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Case Law Database

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

Case No. ADJ119309 (OAK 0332713) ADJ1352097 (OAK 332714)

Regular

Aug 09, 2011

KEN LAWHN vs. FARMERS INSURANCE, HELMSMAN MANAGEMENT

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration of the WCJ's order compelling a neuropsychological evaluation. The Board determined the WCJ's order was an interim discovery ruling, not a final decision on substantive rights, making it ineligible for reconsideration. The applicant's petition for removal was also denied, adopting the WCJ's reasoning for the original order. The applicant had argued the evaluation was an invasion of privacy and unnecessary as neuropsychological health was not at issue.

Workers' Compensation Appeals BoardNeuropsychological QME evaluationNon-industrial closed head injuryOpen labor marketPetition for ReconsiderationPetition for RemovalFindings and OrderDiscovery orderInterim orderSubstantive rights

References

Case No. ADJ11995067

Regular

Jul 25, 2025

ADELINA PEREZ vs. KYONG AE YUN, CHONG MYON YUN, ZENITH INSURANCE COMPANY

Applicant Adelina Perez sought removal of a May 9, 2022, Findings & Order (F&O) by a workers’ compensation administrative law judge (WCJ), which found Dr. Marcel Ponton's medical-legal report inadmissible and ordered his replacement, arguing Dr. Ponton was a treating physician to whom Labor Code section 4062.3 did not apply. The Workers' Compensation Appeals Board (WCAB) treated the petition as one for reconsideration and found that Dr. Ponton was indeed a treating physician, not a panel-selected medical-legal evaluator, rendering section 4062.3 inapplicable. Consequently, the WCAB rescinded the WCJ's F&O, substituted new findings affirming Dr. Ponton's role as a treating physician, and ordered his continuation as the medical-legal neuropsychological evaluator.

RemovalReconsiderationLabor Code section 4062.3Ex parte communicationMedical-legal evaluatorTreating physicianMPNNeuropsychological assessmentTraumatic brain injuryAdmissibility of evidence

References

Case No. ADJ11255525

Regular

Dec 02, 2019

GWENDOLYN JOHNIGAN vs. UC DAVIS MEDICAL CENTER

This case involves an applicant denied workers' compensation benefits for industrial injury to her right leg and knee, with the Workers' Compensation Appeals Board (WCAB) denying her petition for reconsideration. The WCAB adopted the administrative law judge's finding that the applicant did not sustain industrial injury, relying on a panel qualified medical evaluator's opinion that the work duties were insufficient to cause an injury. The applicant argued the medical evidence was not substantial and sought further development of the record. However, the WCAB found the applicant failed to meet her burden of proof with substantial medical evidence. A dissenting opinion argued the medical evidence was insubstantial and required further development.

Petition for ReconsiderationPanel Qualified Medical EvaluatorOrthopedistSubstantial Medical EvidenceFurther DevelopmentSupplemental ReportingDeposition TestimonyIndustrial InjuryRight LegRight Knee

References

Case No. ADJ7014507

Regular

May 23, 2014

JUAN PINZON vs. RC GRAMER CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration of the WCJ's finding of total permanent disability because the vocational expert's opinion was not substantial evidence. The expert failed to address the applicant's orthopedic and psychiatric capacities as assessed by Agreed Medical Evaluators. Consequently, the finding of 100% total permanent disability is rescinded. The case is returned to the trial level for further proceedings, including development of the record on apportionment and the sleep disorder claim.

Workers Compensation Appeals BoardRC Gramer ConstructionState Compensation Insurance FundJuan PinzonFindings Award OrderReconsiderationPermanently Totally DisabledApportionmentVocational Rehabilitation ExpertAlbert Rivas

References

Case No. ADJ519728

Regular

Aug 08, 2011

LOWELL BAPTISTE vs. METROPOLITAN TRANSIT AUTHORITY

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding industrial injury and temporary total disability dating back to 2000. The Board found that the medical opinion relied upon by the workers' compensation judge was not substantial evidence due to staleness, lack of complete records, and insufficient specialization. To ensure a fair resolution, the Board ordered new evaluations by independent orthopedic and psychiatric physicians, who will report on all outstanding medical issues.

Workers' Compensation Appeals BoardReconsiderationCompelling Medical EvaluationsTemporary Total DisabilityIndustrial InjuryOrthopedicsPsychiatrySubstantial EvidenceMedical OpinionWCJ

References

Case No. ADJ14669607

Regular

Apr 10, 2023

DOUGLAS HERB vs. COUNTY OF LOS ANGELES, SEDGWICK CLAIMS MANAGEMENT SERVICES, INCORPORATED

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the original finding that the applicant sustained industrial injuries to his internal system and head, causing 71% permanent disability. The defendant argued the Agreed Medical Evaluator's (AME) report regarding head injury and sleep issues lacked substantial medical evidence. The Board found the AME's report to be substantial, as it was not speculative, based on adequate examination, and explained its reasoning. Furthermore, the Board found the AME's method of analogizing the applicant's headaches to trigeminal neuralgia for impairment rating was permissible and accurately reflected the applicant's activities of daily living deficits.

GERDirritable bowel syndromehypertensionheadachessleep disturbancepermanent partial disabilityapportionmentmedical treatmentattorney's feeAgreed Medical Evaluator

References

Case No. ADJ3763910 (STK 0195200) ADJ6626980

Regular

Feb 06, 2015

JOHN ALARCON vs. PACIFIC GAS & ELECTRIC

This case involves an applicant seeking to modify deposition and Qualified Medical Evaluation (QME) orders due to alleged severe medical conditions. While the applicant agrees to the deposition and QME, they claim their health prevents travel and request these be held at their home. The Appeals Board granted the Petition for Removal, finding the medical record requires further development regarding the alleged travel limitations. The orders for deposition and QME are amended to defer the time and place, returning the matter to the trial level for proceedings on accommodation issues.

Petition for RemovalOrder Compelling DepositionQualified Medical Evaluation (QME)Administrative Law Judge (WCJ)Industrial InjuriesPolymyositisTreating PhysicianMedical ReportTravel LimitationsAccommodation

References

Case No. ADJ10356570

Regular

Oct 20, 2017

SYRUS YARBROUGH vs. SOUTHERN GLAZER'S WINE AND SPIRITS, TRUMBALL INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted applicant Syrus Yarbrough's Petition for Removal, rescinding a previous order compelling him to attend an Agreed Medical Evaluator (AME) appointment. The WCAB found that Labor Code section 4067, relied upon by the judge, did not apply as applicant had not yet attended a formal AME evaluation. Furthermore, the WCAB clarified that Labor Code section 4062.2(f) only applies after an AME evaluation has occurred and does not preclude withdrawal from an AME agreement before such an evaluation. The WCAB noted that the applicant could still be ordered to see his regular physician or a Qualified Medical Evaluator.

Petition for RemovalAgreed Medical EvaluatorPetition to CompelMedical ExaminationSignificant PrejudiceIrreparable HarmLabor Code Section 4067Labor Code Section 4062.2(f)Withdraw from AMEWCAB

References

Case No. ADJ7688956

Regular

Jan 31, 2012

SHARON FRINK vs. SHASTA-TEHAMA-TRINITY JOINT COMMUNITY COLLEGE

The Workers' Compensation Appeals Board granted removal, rescinded prior orders, and returned the case for further proceedings. The issue was whether the applicant must attend a re-evaluation with the same Qualified Medical Evaluator (QME) after he moved his office a short distance. The Board found that Labor Code section 4062.3(j) requires parties to utilize the same QME for subsequent disputes if possible. They clarified that Administrative Director Rule 34(b) regarding the QME's office location applies only to initial evaluations, not re-evaluations. Therefore, the applicant's refusal to travel a short distance for re-evaluation was not grounds for a new panel QME.

Workers' Compensation Appeals BoardPetition for RemovalQualified Medical Examiner (QME)Re-evaluationLabor Code Section 4062.3(j)Administrative Director Rule 34(b)Administrative Director Rule 36(d)Medical Office LocationUnavailable QMECompel Attendance

References

Case No. ADJ3445498 (SFO 0440451) ADJ4010324 (SFO 0496717)

Regular

Jun 30, 2011

JAMES PETERS vs. FEDERAL EXPRESS, SEDGWICK WALLNUT CREEK

This case concerns a Petition for Reconsideration filed by Federal Express and Sedgwick Walnut Creek after an award was made to James Peters for new and further permanent disability. The Appeals Board denied the reconsideration, adopting the Administrative Law Judge's (ALJ) report. The ALJ found sufficient medical evidence of new and further permanent disability based on Agreed Medical Evaluator Dr. Feinberg's reports, leading to an adjusted award of 54% permanent disability. The Board also noted that the defendant's petition contained sanctionable misrepresentations and mis-citations regarding legal precedent.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code section 40672 HannaCalifornia Law of Employee Injuries and Workers' CompensationAgreed Medical EvaluatorQualified Medical EvaluatorPetition to ReopenNew and Further Permanent DisabilityStipulations with Request for Award

References

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Updated Daily

Case Law Database

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

Case No. ADJ119309 (OAK 0332713) ADJ1352097 (OAK 332714)

Regular

Aug 09, 2011

KEN LAWHN vs. FARMERS INSURANCE, HELMSMAN MANAGEMENT

References

Case No. ADJ11995067

Regular

Jul 25, 2025

ADELINA PEREZ vs. KYONG AE YUN, CHONG MYON YUN, ZENITH INSURANCE COMPANY

RemovalReconsiderationLabor Code section 4062.3Ex parte communicationMedical-legal evaluatorTreating physicianMPNNeuropsychological assessmentTraumatic brain injuryAdmissibility of evidence

References

Case No. ADJ11255525

Regular

Dec 02, 2019

GWENDOLYN JOHNIGAN vs. UC DAVIS MEDICAL CENTER

Petition for ReconsiderationPanel Qualified Medical EvaluatorOrthopedistSubstantial Medical EvidenceFurther DevelopmentSupplemental ReportingDeposition TestimonyIndustrial InjuryRight LegRight Knee

References

Case No. ADJ7014507

Regular

May 23, 2014

JUAN PINZON vs. RC GRAMER CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

References

Case No. ADJ519728

Regular

Aug 08, 2011

LOWELL BAPTISTE vs. METROPOLITAN TRANSIT AUTHORITY

Workers' Compensation Appeals BoardReconsiderationCompelling Medical EvaluationsTemporary Total DisabilityIndustrial InjuryOrthopedicsPsychiatrySubstantial EvidenceMedical OpinionWCJ

References

Case No. ADJ14669607

Regular

Apr 10, 2023

DOUGLAS HERB vs. COUNTY OF LOS ANGELES, SEDGWICK CLAIMS MANAGEMENT SERVICES, INCORPORATED

GERDirritable bowel syndromehypertensionheadachessleep disturbancepermanent partial disabilityapportionmentmedical treatmentattorney's feeAgreed Medical Evaluator

References

Case No. ADJ3763910 (STK 0195200) ADJ6626980

Regular

Feb 06, 2015

JOHN ALARCON vs. PACIFIC GAS & ELECTRIC

References

Case No. ADJ10356570

Regular

Oct 20, 2017

SYRUS YARBROUGH vs. SOUTHERN GLAZER'S WINE AND SPIRITS, TRUMBALL INSURANCE COMPANY

Petition for RemovalAgreed Medical EvaluatorPetition to CompelMedical ExaminationSignificant PrejudiceIrreparable HarmLabor Code Section 4067Labor Code Section 4062.2(f)Withdraw from AMEWCAB

References

Case No. ADJ7688956

Regular

Jan 31, 2012

SHARON FRINK vs. SHASTA-TEHAMA-TRINITY JOINT COMMUNITY COLLEGE

References

Case No. ADJ3445498 (SFO 0440451) ADJ4010324 (SFO 0496717)

Regular

Jun 30, 2011

JAMES PETERS vs. FEDERAL EXPRESS, SEDGWICK WALLNUT CREEK

References

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