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

Case No. ADJ4299001 (SAL 0110239)
Regular
Mar 10, 2009

JOAQUIN CORTEZ (MARTINEZ) vs. FRU-CON CONSTRUCTION CORPORATION, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board rescinded a prior award and returned the case for further proceedings. The Board found that the workers' compensation judge (WCJ) improperly disregarded the AMA Guides and relevant case law when determining permanent disability. Specifically, the WCJ's reliance on vocational expert opinions for diminished future earning capacity (DFEC) was inconsistent with established precedent. The matter is remanded for the WCJ to re-evaluate permanent disability consistent with recent en banc decisions addressing rebuttal of the AMA Guides and DFEC portions of the rating schedule.

Workers' Compensation Appeals BoardJoaquin CortezFru-Con Construction CorporationZurich American Insurance CompanyIndustrial InjuryTemporary Total DisabilityPermanent DisabilityDisability Evaluation UnitRebuttalAmerican Medical Association Guides
References
Case No. ADJ6710414
Regular
Dec 02, 2014

JOAQUIN CORTEZ vs. ACTIONS CONTRACTORS, INC., LINCOLN GENERAL INSURANCE COMPANY

This case involves applicant Joaquin Cortez seeking reimbursement for medical expenses incurred with Dr. Elena Konstat and Ames Medical Corporation. Both Dr. Konstat and the defendant, Actions Contractors, Inc., sought reconsideration of a previous WCJ decision. The Board rescinded the prior decision, noting Ames Medical's lien is moot due to withdrawal. The Board found insufficient evidence to determine Dr. Konstat's lien entitlement and returned the case for further proceedings to develop the record regarding MPN notification, treatment denial, and the reasonableness of charges.

Workers' Compensation Appeals BoardMedical Provider NetworkUtilization ReviewLien ClaimantsFindings and AwardCompromise and ReleasePetition for ReconsiderationLabor CodePrimary Treating PhysicianPsychiatric Injury
References
Case No. ADJ4299001
Regular
Mar 08, 2010

JOAQUIN CORTEZ vs. FRU-CON CONSTRUCTION CORPORTION, ZURICH NORTH AMERICAN INSURANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to review the permanent disability rating of 54% awarded to applicant Joaquin Cortez. The defendant argued the rating was improperly calculated under *Ogilvie II*, which dictates the burden of proof lies with the party rebutting the scheduled rating. The WCAB found the vocational expert's analysis flawed due to contradictory assumptions about the applicant's pre- and post-injury earning capacity. Consequently, the WCAB reversed the 54% award, finding the applicant failed to rebut the scheduled 13% permanent disability rating and issued an award for 13% disability.

Ogilvie IIOgilvie IDFECPermanent DisabilityReconsiderationRebuttalVocational ExpertWhole Person ImpairmentRAND dataLabor Code section 4660
References
Case No. ADJ4549941 (OXN 0133428) ADJ1729960 (OXN 0133245)
Regular
Jan 13, 2011

MARIA CORTEZ vs. EL TACO DE MEXICO, SCIF INSURED OXNARD

This case concerns Maria Cortez's workers' compensation claims against El Taco de Mexico and its insurer, SCIF. The Workers' Compensation Appeals Board (WCAB) has issued an order denying reconsideration of a prior decision. The WCAB adopted and incorporated the reasoning of the workers' compensation administrative law judge. Therefore, the petition for reconsideration has been officially denied.

Workers' Compensation Appeals BoardMaria CortezEl Taco de MexicoSCIF Insured OxnardOrder Denying ReconsiderationPetition for ReconsiderationWorkers' compensation administrative law judgeWCJ reportAdopt and incorporateDeidra E. Lowe
References
Case No. LBO 359136
Regular
Dec 17, 2007

JOAQUIN GRANADOS vs. JKB CORPORATION, STATE COMPENSATION INSURANCE FUND

This case involves a dispute over whether the 1997 or 2005 disability rating schedule applies to applicant Joaquin Granados's left knee and back injury, and the appropriateness of apportionment. The Appeals Board granted reconsideration, rescinded the previous award, and returned the matter for new rating instructions. This decision was based on the finding that no medical report established applicant reached permanent and stationary status prior to January 1, 2005, thus mandating the application of the 2005 Schedule. Furthermore, the Board found Dr. Nottage's apportionment report to be substantial evidence, unlike Dr. Schwartz's, and ordered further proceedings based on Dr. Nottage's findings.

Workers' Compensation Appeals BoardJoaquin GranadosJKB CorporationState Compensation Insurance FundAmended Findings and AwardConstruction WorkerIndustrial InjuryLeft KneeBackPermanent Disability
References
Case No. ADJ801957 (LAO 0798054) ADJ2438083 (LAO 0851450)
Regular
Oct 04, 2010

ROBERTO CORTEZ vs. ESP 2000, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INSURANCE COMPANY, in liquidation, by CAMBRIDGE INTEGRATED SERVICES, TIG INSURANCE COMPANY

This case involves two industrial injuries sustained by Roberto Cortez as a deliveryman. The Workers' Compensation Appeals Board affirmed a joint findings and award, confirming two separate injuries in 2000 and a cumulative trauma injury from 2000-2001. The Board also affirmed the judge's calculation of applicant's attorney's fees as a percentage of the award, rather than an hourly rate, despite a dispute over the application of Labor Code section 4066. Ultimately, the Board agreed with the judge's findings on liability and attorney's fees, affirming the original award.

Workers' Compensation Appeals BoardRoberto CortezESP 2000 Inc.California Insurance Guarantee AssociationFremont Insurance CompanyTIG Insurance CompanyADJ801975ADJ2438083specific injurycumulative trauma
References
Case No. ADJ1153404 (BAK 0112784)
Regular
May 28, 2009

Barbara Clark vs. SAN JOAQUIN COMMUNITY HOSPITAL, ADVENTIST HEALTH SYSTEM

This case involves an applicant, Barbara Clark, whose petition for writ of review was denied by the Court of Appeal. The Court found her petition frivolous and intended to harass the defendant, San Joaquin Community Hospital (represented by Adventist Health System). Consequently, the Court remanded the matter to the Workers' Compensation Appeals Board (WCAB) to award attorney fees and costs against Clark. The WCAB, finding the requested fees and costs reasonable, awarded Adventist Health and its attorney $5,266.47 against Barbara Clark.

Workers' Compensation Appeals BoardRemittiturPetition for Writ of ReviewFrivolous PetitionSanctionsAttorney FeesCostsUnreasonable DelayMeritless PetitionLabor Code Section 5801
References
Case No. ADJ1153404
Regular
Jan 03, 2014

BARBARA DIEFENBACH, (BARBARA CLARK) vs. SAN JOAQUIN COMMUNITY HOSPITAL, Permissibly Self-Insured, Administered By ADVENTIST HEALTH SYSTEM

This case involves a petition for reconsideration filed by Barbara Diefenbach (Applicant) against San Joaquin Community Hospital. The Workers' Compensation Appeals Board (WCAB) denied the petition on its merits, adopting the reasoning of the administrative law judge. Furthermore, the petition was subject to dismissal for failure to serve all adverse parties. The Board also admonished the petitioner for procedural violations, including attaching an unauthorized medical report and filing a supplemental petition improperly.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationDENIEDLabor Code section 5905WCAB Rule 10842WCAB Rule 10848sanctionsLab. Code§ 5813administrative law judge
References
Case No. ADJ8969860
Regular
Jul 28, 2016

Miguel Cortez vs. American Security Force, Inc., The Hartford

This case involves an applicant, Miguel Cortez, who sought workers' compensation benefits for an alleged injury to his left shoulder sustained on May 28, 2013. The Workers' Compensation Appeals Board denied his Petition for Reconsideration, upholding the administrative law judge's finding. The Board found Cortez failed to meet his burden of proof for a compensable injury arising out of and occurring in the course of employment. This decision was based heavily on the judge's credibility determination regarding Cortez's inconsistent testimony about the incident and conflicting accounts of the injury provided to medical providers.

AOE/COEPetition for ReconsiderationCredibility determinationBurden of proofLabor Code § 3600(a)(10)Industrial injuryCompensable injuryWCJ reportWitness demeanorTerminated employee
References
Case No. ADJ9843354, ADJ9340113
Regular
Feb 02, 2017

SANDRA CORTEZ vs. EMPLOYMENT RESOURCES GROUP, INC.; CLAIMS R.M.

This case involves an applicant, Sandra Cortez, and defendants Employment Resources Group, Inc. and Claims R.M. The Workers' Compensation Appeals Board dismissed Cortez's petition for reconsideration and denied her petition for removal. The Board found that the WCJ's decision addressed an interlocutory procedural or evidentiary issue, not a final determination of substantive rights or liabilities. Removal was denied because there was no showing of substantial prejudice or irreparable harm, and reconsideration would be an adequate remedy. The Board also clarified that a letter to an AME copied to the applicant's attorney was not an ex parte communication.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFinal OrderSubstantive RightThreshold IssueInterlocutory DecisionProcedural IssueEvidentiary IssueExtraordinary Remedy
References
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