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

Case No. VNO 0510561, VNO 0510562
Regular

JANIS RUSH vs. CALIFORNIA CORRECTIONAL INSTITUTION, STATE COMPENSATION INSURANCE FUND

The defendant, State Compensation Insurance Fund, petitioned for removal to amend an order closing discovery to allow a deposition, but the petition was denied. The Workers' Compensation Appeals Board found the petition contained irrelevant information, suggesting it was partially plagiarized from another case. Crucially, the Board determined the closure of discovery would not cause significant prejudice or irreparable harm to the defendant.

petition for removalagreed medical evaluatorclosure of discoverysignificant prejudiceirreparable harmWCAB Rule 10843Report and Recommendationworkers' compensation administrative law judgeDENYING REMOVALCALIFORNIA CORRECTIONAL INSTITUTION
References
Case No. ADJ10159316
Regular
Sep 25, 2017

Rowdy Rushing vs. Foster Farms

The Workers' Compensation Appeals Board denied reconsideration of a decision finding that Rowdy Rushing did not sustain a left shoulder injury arising out of and occurring in the course of employment with Foster Farms. The Administrative Law Judge found the applicant's testimony regarding a pallet striking his arm not credible, noting inconsistencies with coworker statements and medical reports. Specifically, the applicant's account of the incident and the mechanism of injury was deemed unlikely and not supported by Dr. Ozaeta's medical opinion, which concluded the MRI findings were inconsistent with the described incident. Therefore, the Board affirmed the judge's take-nothing order.

Workers' Compensation Appeals BoardFoster FarmsRowdy RushingFindings and OrderTake nothing orderIndustrial injuryLeft shoulderOctober 92015Taper/packer
References
Case No. ADJ2496388 (AHM 0127594)
Regular
Nov 02, 2009

Janie Stuart vs. OWENS ILLINOIS; Permissibly SelfInsured, Administered by GALLAGHER BASSETT

Attorney's fees and costs granted to Janie Stuart's attorney, Ullasini Joy Dholakia, in the amount of $2,100.00 and $116.20 respectively.

Workers' Compensation Appeals BoardLabor Code Section 5801Supplemental Attorney's FeesPetition for Writ of ReviewReasonable Attorney's FeesCostsOwens IllinoisGallagher BassettUllasini Joy DholakiaDholakia & Associates
References
Case No. VNO 0510561
Regular
Apr 10, 2008

JANIS RUSH vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND (Adjusting Agent)

This case concerns an applicant's cumulative trauma psychiatric injury claim against the Department of Corrections. The defendant sought reconsideration, arguing the agreed medical evaluator's report was insufficient and the applicant's permanent and stationary date was miscalculated. The Board denied reconsideration, finding the defendant failed to timely and properly assert the affirmative defense of good faith personnel action, and therefore, the AME was not required to address it. Additionally, objections to the AME report's validity and the applicant's P&S date were waived due to lack of evidence and proper objection at trial.

Cumulative traumapsyche injurygood faith personnel actionLabor Code §3208.3(h)agreed medical evaluatorsubstantial medical evidencepermanent and stationary dateburden of proofWCJAME report
References
Case No. ADJ869205 (SAC 0294976) ADJ302322 (SAC 0354178)
Regular
Oct 11, 2010

Patricia Rush vs. The Permanente Medical Group; Athens Administrators Concord

This case involves Patricia Rush claiming cumulative trauma injuries to her knees and back, among other body parts, against The Permanente Medical Group. The Workers' Compensation Appeals Board granted reconsideration because the Administrative Law Judge's findings of industrial causation for knee injuries lacked substantial medical evidence, with conflicting and uncertain Qualified Medical Evaluator opinions. The Board rescinded the prior findings and ordered further development of the medical record, suggesting an Agreed Medical Examiner or a court-appointed physician to resolve the causation issue for the knee injuries. The matter is returned to the trial level for a new final determination after the record is further developed on all issues, including injury causation.

Workers' Compensation Appeals BoardPermanente Medical GroupAthens Administratorscumulative trauma injurykneesbackshouldershandswristsindustrial causation
References
Case No. ADJ6995481
Regular
Dec 10, 2012

MARIA FERNANDEZ vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied the Los Angeles Unified School District's Petition for Reconsideration. The applicant, Maria Fernandez, sustained multiple injuries in a 2009 fall, including to her left arm, left knee, back, and right fingers, requiring ongoing medical treatment and mobility aids. The Board found that the case of *Tenet/Centinela Hospital Medical Center v. Workers' Comp. Appeals Bd. (Rushing)* was inapplicable, and adopted the WCJ's report in full. The WCJ recommended upholding the original Findings and Award.

Workers' Compensation Appeals BoardPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeTenet/Centinela Hospital Medical Center v. Workers' Comp. Appeals Bd. (Rushing)Primary Treating PhysicianKaiserSt. Francis HospitalStacy Medical (MPN)Dr. HeskiaoffPhilip A. Sobol MD
References
Case No. RIV 0055748
Regular
Feb 20, 2008

JOSE MONTIEL vs. CAL TECH PRECISION, INC., UNINSURED

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The Board affirmed the judge's findings that the applicant sustained an industrial back injury, requiring surgery, and is entitled to ongoing temporary disability benefits. The Board found the defendant's arguments regarding changing physicians and the timing of the surgery were inapplicable or unsupported by the record.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryLow Back InjuryTemporary DisabilitySpinal SurgeryTenet DefenseRushingLabor Code Sections 4061
References
Case No. ADJ7932835
Regular
Feb 11, 2016

MIRIAM GARCIA vs. SKECHERS ABHR (TEAM ONE), NATIONAL UNION FIRE INSURANCE / AMERICAN HOME ASSURANCE

The Workers' Compensation Appeals Board granted reconsideration, rescinded the WCJ's prior order, and returned the case for further proceedings. The Board found that the defendant provided prompt medical treatment within its MPN and properly notified the applicant about MPN procedures. Therefore, treatment obtained outside the MPN by the applicant was not authorized, and the lien claimants failed to meet their burden of proof.

MPNPetition for ReconsiderationFindings and AwardMedical Provider NetworkLien ClaimantsCompromise and ReleaseRetrospective Utilization ReviewOfficial Medical Fee ScheduleLabor Code Section 4616Rushing defense
References
Case No. ADJ8145469
Regular
Oct 20, 2015

DAISY MIRELES vs. UNLIMITED PCS ONTARIO CORPORATION, PREFERRED EMPLOYERS

The Workers' Compensation Appeals Board denied Daisy Mireles' petition for reconsideration. The Board adopted the WCJ's report, which found Mireles had not met her burden of proving an industrial injury. The WCJ's credibility determination, based on observing witness demeanor, was given great weight. The WCJ found Mireles' claims of orthopedic and psychiatric injury not credible due to her lack of treatment seeking, implausible explanations, and inconsistencies, distinguishing the case from cited precedents.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ credibility determinationAOE/COEcontinuous trauma injurypsychiatric injuryLabor Code Section 3600(a)(10)Labor Code Section 3208.3(h)PQME reportorthopedic claims
References
Case No. ADJ19947925
Regular
May 19, 2025

Andres De Jesus Garcia vs. Slater's 50/50, Security National Insurance Company

Applicant, Andres De Jesus Garcia, sought reconsideration of a March 12, 2025 Findings and Award (F&A) which denied his request for a new primary treating physician (PTP) or a second opinion. The workers' compensation administrative law judge (WCJ) had found that the applicant reached maximum medical improvement (MMI) based on reports from his PTP and a panel qualified medical evaluator (PQME). Applicant contended he is entitled to a change of PTP or a second opinion within the medical provider network (MPN) under various Labor Code sections and WCAB Rules. The Appeals Board granted the Petition for Reconsideration, deferring a final decision after reconsideration to allow for further review of the factual and legal issues.

Petition for ReconsiderationMedical Provider Network (MPN)Primary Treating Physician (PTP)Maximum Medical Improvement (MMI)Qualified Medical Evaluator (PQME)Labor Code sections 4616.3 and 4616.4WCAB Rules 9767.6(e) and 9767.7Tenet/Centinela Hospital Medical Center v. Workers' Comp. Appeals Bd. (Rushing)Labor Code section 5909Electronic Adjudication Management System (EAMS)
References
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