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

Case No. ADJ8227287; ADJ8227026 ADJ8269969
Regular
Jul 16, 2012

RICCARDO VALLEJO vs. SAVE MART SUPERMARKET, PEGASUS RISK MANAGEMENT

The Appeals Board denied the applicant's Petition for Removal, which sought to overturn a WCJ's decision to deny enforcement of subpoenas duces tecum prior to the applicant's deposition. The applicant claimed denial of due process, arguing he was entitled to documents before his deposition on May 16, 2012. However, the WCJ had scheduled a hearing on the discovery issue for June 20, 2012, and the applicant's attorney failed to appear at that hearing. The Board found no clear grievance with the prior ex parte denial given the subsequent non-appearance, and therefore denied the petition.

Petition for RemovalSubpoenas Duces TecumEx parte hearingDeclaration of Readiness to ProceedPriority hearingDiscovery PetitionQualified Medical EvaluatorLabor Code section 4062.1WCJAttorney's fees
References
Case No. ADJ9180559
Regular
Sep 18, 2015

JACKIE SUEHIRO (Dec'd), ALVIN SUEHIRO (Husband) vs. RALPHS GROCERY COMPANY, permissibly self-insured, adjusted by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Appeals Board granted the defendant's petition for removal, rescinding a prior Minute Order. The WCJ had found ex-parte communication by the defendant and ordered a new QME panel without a trial or sworn testimony. The Board found this violated the defendant's due process rights, as no evidence was presented to support the ex-parte communication finding. The case is returned to the trial level for a hearing on all issues, including alleged ex-parte communication, with parties afforded the chance to present evidence and witnesses.

Petition for RemovalMinute OrderQualified Medical EvaluatorEx-parte CommunicationDue ProcessWCJReplacement QME PanelLabor Code Section 5313Admitted EvidenceProof of Service
References
Case No. ADJ4333259 (SAC 0320510) ADJ2035410 (SAC 0320511) ADJ190774 (SAC 0320512) ADJ4455812 (SAC 0344037) ADJ1944370 (SAC 0351922)
Regular
Feb 07, 2011

Christina Aguillon vs. REGIONAL TRANSIT, GREGORY BRAGG & ASSOCIATES; YORK INSURANCE SERVICES SACRAMENTO

The defendant, Regional Transit, petitioned for removal after the WCJ rescinded an order compelling a medical examination, alleging an ex parte discussion with the applicant's attorney violated procedural rules. While the Board agreed the ex parte communication and procedural missteps occurred, they denied removal because the underlying medical examination date had passed, and the issue would be heard on the merits at a conference. The Board found no substantial prejudice to the defendant. However, the applicant's prior attorney's conduct was deemed unprofessional and subject to potential future sanctions.

Petition for RemovalRescinded OrderEx Parte CommunicationWCAB Rule 10324(c)Court Administrator Rule 10281Petition to Compel AttendanceAgreed Medical EvaluationObjectionMinutes of HearingWCJ
References
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. ADJ11584415
Regular
Sep 30, 2019

GUY SYLVA vs. CITY AND COUNTY OF SAN FRANCISCO

This case involves an applicant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that denied temporary disability benefits and a motion to strike a Qualified Medical Evaluator's (QME) reports. The applicant alleged ex parte communication between the defendant and the QME, violating Labor Code section 4062.3. The WCAB granted reconsideration, finding that the issue of ex parte communication was not adequately addressed due to conflicting dates and unadmitted evidence. The matter is remanded to the trial level for further proceedings to determine if ex parte communication occurred and to address the temporary disability issue.

WCABAOE/COEQMEex parte communicationLabor Code section 4062.3Petition for ReconsiderationFindings and Orderremovaltemporary disabilityprimary treating physician
References
Case No. ADJ840413 (SFO 0510835)
Regular
Dec 06, 2010

BASIL HORTON vs. SKYWEST AIRLINES, Permissibly SelfInsured and Administered by SEDGWICK SACRAMENTO

The Appeals Board granted the applicant's Petition for Removal and rescinded the WCJ's order to proceed with a PQME. The WCJ's prior order disqualified an AME due to an ex parte communication. However, the Board found the record inadequate for decision as it lacked stipulated issues and admitted exhibits, violating proper procedure. The case is returned to the trial level to create a sufficient record before any further decisions are made.

Petition for RemovalEx parte communicationAgreed Medical Evaluator (AME)Panel Qualified Medical Evaluator (PQME)WCJWCABRescind orderEvidentiary hearingAdmitted evidenceStipulations
References
Case No. ADJ10887066 ADJ10887074
Regular
Nov 14, 2018

RAUL JUAREZ vs. EB DESIGN, INC., THE HARTFORD INSURANCE

This case concerns defendant's ex parte communication with a QME, specifically sending surveillance video and an advocacy letter without proper notice. The WCAB granted removal, rescinded the trial judge's order striking the QME report, and remanded the case. The Board clarified that WCAB Rule 10507 extends the timeframe for applicant to object to non-medical records, but not the defendant's initial service deadline under Labor Code section 4062.3(b).

RemovalJoint Findings of FactOrder and Opinion on DecisionQualified Medical EvaluatorQME panelorthopedic surgerystrickeninadmissibleLabor Code section 4062.3ex parte communication
References
Case No. ADJ226519 (SDO 0302236) ADJ488924 (SDO 0329999)
Regular
May 23, 2011

Craig Stevens vs. PACIFIC BELL TELEPHONE COMPANY

In this Workers' Compensation Appeals Board case, the applicant, Craig Stevens, sought removal of an order continuing his case to a mandatory settlement conference. Stevens contended entitlement to temporary disability and spinal surgery, and alleged ex parte communication with the Agreed Medical Evaluator (AME), Dr. Harvey Wieseltier, necessitating his disqualification. The Appeals Board denied the Petition for Removal, adopting the WCJ's report and noting the petition was not correctly verified. The underlying issues of medical treatment and temporary disability remain for future proceedings.

Petition for RemovalExpedited HearingMandatory Settlement ConferenceTemporary Disability IndemnitySpinal SurgeryAgreed Medical EvaluatorDisqualificationEx Parte CommunicationLine InstallerIndustrial Injuries
References
Case No. ADJ 7941996
Regular
Apr 26, 2016

ROBERTO ALVAREZ vs. LINK STAFFING, INC., ARCH INSURANCE COMPANY

This case concerns a disputed lien dismissal where the lien claimant's representative allegedly falsified hearing minutes to obtain the rescission of a dismissal order. The Appeals Board dismissed the employer's petition for reconsideration because the rescission order was not a final decision. However, the Board granted removal due to serious allegations of misconduct, remanding the case to the WCJ for an evidentiary hearing on whether the representative appeared, tampered with records, or made false statements. The WCJ is also tasked with making findings and recommendations on potential sanctions under Labor Code section 5813.

Workers' Compensation Appeals BoardReconsiderationLien DismissalPetition for ReconsiderationPetition for RemovalMinutes of HearingFraudMisconductSanctionsLabor Code Section 5813
References
Case No. ADJ9865743
Regular
Oct 16, 2018

FEI YE vs. HUGO BOSS USA, INC, NATIONAL UNION FIRE INSURANCE CO. OF PITTSBURGH, PA, Administered by AIG PROPERTY CASUALTY

The applicant sought reconsideration of an order approving a Compromise and Release (C&R) settlement, alleging fraud and malpractice by his former attorney. The Appeals Board denied reconsideration, finding the applicant failed to prove fraud, mutual mistake, duress, or undue influence to set aside the C&R. Although the Board noted procedural concerns regarding the ex parte submission of the C&R by the applicant's former counsel after being dismissed, it concluded the applicant received due process at a subsequent hearing and failed to establish good cause to rescind the settlement. The applicant's petition was also subject to dismissal for lack of proper verification.

Compromise and ReleasePetition for ReconsiderationWCJPetition to Set AsideGood CauseFraudMutual MistakeDuressUndue InfluenceVerification
References
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