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

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ192431 (SAC 0366013)
Regular
Jul 26, 2010

BRYAN ALBERTSON vs. KUEHNE & NAGEL, INC., TRAVELERS PROPERTY CASUALTY INSURANCE

This case involves a $1000 attorney's fee sanction imposed on Zurich American Insurance Company (Zurich) by a WCJ. Zurich sought reconsideration, arguing the sanction was unjustified and the WCJ acted in excess of powers. After a commissioners' conference and Zurich's subsequent payment of the sanction, the Board found the issue moot regarding payment. However, the Board affirmed the WCJ's original Order Imposing Sanctions, as the merits of the petition were previously rejected and the decision was final.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Imposing SanctionsAttorney's FeeZurich American Insurance CompanyWCJExcess of PowersMoot IssueFinal DecisionCommission Conference
References
Case No. ADJ6650878
Regular
Dec 09, 2015

BRIDGETTE HUNTER vs. DEPARTMENT OF SOCIAL SERVICES IHSS; YORK RISK SERVICES GROUP

The Workers' Compensation Appeals Board denied Bridgette Hunter's Petition for Reconsideration regarding her Stipulated Award for industrial injuries to her spine and psyche. The Board adopted the findings of the Administrative Law Judge, who recommended denial. Although the ALJ noted the petition might be untimely, the Board found insufficient proof of service to make that determination, thus denying reconsideration on other grounds. The applicant's claims of fraud, excess of power, and insufficient evidence were rejected as the award was based on agreed-upon Agreed Medical Evaluator reports.

Workers' Compensation Appeals BoardPetition for ReconsiderationStipulated Awarduntimely filingproof of serviceAME reportsBridgette HunterDepartment of Social Services IHSSYork Risk Services GroupWorkers' Compensation Administrative Law Judge
References
Case No. ADJ1060696
Regular
Jan 14, 2016

MARIA URIBE RAMOS vs. PATTERSON FROZEN FOODS, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INDEMNITY

This case involves an applicant's appeal of Independent Medical Review (IMR) determinations regarding prescription medication refills for Flexeril and Norco. The Workers' Compensation Appeals Board (WCAB) granted the appeal for Flexeril, finding the initial IMR determination was issued in excess of the Administrative Director's powers due to an incomplete medical record. The WCAB affirmed the IMR determination for Norco, agreeing that the record was complete for that medication. A dissenting opinion argued that both IMR determinations for Flexeril and Norco, and an additional IMR determination for clonidine, were flawed and should have been remanded for further review.

Workers' Compensation Appeals BoardIndependent Medical ReviewLabor Code Section 4610.6(h)Plainly Erroneous Finding of FactIncomplete Medical RecordExcess of PowersRemandUtilization ReviewMedical Treatment Utilization ScheduleCompromise and Release
References
Case No. ADJ9346293
En Banc
Apr 13, 2020

ANTHONY DENNIS vs. STATE OF CALIFORNIA – DEPARTMENT OF CORRECTIONS AND REHABILITATION INMATE CLAIMS, STATE COMPENSATION INSURANCE FUND

The WCAB holds that Administrative Director Rule 10133.54 is invalid as it exceeds the statutory authority granted to the Administrative Director and restricts the WCAB's exclusive power to adjudicate compensation claims. It also holds that an employer must provide a bona fide offer of work to avoid liability for a supplemental job displacement benefit voucher.

AD Rule 10133.54Supplemental Job Displacement BenefitWCAB exclusive jurisdictionadministrative director authoritybona fide work offerinmate laborstatutory authorityadjudicatory poweren banc decisionreconsideration
References
Case No. ADJ6721899
Regular
Apr 04, 2014

RICARDO VILLAREAL MENDOZA vs. PUEBLO PACKING INC., BERKSHIRE HATHAWAY, OAK RIVER INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) denied Ricardo Villareal Mendoza's petition for removal. The petition argued that moving Mandatory Settlement Conferences (MSCs) from Santa Barbara to Oxnard caused irreparable harm due to travel burdens. The WCAB cited statutory authority and case law establishing its power to calendar hearings at different district offices based on available resources and space limitations. The Board also noted the availability of CourtCall and alternative arrangements for unrepresented workers to mitigate travel difficulties.

Petition for RemovalWorkers' Compensation Appeals BoardDivision of Workers' CompensationMandatory Settlement ConferenceVenueCourtCallIrreparable HarmJudicial PowersInherent PowersCalendar Control
References
Case No. ADJ4609174 (RDG 0041947)
Regular
Oct 27, 2010

DOYLE CANADA vs. REDDING POWER SAWMILL DIVISION, ESIS PORTLAND

In this Workers' Compensation Appeals Board case, Doyle Canada's petition for reconsideration was denied. The Board adopted the findings of the Workers' Compensation Administrative Law Judge, whose report detailed the reasons for the denial. This order, dated October 27, 2010, upholds the original decision and denies further review. The defendants were Redding Power Sawmill Division and ESIS Portland.

WCABPetition for Reconsiderationworkers' compensation administrative law judgereport of the workers' compensation administrative law judgedeny reconsiderationADJ4609174Redding Power Sawmill DivisionESIS PortlandDoyle CanadaADJUDICATION
References
Case No. ADJ1780566 (FRE 0246374) ADJ428063 (FRE 0246373) ADJ3588105 (FRE 0246375) ADJ2219910 (FRE 0247600)
Regular
Dec 01, 2014

ERIC GORDON vs. FRITO-LAY, INC.

This case involves applicant Eric Gordon's appeal of a denied Independent Medical Review (IMR) determination regarding prescribed medications. The Workers' Compensation Appeals Board (WCAB) denied his petition for reconsideration because the applicant failed to present clear and convincing evidence of specific statutory grounds for overturning the IMR decision. The WCAB also affirmed that it lacks jurisdiction to decide constitutional challenges to the IMR process itself. Consequently, the applicant's attempt to have the IMR decision overturned based on alleged excess of power or constitutional grounds was unsuccessful.

Workers' Compensation Appeals BoardIndependent Medical Review (IMR)Petition for ReconsiderationAdministrative Director's powersLabor Code section 4610.6(h)constitutional issuesArticle XIV Section 4cross-examinationmedically necessaryMaximus Federal Services
References
Case No. ADJ4018708 (SBA 0079160)
Regular
Apr 23, 2010

KATHY KELLERMANN vs. REGENTS OF UCSB, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves Kathy Kellermann's claim for workers' compensation benefits, where the administrative law judge initially found a cumulative trauma injury to her psyche but not to her dental, neurological, or internal systems, awarding 8% permanent disability. Ms. Kellermann sought reconsideration, arguing the judge erred by excluding dental, neurological, and internal injuries, acting in excess of powers regarding an independent medical exam, and improperly relying on certain medical reports for disability assessment. The Appeals Board granted reconsideration to clarify the scope of injury, affirming the finding of psyche injury but not other systems as a compensable consequence. The Board also upheld the 8% permanent disability award, citing precedent allowing reliance on a single physician's relevant and considered opinion even if inconsistent with others.

ADJ4018708SBA 0079160Kathy KellermannRegents of UCSBSedgwick Claims Management ServicesOpinion and Order Granting ReconsiderationDecision After Reconsiderationindustrial cumulative trauma injurypsyche injurydental injury
References
Case No. MON 0290566
Regular
Aug 12, 2008

MARTHA MANRIQUEZ vs. DEPARTMENT OF WATER AND POWER/DEPARTMENT OF WATER & POWER

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration, upholding the administrative law judge's findings that the defendant unreasonably delayed paying a stipulated award, thus incurring penalties and attorney's fees. The Board affirmed the judge's decision to limit the defendant's credit for a third-party settlement to prospective benefits due to the defendant's inaction in pursuing its credit rights after the stipulated award. Furthermore, the Board ruled that the defendant could not apply its third-party credit against the penalties and attorney's fees awarded.

Workers' Compensation Appeals BoardMartha ManriquezDepartment of Water and PowerLabor Code sections 4650(b)58145814.5Supplemental Findings and AwardPetition for Reconsiderationcumulative traumathird-party settlement
References
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