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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. ADJ284264 (VNO 0550515)
Regular
Mar 02, 2009

CAROLEE PETERSON vs. RALPH'S GROCERY COMPANY

The Workers' Compensation Appeals Board affirmed a prior award, granting the applicant the right to treatment with her chosen physician, who was not part of the employer's medical provider network. This decision was based on the employer's failure to provide adequate notice regarding the medical provider network requirements. The Board also upheld the applicant's entitlement to temporary total disability from April 7, 2007, to the present. The employer's contentions regarding compliance and evidence were rejected.

Workers' Compensation Appeals BoardReconsiderationMedical Provider NetworkPrimary Treating PhysicianTemporary Total DisabilityKnight v. United Parcel ServiceLabor Code Section 4610Physician-Patient RelationshipStatutory Notice RequirementsRegulatory Notice Requirements
References
Case No. ADJ17569878
Regular
Apr 28, 2025

Marvin Pineda Contreras vs. Southwest Plastering, Inc.; Zenith Insurance Company

Lien Claimant Oracle Imaging Riverside sought reconsideration of an Order Dismissing Lien issued on December 23, 2024, by the WCJ, following its alleged failure to object to a notice of intention to dismiss. Oracle contended it had not received proper notice of the hearing date, attributing this to the Appeals Board not sending notifications to its P.O. Box. The Appeals Board dismissed the Petition for Reconsideration as premature, returning the matter to the trial level for the WCJ to consider the Petition as one seeking to set aside the Order Dismissing Lien. The Board noted that any aggrieved party may seek reconsideration after the WCJ issues a subsequent decision.

Petition for ReconsiderationOrder Dismissing LienLien ClaimantNotice of IntentionFailure to AttendProper NoticeBad AddressReport and RecommendationCompromise and Release AgreementOrder Approving Compromise and Release
References
Case No. ADJ7582253
Regular
Dec 13, 2011

CHRISTOPHER GONZALEZ vs. 24 HOUR FITNESS, GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board denied reconsideration of an order finding Christopher Gonzalez's claim against 24 Hour Fitness timely. The Board adopted the WCJ's report, which concluded that voluntarily provided medical treatment by the employer extended the statute of limitations to five years. Furthermore, the WCJ found the employer's denial notice failed to comply with notice requirements and contained ambiguous language, and that the applicant met the elements of equitable estoppel, preventing the employer from asserting the statute of limitations defense.

Petition for ReconsiderationDeniedWorkers' Compensation Appeals BoardStatute of LimitationsTollingStandard RectifierVoluntary Medical TreatmentLabor Code Section 5402(c)Equitable EstoppelNotice Requirements
References
Case No. ADJ3057068
Regular
Nov 01, 2010

Cecilio Torres vs. Holbrook Construction, Inc., Lincoln General Insurance Company, American Claims Management, State Compensation Insurance Fund

The Workers' Compensation Appeals Board granted reconsideration, rescinded a prior decision, and returned the case for further proceedings. The applicant claimed a back and other injuries, alleging he notified his supervisor of the incident and subsequent pain before termination. The Board found the applicant met his burden to prove he provided sufficient notice of injury to his supervisor prior to termination, fulfilling the notice requirement of Labor Code section 3600(a)(10). Defendants failed to rebut the applicant's evidence that he reported the injury and requested medical treatment from his supervisor.

Workers' Compensation Appeals BoardReconsiderationLabor Code Section 3600(a)(10)Notice of InjuryTerminationPreponderance of EvidenceSupervisor NoticeActual NoticeEmployer KnowledgeWCJ Decision
References
Case No. ADJ11155531
Regular
Apr 01, 2020

PATRICK ALLEN vs. UNITED PARCEL SERVICE, LIBERTY MUTUAL INSURANCE CO.

The Workers' Compensation Appeals Board granted applicant's petition for removal, rescinded an order compelling attendance at a medical examination, and returned the matter for further proceedings. The Board found the order violated due process because the applicant did not receive prior notice or an opportunity to be heard. The WCJ issued the order as a "walk-through document" without adhering to the required notice of intention procedure. The Board emphasized that due process requires notice and an opportunity to challenge adverse actions before they are issued.

Petition for RemovalOrder Compelling AttendanceMedical ExaminationDue ProcessNoticeOpportunity to be HeardPetition to Compel AttendanceAgreed Medical Evaluator (AME)Walk-through documentWCAB Rule 10789(h)
References
Case No. ADJ9077157
Regular
Jan 24, 2017

JOHN BIRTWELL vs. OAKLAND ATHLETICS, ACE, USA administered by SEDGWICK

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded an order dismissing Mesa Medical Group's lien. The dismissal occurred because no objection was received to a Notice of Intention (NIT) for failure to appear at a lien conference. Although the objection was filed by CA Med Management, which had not formally filed a notice of representation, the WCAB found that due process requires a hearing on the merits of the lien claim. The case is returned to the trial level to determine if Mesa Medical Group has sufficient grounds for relief from its non-appearance.

Petition for ReconsiderationOrder Dismissing LienNotice of Intention (NIT)Lien ConferenceDeclaration of Readiness to Proceed (DOR)Objection to Notice of IntentionCA Med ManagementNotice of RepresentationLabor Code section 4903.6(b)WCAB Rule 10774.5
References
Case No. ADJ4558222 (SJO 0245951)
Regular
Nov 12, 2006

MARK STEPHENS vs. SUN MICROSYSTEMS, permissibly self-insured, administered by MATRIX ABSENCE MANAGEMENT

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior award, finding that the applicant's claim for further medical treatment was barred by the one-year statute of limitations under Labor Code section 5405. Despite the applicant's argument regarding inadequate notice based on the *Carls* decision, the Board concluded that the defendant provided all legally required notices following the industrial hernia injury. Therefore, the applicant's application, filed more than one year after the date of injury, expiration of payments, and last furnished medical benefits, was dismissed.

Labor Code section 5405statute of limitationsreconsiderationFindings and AwardApplication for Adjudication of Claimtollingactual knowledgeadequate noticelegally required noticesself-insured
References
Case No. ADJ476925, ADJ2247284, ADJ3324647, ADJ236582, ADJ2374280, ADJ648207
Regular
Sep 26, 2008

IRMA GUERECA vs. LSG SKY CHEFS, LIBERTY MUTUAL INSURANCE

Reconsideration granted; rescinding WCJ's July 18, 2008 decision; matter returned for further proceedings and new decision. Insufficient evidence to determine if employer provided required MPN notice.

MPNMedical Provider NetworkNotice requirementsLabor Code sections8 Cal. Code RegulationsKnight v. United Parcel Serviceemployer's burden of proofreasonable medical treatmentself-procured treatmenttimeliness of notice
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
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