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

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. ADJ10266237; ADJ10401171
Regular
Aug 15, 2025

WILLIAM AREY vs. MAGIC MOUNTAIN, LLC; HARTFORD ACCIDENT AND INDEMNITY COMPANY

The Workers' Compensation Appeals Board denied defendant Hartford Accident & Indemnity Company's petition for reconsideration. The defendant challenged the April 22, 2025 Joint Findings of Fact and Order, which found that applicant William Arey sustained industrial injuries to his brain, head, nervous system, and circulatory system. Defendant contended the Agreed Medical Evaluator (AME) Dr. Roger Bertoldi's report was not substantial medical evidence and that ex parte contact occurred due to applicant's sister's participation in the evaluation. The Board affirmed the WCJ's decision, finding Dr. Bertoldi's report to be substantial medical evidence and concluding that the sister's assistance was necessary and permissible due to applicant's significant memory impairment, thus not constituting impermissible ex parte contact.

AMEAgreed Medical Evaluatorex parte contactsubstantial medical evidenceindustrial injurycumulative injuryspecific injuryres judicatacollateral estoppelPetition for Reconsideration
References
Case No. ADJ6577154
Regular
Jul 19, 2019

LISA RYAN vs. SUTTER MEMORIAL HOSPITAL, Permissibly Self-Insured

This case involves a registered nurse, Lisa Ryan, who claimed a work-related injury to multiple body parts including her spine, head, and nervous system, allegedly resulting in permanent total disability. The defendant, Sutter Memorial Hospital, petitioned for reconsideration of the initial award, disputing the permanent total disability finding. Subsequently, the parties reached a Compromise and Release agreement for $575,857. The Workers' Compensation Appeals Board approved this settlement, rescinding the prior award, finding the agreement adequate and in the applicant's best interest.

Workers' Compensation Appeals BoardCompromise and ReleaseReconsiderationFindings and AwardPermanent Total DisabilityRegistered NurseSpine InjuryHead InjuryBrain InjuryNervous System
References
Case No. ADJ7099563, ADJ7825176
Regular
Mar 07, 2014

MARIA GONZALEZ (WIDOW) vs. THE GAP, INC. dba BANANA REPUBLIC, AMERICAN ZURICH INSURANCE C/O SPECIALTY RISK

The Workers' Compensation Appeals Board affirmed a prior decision finding that the deceased employee did not sustain an industrial injury to his nervous, cardiac, or hypertension systems. Furthermore, his death was determined not to be industrially caused, and his widow's claim for death benefits was denied. The Board found that the defendant's timely denial of the employee's inter vivos claim precluded the need for a separate denial of the death benefit claim arising from the same alleged injury. The Board also concluded that the applicant failed to present substantial medical evidence demonstrating industrial causation for the alleged conditions or the resulting death.

Workers' Compensation Appeals BoardMiguel Angel GonzalezMaria GonzalezThe Gap Inc.Banana RepublicAmerican Zurich Insuranceindustrial injurynervous systemcardiac systemhypertension
References
Case No. ADJ4330842 (VNO 0331594) ADJ207082 (VNO 0314241) ADJ1775987 (VNO 0376271)
Regular
Aug 05, 2009

OTTOMA L. CURRY vs. STATE OF CALIFORNIA, DEPARTMENT OF TRANSPORTATION, Legally Uninsured, Adjusted By STATE COMPENSATION INSURANCE FUND

This Workers' Compensation Appeals Board decision affirms a prior award finding the applicant sustained a 100% permanent disability due to cumulative trauma to her gastrointestinal system, hypertension, and fibromyalgia. The Board rejected the defendant's arguments regarding the substantiality of the Agreed Medical Examiner's opinions and the necessity of apportionment to a prior award for psychiatric injury. However, the Board amended the award to reflect the parties' stipulation of the applicant's average weekly earnings at $791.54, as initially determined by the WCJ. The lien claimant's petition was deemed moot as their claim was taken off calendar prior to the original hearing.

Cumulative traumaFibromyalgiaPermanent disabilityApportionmentAgreed Medical ExaminerAgreed Medical Examiner (AME)Average weekly earningsLien claimantStipulated awardSenate Bill 899 (SB 899)
References
Case No. ADJ2972614 (VNO 0551694) ADJ3199572 (VNO 0558860)
Regular
Jan 31, 2012

ALI POURFARZAD vs. PALMIRA ASSOCIATES, INC., PREFERRED EMPLOYERS INSURANCE COMPANY

This case involves an applicant claiming industrial injuries to his spine, psychological system, and central nervous system (sleep disorder) from two separate dates of employment. The administrative law judge initially found injury to the psychological and central nervous systems but required further development of the record for permanent disability and apportionment. The Appeals Board determined that neither party presented substantial evidence regarding the causation and permanency of the claimed psychological and central nervous system injuries. Consequently, these issues are deferred, and the record will be developed further, potentially through an Agreed Medical Evaluator or a court-appointed physician.

Petition for ReconsiderationPartial Joint Findings of FactPanel Qualified Medical Evaluator (QME)Substantial EvidenceDevelop the RecordAgreed Medical Evaluator (AME)Regular PhysicianLabor Code Section 5701CausationPsychological Injury
References
Case No. ADJ6603030
Regular
Jul 20, 2018

JEFF DEATON vs. SUPERIOR AMERICAN FLEET, U.S. FIRE INSURANCE COMPANY

This case concerns a defendant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision. The WCAB denied the petition, upholding a prior finding that one-on-one sitter services provided by a lien claimant were reasonable and necessary medical treatment. The defendant argued the WCJ erred in disregarding utilization review and a preferred provider organization agreement, but the WCAB found these arguments unpersuasive. The WCAB also noted the defendant waived the issue of a second review of medical bills by failing to raise it earlier.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderWCJlien claimantCare Meridianone-on-one sitter servicesreasonable and necessary medical treatmentpenaltyLabor Code 4603.2
References
Case No. ADJ10166138
Regular
Apr 07, 2023

MICHAEL DOWLING vs. MANPOWERGROUP, NEW HAMPSHIRE INSURANCE COMPANY, GALLAGHER BASSETT SERVICES

The Workers' Compensation Appeals Board denied the defendants' petition for reconsideration. The defendants contended the Administrative Law Judge erred by stating applicant required medical treatment for his left shoulder and wrist, and by finding an $83\%$ permanent disability with a lifetime pension. The Board adopted the WCJ's report, which corrected the clerical error regarding the shoulder and wrist treatment but upheld the permanent disability finding. The WCJ determined the "addition method," rather than the Combined Values Chart, was the most accurate way to combine the applicant's orthopedic and psychiatric impairments based on substantial medical evidence.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ ReportDenying ReconsiderationAdjudication NumberAdmitted Industrial InjuryCompensable ConsequencesNervous SystemPsycheExcretory System
References
Case No. AHM 129527
Regular
Dec 10, 2007

OMAR ROSAS vs. LAURENCE HOVENIER, F.A. RICHARDS & ASSOCIATES

The Workers' Compensation Appeals Board granted reconsideration, rescinded a prior order, and found that the defendant's liability for temporary disability indemnity ended on May 26, 2007. This decision was based on Labor Code section 4656(c)(1), which limits temporary disability payments to 104 weeks within a two-year period from the commencement of payments. The Board affirmed the finding that the applicant sustained industrial injury to multiple body parts.

WORKERS' COMPENSATION APPEALS BOARDOPINION AND ORDER GRANTING RECONSIDERATIONPetition to Terminate LiabilityTemporary Disability IndemnityLabor Code section 4656subdivision (c)(1)104 compensable weeksSB 899aggregate disability paymentspermanent and stationary
References
Case No. ADJ6780755
Regular
Oct 08, 2012

MARYLYNN REYNOLDS vs. EAST SIDE UNION HIGH SCHOOL, PROTECTED INSURANCE PROGRAM FOR SCHOOLS

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration. The applicant alleged industrial injury to her internal system due to chemical exposure from a vandalized classroom. However, the Qualified Medical Evaluator found no evidence that the applicant's symptoms were industrially caused, suggesting they were likely related to pre-existing allergies and asthma. The Board affirmed the WCJ's finding that the applicant failed to meet her burden of proof for an industrial injury.

Workers' Compensation Appeals BoardPetition for Reconsiderationindustrial injurychemical exposureteacherfire extinguisher vandalismrespiratory systemnervous systemfaceeye irritation
References
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