CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. ADJ4046748 (GOL 087878)
Regular
Oct 14, 2008

VIOLA MIRANDA vs. LOMPOC HOSPITAL DISTRICT, WORKERS' COMPENSATION ADMINISTRATORS

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior denial, and ordered the defendant to provide applicant Viola Miranda with an orthopedic mattress. The Board found that the applicant's treating physician and Qualified Medical Evaluator supported the necessity of the mattress, and the defendant's utilization review did not present sufficient evidence to deny the request. The issue of attorney's fees under Labor Code §4607 was deferred pending a Supreme Court decision.

Workers' Compensation Appeals Boardorthopedic mattressutilization reviewACOEM GuidelinesLabor Code § 4604.5medical treatmentindustrial injurytreating physicianqualified medical evaluatorpermanent disability
References
1
Case No. ADJ393547 (ANA 0389753)
Regular
Apr 06, 2010

TOMAS GARCIA vs. METERMAN INC, STATE COMP. INSURANCE FUND

This case involves a dispute over the authorization of an orthopedic mattress for a workers' compensation applicant. The defendant denied the request through utilization review, citing lack of supporting medical guidelines. The Appeals Board reversed the WCJ's award, finding the applicant failed to properly initiate the dispute resolution process under Labor Code section 4062(a). The matter was returned to the trial level for referral to the Agreed Medical Examiner to address the medical necessity of the mattress.

Utilization ReviewLabor Code Section 4610Labor Code Section 4062(a)Agreed Medical ExaminerOrthopedic MattressMedical Treatment DisputeReconsiderationFindings and AwardExpedited HearingWorkers' Compensation Appeals Board
References
2
Case No. MISSING
Regular Panel Decision

Fernandez v. North Shore Orthopedic Surgery & Sports Medicine, P.C.

Frank Fernandez, an x-ray technician, sued his former employer, North Shore Orthopedic Surgery & Sports Medicine, P.C., for retaliation under Title VII after filing a national origin discrimination complaint. A jury found in favor of Fernandez, awarding back pay, front pay, and punitive damages. North Shore subsequently moved for judgment as a matter of law, a new trial, and to modify the damage awards. The court denied North Shore's motions for judgment and a new trial, affirmed the jury's back pay award, but vacated and reduced the front pay award from $160,000 to $50,000, and the punitive damages award from $100,000 to $50,000.

RetaliationTitle VIIEmployment DiscriminationBack PayFront PayPunitive DamagesMitigation of DamagesFederal Rules of Civil ProcedureJudicial DiscretionEquitable Relief
References
27
Case No. VNO 343876
Regular
Jan 15, 2008

CASSANDRA GIBSON vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board denied the County of Los Angeles' petition for reconsideration, upholding an award for the applicant's future medical treatment. This treatment included a weight loss program, bariatric surgery consultation, physical therapy, and an orthopedic mattress, which the defendant had unreasonably delayed providing. The Board found substantial medical evidence supported the necessity of this treatment and justified penalties for the defendant's delay.

Workers' Compensation Appeals BoardReconsiderationFuture Medical TreatmentWeight Loss ProgramBariatric Surgery ConsultationPhysical TherapyLumbar SpineOrthopedic MattressUnreasonable DelayLabor Code Section 5814 Penalties
References
2
Case No. ADJ10917207
Regular
Aug 13, 2019

CARMEN ROJO vs. K & M MEAT COMPANY, STARR INDEMNITY & LIABILITY COMPANY

This case involves a dispute over the necessity of an additional Qualified Medical Evaluator (QME) panel in orthopedic surgery. The Applicant sought reconsideration of an administrative law judge's (ALJ) order for a new orthopedic QME panel, arguing it was an abuse of discretion and prejudicial. The Appeals Board granted reconsideration, finding the original QME's referral for an orthopedic evaluation was for treatment, not a recommendation for a new medical-legal evaluation. Consequently, the Board amended the ALJ's findings, holding there was no good cause for an additional orthopedic QME panel and denying the defendant's request.

QME panelorthopedic surgeryreconsiderationremovalFindings & Orderchiropractic QMEmedical-legal evaluationgood causesupplemental pleadingmedical dispute
References
9
Case No. ADJ7264915
Regular
Jul 15, 2013

ANA GONZALES vs. WAL-MART ASSOCIATES, INC., ACE AMERICAN INSURANCE

This case involves an applicant who sustained industrial psychiatric injury but whose orthopedic claims were denied due to insufficient medical evidence. The Appeals Board denied the applicant's petition for reconsideration, finding the applicant failed to present substantial medical evidence of industrial causation for her orthopedic complaints. A dissenting commissioner argued that the primary medical evaluator's report was deficient and lacked substantial evidence, warranting further development of the record on orthopedic injuries and other claims. The dissent emphasizes the Board's duty to ensure substantial justice, suggesting it should have ordered further investigation on the denied orthopedic issues.

WCABPetition for ReconsiderationFindings and Orderindustrial injurypsychelow backneckright shoulderright wristright elbow
References
11
Case No. ADJ7558173
Regular
Oct 28, 2014

JESSIE MOORE vs. PASADENA AREA COMMUNITY COLLEGE DISTRICT

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior award, and found the applicant was not temporarily totally disabled after her retirement. The Board determined that while the applicant stated her retirement was reluctant, the primary reasons cited were hostile work environment and emotional stress, not solely orthopedic injuries. Medical evidence did not substantially support the claim that the admitted orthopedic injuries alone rendered her temporarily totally disabled. Consequently, temporary disability benefits were not awarded for the orthopedic injuries.

Workers' Compensation Appeals BoardJessie MoorePasadena Area Community College DistrictKeenan & Associatesstatute of limitationstemporary disabilitycumulative traumacervical spinelumbar spineleft wrist
References
7
Case No. ADJ1350924 (VNO 0092908)
Regular
Apr 06, 2015

DAVID SMITH vs. GENERAL MOTORS, TRISTAR, SEDGWICK CLAIMS MANAGEMENT

This case concerns a defendant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) award. The original award included a hypoallergenic, adjustable king-size mattress and ongoing personal trainer services for the applicant. The defendant argued the mattress was excessive and the trainer unnecessary. The WCAB denied the defendant's petition, largely adopting the WCJ's reasoning for the original award. However, one commissioner dissented on the mattress award, finding insufficient evidence to justify the specific, expensive model.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardTempur Cloud Luxehypoallergenic mattresspersonal trainerWCJAmended Report and Recommendationdurable mattressadjustable mattress
References
0
Case No. ADJ924376 (GRO 0026391)
Regular
Jul 09, 2009

CHRISTOPHER GERKINS vs. VILLA AUTOMOTIVE, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's entitlement to a mattress as part of workers' compensation medical treatment for industrial back and psyche injuries. The defendant sought reconsideration of an award granting a mattress, arguing the applicant failed to prove its necessity. The Appeals Board granted reconsideration, reversing the award. The Board found that while non-medical devices can be awarded, the applicant presented insufficient evidence showing a mattress was reasonably required to cure or relieve his injury, citing a lack of supporting medical reports and studies.

Workers Compensation Appeals BoardGerkinsVilla AutomotiveState Compensation Insurance FundFindings and AwardPetition for ReconsiderationMedical TreatmentAuto MechanicPermanent DisabilityOrthopedic Mattress
References
3
Case No. ADJ2434971 (OAK 0238163)
Regular
Dec 02, 2010

ANA RODRIGUEZ vs. SHERATON PALACE HOTEL, TOKIO MARINE

The Workers' Compensation Appeals Board denied reconsideration of a finding that the applicant, Ana Rodriguez, did not sustain new and further permanent disability subsequent to a 1997 stipulated award. The judge found her testimony regarding increased orthopedic and psychiatric symptoms to be not credible. Medical evidence from Dr. Edington indicated no orthopedic increase in disability since the award, and the psychiatric disability became permanent and stationary concurrently with the orthopedic condition. Therefore, the judge concluded there was no "new and further" disability as defined by Labor Code Section 5410.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedCredibility FindingGarza v. Workers' Comp. Appeals Bd.Stipulated AwardPetition to ReopenNew and Further DisabilityOrthopedic DisabilityPsychiatric Disability
References
2
Showing 1-10 of 406 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational