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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ8580497
Regular
Oct 24, 2014

Anthony Broussard, Chenequa Phelps, William Ortiz vs. Neighborhood House Association; Zenith Insurance Company, Grossmont Family Medical Group; Zenith Insurance Company, Steigerwald Dougherty, Inc.; Zenith Insurance Company

In three consolidated workers' compensation cases, the Appeals Board rescinded its prior consolidation order and imposed $1,000 in sanctions against lien claimant ARS Legal and its representative. The Board found that ARS Legal improperly attempted to compel claims adjusters' appearances via notice, misinterpreting Code of Civil Procedure section 1987(b). The Board rejected ARS Legal's arguments regarding procedural ignorance and good faith, affirming that the representative's duty included understanding proper legal procedures.

Workers' Compensation Appeals BoardZenith Insurance CompanyARS LegalPetition for ReconsiderationOrder Quashing Notice to AppearClaims AdjusterSubpoenaWCJLabor Code Section 5813WCAB Rule 10561
References
Case No. ADJ15763825
Regular
Sep 16, 2025

CLAUDIO CARDOZO vs. ROCK AND ROLL CAR WASH, REDWOOD FIRE AND CASUALTY INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the Petition for Reconsideration filed by Redwood Fire and Casualty Insurance Company dba Berkshire Hathaway Homestate Companies. The petition challenged a lien trial decision concerning a medical-legal evaluation performed by Dr. Michaels of Premier Psychological Services. The WCJ found that a medical dispute regarding psyche existed at the time of the evaluation, Dr. Michaels was validly designated as the Primary Treating Physician, and the evaluation was not barred by the 60-day rule for new claims as it was an amendment to an already accepted claim. The Appeals Board adopted the WCJ's reasoning and denied the petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code Section 5909Adjudication NumberOpinion and Order Denying PetitionWCJ ReportEAMS TransmissionNotice of TransmissionProof of ServiceFindings and Order
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ7222405
Regular
Sep 11, 2012

MANUELA ALVARADO vs. FOODSCO, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board dismissed the Applicant's petition for reconsideration because it was taken from an interlocutory order, not a final decision that determined substantive rights or liabilities. Interlocutory orders concerning procedural or evidentiary matters are not subject to reconsideration. The petition for removal was also denied as the applicant failed to demonstrate substantial prejudice or irreparable harm warranting removal. The Board adopted the Workers' Compensation Judge's report for the denial of removal.

Petition for ReconsiderationFinal OrderSubstantive RightInterlocutory OrderRemovalWCJ's Report and RecommendationSubstantial PrejudiceIrreparable HarmAdministrative LawWorkers' Compensation Appeals Board
References
Case No. ADJ4274323 (ANA 0387677), ADJ1601669 (ANA 0388466)
Significant
Feb 27, 2014

Jose Dubon, Applicant vs. World Restoration, Inc. and State Compensation Insurance Fund

The Appeals Board held that disputes over the timeliness and procedural compliance of utilization review (UR) are legal issues for the WCAB to decide, not matters for independent medical review (IMR). A UR decision is invalid if it has material procedural defects, such as failing to review adequate medical records.

Workers' Compensation Appeals BoardUtilization ReviewIndependent Medical ReviewProcedural DefectsMedical NecessityEn Banc DecisionAdministrative Director's RulesSubstantial Medical EvidenceTimelinessMaterial Procedural Defects
References
Case No. ADJ9101616
Regular
Feb 20, 2018

MARIA MENCITAR vs. JESUS EDGARDO PACHECO, STAR INSURANCE CO., Administered by MEADOWBROOK INSURANCE

The Workers' Compensation Appeals Board (WCAB) granted removal and rescinded a WCJ's order that dismissed a medical-legal provider's petition for determination of non-IBR medical-legal dispute for lack of jurisdiction. The WCAB found the WCJ erred by not holding a hearing, as no procedural rule required the provider to file a lien first. This decision allows the provider to pursue its claim for medical-legal expenses at the trial level.

WCABPetition for RemovalPetition for ReconsiderationPetition for Determination of Non-IBR Medical-Legal DisputeWCJMinute OrderFinal OrderInterlocutory OrderMedical-Legal ExpensesLien Claimant
References
Case No. ADJ7348520, ADJ7343936, ADJ7321306
Regular
Oct 25, 2016

Mauricio Arciniega vs. Santa Monica Seafood Company, Compwest Insurance Company

This case involves a lien claimant, Med-Legal Photocopy, seeking payment for subpoenaed medical records. The defendant objected to the lien on grounds of unreasonable necessity, but their objections were untimely and inadequately raised. The Appeals Board rescinded the prior decision disallowing the lien and remanded the case. This will allow the trial judge to determine the amount due to the lien claimant, as the defendant is precluded from objecting to the reasonableness and necessity of the expenses due to their procedural failures. However, the cost of a consultative rating obtained by the lien claimant is not a recoverable medical-legal expense.

Med-Legal PhotocopyReconsiderationDisallowed LienContested ClaimLabor CodeMedical-Legal ExpensesSubpoenaReasonablenessNecessityObjection
References
Case No. ADJ8025431
Regular
Dec 08, 2015

Martha Brockhoff vs. SUZANNE MCNEELY (SENIOR PLANNING SERVICES), NUFILO OF PITTSBURGH PENNSYLVANIA

The Workers' Compensation Appeals Board dismissed Martha Brockhoff's petition for reconsideration of an approved compromise and release. Brockhoff claimed her former attorney did not fully explain the settlement terms. However, her petition was deemed "skeletal" and unsupported by specific references to the record or legal principles as required by statute and board rules. The Board noted that even if not dismissed for procedural defects, the petition would have been denied on its merits based on the judge's report.

Petition for ReconsiderationOrder Approving Compromise and ReleaseSkeletal PetitionLabor Code section 5902Rule 10846Appeals Board RulesWCJ ReportDismissalInsufficient SpecificityLegal Grounds
References
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