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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ8130064
Regular
Mar 29, 2019

Victor Juarez vs. Masonry by Joe, State Compensation Insurance Fund, Imperium Insurance Company, Athens Administrators, Endurance Southern Insurance

This case involves lien claimants who filed their liens in 2012 but failed to submit timely Labor Code section 4903.8(d) declarations, which were required for liens filed before January 1, 2013, by January 1, 2014. The WCAB granted reconsideration, rescinded the WCJ's order dismissing the liens, and returned the matter for further proceedings. The Board found that while the declarations were untimely, the specific remedy for such untimeliness for pre-2013 liens is not defined in the statute. However, the Board noted that the WCAB possesses equitable powers, including the application of the doctrine of laches, to address unjustifiable delay in lien claims.

Labor Code section 4903.8(d)Lien claimantsPetition for ReconsiderationFindings and Orderuntimely declarationsLabor Code section 4903.8(e)Senate Bill 863equitable doctrine of lachesunjustifiable delayequitable powers
References
Case No. ADJ9346293
En Banc
Apr 13, 2020

ANTHONY DENNIS vs. STATE OF CALIFORNIA – DEPARTMENT OF CORRECTIONS AND REHABILITATION INMATE CLAIMS, STATE COMPENSATION INSURANCE FUND

The WCAB holds that Administrative Director Rule 10133.54 is invalid as it exceeds the statutory authority granted to the Administrative Director and restricts the WCAB's exclusive power to adjudicate compensation claims. It also holds that an employer must provide a bona fide offer of work to avoid liability for a supplemental job displacement benefit voucher.

AD Rule 10133.54Supplemental Job Displacement BenefitWCAB exclusive jurisdictionadministrative director authoritybona fide work offerinmate laborstatutory authorityadjudicatory poweren banc decisionreconsideration
References
Case No. VNO 509949, VNO 518262, VNO 522250
Regular
Feb 13, 2008

THOMAS OSTEEN vs. COUNTY OF LOS ANGELES, TRISTAR RISK MANAGEMENT

The WCAB granted reconsideration to address a defendant's claim of overpayment to a lien claimant, Lee Mathis & Associates/Kerlan & Jobe. The Board found it has jurisdiction over the lien claim, even without a formal filing with the WCAB, because notice was provided to the defendant. The matter was remanded for a new decision by the WCJ on the restitution claim, acknowledging the WCAB's equitable powers.

Workers' Compensation Appeals BoardRestitutionLien ClaimantsJurisdictionLabor Code Section 5304Labor Code Section 4904(a)Labor Code Section 4903(b)Medical Treatment LienMedical-Legal ExpensesEquitable Powers
References
Case No. SRO 0105138, SRO 0105139
Regular
Jan 18, 2008

TRACIE BROOKS vs. NORTHGATE GARAGE DOOR, SUPERIOR NATIONAL INSURANCE COMPANY

The Appeals Board granted reconsideration, finding that driver-assisted transportation to medical appointments, even those set by the applicant's attorney, is an appropriate issue for an Expedited Hearing when the applicant cannot drive. The Board determined it has equitable power to order pre-payment of medical-legal mileage, reversing the WCJ's decision. Consequently, the defendant was ordered to provide a driver for the applicant's QME appointment.

Expedited HearingMedical-legal mileageDriver-assisted transportationAgreed Medical Evaluator (AME)Qualified Medical Evaluator (QME)Pre-payment of expensesEquitable powersLabor Code section 5502(b)Final orderReconsideration
References
Case No. ADJ2304167 (LAO0839866)
Regular
Jan 24, 2012

Jose Saucedo vs. COUNTY OF LOS ANGELES, USC MEDICAL CENTER

In *Saucedo v. County of Los Angeles*, the Workers' Compensation Appeals Board affirmed an order setting aside a case dismissal. The dismissal occurred due to the applicant's failure to appear at a hearing and subsequent lack of objection within the allotted time. However, the applicant later filed a Declaration of Readiness to Proceed, which the judge treated as a timely petition for reconsideration. The Board found this action permissible under equitable powers to favor a hearing on the merits, upholding the applicant's right to litigate his claim.

Declaration of ReadinessOrder Setting Aside DismissalWCJPetition for ReconsiderationOrder of DismissalFailure to AppearTimely ObjectionEquitable PowersDefault*Propria Persona*
References
Case No. ADJ9487589
Regular
Feb 25, 2020

DONNA KNIGHT (DECEASED) vs. MARISAN GROUP, SENTINEL INSURANCE COMPANY, THE HARTFORD

This case concerns the deceased worker's estate's claim for penalties and attorney's fees related to delayed death benefit payments. The Appeals Board affirmed the Workers' Compensation Judge's decision, finding the defendant was entitled to a credit for an overpayment. The majority ruled that the penalty under Labor Code section 4650(d) did not apply because payments were made before the award became final for appellate purposes. A dissenting commissioner argued for the application of penalties and attorney's fees due to the defendant's failure to pay accrued interest.

Labor Code section 4650(d)Death benefitsPenaltyAttorney's feesCreditInterestReconsiderationFinality of awardEquitable creditUnilateral mistake of law
References
Case No. ADJ614533 (LAO 0820975)
Regular
Mar 12, 2020

GERARDO RIVERA, vs. FALCON WEST INC.; STATE COMPENSATION INSURANCE FUND,

The WCAB granted the lien claimant's petition for reconsideration, rescinding the prior order that barred the 2003 lien claim based on laches. The Board found that the defendant failed to present any evidence to prove prejudice or change of position resulting from the claimant's delay. Consequently, the case is returned to the trial level for further proceedings to develop the record regarding the laches defense.

Lien claimantLachesPetition for ReconsiderationWorkers' Compensation Appeals BoardFindings and OrderAdministrative law judgePetitionDeclaration of Readiness to ProceedBurden of proofPrejudice
References
Case No. ADJ9138064
Regular
Sep 02, 2016

EZEQUIEL HERNANDEZ vs. MURANAKA FARMS, INC., ZENITH INSURANCE COMPANY

Zenith Insurance sought reconsideration of an order requiring it to distribute attorney fees held in trust. Zenith had mistakenly paid the full $6,000 to one attorney, Manuel Martinez, who then failed to fully distribute the funds to the other two attorneys as agreed. The Appeals Board granted reconsideration, finding prior agreements and orders already dictated the fee distribution between the attorneys. Consequently, the Board rescinded the June 10, 2016 order and directed Manuel Martinez to comply with prior court orders for distribution.

Petition for ReconsiderationStipulation and OrderCompromise and ReleaseAttorney FeesTrust AccountMistake in DistributionUnjust EnrichmentPlenary PowerEquitable PowersRestitution
References
Case No. ADJ3937799
Regular
Nov 07, 2025

RAMONA MELERO vs. DOROTHY SHEA ENDEAVORS, ALLIANZ RESOLUTION MANAGEMENT

The Workers' Compensation Appeals Board granted reconsideration of the Findings of Fact and Order issued on December 31, 2020, by the WCJ, concerning a dispute over the timeliness of utilization review (UR) for applicant Ramona Melero's home health care request. Applicant contended that the utilization reviewer improperly delayed the request. The Board affirmed the WCJ's finding that defendant timely completed UR, stating that there was no evidence to support the applicant's argument that the reasons for the delay were already known to the defendant. The Board also discussed its equitable powers and the doctrine of equitable tolling in cases where administrative errors prevent timely action on petitions for reconsideration.

Utilization ReviewIndependent Medical ReviewPetition for ReconsiderationEquitable TollingLachesDue ProcessSubstantial JusticeRequest for AuthorizationHome Health CareClaims Administrator
References
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