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

Case No. ADJ17146948; ADJ17146930; ADJ15040609
Regular
Apr 28, 2025

WAYNE BLOSSER vs. RB SPENCER, INC., INSURANCE COMPANY OF THE WEST

Applicant Wayne Blosser sustained multiple industrial injuries, leading to a WCJ award for home modifications, including a mobile home construction and interim ADA-compliant housing, citing the defendant's failure to timely investigate treatment needs. Defendant sought reconsideration, arguing due process violations, lack of WCJ jurisdiction over home modifications, and insufficient evidentiary support for the award. The Workers' Compensation Appeals Board denied the petition, affirming the WCJ's findings that the defendant had ample notice to investigate and that the issue fell within the WCJ's jurisdiction given the parties' stipulations on medical necessity and the implementation nature of the dispute. The Board emphasized the employer's affirmative duty to investigate and provide benefits upon notice of potential needs.

Workers' Compensation Appeals BoardIndustrial InjuryAC HVAC Commercial InstallerHome ModificationsADA Compliant ApartmentSkilled Nursing FacilityUtilization ReviewIndependent Medical ReviewDue ProcessLabor Code
References
Case No. ADJ6743541, ADJ6769168
Regular
Nov 03, 2014

DEBORAH PRYOR vs. INSTITUTE FOR REDESIGNED LEARNING, STATE COMPENSATION INSURANCE FUND, SPECIAL NEEDS NETWORK, INC., ENDURANCE INSURANCE COMPANY

State Compensation Insurance Fund (SCIF) sought reconsideration of an arbitrator's decision denying their contribution claim against Endurance Insurance Company. The arbitrator found that the applicant did not sustain a cumulative injury during her employment with Special Needs Network, insured by Endurance, and therefore Endurance was not liable. The Workers' Compensation Appeals Board denied SCIF's petition, adopting the arbitrator's reasoning that there was insufficient evidence of injurious exposure at Special Needs to establish Endurance's liability. The Board concluded that the applicant's symptoms were due to prior cumulative trauma from employment at Institute for Redesigned Learning, not Special Needs.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for ContributionCumulative InjuryDate of InjuryLabor Code Section 5412Labor Code Section 5500.5Injurious ExposureSubstantial EvidenceCompromise and Release Agreement
References
Case No. ADJ10682518
Regular
Nov 30, 2017

LORENZO ENRIQUEZ vs. HOUSE FOODS AMERICA, TOKIO MARINE MANAGEMENT

This case involves a Petition for Removal and Reconsideration filed by the defendant, House Foods America and Tokio Marine Management. The Appeals Board dismissed the Petition for Removal, finding that the WCJ's finding of injury arising out of and occurring in the course of employment was a final order, making reconsideration the proper remedy. The Board denied reconsideration, adopting the WCJ's findings and giving significant weight to their credibility determinations regarding the applicant's testimony.

RemovalReconsiderationPetition for RemovalPetition for ReconsiderationAppeals Board Rule 10843Final OrderSubstantive RightThreshold IssueAOE/COECredibility Determination
References
Case No. ADJ4012081 (SBA 0086539)
Regular
Aug 19, 2014

KAREN SEGROVES vs. BURGER BARN\/PAULA'S PANCAKE HOUSE, THE HARTFORD

In Segroves v. Burger Barn/Paula's Pancake House, the Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration of a May 29, 2014 award. The WCAB determined that further study of the factual and legal issues was necessary to ensure a just and reasoned decision. Consequently, all future filings related to this case must be submitted in writing directly to the WCAB Commissioners in San Francisco, not to any district office or through the electronic system.

Petition for ReconsiderationFindings of Fact and AwardStatutory time constraintsFactual and legal issuesJust and reasoned decisionDecision After ReconsiderationOffice of the CommissionersElectronic Adjudication Management SystemOxnard District OfficeSan Francisco
References
Case No. ADJ7711348
Regular
Mar 26, 2013

MIRIAN MERINO vs. ALMORE DYE HOUSE, INC., EMPLOYERS COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of the WCJ's January 3, 2013 decision in the case of Mirian Merino v. Almore Dye House, Inc. and Employers Compensation Insurance Company. The Board rescinded the WCJ's decision and remanded the case back to the trial level for further proceedings and a new decision. This action is not a final determination on the merits of the claims.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeReconsideration GrantedDecision RescindedFurther ProceedingsTrial LevelNew DecisionJanuary 3 2013March 26 2013
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. ADJ4564984 (MON 0201538)
Regular
Apr 20, 2009

EdUARDO RODRIGUEZ (Deceased) RODRIGUEZ, Teresita (Wife) vs. COUNTY OF LOS ANGELES, USC MEDICAL CENTER, et al.

The Workers' Compensation Appeals Board granted reconsideration to address deficiencies in the original award for home health care services. The Board found a lack of substantial evidence supporting the necessity and duration of care provided by the deceased worker's wife, Teresita Rodriguez. Crucially, the WCJ failed to specify the basis for the awarded hours and hourly rate, and did not adequately address potential differences in rates over time or periods of hospitalization. The matter was returned to the trial level for further development of the record to determine the actual need for care, the precise number of hours, and appropriate rates, as well as to clarify the defendant's notice of the need for services.

Workers Compensation Appeals BoardReconsiderationFindings and AwardHome Health Care ServicesLien ClaimantAgreed Medical EvaluatorIndustrial InjuryPermanent DisabilitySelf-Procured Medical TreatmentRenal Failure
References
Case No. ADJ9617818
Regular
Jun 23, 2015

WILLIAM PRESTON vs. JP MORGAN CHASE BANK (NEWPORT BEACH), NATIONAL UNION FIRE INS. CO. OF PITTSBURG, BROADSPIRE

The Workers' Compensation Appeals Board denied the applicant's Petition for Removal, finding no good cause. The applicant claimed the mandatory settlement conference was wrongly continued, causing prejudice due to homelessness. However, the applicant had previously declared discovery complete but then admitted otherwise at the hearing. The Board adopted the WCJ's recommendation, noting the applicant's contradictory statements and the need for a complete record.

Petition for RemovalMandatory Settlement ConferenceQualified Medical ExaminerDiscoveryContinuing HearingPerjurySignificant PrejudiceIrreparable HarmDeclarations of ReadinessWCJ Report and Recommendation
References
Case No. ADJ2002839 (SAC 0332621)
Regular
Jun 25, 2010

PATRICK C. O'BRIEN vs. WARDEN'S AUTO REPAIR, STATE COMPENSATION INSURANCE FUND

The applicant sought to commute his future life pension payments due to pressing financial needs, including vehicle replacement, home repairs, and dental treatment, which were supported by unrebutted evidence. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, reversing the prior denial. The WCAB found that while the administrative law judge correctly identified the applicant's emergencies, the denial overly focused on speculative future needs. Ultimately, the WCAB determined that full commutation of the life pension was in the applicant's best interest and returned the case for attorney's fee determination.

CommutationLife PensionPressing Financial NeedsBest InterestLabor Code § 5100ReconsiderationStipulated AwardPermanent DisabilityIndustrial InjuryWCAB
References
Case No. ADJ2320623
Regular
Oct 25, 2010

SAMIR SOLOMON vs. TRI VALLEY BUICK, PONTIAC, GMC, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For CASUALTY RECIPROCAL EXCHANGE, In Liquidation

This case involves a workers' compensation claim for an automobile salesman injured on April 14, 2001, resulting in spinal and psychiatric injuries. The WCJ awarded temporary disability through June 22, 2004, 52¼% permanent disability, and further medical treatment for the psyche, but not the spine, denying defendant credit for civil damages. Both applicant and defendant sought reconsideration, arguing various evidentiary errors, particularly regarding the duration of temporary disability and the need for spinal treatment. The Appeals Board denied reconsideration of both petitions, affirming the WCJ's decision, though one Commissioner dissented, believing the applicant's temporary disability claim and spinal treatment need further development.

Workers' Compensation Appeals BoardIndustrial InjurySpine InjuryPsychiatric InjuryTemporary DisabilityPermanent DisabilityApportionmentMedical TreatmentCivil DamagesReconsideration
References
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