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

Case No. ADJ8 440661 ADJ8954872 ADJ8954861
Regular
Mar 18, 2016

CRAIG GROTH vs. COASTLAND, INC. dba COAST LANDSCAPE, BRECKENRIDGE INSURANCE SERVICES, LLC, AMTRUST NORTH AMERICA

The Workers' Compensation Appeals Board granted reconsideration and amended the prior award, finding the applicant's dog bite injury claim (ADJ8440661) was not barred by the statute of limitations. This decision reversed the trial judge's finding, holding that the employer's failure to inform the applicant of his workers' compensation rights tolled the statute until the claim was officially reported. The Board found prejudice to the applicant without tolling and rejected the defendant's argument regarding prejudice to the carrier, noting the insurer retains credit rights. The case is returned to the trial level for further proceedings on other issues related to ADJ8440661.

Workers Compensation Appeals BoardCumulative InjuryStatute of LimitationsTollingEmployer Duty to InformDog BiteLandscape Construction WorkerReconsiderationJoint Findings and AwardMedical Legal Costs
References
Case No. ADJ3637976 (BAK 0135676)
Regular
Jul 17, 2012

ANGEL VILLATORO vs. KERN LABOR CONTRACTING, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for PAULA INSURANCE, in liquidation

The Workers' Compensation Appeals Board affirmed the disallowance of the Center for Orthopedic Surgery's (COS) lien for unpaid medical treatment. COS provided treatment in 2001, received a partial payment from the insurer, Paula Insurance, and later filed a lien claim in 2011. The Board found the lien claim was barred by the statute of limitations under Labor Code Section 4903.5, which dictates specific filing deadlines after injury, service, or case resolution. Arguments for equitable tolling or estoppel were rejected, as COS unreasonably delayed filing its lien for nearly nine years after the insurer's partial payment.

CIGAPaula InsuranceCenter for Orthopedic SurgeryLien claimStatute of limitationsLabor Code § 4903.5Compromise & ReleaseReconsiderationMedical treatment lienEquitable estoppel
References
Case No. ADJ8853372
Regular
Dec 15, 2014

FRANK SOFER vs. VERA CAMPBELL KDWZ, TOWER GROUP COMPANIES

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding that the applicant was an employee of Vera Campbell and KDWZ. The Board agreed with the Administrative Law Judge's report, which found the applicant's claim was not barred by the statute of limitations due to equitable tolling. This equitable tolling was based on the applicant's timely civil lawsuit against the employer for failing to provide workers' compensation insurance, which alerted the defendant to the potential claim. The Board also noted the defendant presented no evidence to rebut the applicant's medical evidence of injury.

ADJ8853372Petition for ReconsiderationEmployee statusLabor Code 2750.5Statute of limitationsEquitable tollingMedical evidenceEstoppelLachesTraumatic brain injury
References
Case No. ADJ9332592
Regular
Dec 22, 2016

MARIA ARCE vs. PHILLIPS-VAN HEUSEN CORPORATION, LIBERTY MUTUAL INSURANCE

The Workers' Compensation Appeals Board rescinded a prior decision, finding applicant's claim barred by the statute of limitations. Although the employer failed to notify the applicant of her workers' compensation rights, the Board determined the statute was tolled only until the applicant signed the claim form and application on November 17, 2010. Given the stipulated date of injury as January 7, 2011, and the application filing on February 12, 2014, the claim was filed beyond the one-year limitation. Therefore, the applicant was found to have taken nothing by way of her application.

Workers Compensation Appeals BoardStatute of LimitationsLabor Code Section 5405Petition for ReconsiderationApplication for Adjudication of ClaimDate of InjuryCompensation PaidMedical TreatmentTollingReynolds v. Workmen's Comp. Appeals Bd.
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
Case No. ADJ9904638, ADJ7352002
Regular
Jul 25, 2017

Carmen Caez vs. California Department of Social Services (IHSS), administered by YORK RISK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board granted reconsideration, amending the prior decision to defer the statute of limitations issue for the applicant's low back and other injuries sustained on November 1, 2008. The Board found the initial determination barring benefits lacked substantial evidence, particularly regarding the timeliness of the claim under Labor Code section 5405. Further development of the record is required to address potential tolling of the statute of limitations due to the employer's failure to provide proper workers' compensation notification. The case is returned for further proceedings to resolve these issues.

ADJ9904638ADJ7352002IHSS caregiverLabor Code sections 35503551statute of limitations tolledclaim formHoneywell v. Workers' Comp. Appeals Bd.denial letterApplication for Adjudication
References
Case No. ADJ2976308 (AHM 0075910) ADJ1926826 (AHM 0077308)
Regular
Jan 10, 2011

CLIFFORD GAMBLE vs. UNITED AIRLINES

This case concerns an applicant's claim for vocational rehabilitation benefits from United Airlines. The applicant interrupted services and did not seek reinstatement until over five years after the date of injury, which is beyond the statute of limitations. The Board denied reconsideration, finding that the applicant's vested right to benefits did not overcome the expired statute of limitations due to the delay. Applicant's arguments regarding improper notice, equitable tolling, and prior litigation were also rejected.

Vocational rehabilitationReconsiderationSubject matter jurisdictionVested rightSunset dateInterruptionStatute of limitationsReopenEquitable tollingLaches
References
Case No. ADJ5826846
Regular
Feb 27, 2014

ANGUSTIA FOSTER vs. BARRETT BUSINESS SERVICES

This case concerns a lien filed by California Shock Trauma Air Rescue (CSTAR) for helicopter transport services provided to the applicant. The Appeals Board granted reconsideration, finding that CSTAR's lien, filed on June 8, 2011, was timely. The Board held that the federal litigation initiated by CSTAR against the defendant served to equitably toll the statute of limitations for filing the lien, as it provided the defendant with timely notice of the claim. Consequently, the WCJ's prior decision dismissing the lien as untimely was rescinded.

Angustia FosterBarrett Business ServicesCalifornia Shock Trauma Air RescueCSTARrescue helicoptertimelinessstatute of limitationsLabor Code section 4903.5Labor Code section 5804equitable tolling
References
Case No. ADJ12223070
Regular
Aug 04, 2025

BRIAN WARD vs. LOS ANGELES DODGERS, BALTIMORE ORIOLES, ACE AMERICAN INSURANCE

The applicant, Brian Ward, a former professional athlete, sought reconsideration of a WCJ's January 20, 2022 Findings and Order that found no subject matter jurisdiction over his claim. Ward, a California resident, argued his contract was made in California despite never playing or training in the state. The Workers' Compensation Appeals Board (WCAB) granted the petition for reconsideration, concluding there was insufficient evidence to support the WCJ's initial decision without further development of the record. The WCAB also applied equitable tolling due to administrative delays and deferred a final decision pending a complete review of the merits.

Workers' Compensation Appeals BoardPetition for ReconsiderationSubject Matter JurisdictionProfessional AthleteContract of HireCalifornia ResidentEquitable TollingLabor Code Section 5909Due ProcessSubstantial Justice
References
Case No. ADJ1968745; ADJ3771069; ADJ1711136
Regular
Aug 04, 2025

PETER WATSON vs. FPL ENERGY, BROADSPIRE SERVICES

The Workers' Compensation Appeals Board denied the Petition for Reconsideration filed by The Prescription Center Pharmacy. The petition challenged a Findings and Order from August 29, 2022, concerning the disallowance of medication charges for applicant Peter Watson. The Board applied equitable tolling to the statutory 60-day period for acting on the petition due to administrative delays in receiving the case file, ensuring a decision on the merits. The Board ultimately concluded that the petitioner failed to establish grounds for reopening discovery, willful suppression of evidence by the defendant FPL Energy, or the medical necessity for many of the disallowed medications, based on the findings of Agreed Medical Examiner Dr. Mark Hyman.

Workers' Compensation Appeals BoardPetition for ReconsiderationEquitable TollingLabor Code Section 5909Electronic Adjudication Management System (EAMS)Due ProcessSubstantial JusticeFindings and AwardPrescription Center PharmacyAdverse Inference
References
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