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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ16022807
Regular
Aug 08, 2025

ISRAEL MORALES ROJAS vs. CHRISTENSEN BROTHERS GENERAL ENGINEERING, INC., STATE COMPENSATION INSURANCE FUND

Applicant Israel Morales Rojas petitioned for reconsideration of a WCJ's July 7, 2023, decision that denied his entitlement to a specific post-acute residential rehabilitation program. The Appeals Board granted reconsideration to review the matter. While the reconsideration was pending, the Board was advised that a proposed settlement had been reached. Consequently, the Board rescinded the WCJ's original decision and returned the case to the trial level for the WCJ to consider the proposed settlement.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderBurden of ProofReasonableness of TreatmentCasa Colina Transitional Living CenterInterdisciplinary Post-Acute Residential Rehabilitation ProgramSettlementRescindedReturned to Trial Level
References
Case No. ADJ7286862, ADJ7604060
Regular
Sep 14, 2015

Kelly Tinsley vs. VERTIS COMMUNICATIONS, ACE USA INSURANCE

This case involves a denial of a defendant's petition for reconsideration regarding a workers' compensation award. The defendant's Utilization Review (UR) of the applicant's requested continued treatment at a residential rehabilitation center was deemed invalid by the Administrative Law Judge (ALJ) due to untimeliness in communication. The Workers' Compensation Appeals Board (WCAB) affirmed the ALJ's decision, finding the UR invalid because the defendant failed to prove timely communication to the physician as required by statute. Consequently, the WCAB upheld the award of continued treatment, deeming it reasonable and supported by substantial medical evidence.

Workers' Compensation Appeals BoardPetition for ReconsiderationUtilization ReviewUntimelinessRequest for AuthorizationTransitional Living CenterResidential ProgramPost-Acute Physical RehabilitationPsychiatric InjuryIndependent Medical Review
References
Case No. ADJ2255750 (LAO 0803099)
Regular
Sep 14, 2009

RAQUEL ZUNIGA vs. RADIO SHACK, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and awarded attorney's fees for services in obtaining vocational rehabilitation benefits. The Board found that the applicant's attorney was entitled to a fee calculated as 15% of the *new money* awarded in the Rehabilitation Unit's Determination and Order, not the total VRMA amount. Because the defendant failed to withhold any funds for attorney fees despite knowing the applicant was represented, the defendant was ordered to pay the awarded attorney's fee.

Workers' Compensation Appeals BoardRaquel ZunigaRadio ShackLiberty Mutual Insurance CompanyADJ2255750Attorney FeesVocational RehabilitationQualified Rehabilitation RepresentativeDetermination and OrderRehabilitation Unit
References
Case No. ADJ3735030 (LAO 0804978) ADJ1855956 (LAO 0804979)
Regular
Apr 10, 2013

NATALIE KIDD vs. INLAND GLOBAL MEDICAL GROUP, STATE COMPENSATION INSURANCE FUND

This case concerns Natalie Kidd's entitlement to vocational rehabilitation services after her 2001 injury. The Appeals Board affirmed the WCJ's decision, finding the Rehabilitation Unit's 2008 Determination to be a final, unappealed order. This vested Kidd's right to vocational rehabilitation benefits, overriding the subsequent repeal of Labor Code Section 139.5. Consequently, Kidd is entitled to retroactive and ongoing VRMA at the temporary disability rate, with specific adjustments for periods of interrupt status and receipt of medical temporary disability.

Vocational RehabilitationVRMAQualified Rehabilitation RepresentativeQRRRehabilitation UnitDeterminationFindings Award OrderFA&OPetition for ReconsiderationWCJ
References
Case No. AHM 0091706 AHM 0102322
Regular
Aug 22, 2007

MATTHEW MCCORD vs. COUNTY OF SANTA BARBARA, RISK MANAGEMENT

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and reversed the prior award of vocational rehabilitation maintenance allowance (VRMA) for applicant Matthew McCord. The Board found that McCord's liability for vocational rehabilitation services ended on October 17, 2003, the scheduled termination date of his rehabilitation plan. McCord's failure to complete the plan, despite receiving one, and his subsequent return to work as a court bailiff, rendered him ineligible for VRMA after that date.

Workers' Compensation Appeals BoardVocational RehabilitationCollateral EstoppelRes JudicataNotice of Potential Eligibility (NOPE)Vocational Rehabilitation Maintenance Allowance (VRMA)Qualified Injured Worker (QIW)Rehabilitation PlanMedical RestrictionsRetirement Board
References
Case No. ADJ4265715
Regular
Jul 14, 2010

ARNIE K. RAGLAND vs. METROPOLITAN PROVISION, ARGONAUT INSURANCE COMPANY

This case involves an applicant seeking retroactive vocational rehabilitation maintenance allowance (VRMA) benefits after the statutory basis for these benefits was repealed. The applicant's entitlement to VRMA from a specific date forward was established by a Rehabilitation Unit Determination that became final before the repeal. The Appeals Board granted reconsideration, rescinded the prior adverse finding, and remanded the case for determination of the specific VRMA amounts due based on that final Determination. Therefore, the applicant's right to VRMA from the date of the final Determination vested before the statute's repeal.

VRMAVocational RehabilitationVested RightLabor Code 139.5RepealRehabilitation UnitDeterminationWorkers' Compensation Appeals BoardIndustrial InjuryPermanent Disability
References
Case No. ADJ3867236 (LAO 0817551)
Regular
Jan 20, 2012

RODNEY LIDDELL vs. LOS ANGELES COUNTY PARKS & RECREATION, Permissibly Self-Insured c/o INTERCARE INSURANCE

The Appeals Board affirmed the WCJ's decision finding applicant entitled to vocational rehabilitation services and VRMA. The defendant argued that jurisdiction had expired and no procedural framework existed for completing a vocational rehabilitation plan. However, the Board found the defendant failed to comply with interruption notice requirements, thereby preserving the applicant's right to services. The Board suggested parties agree to a QRR or return to the WCJ for dispute resolution, confirming an adequate framework remains.

Workers' Compensation Appeals BoardReconsiderationFindings Order and AwardVocational RehabilitationVRMALabor Code Section 5410Rehabilitation UnitQualified Rehabilitation RepresentativeAdministrative Director Rule 9813Interruption Notice
References
Case No. STK 178713
Regular
Sep 17, 2007

FRED VAN DYKEN vs. FRAGOMEN, DEL RAY, BERNSEN & LOWERY, ATLANTIC MUTUAL FIRE INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and amended a prior decision. While affirming the apportionment of permanent disability and the credit for overpaid indemnity, the Board found the employer unreasonably delayed vocational rehabilitation benefits. The applicant is now entitled to retroactive vocational rehabilitation maintenance allowance at the temporary disability rate for the period of that delay.

Vocational RehabilitationApportionmentQualified Medical ExaminerPermanent DisabilityTemporary DisabilityEMG/NCV StudiesRehabilitation UnitDelay of BenefitsThird Party CreditVocational Rehabilitation Maintenance Allowance
References
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