codes, and deemed the challenge to the prior C&R disapproval moot due to an amended C&R.

Petition for RemovalCompromise and ReleaseElectronic SignaturesIn-Person HearingRemote AppearanceDue ProcessWCJ OrderRescind OrderGood CauseWitness Testimony
References
Case No. ADJ9074637
Regular
Dec 03, 2018

ANA RAMOS vs. TRI-STATE EMPLOYMENT SERVICES/ DIAMOND STAFFING; LUMBERMEN'S UNDERWRITING ALLIANCE, in liquidation, administered by CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Appeals Board denied the Petition for Removal because the petitioner failed to demonstrate substantial prejudice or irreparable harm that reconsideration would not adequately address. Additionally, the lien claimant violated WCAB rules by including impermissible attachments to their petition. One attachment documented prohibited ex parte communications with the judge. The lien claimant was admonished to follow Appeals Board rules to avoid potential sanctions.

Petition for RemovalSubstantial PrejudiceIrreparable HarmReconsiderationEx Parte CommunicationLien ClaimantWCAB Rule 10842WCAB Rule 10324(c)SanctionsLabor Code Section 5813
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. SDO 0354449
Regular
Sep 20, 2007

ADAM PERRY vs. HAMMOND \& MASING CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed a prior award denying additional temporary disability payments beyond the statutory 104-week limit. The applicant sought to extend payments based on his knee surgeries, arguing they constituted "amputations" under Labor Code section 4656(c)(2)(C). The Board held that the term "amputation" in this context refers to the severance of external body parts, not the surgical removal of internal knee fragments or cartilage.

Workers' Compensation Appeals BoardIndustrial InjuryPsyche InjuryTemporary Total DisabilityLabor Code Section 4656(c)(1)Labor Code Section 4656(c)(2)(C)AmputationsOsteochondral FragmentChondroplastyACL Reconstruction
References
Case No. SAC 0284418
Regular
Apr 04, 2008

AARON CARTER vs. POLYMER TECHNOLOGIES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE COMPANY

The Appeals Board granted reconsideration, finding that the California Insurance Guarantee Association (CIGA) is contractually obligated to pay U.C. Davis Medical Center's bill based on a prior compromise and release agreement. The Board rescinded the prior decision, ruling that CIGA's agreement to "hold harmless" the applicant from the UCD bill constituted a promise to pay it. The case was returned to the trial level for further proceedings to consider any defenses CIGA may have against the UCD bill.

Workers' Compensation Appeals BoardCIGAPolymer TechnologiesSuperior National Insurance CompanyU.C. Davis Medical CenterU.C. Davis Professional Medical Grouplien claimantscompromise and releasehold harmlesscollateral estoppel
References
Case No. ADJ3656063 (SRO 0135622)
Regular
May 03, 2012

HARVEY JOHNSON vs. ASIEN'S APPLIANCE, STATE COMPENSATION INSURANCE FUND

The Applicant sought removal of an order suspending action on a Compromise and Release (C&R) that was mistakenly filed. The Applicant argued the WCJ erred, as both parties agreed the C&R should be stricken to allow for voluntary arbitration, but the WCJ's pending order blocked this. The Appeals Board denied the Petition for Removal, finding no significant prejudice or irreparable harm as no action was taken on the C&R. The Board clarified that upon remand, parties can jointly withdraw the C&R or seek disapproval, then request arbitration.

Petition for RemovalOrder Suspending ActionCompromise and ReleaseVoluntary ArbitrationStriken from the recordSignificant prejudiceIrreparable harmJoint requestTrial levelStipulate to withdraw
References
Case No. ADJ7709630
Regular
Feb 21, 2012

CARLOS RUIZ vs. VULCAN MATERIAL COMPANY, OLD REPUBLIC INSURANCE

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration regarding temporary disability benefits, finding no exception applied to the 104-week limit. However, the Board granted the applicant's Petition for Removal, rescinded the Order Compelling a medical examination, and returned the matter for further proceedings. This action was taken due to allegations of defendant's violation of Labor Code section 4062.3(c) and potential prejudice to the applicant.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFindings and OrderOrder Compelling Medical ExaminationLabor Code section 4656(c)(2)Labor Code section 4656(c)(3)temporary disability benefitsstatutory limitamputation exception
References
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