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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ2738004
Regular
Nov 24, 2014

RONALD PAYTON vs. KLEINFELDER GROUP, AIG CLAIMS

The Workers' Compensation Appeals Board denied Ronald Payton's petition for reconsideration of a prior decision. The Board adopted the administrative law judge's report, which found that Payton's claims of injury were not supported by substantial evidence. The judge detailed how Payton, proceeding pro se, failed to present new or relevant evidence and misrepresented existing medical opinions. Therefore, the Board affirmed the original denial of the claim.

Petition for ReconsiderationSubstantial EvidenceAgreed Medical EvaluatorPro PerDWC-1MMIAgreed Medical EvaluatorPro SeNon-industrial PneumoniaToxicology
References
Case No. ADJ7432904
Regular
Sep 24, 2012

NEDA MOTAVAKEL vs. FANTASTIC SAM'S, TOWER SELECT INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, STAR INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, ENDURANCE WORKERS' COMPENSATION, SOUTHERN INSURANCE CO., FIRSTCOMP OMAHA

This case involves an appeal by Star and Tower Insurance Companies regarding a workers' compensation award. The primary issue is the applicant's average weekly earnings, specifically the inclusion of tip income, which was not adequately substantiated by documentary evidence. The Appeals Board found the initial decision lacked substantial evidence regarding earnings and rescinded the award. The matter is remanded for further proceedings to properly develop the evidentiary record on earnings and insurance coverage dates before a new decision is issued.

Workers' Compensation Appeals BoardNeda MotavakelFantastic Sam'sTower Select Insurance CompanyStar Insurance CompanyIllinois Midwest Insurance AgencyLLEndurance Workers' CompensationSouthern Insurance CompanyFirstComp Omaha
References
Case No. ADJ3964372 (MON 0247784) ADJ4081926 (MON 0247785)
Regular
Dec 07, 2018

ROBERT BAKER vs. CITY OF COMPTON

The Workers' Compensation Appeals Board dismissed applicant Robert Baker's Petition for Reconsideration because it was filed *in pro per* without proof of service on all adverse parties, including his own attorney. The petition also failed to meet the requirements of Appeals Board Rule 10856 by not providing a specific offer of proof for newly discovered evidence or fraud. Consequently, the Board found the petition defective on multiple grounds.

Petition for Reconsiderationin pro perJoint Order Approving C&RWCJAppeals Board Rule 10856newly discovered evidenceoffer of proofcumulative evidenceproof of serviceadverse parties
References
Case No. ADJ8597474
Regular
Apr 02, 2018

SID AJAZ vs. COLDWELL BANKER, AMERICAN CASUALTY COMPANY

The Workers' Compensation Appeals Board granted the defendant's Petition for Removal, rescinding the prior Order that rejected Qualified Medical Evaluator (QME) Dr. Miner's reports. While agreeing Dr. Miner's reports lacked substantial evidence, the Board found the WCJ erred in ordering a new QME panel. Instead, the Board remanded the case to the WCJ to further develop the record, potentially by appointing a regular physician given the applicant's pro per status.

Petition for RemovalOpinion and OrderQualified Medical Evaluator (QME)Substantial EvidenceWorkers' Compensation Appeals Board (WCAB)Administrative Law Judge (WCJ)Supplemental ReportAgreed Medical Evaluator (AME)Develop the RecordPro Per
References
Case No. ADJ4374543 (SAC 0258458)
Regular
Mar 22, 2010

SANDRA MCREYNOLDS vs. SACRAMENTO CITY UNIFIED SCHOOL DISTRICT; Permissibly Self-Insured, Adjusted By SCHOOLS INSURANCE AUTHORITY

The Appeals Board granted reconsideration and rescinded the original award, finding that the applicant, appearing pro per, may have been denied due process. Specifically, the Board determined that the WCJ erred by not allowing the applicant to present her witness, Ms. McKay, and did not adequately provide the applicant an opportunity to question the occupational therapist. The case is returned to a trial-level WCJ for further proceedings, including testimony from Ms. McKay and opportunity for cross-examination. The Board declined to address other contentions due to this disposition.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardCompromise and ReleaseIndustrial InjuryMedical CareScooter LiftDue ProcessPro PerWitness Testimony
References
Case No. ADJ3507926 (MON 0335218)
Regular
Mar 04, 2013

Douglas Maida vs. GEP Entertainment Services, AIG Claim Services, Inc.

The applicant's attorney sought to withdraw from representation due to a breakdown in the attorney-client relationship, primarily stemming from the applicant's frustration over a credit issue. The Workers' Compensation Appeals Board dismissed the petition for reconsideration because the WCJ's order denying withdrawal was not a final order. However, the Board granted the petition for removal, rescinded the WCJ's order, and allowed the attorney's withdrawal. The case is returned to the Presiding Judge to address the unresolved credit issue, potentially through a settlement conference with the applicant appearing in pro per.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalWCJWithdrawal of AttorneyCumulative TraumaStipulations with Request for AwardPermanent DisabilityCreditThird Party Case
References
Case No. ADJ1959622 (AHM 0143618) ADJ3555484 (AHM 0143619)
Regular
Feb 14, 2011

KAI-SEN TSAI vs. SUN SALES LA, INC., UNINSURED EMPLOYERS BENEFIT TRUST FUND, Rosa Lam

The Workers' Compensation Appeals Board dismissed Rosa Lam's petition for reconsideration of an approved Compromise and Release because it was filed untimely. Lam, acting "in pro per" despite being represented by counsel, alleged fraud, non-industrial causes, witness credibility issues, and ineffective assistance of her attorney who allegedly coerced her into signing the settlement. The Board found the petition was filed 29 days after the order, exceeding the 20-day jurisdictional deadline. Even if timely, the Board would have denied it, as ineffective assistance of counsel is not grounds to set aside an order and no undue influence was demonstrated.

Workers' Compensation Appeals BoardSun Sales LAInc.Uninsured Employers Benefit Trust FundRosa LamPetition for ReconsiderationOrder Approving Compromise and ReleaseIn Pro PerFraudulent ClaimsNon-Industrial Causes
References
Case No. ADJ7157224
Regular
Sep 12, 2011

NORMA NERI vs. KRISPY KREME DOUGHNUTS, TWIN CITY FIRE INSURANCE, SEDGWICK CMS/SRS

This case involves Norma Neri's pro per petition for reconsideration of an approved Compromise and Release agreement. Her petition was dismissed by the Workers' Compensation Appeals Board because it was unverified, unsigned, and failed to state the grounds for reconsideration. The Board noted that Labor Code section 5902 requires verification of such petitions and that applicant had not cured this defect despite notice. Therefore, the Board found good cause to dismiss the petition.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationCompromise and Releaseunverified petitionunsigned petitionLabor Code section 5902verification defectLucena v. Diablo Auto Bodygrounds for reconsiderationmaterial evidence
References
Case No. ADJ7485844, ADJ7485852
Regular
Nov 26, 2012

MDR-81 XYZZX vs. COUNTY OF LOS ANGELES DEPARTMENT OF HEALTH, TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board (WCAB) denied reconsideration of an award to an applicant who sustained injuries as a Public Health Nurse from 1991 to 1999. The applicant, proceeding pro per after dismissing her fourth attorney, contested issues including overpayment credits and the review of evidence. The WCAB adopted the findings of the Workers' Compensation Judge (WCJ), who found the applicant's contentions regarding the evidence and overpayment credits unpersuasive. The WCAB also suggested the applicant contact the Information and Assistance Officer for guidance on understanding the award and legal process.

Workers' Compensation Appeals BoardReconsideration DeniedPublic Health NurseDates of InjuryParts of Body InjuredFindings and AwardPetition for ReconsiderationApplicant in Pro PerAgreed Medical ExaminersTemporary Disability Indemnity
References
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