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

Case No. VNO 178912 LAO 571596
Regular
Oct 04, 2007

MARCUS CAZARES vs. NORMAN BELL ENTERPRISES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's petitions for reconsideration, writ of mandate, and removal. The WCAB found that the order denying an expedited hearing was interlocutory and not subject to reconsideration, and that the WCAB lacks jurisdiction to issue writs of mandate. Furthermore, the applicant failed to demonstrate substantial prejudice or irreparable harm to warrant removal.

WCABOpinion and OrdersDismissing PetitionPetition for ReconsiderationPetition for Writ of MandatePetition for RemovalExpedited Hearing5402 PresumptionLabor Code Section 5402Interlocutory Procedural Order
References
Case No. ADJ9725488
Regular
Nov 13, 2015

Norris Hollie vs. Management Training Corporation, Zurich American Insurance Company, ESIS

The Workers' Compensation Appeals Board denied reconsideration for applicant Norris Hollie, upholding a finding that his right knee injury on April 27, 2014, did not arise out of or occur in the course of his employment. The Board agreed that Hollie's participation in a continuing medical education program, while necessary to maintain his license, was not a reasonable expectation of his employment as a physician. There was no evidence of employer mandate, knowledge, or encouragement of this specific off-duty educational activity. Therefore, the injury sustained during this program was not deemed industrial.

Continuing educationMedical license renewalOff-duty activityReasonable expectancy of employmentCourse of employmentArising out of employmentIndustrial injuryPetition for reconsiderationFindings and AwardWCJ Report
References
Case No. ADJ6663169
Regular
Jan 27, 2010

RICHARD SHILTS (Deceased), KAAREN GUEST (Widow) vs. BRUNTON ENTERPRISES, INC., SEABRIGHT INSURANCE CO.

This case concerns whether a union's "carve-out" agreement, allowing for alternative dispute resolution under Labor Code ยง 3201.5, applies to dependent death benefits. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, reversing a prior finding. The WCAB held that "carve-out" agreements, by their plain language, apply only to "employees" and not to dependents' death benefit claims. Because dependents' rights to death benefits are independent of the deceased employee's claim and constitutionally mandated, the WCAB found these claims fall under its exclusive jurisdiction.

carve-out agreementLabor Code section 3201.5death benefitsdependents' claimalternative dispute resolutionWCAB jurisdictioncollective bargaining agreementindustrial injurywidowinsurer
References
Case No. ADJ7410706
Regular
Mar 09, 2016

AUGUSTA NEWSON vs. ANTELOPE VALLEY TRANSPORTATION AGENCY

The Workers' Compensation Appeals Board denied Augusta Newson's petition for removal, finding she failed to demonstrate substantial prejudice or irreparable harm. The Board adopted the Workers' Compensation Judge's reasoning that reconsideration would be an adequate remedy. Newson sought to reopen discovery, arguing a PQME's report was insufficient and additional QME panels were needed, but the Board found she lacked good cause and diligence. The case will proceed to trial as scheduled.

RemovalPetition for RemovalWCJ ReportSubstantial PrejudiceIrreparable HarmReconsiderationQualified Medical EvaluatorPanel QMEFurther DiscoveryMedical Dispute
References
Case No. ADJ8716925
Regular
May 27, 2025

MARCO VILLA vs. SHULTZ STEEL COMPANY INC, TRAVELERS DIAMOND BAR

Applicant Marco Villa petitioned for reconsideration of a February 19, 2025, Findings and Award (F&A) that found his permanent disability to be 61% and did not categorize his injury as catastrophic. The Appeals Board, after reviewing the petition, defendant's answer, and the WCJ's report, determined that the record was not adequately developed, specifically concerning medical evidence on Activities of Daily Living (ADLs) and the proper evaluation of sub-rosa videos in the context of catastrophic injury. The Board granted the petition for reconsideration but deferred a final decision on the merits, indicating further review and proceedings are necessary to ensure a just and reasoned outcome.

Petition for ReconsiderationFindings and AwardCatastrophic InjuryPermanent DisabilitySubstantial EvidenceMedical OpinionActivities of Daily Living (ADLs)Sub-rosa VideoVocational ExpertDEU Rating
References
Case No. ADJ1085807 (BAK 0154474) ADJ6601730
Regular
Sep 15, 2015

MARIA CORTEZ vs. KIRSCHENMAN ENTERPRISES, WAUSAU UNDERWRITERS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Dr. Moelleken's petition for reconsideration, affirming the disallowance of his lien. However, they granted Associated Reproduction Services' (ARS) petition, deferring their lien claim due to an ongoing federal injunction affecting lien dismissals for unpaid activation fees. The Ninth Circuit's decision vacating the injunction was not yet final, thus the injunction remained in effect. ARS's lien will be decided on its merits pending further developments.

Workers' Compensation Appeals BoardLien ClaimantsPetition for ReconsiderationFindings and OrdersAdministrative Law JudgeActivation FeeInjunctionMandateJudicial NoticeFederal Court
References
Case No. ADJ12632885
Regular
May 06, 2025

Odilio Velasquez vs. Blue Core Construction, Inc.; State Compensation Insurance Fund

Applicant Odilio Velasquez sustained an industrial injury to his head, brain, neck, and back. The defendant, State Compensation Insurance Fund, sought reconsideration of a Findings and Award (F&A) that mandated the continuation of home health care services for the applicant. The defendant argued that its provision of services was utilization review-mandated and the case law relied upon by the WCJ, Patterson, only applied to unilateral decisions to offer medical treatment. The Appeals Board denied the petition for reconsideration, agreeing with the WCJ that the defendant failed to establish a change in the applicant's condition or circumstances to cease previously authorized treatment, affirming that the Patterson analysis applied.

PattersonUtilization ReviewHome Health CareChange in ConditionPetition for ReconsiderationLabor Code Section 5909Labor Code Section 4600Independent Medical ReviewRequest for AuthorizationFindings and Award
References
Case No. ADJ3535372 (POM 0252700) ADJ4563878 (POM 0290856)
Regular
Sep 23, 2013

JANET BOWEN vs. MICHAEL J'S RESTAURANT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, administered by INTERCARE INSURANCE SERVICES for PACIFIC NATIONAL INSURANCE, in liquidation, GLENDORA CONTINENTAL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a prior order finding the California Insurance Guarantee Association (CIGA) entitled to reimbursement from the State Compensation Insurance Fund (SCIF). SCIF argued CIGA's reimbursement claim was untimely and that CIGA knew of SCIF's joint liability. CIGA asserted SCIF never contested the reimbursement amount. The Board affirmed the WCJ's decision, clarifying CIGA's statutory role and distinguishing "coverage" from "covered claim," deeming SCIF's arguments regarding coverage misplaced.

California Workers CompensationCIGASCIFReimbursementPetition for ReconsiderationFindings and OrderStipulated AwardCovered ClaimsInsolvent InsurerInsurance Code Section 1063
References
Case No. ADJ1283525
Regular
May 17, 2010

ANTOONIO OLIVERA (Decedent), MARIA GOMEZ OLIVERA (Surviving Spouse) vs. RICK PLANO STABLES, UNINSURED EMPLOYERS BENEFIT TRUST FUND

The Workers' Compensation Appeals Board (WCAB) rescinded a prior decision and returned the case for further proceedings due to insufficient evidence regarding the decedent's employer. The WCAB found conflicting testimony and lack of clear evidence establishing employment with Rick Plano Stables on the alleged date of injury. The matter was remanded to properly substitute the surviving spouse as the applicant and to develop the record on the employer's identity and the date of injury.

Workers' Compensation Appeals BoardDecedent's spouseReconsiderationFindings and OrderSubstantial evidenceDevelop the recordInsufficient evidenceConstitutional mandateDevelop the recordUninsured Employers Benefit Trust Fund
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
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