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. 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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ10954204
Regular
Sep 15, 2022

MARIA FLORES vs. PINNACLE HEALTH CORP., SUMMARY OF EVIDENCE INSURANCE COMPANY OF THE WEST, AFFINITY HOME HEALTH CARE SERVICES, FALLS LAKE FIRE & CASUALTY INSURANCE, SEDGWICK CMS, HOME HEALTH CARE SOLUTIONS, INC.

The Workers' Compensation Appeals Board denied a petition for reconsideration filed by Home Health Care Solutions. The applicant, an LVN, was injured in a car accident while traveling between patients for multiple agencies. The Board adopted the WCJ's report, which found the injury arose out of and occurred in the course of employment for Home Health Care Solutions. This decision was based on the fact that the applicant was required to use her own vehicle, which extended the employer-employee relationship beyond direct service. The WCJ also found the going and coming rule did not bar the claim due to the required use of transportation between patient locations.

Workers' Compensation Appeals BoardPetition for ReconsiderationGoing and Coming RuleAOE/COELVNCar AccidentAutomobile ExceptionTransitEmployment RelationshipRequired Vehicle Use
References
Case No. VNO 0508480
Regular
Dec 06, 2007

MICHELLE LORD vs. RITE-AID CORPORATION, ST. PAUL TRAVELERS

The Workers' Compensation Appeals Board granted reconsideration of an award for home health care, finding the original decision lacked substantial evidence. The Board rescinded the award and returned the case for further development of the record concerning the applicant's past and future home health care needs. Specifically, the Agreed Medical Examiner must clarify their opinion on the reasonableness and necessity of past and future home health care.

Workers' Compensation Appeals BoardRite-Aid CorporationSt. Paul TravelersMichelle LordFindings and AwardReconsiderationHome health careIndustrial injuryAgreed Medical ExaminerActivities of Daily Living
References
Case No. ADJ 1387363 (SBR 0269737) ADJ2131808 (SBR 0276089) ADJ2394028 (SBR 0337198)
Regular
Jul 06, 2016

FRIEDA WILLIAMS vs. MONTGOMERY ELEVATOR, AIG/CHARTIS

The Workers' Compensation Appeals Board affirmed an award finding Montgomery Elevator liable for unreasonably delayed home health care services for Frieda Williams. The Board found that the defendant received a prescription for home health care more than 14 days before the specified treatment period, establishing their liability. Penalties and attorney's fees were upheld due to the defendant's failure to provide necessary care despite prior stipulations and medical recommendations. The Board also affirmed applicant's standing to collect on behalf of her family caregiver.

Workers Compensation Appeals BoardReconsiderationJoint Findings of FactAward and OrdersWCJHome Health CareUnreasonable DelayPenalty24 Hour Home Health CareSelf-Procured Services
References
Case No. ADJ12194461
Regular
Dec 10, 2020

Antonio Lemus vs. STEVE P. RADOS, INC., STARR INDEMNITY & LIABILITY COMPANY

This case concerns applicant Antonio Lemus's entitlement to home health care following an admitted industrial head injury. Defendant sought reconsideration of a WCJ's award enforcing a Utilization Review (UR) determination that modified but approved home health aide services. The defendant argued the WCJ lacked jurisdiction to enforce the UR determination due to a second, later UR denial of the same request, which they claimed was timely. The Appeals Board affirmed the WCJ's decision, finding jurisdiction to enforce the initial UR approval and deeming the subsequent denial an improper "self-granted appeal." The Board concluded the applicant was entitled to the treatment approved by the first UR determination.

Workers' Compensation Appeals BoardUtilization ReviewRequest for AuthorizationIndependent Medical ReviewFindings Orders and AwardPetition for ReconsiderationNurse Case ManagerTraumatic Brain InjuryHome Health AideMedical Treatment
References
Case No. ADJ2271789
Regular
May 07, 2019

JEFFREY MITCHELL vs. ERNEST JOHN SMITH, UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case involves a workers' compensation applicant seeking reconsideration of a decision awarding him 42 hours of weekly home health care, an ultralight wheelchair, and home modifications. The Uninsured Employers Benefit Trust Fund (UEBTF) argued against liability, claiming the treating physician did not use the correct form for home health care requests and that it had timely conducted utilization review. The Appeals Board affirmed the award, finding the UEBTF had a duty to investigate the need for services upon receiving medical reports and recommendations. Furthermore, the Board held that a prior stipulation obligated the UEBTF to continue providing home health care, and their utilization review process was either untimely or improperly conducted.

UEBTFReconsiderationFindings and AwardHome Health CareHome ModificationsUltralight WheelchairUtilization ReviewStipulationPanel Qualified Medical EvaluatorPrimary Treating Physician
References
Case No. ADJ1755508 (SRO 0142328)
Regular
Dec 21, 2012

SOSTENES REYES vs. PROTRADES CONNECTIONS, AMERICAN HOME ASSURANCE, Adjusted By CHARTIS INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to amend a prior award. While affirming most findings, the Board corrected a clerical error, changing the start date for applicant's home health care services to December 3, 2011. The Board upheld the finding that the defendant unreasonably delayed payment for these services, imposing a 25% penalty. The parties were ordered to adjust the payment amounts accordingly, with jurisdiction reserved for any disputes.

WCABProtrades ConnectionsAmerican Home AssuranceChartis InsuranceSosthenes Reyesindustrial injurycognitive impairmentmemory impairmentpost-traumatic stress disorderpermanent total disability
References
Case No. ADJ2304030 (OAK 0305414)
Regular
Dec 09, 2011

HAINE COLLINS vs. SAFETY SERVICE SCAFFOLD, INC., STATE COMPENSATION INSURANCE FUND

This case involved a dispute over home health care payments for an injured worker. The defendant argued that payments should be withheld due to the applicant's initial refusal of a home health evaluation. However, the Board found that the stipulated order for payment was not conditional on the evaluation itself. The Board affirmed the prior order for payment, clarifying that the only conditional aspect pertained to the nurse case manager's identity. Therefore, the defendant's petition for reconsideration was denied.

WCABPetition for ReconsiderationHome Health CareStipulated OrderNurse Case ManagerEK Health reportWCJRetrospective PaymentIndustrial InjuryScaffold Erector
References
Case No. ADJ3164730 (LBO 0135441), ADJ3921082 (LBO 0100188), ADJ451512 (LBO 0100187)
Regular
Jan 03, 2011

SOMBOON INTRACHOOTO vs. COUNTY OF LOS ANGELES/RANCHO PRINCIPAL RECONSIDERATION Permissibly Self-Insured

This case involves a workers' compensation claim for permanent total disability and lifetime medical care awarded to an applicant who sustained industrial injuries as a registered nurse. The applicant's husband, also a lien claimant, provided 24-hour home health aide services after December 5, 2004. While the original award set the reasonable value of these services at $100 per day, the Appeals Board granted reconsideration. The Board increased the daily reimbursement rate to $200, finding it consistent with the evidence of actual care provided and more economical for the defendant than hiring external agencies or institutionalizing the applicant.

Workers' Compensation Appeals BoardSomboon IntrachootoCounty of Los AngelesJoint Supplemental Findings and Awardpermanent total disabilitylifetime medical carehome health aidereasonable value of servicespetition for reconsiderationAgreed Medical Examiner (AME)
References
Case No. ADJ845033 (VNO 0407336) ADJ1911914 (VNO 0412063) ADJ1461680 (VNO 0338656) ADJ2866384 (VNO 0338654) ADJ451885 (MON 0224886) ADJ1364506 (VNO 0407335) ADJ2640142 (VNO 0407334) ADJ1480083 (MON 0264343)
Regular
Apr 04, 2012

DONALD RENETZKY vs. STATE OF CALIFORNIA, DEPARTMENT OF INDUSTRIAL RELATIONS, STATE COMPENSATION INSURANCE FUND

This case involves a defendant's petition for removal concerning potential discovery closure under Labor Code section 5502(e)(3). The defendant argues prejudice due to unresolved discovery issues related to applicant's home health care services claim, particularly regarding an increase in prescribed hours. The Appeals Board granted removal, deeming the prior conference a status/discovery conference. This allows for completion of discovery to facilitate a just resolution and prevent prejudice to the defendant.

Petition for RemovalDiscovery ClosureLabor Code Section 5502(e)(3)Pretrial Conference StatementMandatory Settlement ConferenceHome Health Care ServicesAgreed Medical ExaminerTreating PhysicianHome Health Care EvaluatorDeposition
References
Showing 1-10 of 1,156 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