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Case Law Database

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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
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. ADJ4258585 (OXN 0130492) ADJ220258 (OXN 0130487)
Regular
Apr 17, 2018

ENRIQUE HERRERA vs. MAPLE LEAF FOODS, U.S. FIRE INSURANCE COMPANY, ALEA NORTH AMERICAN INSURANCE COMPANY

This notice informs parties that the Workers' Compensation Appeals Board (WCAB) intends to admit its rating instructions and a disability rater's recommended permanent disability rating into evidence. The WCAB previously granted reconsideration for further study. Parties have seven days to object to the rating instructions or the recommended rating, with specific procedures for addressing objections. If no timely objection is filed, the matters will be submitted for decision thirty days after service.

WORKERS' COMPENSATION APPEALS BOARDPermanent Disability RatingDisability Evaluation UnitRating InstructionsRecommended Permanent Disability RatingJoint RatingReconsiderationObjectionRater Cross-ExaminationRebuttal Evidence
References
Case No. ADJ316515 (SAL 0118244) ADJ1659308 (SAL 0048019)
Regular
Apr 06, 2009

DONN TRENNER vs. MONTEREY PENINSULA AIRPORT DISTRICT, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration, rescinded the WCJ's award, and returned the case for further proceedings. The WCJ incorrectly calculated attorney fees under Labor Code section 5814.5 by applying a percentage of a penalty, rather than assessing reasonable hours at a reasonable rate. The Board emphasized that the fee determination must follow the controlling factors outlined in *Ramirez v. Drive Financial Services*. The case is remanded to ensure the attorney fee award is neither disproportionate to benefits obtained nor based on an impermissible calculation method.

Labor Code Section 5814.5Ramirez v. Drive Financial ServicesWCJAppeals Board en bancattorney's feespenaltymedical treatmentablation procedureco-pay reimbursementRocha v. Puccia Construction Co.
References
Case No. ADJ11368246
Regular
Mar 03, 2020

Marta Ubillus vs. One Stop Employment Services, LLC/Vensure Employer Services, Security National Insurance Company, State National Insurance Company

The Workers' Compensation Appeals Board (WCAB) denied the lien claimant's petition for reconsideration regarding the valuation of interpreter services. The WCAB adopted the Administrative Law Judge's (ALJ) report, which found that while the defendant did not present rebuttal evidence, the ALJ had substantial evidence to make a determination. The ALJ determined a market rate of $114.97 per hour but noted the lien claimant failed to provide sufficient evidence of the duration of services on most dates, preventing application of the market rate. Consequently, the statutory rate was applied for those services.

WCABPetition for ReconsiderationDeniedLien ClaimantInterpreter ServicesMarket RateStatutory RateWCJ ReportSubstantial EvidenceFindings and Award
References
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. ADJ10138143
Regular
Sep 01, 2017

SHIRLEY BROWN vs. MERCY MEDICAL CENTER MERCED COMMUNITY CAMPUS, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, amending a prior decision. The Board ruled that attorney's fees for the applicant's counsel should be based entirely on their reasonable hourly rate and hours worked, not a combination of hourly rate and a percentage of the recovery. This decision clarified that fees owed by an employer under Labor Code § 4064(c) for an unrepresented employee's attorney are determined by the reasonableness of hours and hourly rate, not the indemnity awarded. Consequently, the applicant's attorney was awarded $10,758.75.

Workers' Compensation Appeals BoardPetition for ReconsiderationAttorney's FeesHourly RatePercentage of RecoveryLabor Code § 4064Declaration of Readiness to ProceedStipulations with Request for AwardQuantum MeruitIndemnity
References
Case No. ADJ515169 ADJ620656
Regular
Oct 04, 2017

SERGIO CHAIREZ vs. CHEROKEE BINDERY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for PAULA INSURANCE

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, affirming the administrative law judge's finding that \$13.75 per hour was an adequate rate for home healthcare services. The Board found insufficient evidence that the applicant's spouse performed services requiring a higher Licensed Vocational Nurse (LVN) rate. However, the case was removed to the Appeals Board to return the issue of applicant's attorney's fees to the trial level for further proceedings and decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationHome Healthcare RateLicensed Vocational NurseCatheterizationHourly RateStipulated AwardAttorney's FeesRemovalDecision After Removal
References
Case No. ADJ758842 (VNO 0559214)
Regular
Dec 17, 2010

JOHN PATCHETT vs. CITY OF LOS ANGELES

The Appeals Board denied the applicant's petition for removal, affirming the WCJ's decision to vacate the submission. This action was based on the DEU evaluator's testimony, which revealed deficiencies in the AMEs' reports concerning the AMA Guides. The Board found the applicant waived any objection to this testimony by failing to object at trial, and that the evaluator's expert opinion was permissible per *Blackledge v. Bank of America*. Defendant's objection, though not styled as a motion to strike, sufficiently raised the issues leading to the vacation of the rating.

Petition for RemovalOrder Vacating SubmissionDEU evaluatorAMA Guidesagreed medical evaluators (AMEs)rating instructionssubstantial evidenceobjective factors of disabilitywhole person impairmentformal rating
References
Case No. ADJ4564984 (MON 0201538)
Regular
Apr 20, 2009

EdUARDO RODRIGUEZ (Deceased) RODRIGUEZ, Teresita (Wife) vs. COUNTY OF LOS ANGELES, USC MEDICAL CENTER, et al.

The Workers' Compensation Appeals Board granted reconsideration to address deficiencies in the original award for home health care services. The Board found a lack of substantial evidence supporting the necessity and duration of care provided by the deceased worker's wife, Teresita Rodriguez. Crucially, the WCJ failed to specify the basis for the awarded hours and hourly rate, and did not adequately address potential differences in rates over time or periods of hospitalization. The matter was returned to the trial level for further development of the record to determine the actual need for care, the precise number of hours, and appropriate rates, as well as to clarify the defendant's notice of the need for services.

Workers Compensation Appeals BoardReconsiderationFindings and AwardHome Health Care ServicesLien ClaimantAgreed Medical EvaluatorIndustrial InjuryPermanent DisabilitySelf-Procured Medical TreatmentRenal Failure
References
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