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

Case No. ADJ7009322
Regular
Nov 17, 2015

PENNY VERDIN vs. HEALDSBURG SENIOR LIVING, LLC, dba, HEALDSBURG SENIOR LIVING COMMUNITY, CARE WEST INSURANCE

This case involved an applicant who alleged her termination constituted discrimination under Labor Code section 132a. The applicant argued her employer terminated her due to her permanent and stationary industrial injury, especially after withdrawing a modified duty position without an interactive process. While a prima facie case was established, the defendant successfully rebutted the claim by demonstrating no available permanent positions accommodated the applicant's work restrictions. The Appeals Board denied reconsideration, affirming the employer had a legitimate business reason for termination and the applicant failed to provide contradictory evidence.

Workers' Compensation Appeals BoardPenny VerdinHealdsburg Senior LivingLLCCare West InsuranceLabor Code Section 132aDiscriminationPermanent and Stationary InjuryModified DutyTemporary Disability
References
Case No. ADJ6729351
Regular
Jul 06, 2012

TERESA MALDONADO vs. SUNRISE SENIOR LIVING, SEDGWICK CMS

This case, *Maldonado v. Sunrise Senior Living*, involved an applicant seeking reconsideration of a prior decision by the Workers' Compensation Appeals Board (WCAB). The WCAB reviewed the petition for reconsideration and the administrative law judge's report. Finding no grounds to overturn the initial decision, the WCAB formally denied the petition for reconsideration. The order adopting the judge's reasoning implies the original ruling was affirmed.

Workers' Compensation Appeals BoardSunrise Senior LivingSedgwick CMSADJ6729351Long Beach District OfficeDenying ReconsiderationPetition for ReconsiderationAdministrative Law Judge ReportRecord ReviewAdopt and Incorporate
References
Case No. ADJ10579672
Regular
Jan 03, 2019

EVELYN MENDOZA vs. VINTAGE SENIOR LIVING, SAFETY NATIONAL CASUALTY CORPORATION

The Appeals Board denied the applicant's petition for reconsideration, affirming the WCJ's nunc pro tunc order. This order amended the original Compromise and Release to include a finding that a good faith dispute existed regarding the injury AOE/COE, which was necessary to extinguish liability for a Supplemental Job Displacement (SJDB) voucher. The Board found that the WCJ intended to settle the SJDB voucher claim at the time of the original order but failed to explicitly record this finding. Therefore, the nunc pro tunc order corrected a clerical omission to reflect the court's prior decision, rather than altering the substance of the original judgment.

Workers' Compensation Appeals BoardEvelyn MendozaVintage Senior LivingSafety National Casualty CorporationAthens AdministratorsADJ10579672Opinion and Decision After ReconsiderationFindings of Fact and OrdersCompromise and ReleaseNunc Pro Tunc
References
Case No. ADJ8501384
Regular
Dec 30, 2014

ARTEMIO VASQUEZ vs. INTEGRAL SENIOR LIVING, HELMSMAN MANAGEMENT SERVICES

This case involves a Petition for Removal filed by the applicant, Artemio Vasquez, against Integral Senior Living and Helmsman Management Services. The applicant sought removal due to incomplete discovery, specifically concerning a neurologist, internist, and sleep study, and alleged prejudice from proceeding to trial. The Workers' Compensation Appeals Board denied the petition, adopting the WCJ's report. The Board found the objection untimely, noted the applicant's failure to object to the Declaration of Readiness or diligently pursue discovery, and concluded that any issues with the PQME report could be addressed by the trial judge or via post-trial remedies, thus not causing irreparable harm.

Petition for RemovalWorkers' Compensation Appeals BoardAdministrative Law JudgeDeclaration of Readiness to ProceedMandatory Settlement ConferenceDiscoveryPrejudiceIrreparable HarmPanel Qualified Medical ExaminerAOE/COE
References
Case No. ADJ1091802 (SBR 0342159)
Regular
Nov 09, 2010

GEORGE QUINN, JR., et al vs. VISTAR MANAGEMENT, ZURICH AMERICAN, administered by GALLAGHER BASSETT SERVICES, INCORPORATED

This case involved a deceased worker whose family sought death benefits, claiming partial dependency. The Workers' Compensation Appeals Board denied reconsideration of the prior award, which found no dependents and allocated the benefit to the state. The majority ruled that the decedent's financial contributions and household chores did not exceed the cost of his own living expenses or constitute support. However, one commissioner dissented, arguing for remand to determine if the decedent's personal care for his grandmother constituted extraordinary services qualifying as support.

Death benefitdependentspartial dependencycommunity livingfamily potcontributionsstandard of livingsupport paymentsadult childDeceased employee
References
Case No. ADJ8066822
Regular
May 30, 2019

SCOTT WALL vs. COUNTY OF SACRAMENTO

This case concerns a deputy sheriff sergeant, Scott Wall, who alleges discrimination under Labor Code section 132a. Wall was denied a requested transfer to a patrol division while on injury leave, despite having the seniority for it. The Workers' Compensation Appeals Board affirmed the finding that the County of Sacramento discriminated against Wall by denying the transfer, as less senior employees were transferred. The employer's defense of business necessity was rejected because the County had other options to fill the critical patrol positions.

Labor Code section 132aDiscriminationRetaliationTransfer denialSeniorityBusiness necessityPrima facie caseDisadvantageous treatmentWCJReconsideration
References
Case No. ADJ5836855
Regular
Dec 11, 2012

Malory Wheat vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) rescinded a prior award allowing a lien for living expenses claimed by the CCPOA Benefits Trust Fund. The WCAB held that liens in workers' compensation are strictly statutory and the CCPOA's claim for reimbursement of benefits advanced did not fit within the specific provisions of Labor Code sections 4903 or 4903.1 for "living expenses" or benefits provided by a "self-insured employee welfare benefit plan." The Board clarified that liens for living expenses are intended for those who loan money or extend credit, not for contractual obligations of insurance or benefit plans.

Workers' Compensation Appeals BoardMalory WheatState Compensation Insurance FundCCPOA Benefits Trust Fundlien claimantLabor Code section 4903(c)Labor Code section 4903.1(a)(1)Labor Code section 4903.1(a)(2)Labor Code section 4903.1(a)(3)living expenses
References
Case No. ADJ2806552 (SAC 0224145)
Regular
May 13, 2009

JOELLE NEELEY vs. STATE OF CALIFORNIA, UNEMPLOYMENT INSURANCE APPEALS BOARD, LEGALLY UNINSURED

This case concerns a defendant's petition for removal denied by the Workers' Compensation Appeals Board. The defendant objected to a trial continuance, arguing due process violations due to premature trial scheduling and questioning the evidence supporting the need for assisted living. The Board affirmed the WCJ's decision, clarifying that the trial issue is causation for the need of assisted living, not its necessity or utilization review. Therefore, the matter will proceed to trial on the disputed issue of causation and liability for assisted living costs.

Petition for RemovalMandatory Settlement ConferencePrimary Treating PhysicianAgreed Medical EvaluatorEvidence-Based MedicineSubstantial EvidenceAssisted Living FacilityCausation of NeedUtilization ReviewIndustrial Injuries
References
Case No. ADJ8335165
Regular
Feb 26, 2018

KATHY TATICK vs. COUNTY OF SANTA BARBARA, CORVEL CORPORATION

The Workers' Compensation Appeals Board (WCAB) rescinded a prior decision denying a lien claimant's claim. The lien claimant sought reimbursement for legal services related to disability retirement benefits or, alternatively, for living expenses. The WCAB found it premature to rule on the lien's validity without an actual filed lien and awarded compensation to the applicant. The case was returned to the WCJ for further proceedings to determine if the services qualify as attorney's fees for workers' compensation claims and to assess the living expense lien according to established precedent.

WCABlien claimantreconsiderationFindings and OrderLabor Code § 4903attorney's feesliving expensesindustrial injurycompensationDOR
References
Case No. ADJ8665921
Regular
Aug 13, 2014

CALVYN WHITE vs. DEPARTMENT OF SOCIAL SERVICES

This case concerns an employer's petition for reconsideration of an award requiring ongoing medical treatment, including assisted living and wheelchair repairs for an injured worker. The defendant argued that the worker needed to submit a new authorization request after the previous one expired and that the necessity of assisted living was not sufficiently proven. The Board denied the petition, relying on the *Patterson v. The Oaks Farm* precedent, which places the burden on the employer to demonstrate that previously authorized treatment is no longer reasonably required due to a change in the worker's condition. The defendant failed to present any evidence of such a change, thus upholding the original award.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardUtilization ReviewRequest for AuthorizationAssisted LivingMedical TreatmentIndustrial InjuryCaregiverState Compensation Insurance Fund
References
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