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Case Law Database

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

Case No. ADJ7162659

Regular

Nov 07, 2013

,JUAN MORA, vs. ,CHIPOTLE MEXICAN GRILL and ZURICH AMERICAN INSURANCE administered by GALLAGHER BASSETT; CALIFORNIA COMFORT VANS, and AMTRUST NORTH AMERICA, ACE FIRE UNDERWRITERS INSURANCE COMPANY/ACE GROUP, et. al.,

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration because the challenged order was procedural and not a final determination of substantive rights. The WCAB found that an interim order striking a doctor's opinion due to ex parte communication is not subject to reconsideration under Labor Code Section 5900(a). The case was returned to the trial level for clarification of the original order, specifically whether all of the doctor's reports were stricken and if the doctor was dismissed as the Qualified Medical Examiner. This clarification is necessary for proper further proceedings and potential issuance of a replacement QME panel.

WORKERS' COMPENSATION APPEALS BOARDPETITION FOR RECONSIDERATIONORDER STRIKINGEX PARTE COMMUNICATIONQUALIFIED MEDICAL EXAMINER (QME)LABOR CODE SECTION 4062.3FINAL ORDERINTERIM PROCEDURAL ORDERSDISCOVERYEVIDENTIARY MATTERS

References

Case No. ADJ3133261 (VNO 0400017)

Regular

Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION

References

Case No. ADJ11255791

Regular

Nov 02, 2019

MARIA FRANCISCA JIMENEZ vs. J. RODRIGUEZ FARM LABOR CONTRACTOR, INC., ZENITH INSURANCE COMPANY

In this workers' compensation case, the defendant sought removal of a trial setting order due to an alleged ex parte communication between the applicant's attorney and the Qualified Medical Evaluator (QME). The Appeals Board granted removal, finding that the issue of the QME's report admissibility must be resolved before proceeding to trial on all issues. The Board rescinded the prior orders and remanded the matter for adjudication of the QME dispute first, noting that prejudice is not necessarily required for a violation of ex parte communication rules. This bifurcated approach aims for judicial efficiency, preventing potentially unnecessary trials if a new QME is ultimately required.

Petition for RemovalEx Parte CommunicationQualified Medical Evaluator (QME)Admissibility of ReportsPre-Trial ConferenceDiscoveryCase LawLabor CodeAppeals BoardRemoval Order

References

Case No. ADJ8958848

Regular

May 24, 2016

SHELLANE DODLEY vs. PROFESSIONAL SECURITY CONSULTANTS

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration, finding that the WCJ's order excluding an agreed medical evaluator's reports due to ex-parte communication was not a final order. However, the Board granted removal, rescinded the WCJ's order, and returned the case to the trial level for further proceedings. The Board found that while the defendant violated rules regarding ex-parte communication with the AME, the applicant waived the right to exclude the AME's reports by proceeding with the evaluation. The case will be reconsidered for issues regarding the adequacy of the stipulations and whether further development of the record is needed.

Workers' Compensation Appeals BoardAgreed Medical EvaluatorEx-parte communicationPetition for ReconsiderationPetition for RemovalJoint Partial Findings of Fact and OrderStipulations with Request for AwardPrimary Treating PhysicianPermanent DisabilityApportionment

References

Case No. ADJ6502775, ADJ6498620, ADJ8109003, ADJ8115890

Regular

May 09, 2014

MARIA POHYAR vs. DEY LP, AMERICAN ZURICH INSURANCE COMPANY, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration because the challenged order was not a "final order" subject to reconsideration. The WCAB also denied the Petition for Removal, agreeing with the Administrative Law Judge that the issue of whether the defendant Zurich is entitled to a new Qualified Medical Evaluator (QME) panel was only before the WCJ based on a procedural rule regarding appointment notification forms, not ex parte communications. The WCAB clarified that issues of ex parte communications and the applicability of related statutes and rules were not yet properly before the Board. Therefore, the applicant's request for the WCAB to assert jurisdiction and rule against Zurich on the QME panel issue was denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalJurisdictionQualified Medical Evaluator (QME)Panel QMEDivision of Workers' Compensation (DWC) RulesLabor Code section 4062.3Ex parte communicationMedical Director

References

Case No. ADJ2902954; ADJ2715753

Regular

Jan 14, 2014

DONALD GREEN vs. COMPTON UNIFIED SCHOOL DISTRICT

The Appeals Board dismissed the lien claimant's Petition for Reconsideration and granted removal on its own motion. It affirmed the Administrative Law Judge's order setting aside a prior lien allowance due to potential service and ex parte communication issues. The matter was returned to the trial level for reassignment to a new judge to address outstanding issues, including proper service, ex parte communication, the propriety of setting aside the lien order, and potential sanctions.

Workers' Compensation Appeals BoardLien claimantReconsiderationRemovalOrder Setting AsideEx parte communicationProper serviceNotice of Intent to Allow LienAmended Order Allowing LienSubstituted counsel

References

Case No. ADJ4013684 (OAK 0307613) ADJ620772 (OAK 0294537)

Regular

Jul 28, 2014

DANIEL GRANZELLA vs. RICHMOND SANITARY

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration and denied their petition for removal. The defendant sought to be relieved from an agreed medical examiner (AME) agreement with Dr. Warbritton, alleging bias and ex parte communication. The Board found that the WCJ's order denying the motion to be relieved from the AME agreement was interlocutory and thus not subject to reconsideration. Furthermore, the Board found no basis for removal, as the defendant failed to establish bias or irreparable harm, and their ex parte communication claim was waived by their delay in raising the issue after receiving further medical reports.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalAgreed Medical Examiner (AME)BiasEx Parte CommunicationLabor Code § 5900Interlocutory OrderFinal OrderSubstantive Right

References

Case No. ADJ8162345, ADJ7959552

Regular

Oct 07, 2014

MARIA CHAVEZ MARTINEZ vs. RESTAURANT LEADERSHIP GROUP, CALIFORNIA RESTAURANT MUTUAL BENEFIT CORPORATION, AMERICAN CLAIMS MANAGEMENT

Lien claimants' petitions challenging a WCJ's order denying their ex parte petition and ordering depositions were dismissed. The Board found the initial petition for reconsideration untimely, as it was filed 21 days after personal service, and the order was not a final one. The second petition for removal was denied as the lien claimants failed to demonstrate significant prejudice or irreparable harm, and the WCJ's reasoning was sound.

Workers' Compensation Appeals BoardLien ClaimantsPetition for ReconsiderationPetition for RemovalUntimely PetitionFinal OrderEx Parte PetitionWCJ OrderDiscovery BurdenJurisdictional Time Limit

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. ADJ7271474

Regular

Aug 22, 2011

BRIAN DEGEN vs. BONITA UNIFIED SCHOOL DISTRICT, YORK UPLAND

The defendant school district sought reconsideration of an order striking the Qualified Medical Evaluator's (QME) reports and ordering a new panel, arguing a voicemail did not constitute ex parte communication and that the WCJ erred on other grounds. The Appeals Board dismissed the defendant's petition as it was not from a final order. However, the Board granted removal on its own motion, rescinded the WCJ's order, and ruled the QME's voicemail was insignificant and not an ex parte communication. Consequently, the QME will remain, his reports are not stricken, and the case is returned for further proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissalRemovalQualified Medical Evaluator (PQME)Ex Parte CommunicationLabor Code Section 5310Alvarez v. Workers' Comp. Appeals Bd.VoicemailDeposition Fee

References

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Updated Daily

Case Law Database

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

Case No. ADJ7162659

Regular

Nov 07, 2013

,JUAN MORA, vs. ,CHIPOTLE MEXICAN GRILL and ZURICH AMERICAN INSURANCE administered by GALLAGHER BASSETT; CALIFORNIA COMFORT VANS, and AMTRUST NORTH AMERICA, ACE FIRE UNDERWRITERS INSURANCE COMPANY/ACE GROUP, et. al.,

References

Case No. ADJ3133261 (VNO 0400017)

Regular

Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

References

Case No. ADJ11255791

Regular

Nov 02, 2019

MARIA FRANCISCA JIMENEZ vs. J. RODRIGUEZ FARM LABOR CONTRACTOR, INC., ZENITH INSURANCE COMPANY

Petition for RemovalEx Parte CommunicationQualified Medical Evaluator (QME)Admissibility of ReportsPre-Trial ConferenceDiscoveryCase LawLabor CodeAppeals BoardRemoval Order

References

Case No. ADJ8958848

Regular

May 24, 2016

SHELLANE DODLEY vs. PROFESSIONAL SECURITY CONSULTANTS

References

Case No. ADJ6502775, ADJ6498620, ADJ8109003, ADJ8115890

Regular

May 09, 2014

MARIA POHYAR vs. DEY LP, AMERICAN ZURICH INSURANCE COMPANY, LIBERTY MUTUAL INSURANCE COMPANY

References

Case No. ADJ2902954; ADJ2715753

Regular

Jan 14, 2014

DONALD GREEN vs. COMPTON UNIFIED SCHOOL DISTRICT

References

Case No. ADJ4013684 (OAK 0307613) ADJ620772 (OAK 0294537)

Regular

Jul 28, 2014

DANIEL GRANZELLA vs. RICHMOND SANITARY

References

Case No. ADJ8162345, ADJ7959552

Regular

Oct 07, 2014

MARIA CHAVEZ MARTINEZ vs. RESTAURANT LEADERSHIP GROUP, CALIFORNIA RESTAURANT MUTUAL BENEFIT CORPORATION, AMERICAN CLAIMS MANAGEMENT

Workers' Compensation Appeals BoardLien ClaimantsPetition for ReconsiderationPetition for RemovalUntimely PetitionFinal OrderEx Parte PetitionWCJ OrderDiscovery BurdenJurisdictional Time Limit

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.

Petition for RemovalMinute OrderQualified Medical EvaluatorEx-parte CommunicationDue ProcessWCJReplacement QME PanelLabor Code Section 5313Admitted EvidenceProof of Service

References

Case No. ADJ7271474

Regular

Aug 22, 2011

BRIAN DEGEN vs. BONITA UNIFIED SCHOOL DISTRICT, YORK UPLAND

References

Showing 1-10 of 8,977 results

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