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

Case No. ADJ1775959 (ANA 0387306) ADJ2257120 (ANA 0386617)
Regular
May 17, 2010

SILVIA MORA vs. STEELCASE, INC., LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior decision that ordered a lien claimant to reimburse the defendant for chiropractic treatment exceeding the statutory limit. The WCAB held that Labor Code section 4604.5(d)(1) limits chiropractic visits but does not authorize restitution for voluntary payment of excessive treatment. Citing the equitable principles established in *American Psychometric Consultants, Inc. v. Workers' Compensation Appeals Board (Hurtado)*, the Board found that both parties were equally aware of the legal limits, and the defendant voluntarily paid the excess charges. The WCAB emphasized transactional stability, stating that undoing such payments would negatively impact the workers' compensation system.

Workers' Compensation Appeals BoardLien claimantReconsiderationFindings and OrderLabor Code section 4604.5(d)(1)Chiropractic visitsReimbursementPetition for ReimbursementMedical treatment lienEquitable restitution
References
Case No. ADJ2022332 (ANA 0334821) ADJ947209 (ANA 0334822)
Regular
Feb 27, 2014

JOHN SHEA vs. PROPSERV, INC., CENTRE INSURANCE. COMPANY., CIGA For CALCOMP, In Liquidation

The California Workers' Compensation Appeals Board affirmed the Arbitrator's decision denying CIGA's requests for contribution and reimbursement from Centre Insurance Company. CIGA stipulated to liability for the injury date in 2000, and the Board found that CIGA's subsequent claims of mistake were untimely and lacked good cause to reopen a final award. The Board emphasized the importance of finality in awards and that CIGA failed to timely raise equitable arguments. Therefore, CIGA's appeal for contribution and reimbursement was unsuccessful.

CIGACalCompContributionReimbursementStipulated AwardGood CauseReopenEquitable ArgumentsPrejudgment InterestDate of Injury
References
Case No. ADJ4465666 (OAK 0286384) ADJ2738204 (OAK 0277457)
Regular
Jun 22, 2012

NAQUISHA HENSLEY vs. A.C. TRANSIT DISTRICT, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Appeals Board granted reconsideration, rescinding the WCJ's decision that denied the employer reimbursement for a $10,200 mistaken payment. The Board found the applicant should have known the payment was an error, given its identical amount to a previous settlement check from the Subsequent Injuries Benefits Trust Fund. While the employer's adjuster was negligent, the Board exercised its discretion to allow the employer a credit of $10,200 against future workers' compensation benefits rather than ordering direct reimbursement due to the time lapse and applicant's spending of the funds. This credit includes future medical treatment, acknowledging the employer's fault in the overpayment.

Workers' Compensation Appeals BoardA.C. Transit DistrictSubsequent Injuries Benefits Trust FundPetition for ReconsiderationFindings And OrdersErroneous PaymentReimbursementCreditStipulated AwardsCompromise and Release
References
Case No. STK 0182326
Regular
Oct 15, 2007

MICHAEL JACKSON vs. ODWALLA, INC, ROYAL INDEMNITY, LABOR READY, LUMBERMAN'S MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted Royal Indemnity's petition for removal to address a dispute over equitable reimbursement between defendants ESIS and Royal Indemnity. The core issue is determining Michael Jackson's employer status to resolve which insurer bears full liability for his injury, as the original award finding Labor Ready as the employer was rescinded. The Board rescinded the order taking the case off calendar and returned it to the trial level for further proceedings.

Workers' Compensation Appeals BoardRemovalFindings and AwardOrder Taking Off CalendarLabor ReadyOdwallaIncRoyal IndemnityESISTemporary Staffing Agency
References
Case No. ADJ387954 (OXN 0145858) ADJ2973719 (OXN 0145147)
Regular
Oct 27, 2017

FRANCISCO PRIETO vs. O.C. CONTRACTING, INC., AMERICAN INTERNATIONAL GROUP, INC., UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case concerns a Petition for Reimbursement filed by Granite State Insurance Company against the Uninsured Employers Benefits Trust Fund (UEBTF). Granite State mistakenly paid workers' compensation benefits to an employee injured while working for an uninsured employer. The Workers' Compensation Appeals Board (WCAB) rescinded a prior order granting reimbursement, holding that UEBTF is not statutorily liable to reimburse insurance carriers for erroneous payments. The WCAB emphasized that UEBTF's purpose is to provide benefits to injured workers of uninsured employers, not to indemnify insurers. A dissenting opinion argued for amending the order to allow reimbursement to Granite State through applicant from funds UEBTF owes the applicant.

Uninsured Employers Benefits Trust FundGranite State Insurance CompanyPetition for ReimbursementLabor Code sections 37153716mistaken paymentillegally uninsured employerLabor Code section 4909creditdirect reimbursement
References
Case No. ADJ17547374
Regular
Oct 16, 2025

WARREN P. HARVEY vs. SOCAL MACHINE, INC., TRUCK INSURANCE EXCHANGE, FARMERS INSURANCE

The Workers' Compensation Appeals Board considered applicant Warren P. Harvey's petition for reconsideration regarding the equitable hourly reimbursement rates for in-home health care provided by his spouse, asserting errors in the WCJ's rate calculation and attorneys' fees. After an unsuccessful settlement conference, the parties filed Stipulations With Request for Award, agreeing to permanent total disability and further medical treatment for the applicant, though these stipulations did not resolve the reconsideration issues. The Board approved these stipulations, finding them adequate and in the applicant's best interest, and issued an award based upon them, which included specific disability indemnity, medical treatment, and attorney's fees. The Board also commended the parties for resolving some important issues and urged them to continue efforts on the remaining disputes.

Equitable hourly reimbursement ratesIn-home health careCaregiver dutiesNursing dutiesCommunity HHC providerPetition for reconsiderationStipulations With Request for AwardPermanent total disabilityTemporary disability indemnityAttorneys' fee
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. ADJ122717
Regular
Dec 13, 2012

JOE MARTINEZ vs. CDC-CORCORAN STATE PRISON, STATE COMPENSATION INSURANCE FUND

Here is a summary of the case in four sentences: The Workers' Compensation Appeals Board denied a lien claim by the CCPOA Benefits Trust Fund for over $42,000 paid to applicant Joe Martinez for living expenses. The Board found no statutory authority under Labor Code sections 4903 or 4903.1 to allow reimbursement for living expenses paid by a self-insured employee welfare benefit plan. Specifically, Labor Code section 4903.1(a)(3) only permits such liens for group disability policies under specific conditions not met here. The Board affirmed the trial judge's decision disallowing the lien.

Workers' Compensation Appeals BoardLien claimLabor Code section 4903(c)Living expensesSelf-insured employee welfare benefit planStatutory authorizationReimbursementPermanent disabilityTemporary disabilityGroup disability policy
References
Case No. ADJ3957329 (OAK 0162600) ADJ621097 (OAK 0183630)
Regular
Jan 27, 2017

JUDITH KRAFT vs. CORREY JAMESTOWN, HARTFORD INSURANCE COMPANY, FACILITY SYSTEMS, INC., BROADSPIRE CONCORD

Here's a summary for a lawyer in maximum four sentences: Hartford Insurance sought removal of an order requiring it to administer the applicant's future medical award for all body parts. Hartford argued this would cause irreparable harm by potentially barring reimbursement from CIGA for neck injury treatment, for which Hartford claims no current liability. The Workers' Compensation Appeals Board denied removal, adopting the judge's reasoning that potential prejudice to Hartford was outweighed by applicant's need for a single administrator and the judge's discretion to assign administration pending adjudication of neck injury liability. Commissioner Lowe dissented, arguing Hartford faces substantial prejudice and potential liability for an injury it did not insure.

Workers' Compensation Appeals BoardPetition for RemovalFindings of FactAdministrative Law JudgeIndustrial InjuryLow BackLeft AnkleNeckDistrict ManagerAccount Executive
References
Case No. ADJ 3060603
Regular
Sep 02, 2008

Kathleen Umphrey vs. AMERICAN APARTMENT COMPANY, EMPLOYER'S INSURANCE OF WAUSAU

Reconsideration granted; rescinded order for applicant's attorney to reimburse defendant $150 for missed appointment.

Workers' Compensation Appeals BoardKathleen UmphreyAmerican Apartment CompanyEmployer's Insurance of WausauVocational Rehabilitation ExpertMissed AppointmentReimbursementSanctionsLabor Code Section 5813Labor Code Section 5811
References
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