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

Case No. ADJ926004 (MON 0350313)
Regular
Nov 26, 2012

PAULENE THOMSON vs. SOUTHERN KERN UNIFIED SCHOOL DISTRICT, SELF-INSURED SCHOOLS OF CALIFORNIA

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration of a prior award. The original award found the applicant reached maximum medical improvement (MMI) on January 7, 2008, entitling her to increased benefits. The defendant argued this MMI date was incorrect and contradicted by Agreed Medical Evaluator reports. The Board amended the award to defer the MMI date issue, allowing parties to adjust it, and returned the case for further proceedings.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and AwardMaximum Medical Improvement (MMI)Labor Code Section 4658Agreed Medical Evaluator (AME)Permanent Disability IndemnityTemporary Disability IndemnityStipulationsPermanent and Stationary Date
References
Case No. ADJ8947837
Regular
Jun 09, 2015

JOSE JIMENEZ vs. BARRETT BUSINESS SERVICES, INC.; CORVEL

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior award, and issued a new finding that applicant Jose Jimenez sustained industrial injury to his back, as stipulated by the parties. The Board deferred issues regarding injury to lower extremities, psyche, and internal systems, as well as maximum medical improvement (MMI) and temporary total disability indemnity. The Board noted defendant's failure to properly serve the petition for reconsideration but declined to dismiss it, issuing a strong admonishment for future compliance.

Petition for ReconsiderationFindings and AwardMaximum Medical Improvement (MMI)Temporary Total Disability (TTD) indemnityStipulationMedical Provider Network (MPN)Qualified Medical Evaluator (QME)Substantial EvidenceMedical OpinionPermanent and Stationary Date
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
Case No. ADJ1036181 (LAO 0861182) ADJ1313689 (LAO 0861180) ADJ3257740 (LAO 0861181)
Regular
Dec 23, 2019

CONNIE EDGE, RONNIE EDGE vs. WORLD CITRUS WEST, NATIONWIDE INSURANCE

The Workers' Compensation Appeals Board denied reconsideration of a prior decision on attorney fee allocation in a workers' compensation case. The Appeals Board adopted the Workers' Compensation Judge's report, giving great weight to their credibility determinations. The Judge found no substantial evidence to overturn their prior ruling on the division of fees between two attorneys, Glauber and Hershewe. The Judge's report detailed that the fee division was based on Labor Code Section 4906(d), considering responsibility, care, time, and results obtained by each attorney, and found no ex parte communication occurred.

WCABPetition for ReconsiderationWCJ Credibility DeterminationsEx Parte CommunicationDue ProcessLabor Code Section 4906(d)Attorney FeesCompromise and ReleaseCumulative TraumaSpecific Injury
References
Case No. ADJ9060523
Regular
Sep 22, 2025

JOANNA PEREZ vs. COUNTY OF RIVERSIDE

Applicant Joanna Perez sought reconsideration of a WCJ's decision which found she sustained industrial injury in the form of sleep disorder and psyche, and was temporarily disabled from January 29, 2014, through August 25, 2022. Defendant County of Riverside contended a lack of substantial medical evidence for these findings. The Workers' Compensation Appeals Board denied the petition, affirming the WCJ's reliance on credible applicant testimony and reports from Agreed Medical Evaluator Dr. Levine and Qualified Medical Evaluator Dr. Kim. The Board also upheld the finding of psychiatric injury based on Dr. Flores's predominant causation analysis and noted the defendant waived the good faith personnel action defense.

AOE/COEsleep disorderpsyche injurytemporary disabilityMMIsubstantial medical evidencepredominant causationRolda analysisgood faith personnel actionPolysomnogram
References
Case No. ADJ2746912 (SFO 0432276)
Regular
Jul 06, 2009

JANICE HOLMES vs. NEXT LEVEL COMMUNICATIONS, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of an order terminating temporary disability, deeming the applicant's petition timely due to defective service of the original order. The Board found inconsistencies in the defendant's petition and a lack of medical evidence to support a finding of permanent and stationary status. Consequently, the Board rescinded the termination order and returned the case for further proceedings on the issue of total temporary disability.

Workers' Compensation Appeals BoardTemporary Disability IndemnityReconsiderationOrder Terminating LiabilityIndustrial InjuryMechanical AssemblerStock PersonBack InjuryNeck InjuryBilateral Upper Extremities
References
Case No. ADJ13703697
Regular
May 22, 2025

VICTOR ROMERO vs. SANTA BARBARA SMOKEHOUSE, COMPWEST INSURANCE COMPANY

Victor Romero, the applicant, sustained a COVID-19 related injury resulting in pulmonary fibrosis and chronic lung disease. The defendant, Santa Barbara Smokehouse and Compwest Insurance Company, sought reconsideration of a Findings and Award (F&A) which entitled the applicant to temporary disability exceeding 104 weeks. The defendant argued that Dr. Gerald Markovitz's medical report was not substantial evidence and that their due process rights were violated. The Workers' Compensation Appeals Board reviewed the petition and the WCJ's report, affirming that Dr. Markovitz's report constituted substantial medical evidence. Consequently, the Board denied the defendant's Petition for Reconsideration.

AOE/COECOVID-19Pulmonary fibrosisChronic lung diseaseTemporary disabilityLabor Code § 4656Permanent and stationaryMMIPetition for reconsiderationSubstantial medical evidence
References
Case No. ADJ2738004
Regular
Nov 24, 2014

RONALD PAYTON vs. KLEINFELDER GROUP, AIG CLAIMS

The Workers' Compensation Appeals Board denied Ronald Payton's petition for reconsideration of a prior decision. The Board adopted the administrative law judge's report, which found that Payton's claims of injury were not supported by substantial evidence. The judge detailed how Payton, proceeding pro se, failed to present new or relevant evidence and misrepresented existing medical opinions. Therefore, the Board affirmed the original denial of the claim.

Petition for ReconsiderationSubstantial EvidenceAgreed Medical EvaluatorPro PerDWC-1MMIAgreed Medical EvaluatorPro SeNon-industrial PneumoniaToxicology
References
Case No. ADJ1472309 (AHM 0151731)
Regular
Apr 29, 2015

Luis Hernandez vs. REI Electric, Inc., Truck Insurance Exchange

The Workers' Compensation Appeals Board reconsidered the denial of the applicant's psychiatric injury claim, which was initially barred due to employment duration less than six months under Labor Code section 3208.3(d). The Board found the applicant's finger amputation, a gruesome industrial accident, constituted a "sudden and extraordinary employment condition." Therefore, the psychiatric claim is not barred by the six-month employment threshold, and this issue, along with permanent disability and future medical treatment, will be further developed.

3208.3(d)reconsiderationOpinion and DecisionPetition for ReconsiderationFindings and AwardWCJpsychiatric injurysudden and extraordinary employment conditionverifiedMMI
References
Case No. ADJ10789448
Regular
Mar 07, 2023

MARCELO CHAN HAU vs. BARRETT BUSINESS SERVICES, INC., ACE AMERICAN INSURANCE COMPANY, CORVEL CORPORATION

The Workers' Compensation Appeals Board affirmed a prior decision denying liens for medical treatment provided by claimants Ira Reinherz Chiropractic Inc. and Sachet Pream. The Board found that the applicant received treatment within the employer's Medical Provider Network (MPN) and that there was no evidence the defendant denied medical treatment or failed to comply with MPN regulations. Therefore, the defendant was not liable for the self-procured treatment provided by the lien claimants outside the MPN. The claimants' argument regarding procedural time requirements was also rejected.

Workers' Compensation Appeals BoardMedical Provider NetworkMPNLien ClaimantsFindings of Fact and OrderAdministrative Director RulesAOE/COEQualified Medical ExaminerQMEMaximum Medical Improvement
References
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