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

Case No. ADJ7184539, ADJ7671268
Regular
Mar 14, 2014

KUANE WASHINGTON vs. SANTA CLARA VALLEY TRANSPORTATION AUTHORITY

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's Petition for Removal because it was filed untimely. The defendant electronically submitted their petition three minutes after the 5:00 PM deadline on the final day for filing. The WCAB also noted that even if timely, the petition lacked merit and indicated potential gamesmanship by the defendant, warning of future sanctions.

Petition for RemovalUntimely FilingEAMSBatch IDChange of VenueGood CauseLabor Code section 5501.6FrivolousnessGamesmanshipSanctions
References
Case No. ADJ3501807 (SRO 0141934)
Regular
Sep 08, 2011

JESSICA REYNOLDS vs. AMERICAN MEDICAL RESPONSE, ACE AMERICAN INSURANCE

The Appeals Board denied the defendant's Petition for Removal seeking to replace a Qualified Medical Evaluator (QME). The defendant argued the QME violated Administrative Director Rule 34(b) by scheduling an exam at an unlisted address. However, the Board found the defendant failed to demonstrate substantial prejudice or irreparable harm necessary for removal. The Board agreed with the WCJ's finding that the objection appeared to be an attempt at "doctor shopping" and gamesmanship, contrary to the policy of substantial justice.

Petition for RemovalQualified Medical EvaluatorReplacement Panel QMELabor Code section 4062.2Administrative Director Rule 34(b)substantial prejudiceirreparable harmdoctor shoppinggamesmanshipsocial public policy
References
Case No. ADJ9172419
Regular
Aug 04, 2014

Gregory Mejia vs. MARMOT MOUNTAIN, LLC, ZURICH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration, upholding the judge's prior decision. The Board affirmed that the applicant's attorney's petition for a replacement QME panel was not frivolous, nor did it constitute ex parte communication. Furthermore, the Board admonished defense counsel for "excessive gamesmanship" which unnecessarily delayed resolution of the injured worker's claim. The denial of reconsideration means the prior order regarding the QME panel and the absence of sanctions against the applicant's attorney stands.

Workers' Compensation Appeals BoardPetition for ReconsiderationQualified Medical EvaluatorQME panelsanctionsfrivolous petitionexcessive gamesmanshipbad faithLabor Code section 5813permanent disability
References
Case No. ADJ9154960
Regular
Mar 25, 2014

IVAN SANCHEZ vs. NATIVE FOODS CALIFORNIA, CALIFORNIA RESTAURANT MUTUAL BENEFIT CORPORATION, AMERICAN CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board (WCAB) denied Ivan Sanchez's Petition for Removal. The WCAB found that the venue of hearings is determined by the Division of Workers' Compensation based on available resources, not solely by the applicant's preferred district office. Furthermore, the WCAB noted that CourtCall is an available option for remote appearances. Finally, the petition was procedurally defective as it was unverified, providing an independent basis for denial.

Petition for RemovalWorkers' Compensation Appeals BoardDivision of Workers' CompensationVenueMedical treatment lien conferencesCourtCallMandatory settlement conferenceExpedited hearingsUnverified petitionCosts and Sanctions
References
Case No. ADJ107733
Regular
May 03, 2011

ALFREDO GUTIERREZ vs. VIKING COMPANY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition to disqualify Administrative Law Judge (ALJ) James Hopkins. The applicant's attorney claimed the ALJ demonstrated animosity and bias by stating the case was rescheduled "Because, it's you" when referring to the attorney. Although the ALJ cited administrative difficulties, he did not deny making the statement. The WCAB found this statement sufficient to establish an appearance of bias, warranting disqualification. The case will be reset for trial before a different ALJ, with priority given due to the repeated postponements.

Petition for DisqualificationWCJ biasappearance of biasattorney biasLabor Code section 5311mandatory settlement conferencedouble bookedanimosity and gamesmanshipprocedural historyexpedited hearings
References
Case No. ADJ8212510
Regular
Feb 19, 2013

SANTOS ARIN RODRIGUEZ vs. JK FARMS PARTNERSHIP, INSURANCE COMPANY OF THE WEST\EXPLORER

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, rescinded the prior Findings and Award, and returned the case for further development of the record. The Board found that the second opinion physician's report was incomplete due to the defendant's refusal to authorize recommended diagnostic tests. This refusal prevented the physician from rendering a definitive opinion on the necessity of spinal surgery. The Board admonished the defendant for this delay and gamesmanship, emphasizing the need for authorized further testing.

Workers' Compensation Appeals BoardPetition for ReconsiderationSpinal SurgeryUtilization ReviewSecond OpinionNerve Conduction StudyEMG StudiesLumbar FusionDynamic Radiographic StudiesDeclaration of Readiness to Proceed
References
Case No. ADJ6872612
Regular
Oct 22, 2013

AIDA LOPEZ vs. C&S WHOLESALE GROCERIES

The Workers' Compensation Appeals Board (WCAB) rescinded a prior order reinstating findings that applicant sustained an industrial psychiatric injury and ordered a new psychiatric PQME due to alleged ex-parte communication. The WCAB found that crucial evidence regarding the communication, specifically letters between the defendant and the PQME, was not admitted into the record. Therefore, the case is returned to the trial level for clarification of the evidence and a new decision, while also cautioning against gamesmanship and suggesting an Agreed Medical Examination (AME) to expedite the process.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationOrder Reinstating Findings and OrderPanel Qualified Medical Examiner (PQME)Labor Code section 4062.3(e)Ex-parte communicationDiscoveryAgreed Medical Examination (AME)Writ of ReviewPanel striking
References
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