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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ8931511
Regular
Sep 04, 2014

DOUGLAS FEUTZ vs. COUNTY OF SACRAMENTO

The Workers' Compensation Appeals Board denied the applicant's petition for removal, affirming the WCJ's decision. The applicant's attorney objected to a supplemental QME report being untimely, but did not request a new QME panel until after reviewing the report. The Board found this action constituted a waiver of the objection because the request was not made contemporaneously with the objection to the violation. Allowing such a delay would undermine efficient dispute resolution and permit doctor shopping.

Petition for RemovalSupplemental ReportPanel Qualified Medical EvaluatorPQMEMedical UnitReplacement QME PanelTimely Supplemental ReportProcedural ViolationWaiverDoctor-Shopping
References
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. ADJ7558401
Regular
May 28, 2013

ROBERT RICE vs. PROCUT, LLC, ZENITH INSURANCE COMPANY

The WCAB granted reconsideration to address the defendant's challenge to the 45% permanent disability award. The defendant argued the Qualified Medical Evaluator's (PQME) opinion was unsubstantiated, particularly regarding the lumbar spine rating and the inclusion of pain impairment. The WCAB found the PQME's reports lacked sufficient rationale and explanation, failing to adequately justify the Almaraz-Guzman rating. Consequently, the WCAB rescinded the award and returned the case for further medical record development.

Workers' Compensation Appeals BoardProCut LLCZenith Insurance CompanyRobert Ricepermanent disabilityqualified medical evaluatorPQMEDr. Sanjay Chauhanwhole person impairmentAMA Guides
References
Case No. ADJ8668832
Regular

BACILIO ANGEL SALAZAR vs. SAN DIEGO PERSONNEL AND EMPLOYMENT AGENCY, INC., AMTRUST NORTH AMERICA for CASTLEPOINT NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for removal, rescinding a prior order that deemed a QME report timely. The Board found Dr. Tahami's psychiatric evaluation report was untimely served on the defendant. As the defendant objected prior to receiving the report, they are entitled to a replacement QME panel in psychiatry.

Petition for RemovalQualified Medical EvaluatorQME paneluntimely reportreplacement QMEAdministrative Director RuleLabor Codepsychiatric injurymedical-legal evaluationsubstantial prejudice
References
Case No. ADJ6535347, ADJ6534384
Regular
Nov 02, 2015

CHRISTINE KNAPP vs. COUNTY OF FRESNO

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration. The applicant sought to overturn findings of $53\%$ permanent disability and disputed the exclusion of vocational expert reports and a claim of $100\%$ disability. The Board found the petition contained numerous factual misrepresentations and violations of WCAB rules and professional conduct by the applicant's attorney. The Board adopted the WCJ's report, which recommended denial due to the petition's legal defects and factual inaccuracies.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardOccupational Group NumberIndustrial InjuryRight ShoulderMigraine HeadachesPermanent DisabilityAgreed Medical ExaminerQualified Medical Examiner
References
Case No. ADJ8040191
Regular
Sep 18, 2013

JOEL GOODEN vs. HILLS PET NUTRITION, INC., ACE AMERICAN INSURANCE COMPANY

The defendant petitioned for removal, seeking to overturn an order vacating submission of the case for further medical record development. The administrative law judge (WCJ) had vacated submission to review PQME reports from Dr. Georgis and Dr. Francisco. The WCJ subsequently took the matter off calendar to allow parties to obtain a supplemental report from the PQME reviewing Dr. Francisco's report. As the issue raised by the defendant's petition is now moot due to the subsequent order, the Appeals Board dismissed the Petition for Removal.

Petition for RemovalVacating SubmissionPQMESupplemental ReportWCJOff CalendarMootAppeals BoardWorkers' CompensationCase Development
References
Case No. ADJ1644999 (LAO0880435)
Regular
Dec 11, 2012

, MANUEL FERNIZA, vs. , RENT A CENTER, INC.; FIREMAN'S FUND INSURANCE COMPANY/ASSOCIATED INDEMNITY,

The Workers' Compensation Appeals Board (WCAB) vacated its prior order granting reconsideration and dismissed the applicant's petition. The WCAB determined that the applicant's petition sought reconsideration of an interim procedural order, not a final decision, which is not appealable. Even if the merits were considered, the WCAB would have affirmed the judge's decision, finding the QME report timely and deferring a decision on treatment authorization until a PQME urological report was issued.

Workers' Compensation Appeals BoardReconsiderationFinal OrderInterim OrdersPanel Qualified Medical ExaminerMedical Provider NetworkUrological ConditionIndustrial InjuryAdministrative DirectorWCJ Report
References
Case No. ADJ2030213; ADJ2904030; ADJ4232151
Regular
Oct 22, 2014

LETICIA SANCHEZ vs. BARRETT BUSINESS SERVICES, INC.

This case involves a Petition for Reconsideration filed by lien claimant Dr. Elena Konstat regarding a workers' compensation award. The Workers' Compensation Appeals Board denied reconsideration, adopting the findings of the Workers' Compensation Judge. The judge found the opinion of Dr. Mory Framer more persuasive than Dr. Konstat's report, despite conflicting medical opinions. Dr. Framer concluded the applicant's psyche injury was non-industrial, while Dr. Konstat did not fully address pre-existing conditions or non-industrial stressors.

Workers' Compensation Appeals BoardPetition for Reconsiderationsubstantial evidencelien claimantfindings and ordertimely petitionadmitted injuriesdenied body partspsyche injurypermanent disability
References
Case No. ADJ9795000
Regular
Sep 15, 2015

JACQUITA HUNTLEY vs. A.H. 2005 MANAGEMENT, PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE COMPANY

The applicant sought removal of a WCJ's finding that the defendant's request for a Qualified Medical Examiner (PQME) was valid. Applicant argued her prior PQME request and the defendant's failure to attach proper documentation invalidated their request. The Board denied the removal petition, adopting the WCJ's report which noted the applicant stipulated to the invalidity of her own PQME request. Furthermore, the Board admonished applicant's attorneys for making false statements and potentially violating Labor Code section 5813.

Petition for RemovalQualified Medical Examiner (PQME)Labor Code section 4061Rule 31.1StipulationTreating PhysicianOrthopedic Surgical PanelChiropractic PQMEBad Faith ActionsFrivolous Tactics
References
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