CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. ADJ7946529
Regular
May 15, 2012

FELICIANO ESPINOZA vs. INTERGEM, ARGONAUT INSURANCE COMPANY

The Appeals Board granted reconsideration because the initial award of temporary disability was based on a chiropractor's report deemed not substantial evidence, due to unclear examination methods including a potential phone-only consultation. The Board found this evidence insufficient to support the temporary disability period awarded. Consequently, the Board rescinded the prior award and returned the case to the WCJ to further develop the medical record. This includes potentially obtaining supplemental reports or deposing the agreed medical examiner regarding the applicant's period of total temporary disability.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardTemporary DisabilityIndustrial InjurySubstantial EvidenceMedical OpinionFurther Development of RecordWCJEdward Komberg D.C.
References
Case No. ADJ10934545
Regular
Aug 23, 2019

Richard Rodriguez vs. CPG FOODS, LLC/GALA FOOD, Cannon Cochran Management Services Inc.

The Appeals Board granted reconsideration and modified the original award, finding that the Qualified Medical Examiner's (QME) apportionment opinion lacked substantial evidence. The Board reversed the original 12% permanent disability finding, awarding 16% based on the QME's impairment rating after reviewing surveillance video evidence. The Board also clarified that treating physician reports from Dr. Mahboubian and Dr. Ahmed are admitted into evidence and may be relied upon. Finally, the Board affirmed the original findings regarding the injured body parts and the permanent and stationary date.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardApplicantDefendantsInjury AOE/COEUpper BackHipsKneesTemporary Total Disability
References
Case No. ADJ11428234
Regular
Oct 17, 2025

RAMON COLLADO vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, CENTINELA STATE PRISON

The Workers' Compensation Appeals Board granted reconsideration to study the factual and legal issues in Ramon Collado's case against the California Department of Corrections and Centinela State Prison. Collado sought reconsideration of a WCJ's Findings and Order from July 28, 2021, which concluded he failed to prove an industrially caused heart/hypertension injury between December 20, 2012, and August 14, 2018. The Board found the Qualified Medical Evaluator's opinion on whether Collado's condition was an aggravation or mere exacerbation of prior injuries was unclear and contradictory, failing to constitute substantial medical evidence. Consequently, the Board rescinded the WCJ's decision and returned the matter to the trial level for further proceedings, including the development of the medical record and a determination on the applicability of Labor Code section 3212 presumptions.

Workers Compensation Appeals BoardRamon ColladoCalifornia Department of CorrectionsCentinela State PrisonState Compensation Insurance FundOpinion and Decision After ReconsiderationFindings and Orderworkers' compensation administrative law judgeindustrially caused injuryexacerbation
References
Case No. GOL 0089200
Regular
Mar 21, 2008

YOLANDA MARQUEZ vs. COMP USA, AIG, AMERICAN INT'L CLAIMS SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a decision that apportioned 75% of the applicant's disability to non-industrial factors based on the Agreed Medical Examiner's (AME) opinion. The Board found that the AME's apportionment might have been based on the cause of the injury rather than the cause of the disability, which is an incorrect legal standard. Therefore, the Board deferred the issues of permanent disability, apportionment, and attorney's fees and returned the case to the trial level for further development of the record on apportionment.

Workers Compensation Appeals BoardYolanda MarquezCOMP USAAIGAmerican International Claims ServicesFindings and Awardindustrial injurypermanent disabilityapportionmentAgreed Medical Examiner (AME)
References
Case No. ADJ7264915
Regular
Jul 15, 2013

ANA GONZALES vs. WAL-MART ASSOCIATES, INC., ACE AMERICAN INSURANCE

This case involves an applicant who sustained industrial psychiatric injury but whose orthopedic claims were denied due to insufficient medical evidence. The Appeals Board denied the applicant's petition for reconsideration, finding the applicant failed to present substantial medical evidence of industrial causation for her orthopedic complaints. A dissenting commissioner argued that the primary medical evaluator's report was deficient and lacked substantial evidence, warranting further development of the record on orthopedic injuries and other claims. The dissent emphasizes the Board's duty to ensure substantial justice, suggesting it should have ordered further investigation on the denied orthopedic issues.

WCABPetition for ReconsiderationFindings and Orderindustrial injurypsychelow backneckright shoulderright wristright elbow
References
Case No. ADJ8399186
Regular
Jul 25, 2013

MARIBEL HERNANDEZ vs. NORMA'S RESTAURANT; FARMERS

The Workers' Compensation Appeals Board (WCAB) denied Maribel Hernandez's petition for reconsideration. The WCAB adopted the reasoning of the WCJ, who found that the applicant did not sustain an injury arising out of and in the course of employment (AOE/COE). This decision was based on the totality of the record, including inconsistencies in the applicant's testimony regarding symptom onset and information provided to her physician, as well as her delay in seeking medical treatment and not missing work. The WCAB deferred to the WCJ's credibility findings, which it found were not arbitrary, and determined that Dr. Hunt's report did not constitute substantial evidence due to its failure to incorporate subsequent medical findings.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ credibility findingsubstantial medical evidenceDr. Timothy HuntDr. RafaelEMG studyAOE/COE analysisinconsistency in testimonyapplicant credibility
References
Case No. ADJ6938398 ADJ6938554
Regular
Mar 13, 2012

JOSEFINA CASTANEDA vs. 99 CENT ONLY STORES, INC.

The Workers' Compensation Appeals Board denied reconsideration, upholding the WCJ's decision to deny the applicant's claim for industrial injury. This denial was based on the applicant's failure to disclose a prior significant injury and subsequent compromise and release agreement, which rendered her medical reports unsubstantial evidence. The Board found the applicant's testimony regarding her current injury was not credible and she failed to meet her burden of proof for injury arising out of and in the course of employment. The court deferred to the WCJ's credibility findings, citing relevant case law.

AOE-COEsubstantial evidencecredibility findingHegglin v. Workers' Comp. Appeals Bd.Garza v. Workmen's Comp. Appeals Bd.Petition for ReconsiderationCompromise and Releaseinadequate medical historieserroneous medical reportsdeveloped the record
References
Case No. ADJ6408456
Regular
May 17, 2010

KENNETH M. HOOVER vs. CITY OF POMONA

The Appeals Board granted reconsideration of the WCJ's award of 100% permanent total disability. The Board found that the WCJ's decision was not supported by substantial evidence, primarily due to deficiencies in Dr. Grodan's medical reporting regarding the applicant's skin and cardiovascular conditions. The matter was returned to the trial level for further development of the record and a new decision. The Board confirmed the application of the 1997 Permanent Disability Rating Schedule and the admission of Dr. Shirman's report.

WORKERS' COMPENSATION APPEALS BOARDADJ6408456KENNETH M. HOOVERCITY OF POMONAreconsiderationFindings and Award and Orderworkers' compensation administrative law judgeWCJMay 172010
References
Case No. ADJ3357881
Regular
Apr 06, 2012

HELEN DEMBY vs. MAXIM HEALTHCARE SERVICES, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

The Workers' Compensation Appeals Board granted reconsideration, rescinding a previous award. The Board found that medical treatment provided by True Sleep LLC was not reasonable or necessary for the applicant's industrial injury. This decision was based on the lack of substantial medical evidence linking the treatment to the applicant's admitted back injury, and no evidence establishing a separate industrial sleep injury.

Workers' Compensation Appeals BoardHelen DembyMaxim Healthcare ServicesInsurance Company of the State of PennsylvaniaESISADJ3357881LAO 0874404Petition for ReconsiderationFindings and AwardWCJ
References
Case No. ADJ 2542589 [AHM 0109935]
Regular
Aug 26, 2008

EPIFANIO ANAYA vs. MPC INDUSTRIAL PRODUCTS, INC., HARBOR SPECIALTY INSURANCE CO.

The WCAB granted reconsideration, rescinding the June 9, 2008 Findings and Award and returning the matter to the WCJ for further proceedings due to deficiencies in the medical evaluator's apportionment findings.

Workers' Compensation Appeals BoardEpifanio AnayaMPC Industrial ProductsHarbor Specialty Insurance Co.Employers Compensation Insurance Companyindustrial injurypermanent disabilityapportionmentsubstantial medical evidenceDr. Lewis
References
Showing 1-10 of 14 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational