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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ8410459
Regular
Oct 22, 2019

DIETRA WALKER vs. YMCA METROPOLITAN LOS ANGELES

The Workers' Compensation Appeals Board (WCAB) granted the applicant's Petition for Reconsideration, overturning the trial judge's decision to strike a Qualified Medical Evaluator's (QME) report. The WCAB found no disqualifying conflict of interest for Dr. Gabriel, despite co-authored articles and past professional association with another dentist, Dr. Schames. Furthermore, the Board deemed the defendant's motion to strike Dr. Gabriel untimely due to a nearly three-year delay after his deposition. The case is affirmed with an amendment finding Dr. Gabriel free of conflict, and the defendant's motion is denied.

QMEconflict of interestdisqualifying conflict of interestlachesestoppelpetition for reconsiderationremovalmotion to strikeAOE/COEdeposition
References
Case No. ADJ3225136 (OAK 0345446)
Regular
Aug 28, 2012

MICHAEL GIAMMONA vs. FISHER DEVELOPMENT AND TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case involves defendant Travelers Property and Casualty's repeated attempts to disqualify a Qualified Medical Examiner (PQME) due to alleged conflicts of interest and the PQME's review of a prior PQME's report. The Appeals Board dismissed the defendant's petition for reconsideration, as the underlying order was an interim procedural matter, not a final decision. The Board also denied the petition for removal, finding it was inappropriately filed for the same reasons previously addressed in a prior ruling. The Board admonished the defendant for ignoring prior guidance on the proper procedural avenues.

Petition for ReconsiderationPetition for RemovalPanel Qualified Medical ExaminerPQME conflict of interestRule 41.5 disqualificationinterim procedural orderfinal ordermedical-legal discoveryworkers' compensation benefitsOakland District Office
References
Case No. ADJ7802984
Regular
May 21, 2012

DEBRA HARDEN vs. GOLDEN ONE CREDIT UNION, TRAVELERS INSURANCE

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's untimely petition for removal but granted removal on its own motion due to significant prejudice. The WCAB rescinded a prior finding that granted the defendant's request for a replacement QME due to a claimed conflict of interest. The matter was returned to the trial level for further proceedings to ensure the applicant received due process and a hearing on the conflict of interest allegations. This action was taken to achieve substantial justice given procedural irregularities and potential irreparable harm to the applicant.

Workers' Compensation Appeals BoardPetition for RemovalQualified Medical EvaluatorQME panelconflict of interestdue processadministrative law judgeWCJPetition to Removeuntimely
References
Case No. ADJ8339009
Regular
Jan 08, 2016

WINSTON ROCKEFELLER (Dec'd), SUZANNA ROCKEFELLER (Dependent), ERIKA OSWALD (Dependent) vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS NORTHERN TRANSPORTATION HUBQ-ADMINISTRATION; legally uninsured; administered by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board intends to rescind its prior order granting reconsideration and dismiss the applicant's petition as moot. This action is prompted by the defendant's assertion that a new Panel Qualified Medical Examiner has been appointed and has issued reports, rendering the original dispute regarding the disqualification of the previous PQME moot. The Board will proceed with rescinding and dismissing unless the applicant demonstrates good cause why the issue remains live. No decision on the merits of the original petition has been made.

WCABPetition for ReconsiderationFindings and OrderPanel Qualified Medical ExaminerPQMERule 41.5(d)(2)(A)disqualifying conflict of interestmoot issueNotice of Moot IssueOpinion and Order Granting Reconsideration
References
Case No. ADJ7626422
Regular
Dec 03, 2014

JOSE AHUMADA vs. BUILDING MATERIALS HOLDING, ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's petition for reconsideration because it sought review of an interlocutory order, not a final decision. However, the WCAB granted removal on its own motion to address the WCJ's order. This order, which directed the parties to obtain a new Qualified Medical Evaluator (PQME), was rescinded because the issue was moot after the defendant canceled the deposition and the PQME became available within the statutory timeframe. The WCAB cautioned the defendant for seeking reconsideration of a non-final procedural order.

PQMEPetition for ReconsiderationWCJ Orderdepositionreplacement PQMEinterlocutory orderremovalrescindedmoot issuevocational expert
References
Case No. ADJ7674144
Regular
Oct 21, 2015

CHERYL FRANK vs. NOVATO UNIFIED SCHOOL DISTRICT, YORK RISK SERVICES GROUP

The Workers' Compensation Appeals Board (WCAB) affirmed a prior decision finding that most alleged industrial stressors leading to the applicant's psyche injury claim were not barred by Labor Code section 3208.3(d). The WCAB upheld the administrative law judge's (WCJ) determination that the panel Qualified Medical Evaluator's (PQME) reports lacked substantial evidence and removed the PQME. The WCAB dismissed the defendant's petition for removal, finding reconsideration to be the appropriate remedy and giving significant weight to the WCJ's credibility determinations.

Workers' Compensation Appeals Boardpsychiatric injuryindustrial stressorLabor Code section 3208.3(d)removalQualified Medical EvaluatorPQMEsubstantial evidencecredibility determinationsPetition for Reconsideration
References
Case No. ADJ3616652 (SAC 0296975)
Regular
Feb 07, 2013

SAMUEL WILLIAMS vs. STARVING STUDENTS, LEGION INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

This case concerns the applicant's claim for interest on a workers' compensation settlement paid late by Legion Insurance, now administered by CIGA. The applicant was awarded 10% interest on delayed payments, but CIGA sought reconsideration, arguing the interest issue was not properly raised, interest accrued before CIGA's involvement is not covered, and stipulations waived interest. The Appeals Board granted reconsideration, amending the award to apply interest only on payments made on or after March 4, 2003, when CIGA assumed liability, allowing credit for overpayments made to the applicant.

Workers Compensation Appeals BoardLegion InsuranceCIGACompromise and Release AgreementInterest on AwardLiquidationGuarantorStipulationOrder Approving Compromise and ReleaseStatutory Interest
References
Case No. ADJ1367543 (POM 0286181)
Regular
May 11, 2012

XJU BIN CAO vs. WO HIN INTERNATIONAL, INC., BERKSHIRE HATHAWAY

The Appeals Board rescinded the WCJ's decision, finding that the November 3, 2010 Stipulation and Order was an enforceable contract despite the parties' differing interpretations of unstated interest and penalty clauses. The Board ruled the lien claimant is entitled to interest under Labor Code section 5800 on the $17,000 payment from the agreement date to payment. However, no penalty was awarded as the defendant's delay in payment was not deemed unreasonable.

Workers' Compensation Appeals BoardReconsiderationStipulation and OrderMeeting of the MindsLabor Code Section 5800Lien ClaimantInterestPenaltiesLabor Code Section 5814Unreasonable Delay
References
Case No. ADJ8898297
Regular
Mar 27, 2015

MARY ROBY-LEWIS vs. COUNTY OF SACRAMENTO

This case involves the County of Sacramento's attempt to overturn an order striking their chosen Qualified Medical Examiner (PQME) and a consulting physician. The defendant argued this order caused irreparable harm and that the applicant waived objections by delaying their request. The Appeals Board dismissed the reconsideration petition as untimely because the order wasn't final, but granted removal and rescinded the WCJ's order. The majority found the applicant's objections lacked merit and that denying removal would cause prejudice, while a dissenting opinion argued the defendant failed to comply with procedural rules regarding document submission to the PQME.

PQMEPetition for ReconsiderationPetition for RemovalOrder Striking PQMELabor Code Section 4062.3(b)Panel Qualified Medical ExaminerWCJ OrderApplicantDefendantSubstantial Prejudice
References
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