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

Case No. ADJ7688956
Regular
Jan 31, 2012

SHARON FRINK vs. SHASTA-TEHAMA-TRINITY JOINT COMMUNITY COLLEGE

The Workers' Compensation Appeals Board granted removal, rescinded prior orders, and returned the case for further proceedings. The issue was whether the applicant must attend a re-evaluation with the same Qualified Medical Evaluator (QME) after he moved his office a short distance. The Board found that Labor Code section 4062.3(j) requires parties to utilize the same QME for subsequent disputes if possible. They clarified that Administrative Director Rule 34(b) regarding the QME's office location applies only to initial evaluations, not re-evaluations. Therefore, the applicant's refusal to travel a short distance for re-evaluation was not grounds for a new panel QME.

Workers' Compensation Appeals BoardPetition for RemovalQualified Medical Examiner (QME)Re-evaluationLabor Code Section 4062.3(j)Administrative Director Rule 34(b)Administrative Director Rule 36(d)Medical Office LocationUnavailable QMECompel Attendance
References
Case No. ADJ3004293
Regular
May 15, 2009

JOHN M. WILLIAMS vs. RE-BUILDERS, INC., dba RE-BUILDERS NORTH BAY and STATE COMPENSATION INSURANCE FUND, LABOR CONNECTION, INC., CAMBRIDGE INTEGRATED SERVICES GROUP, INC., CIGA for RELIANCE INSURANCE

This case concerns CIGA's liability for an applicant's workers' compensation benefits after the general employer's insurer became insolvent. The Workers' Compensation Appeals Board (WCAB) overturned a prior finding, ruling that the special employer's SCIF policy constituted "other insurance." Therefore, under Insurance Code section 1063.1(c)(9)(A), CIGA is relieved of liability. The matter was returned for determination of reimbursement between CIGA and SCIF.

CIGASCIFgeneral employerspecial employerLabor ConnectionRe-BuildersInc.Reliance Insuranceother insuranceInsurance Code section 1063.1(c)(9)(A)
References
Case No. ADJ8396609
Regular
Sep 20, 2013

KELLY SNOW vs. HEALTH NET, INC., SEDGWICK CMS

The Appeals Board granted the applicant's Petition for Removal, rescinding prior orders that compelled the release of her psychotherapist's records and quashed subpoenas. The applicant argued these records were privileged psychotherapist-patient communications, and the therapist was not a physician or psychologist, thus their records were not discoverable for QME review. The Board found that while the psychotherapist-patient privilege exists, it is subject to waiver when mental condition is placed in issue by the patient, but this waiver is limited to relevant records. The case was returned to the trial level to determine if Ms. Bradley's records are relevant to the disclosed psychiatric injury or unrelated.

Petition for RemovalPetition to Quash Subpoena Duces TecumPsychotherapist-patient privilegeQualified Medical EvaluatorLabor Code section 3209.3Administrative Director Rule 35Evidence Code section 1010Holder of the privilegeEvidence Code section 1013Evidence Code section 1014
References
Case No. ADJ8424952
Regular
Sep 10, 2014

ALFONSO CRUZ vs. SIERRA CIRCUITS, INC.; THE HARTFORD

This case involves an applicant's petition for removal regarding deposition questions about medical history and insurance coverage. The Workers' Compensation Appeals Board (WCAB) granted the petition in part, allowing questions about medical insurance and personal doctors, as these are discoverable under CCP § 2017.010. However, the WCAB found questions about past medical treatment paid by others and prior hospitalizations to be overbroad, as they could infringe on the physician-patient privilege regarding unrelated conditions. The Board ordered the applicant to answer specific questions but requires defendants to reframe broader questions concerning medical history to avoid privileged information.

Petition for RemovalFifth AmendmentFirst Amendmentphysician-patient privilegeconfidential communicationindustrial injurymedical historydeposition questionsCode of Civil Procedure section 2017.010Evidence Code sections 990
References
Case No. ADJ9843524
Regular
Dec 13, 2017

THEODORE MEREDITH vs. SWIFT TRANSPORTATION, ESIS, administered by GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board dismissed Theodore Meredith's Petition for Reconsideration as untimely, as it was filed significantly past the jurisdictional 25-day deadline following service of the WCJ's order. Despite the dismissal, the Board noted the petition might indicate a desire to re-initiate the claim. They returned the matter to the trial level for the WCJ to determine if the petition effectively sought to re-initiate the claim, subject to statute of limitations. The WCJ will develop the record and applicant may file a Declaration of Readiness to Proceed.

Petition for Reconsiderationuntimelyjurisdictionaldismissedstatute of limitationsLabor CodeCal. Code Regs.Workers' Compensation Appeals BoardWCJre-initiate claim
References
Case No. ADJ9097334
Regular
Apr 25, 2016

CHARLES GELETKO vs. CALIFORNIA HIGHWAY PATROL, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of an award granting applicant benefits, arguing the administrative law judge (WCJ) improperly calculated the applicant's permanent disability. The SIBTF contended the WCJ erred by applying a 1.4 adjustment factor and by adding individual impairments rather than combining them. The Appeals Board granted reconsideration, agreeing with the WCJ's report to affirm the award while correcting a mathematical error, ultimately awarding applicant 82% permanent disability. The Board found the 1.4 modifier applicable under the relevant statute, but upheld the prohibition against using the Combined Values Chart when assessing SIBTF eligibility due to statutory exclusions for age and occupation adjustments.

Subsequent Injuries Benefits Trust FundLabor Code section 4751permanent disability thresholdwhole-person impairmentsection 4660.11.4 modifierCombined Values ChartCalifornia Highway Patrolcumulative trauma injurycardiovascular system
References
Case No. ADJ9455597
Regular
Nov 09, 2015

MISAEL CHAVEZ vs. BRENT REDMOND TRANSPORTATION, INC., DISCOVER RE

This case involves applicant Misael Chavez seeking reconsideration of a decision by the Workers' Compensation Appeals Board (WCAB) filed on August 24, 2015. The WCAB has granted reconsideration to allow further study of the factual and legal issues presented. This action is deemed necessary to ensure a complete understanding of the record and to issue a just and reasoned decision. All future correspondence related to the petition for reconsideration must be filed directly with the WCAB Commissioners in San Francisco, not with district offices or electronically.

Petition for ReconsiderationWorkers' Compensation Appeals BoardBrent Redmond TransportationDiscover ReCottingham & Butler Claim ServicesMisael ChavezADJ9455597Opinion and OrderStatutory Time ConstraintsFactual and Legal Issues
References
Case No. ADJ6446675
Regular
Feb 01, 2011

ANAID AYVAZYAN vs. ST. JOHN KNITS, DISCOVER RE, Administered By CCMSI

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration. The Board affirmed the WCJ's decision, finding the Agreed Medical Examiner's (AME) report constituted substantial evidence despite defendant's arguments against it. The Board also addressed the defendant's contention regarding the exclusion of Dr. Uejo's testimony, clarifying it was properly admitted but afforded little weight as a rebuttal witness on rating, not as a medical expert. Consequently, the defendant's petition was denied, upholding the original findings.

Workers' Compensation Appeals BoardSt. John KnitsDiscover RECCMSIAnaid AyvazyanPetition for ReconsiderationReport and RecommendationWCJDr. Uejorating expert
References
Case No. ADJ9441801 ADJ10298288
Regular
Jul 21, 2017

PAULA WALTON vs. PORTS AMERICA, DISCOVERY RE, GALLAGHER BASSETT, SSA CONTAINERS, INC., METRO RISK MANAGEMENT

In this workers' compensation matter, the Appeals Board granted Ports America's Petition for Reconsideration. The Board rescinded the Administrative Law Judge's (ALJ) Joint Findings and Order of July 17, 2017. The case is now returned to the trial level for further proceedings by the ALJ.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings and OrderWCJPorts AmericaDiscovery ReGallagher BassettSSA ContainersMetro Risk ManagementADJ9441801
References
Case No. ADJ3433658 (SRO 0118954)
Regular
Mar 17, 2011

FRANK VONADA vs. GAMBRO HEALTHCARE, SUNNYSIDE REHABILITATION, ESIS, CIGA

The applicant sought removal of an Order Closing Discovery to re-examine disputed medical treatment issues. The Workers' Compensation Appeals Board (WCAB) considered the case based on the applicant's petition for removal and the defendants' answer. The WCJ recommended dismissal as the applicant had previously withdrawn their petition to remove. The WCAB agreed with the WCJ and dismissed the petition for removal because it had been withdrawn.

Petition for RemovalOrder Closing DiscoveryMandatory Settlement ConferenceAgreed Medical ExaminerDue ProcessWCJWithdrawal of PetitionWorkers' Compensation Appeals BoardDismissalRe-examination
References
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