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

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. ADJ 4252592 (VNO 0411668)ADJ 3234790 (VNO 0443319) (MF)
Regular
May 04, 2012

HARRY WINSTON vs. CITY OF LOS ANGELES

This case concerns a petition for reconsideration by the City of Los Angeles challenging the Administrative Law Judge's (ALJ) finding of a single cumulative trauma injury. The applicant stipulated to two separate cumulative trauma periods for various injuries, but subsequent medical opinions from treating physicians concluded there was one continuous cumulative trauma injury spanning the applicant's entire employment. The ALJ amended the stipulations to align with this medical evidence and dismissed one of the applicant's cases as duplicative. Therefore, the ALJ recommends denying the employer's petition for reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationCumulative Trauma InjuryAmended FindingsOpinion on DecisionStipulationsMedical EvaluationQualified Medical EvaluationAgreed Medical EvaluationDate of Injury
References
Case No. ADJ18890787; ADJ10622598; ADJ10936287; ADJ11180688
Regular
Apr 01, 2025

Kevin Perry vs. Asset Protection and Security Services L.P., Insurance Company of the State of PA

The applicant, Kevin Perry, sought reconsideration of a prior Order Dismissing Case with Prejudice, which was based on the doctrine of res judicata. The Workers' Compensation Appeals Board (WCAB) acknowledged that the petition was timely filed within the 60-day statutory period. However, due to the absence of a complete evidentiary record from the lower tribunal, the WCAB was unable to adequately review the applicant's contentions. Consequently, the Petition for Reconsideration was dismissed as premature, and the matter was returned to the Presiding Workers' Compensation Judge (PWCJ) with a recommendation to treat the original petition as one to set aside the initial Order Dismissing, allowing for further proceedings and a new decision that can then be subject to reconsideration.

Res judicataVexatious litigantPetition for reconsiderationOrder dismissing case with prejudiceLabor Code section 5909Cumulative traumaAsset Protection and Security ServicesGallagher Bassett ServicesAIG ClaimsApplication for Adjudication of Claim
References
Case No. ADJ2987188 (LBO 0277672) ADJ6543172
Regular
Sep 15, 2015

LUPE CHAVEZ vs. COUNTY OF LOS ANGELES, TRISTAR RISK MANAGEMENT

This order denies Lupe Chavez's Petition for Reconsideration in her workers' compensation case against the County of Los Angeles and Tristar Risk Management. The Workers' Compensation Appeals Board adopted the reasoning of the workers' compensation administrative law judge's report. Therefore, the denial of reconsideration stands.

Petition for ReconsiderationWorkers' Compensation Appeals BoardAdministrative Law Judge ReportDenying ReconsiderationCounty of Los AngelesTristar Risk ManagementCase Number ADJ2987188Case Number ADJ6543172San FranciscoCalifornia
References
Case No. ADJ2340102 (LAO 0751270) ADJ4406096 (LAO 0784412)
Regular
Apr 27, 2017

JOSE MORFIN vs. WHITE MEMORIAL MEDICAL CENTER, ADVENTIST HEALTH

This case involves an award of additional attorney's fees for applicant's counsel in the California Court of Appeal. The court remanded the matter for supplemental fees after the defendant's unsuccessful Petition for Writ of Review. While applicant's attorney sought $11,480.00 in fees, the Board found this excessive and awarded $8,000.00 based on a review of the appellate work and the contentious history of the litigation. The Board also awarded the requested costs of $67.58, totaling $8,067.58 in additional appellate attorney's fees and costs.

Workers' Compensation Appeals BoardSupplemental Attorney's FeesPetition for Writ of ReviewLabor Code § 5801Labor Code § 5811Appellate Attorney's FeesItemization of Attorney's FeesExcessive Fee RequestReasonable Fee DeterminationCase-by-Case Basis
References
Case No. FRE 0191303
Regular
Nov 27, 2007

NORMA OZUNA vs. COUNTY OF FRESNO

The Workers' Compensation Appeals Board (WCAB) rescinded a finding that the defendant was not responsible for the costs of the applicant's vocational expert. The WCAB remanded the case to the trial level for further analysis, instructing the judge to consider the factors outlined in *Costa v. Hardy Diagnostic* regarding the reasonableness and necessity of expert costs. The decision does not comment on the merits of whether the costs are ultimately reimbursable.

Vocational expert costsLabor Code section 5811Costa v. Hardy DiagnosticPermanent Disability Rating ScheduleAppeals Board en banccumulative traumaHepatitis Ccorrectional officeragreed medical evaluatorfindings of fact and award
References
Case No. ADJ6766619 (MF) ADJ6766620
Regular
Feb 28, 2018

MARIA DURAN vs. FOREVER 21 RETAIL, INC., CHUBB GROUP

This case involves Maria Duran's request for home health care services, which was initially denied by utilization review (UR) and upheld by Independent Medical Review (IMR). The applicant argued that her need for assistance with household chores and personal hygiene fell outside the scope of the Medical Treatment Utilization Schedule (MTUS) guidelines as applied. While the Board acknowledges that the specific MTUS guideline used in this case was later found to be an invalid regulation in a related case, it affirmed the original decision. This affirmance was based on the finding that the initial request for services was too vague, lacking specific details on the type, frequency, and duration of care, and that a revised request could be made.

Workers' Compensation Appeals BoardMaria DuranForever 21 RetailInc.Chubb GroupOpinion and Decision After ReconsiderationIndependent Medical ReviewIMRUtilization ReviewUR
References
Case No. ADJ3180407 (LAO 0785803)
Regular
Nov 10, 2008

Carl Brewer vs. CAPITAL REPROGRAPHICS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for VILLANOVA INSURANCE, In Liquidation

This case concerns CIGA's petition for reconsideration of a WCJ's award of penalties for various payment failures, including attorney fees, home health care, and a case management nurse. CIGA argues these penalties are not "covered claims" under its statutory exemption. The Appeals Board granted reconsideration, rescinded the prior order, and returned the case to the trial level due to a missing case file.

CIGAVillanova InsurancePenaltiesAttorneys FeesHome Health CareGuardian Ad LitemCase Management NurseInsurance Code Section 1063.1(c)(8)Covered ClaimsReconsideration
References
Case No. ADJ8307394
Regular
Nov 16, 2015

ROSALIO ESPARZA-SALAS vs. INTERAMERICAN MOTOR CORPORATION, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case involves an applicant appealing a decision awarding a lien for the Employment Development Department (EDD). The applicant argued EDD failed to prove its lien was duplicative of permanent disability benefits. The Appeals Board granted reconsideration to further examine the issue. The Board affirmed the original award but deferred the EDD lien, remanding the case for further proceedings to develop evidence on proper notice and potential duplicate payments.

ROSALIO ESPARZA-SALASINTERAMERICAN MOTOR CORPORATIONTRAVELERS PROPERTY CASUALTY COMPANY OF AMERICAADJ8307394OPINION AND DECISION AFTER RECONSIDERATIONEmployment Development Department (EDD)lienpermanent disability awardduplicative benefitsMedical Provider Network
References
Case No. ADJ4225526 (GOL 0092072)
Regular
Apr 20, 2017

JESUS ARROYO vs. JOHN CRAVENS PLASTERING, STATE COMPENSATION INSURANCE FUND

This case involves Jesus Arroyo's petition for reconsideration of a Workers' Compensation Appeals Board decision. The Board denied reconsideration, adopting the reasoning of the workers' compensation administrative law judge. Medical evidence from Dr. Markovitz established that Arroyo suffered a total and permanent disability resulting from industrial injuries, including an aortic aneurysm repair and subsequent strokes. The Board found Dr. Markovitz's opinions constituted substantial medical evidence, despite conflicting defense opinions, and affirmed that all necessary medical care and permanent disability were industrially caused.

Workers' Compensation Appeals BoardJesus ArroyoJohn Cravens PlasteringState Compensation Insurance FundPetition for ReconsiderationAgreed Medical ExaminerGerald Markovitzechocardiogramaortic root dilationexpanding aortic aneurysm
References
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