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

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ4357722 (SBR 0307145) ADJ5714365
Regular
Jun 06, 2012

ANASTASIA JENKINS vs. NEXT ENTERPRISES, INC.

This case involves Anastasia Jenkins' workers' compensation claim against Next Enterprises and the California Insurance Guarantee Association. The Second Appellate District affirmed the Appeals Board's decision that Pinnacle Lien Services could represent multiple lien claimants. The appellate court remanded the case for further proceedings consistent with its opinion. The Appeals Board is now returning the case to the trial level for the workers' compensation judge to conduct necessary proceedings and issue decisions.

ADJ4357722ADJ5714365Anastacia JenkinsNext Enterprises Inc.California Insurance Guarantee AssociationVillanova Insurance liquidationOracle ImagingN-CareNations Surgery CenterPinnacle Lien Services
References
Case No. ADJ9394000
Regular
Apr 13, 2015

CHRISTINE REDDEN vs. MJT ENTERPRISE, INC. dba BLUE RIBBON PERSONNEL, CASTLE POINT NATIONAL INSURANCE COMPANY, YORK RISK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board denied reconsideration of the judge's decision, upholding the applicant's psychiatric injury claim. The WCAB gave significant weight to the judge's credibility determinations, finding no substantial evidence to overturn them. The Board also admonished the defendant's counsel for misrepresenting the evidentiary record in their petition. The applicant's injury was deemed not barred by the "6-month rule" because the incident was found to be a "sudden and extraordinary" event.

Petition for ReconsiderationWorkers' Compensation Appeals BoardMJT EnterpriseInc.Castle Point National Insurance CompanyYork Risk Services GroupInc.ADJ9394000WCJ credibility determinationsGarza v. Workmen's Comp. Appeals Bd.
References
Case No. VNO 422650
Regular
Feb 13, 2008

CLAUDIA GRACIANO vs. FLEETWOOD ENTERRPRISES, INC., Permissibly Self-Insured, Administered by MATRIX ABSENCE MANAGEMENT, INC.

The Appeals Board granted reconsideration, rescinded the original award, and returned the case for further medical evidence. The Board found the existing medical reports insufficient to justify findings on industrial injury, temporary disability, and permanent disability. A "regular physician" will be appointed to further develop the medical record regarding the applicant's bilateral foot injury and related issues.

Workers' Compensation Appeals BoardFleetwod EnterprisesInc.Matrix Absence ManagementInc.Claudia Gracianobilateral feet injurytemporary disabilitypermanent disabilityself-procured medical treatment
References
Case No. MON 0304723
Regular
Jul 15, 2008

KHALIL TANTAWI vs. UNIFORMS, INC., MICROSOURCE MANAGEMENT, INC., GRANITE STATE INSURANCE COMPANY, AIG CLAIM SERVICES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of an arbitrator's decision that Granite State Insurance Company and State Compensation Insurance Fund only covered clerical and outside sales staff for Microsource Management, Inc. The Board found the arbitrator's decision lacked required express findings of fact and a determination of rights, and rescinded the decision. The case is returned to the trial level for further development of evidence regarding the applicant's exact job role on the date of injury and to issue a new decision with proper findings and an order.

Workers Compensation Appeals BoardKhalil TantawiUniforms IncMicrosource Management IncGranite State Insurance CompanyAIG Claim Services IncState Compensation Insurance Fundspecial employergeneral employeroutside salesperson
References
Case No. SJO 244847
Regular
Feb 06, 2008

Celestine Lewis vs. COCA-COLA ENTERPRISES, INC.

This case concerns Celestine Lewis's claim against Coca-Cola Enterprises for workers' compensation benefits. The Workers' Compensation Appeals Board (WCAB) denied Lewis's petition for reconsideration of a prior decision regarding the apportionment of her permanent disability. The WCAB adopted the Administrative Law Judge's report, which upheld the apportionment of 30% of Lewis's permanent disability to pre-existing arthritis, consistent with recent legislative changes emphasizing apportionment to causative factors including pathology.

Workers' Compensation Appeals BoardCelestine LewisCoca-Cola EnterprisesInc.Permissibly Self-InsuredPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeDivision of Workers' CompensationJudicial AuthorityOriginal Jurisdiction
References
Case No. ADJ6766619 (MF) ADJ6766620
Regular
Feb 28, 2018

MARIA DURAN vs. FOREVER 21 RETAIL, INC., CHUBB GROUP

This case involves Maria Duran's request for home health care services, which was initially denied by utilization review (UR) and upheld by Independent Medical Review (IMR). The applicant argued that her need for assistance with household chores and personal hygiene fell outside the scope of the Medical Treatment Utilization Schedule (MTUS) guidelines as applied. While the Board acknowledges that the specific MTUS guideline used in this case was later found to be an invalid regulation in a related case, it affirmed the original decision. This affirmance was based on the finding that the initial request for services was too vague, lacking specific details on the type, frequency, and duration of care, and that a revised request could be made.

Workers' Compensation Appeals BoardMaria DuranForever 21 RetailInc.Chubb GroupOpinion and Decision After ReconsiderationIndependent Medical ReviewIMRUtilization ReviewUR
References
Case No. ADJ4657834 (SFO 0500292)
Regular
Jun 07, 2010

LILIA LLERANDI CHAPITAL, GUSTAVO HILDALGO (Deceased) vs. DWIGHT JEFFERS, aka DWIGHT E. JEFFERS, individually and as a substantial shareholder of DEJ ENTERPRISES a NEVADA CORPORATION, illegally uninsured, EXPERT PLASTERING INC. and CALIFORNIA INSURANCE COMPANY, BEHLER ASSOCIATES INC. dba BEHLER CONSTRUCTION and STATE COMPENSATION INSURANCE FUND

This Workers' Compensation Appeals Board decision granted reconsideration to amend a finding. The Board affirmed that the deceased was employed by Dwight Jeffers, individually and uninsured, and not by Expert Plastering, DEJ Enterprises, or Behler Construction. The Court rejected the argument that Labor Code section 2750.5 compelled a finding of employment with Behler due to Jeffers's lack of license, as Jeffers was not a subcontractor of Behler.

WCABdeclaratory reliefsole jurisdictiongeneral employmentspecial employmentalter ego doctrinedual employmentjoint employmentLabor Code section 2750.5unlicensed contractor
References
Case No. ADJ10334027
Regular
Feb 24, 2017

MAURICIO VALENCIA ALEJANDRE vs. AEROGROUND INC, XL INSURANCE COMPANY, GALLAGHER BASSETT SERVICES, INC

This Workers' Compensation Appeals Board case concerns a Petition for Removal filed by the defendant, Aeroground Inc., challenging an Order setting a trial date. The defendant argued a due process violation due to not being allowed to file a pre-trial conference statement after missing a prior hearing. However, the parties subsequently submitted a Compromise and Release agreement that was approved. Consequently, the Board dismissed the Petition for Removal as moot because the case was resolved.

Petition for RemovalWorkers' Compensation Appeals BoardWCJ OrderPre-trial conference statementDue process violationCompromise and ReleaseOrder Approving Compromise and ReleaseDismissedAdministrative Law JudgeAEROGROUND INC
References
Case No. ADJ7621915
Regular
Jun 12, 2014

MIRIAN OCHOA vs. SODEXHO, INC.

The Workers' Compensation Appeals Board (WCAB) denied Sodexho, Inc.'s Petition for Removal in the case of Mirian Ochoa. The WCAB adopted the administrative law judge's report and found that the petitioner may have materially misrepresented the record. The Board noted that the judge may investigate sanctions for this potential violation of WCAB Rule 10561(b)(5)(A). Consequently, the Petition for Removal was denied.

Petition for RemovalWCAB Rule 10561(b)(5)(A)Materially misrepresentedSanctionsWorkers' Compensation Administrative Law JudgeDeny removalReport of the workers' compensation administrative law judgeADJ7621915SODEXHOINC.
References
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