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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. ADJ11295277
Regular
Mar 30, 2020

MARIA PARTIDA vs. ST. JOHN KNITS, INC., THE HARTFORD

The WCAB granted reconsideration to further review the exclusion of QME Dr. Amory's reports. Defendant argues applicant failed to prove injury arising out of and in the course of employment and that the exclusion of Dr. Amory's reports was an error. The Board will rescind the prior order and return the matter for further proceedings, specifically focusing on whether defense counsel violated Labor Code Section 4062.3 regarding communication with the QME and service of sub rosa DVD. The Board directs the WCJ to analyze these issues consistent with the precedent set in *Suon v. California Dairies*.

Workers' Compensation Appeals BoardReconsiderationFindings of Fact and OrderQualified Medical EvaluatorEx Parte CommunicationLabor Code Section 4062.3Sub Rosa DVDSubstantial Medical EvidenceArising Out of and in the Course of EmploymentAdmissibility of Evidence
References
Case No. ADJ9013590, ADJ9014316, ADJ9489408
En Banc
Oct 23, 2018

Sandab Suon vs. California Dairies, Insurance Company of the West, The Hartford, Starr Indemnity and Liability Insurance Company

The Appeals Board granted a petition for removal to address a dispute over alleged ex parte communication with a Qualified Medical Evaluator (QME), rescinding the lower court's findings and returning the matter to the trial level for further proceedings.

Labor Code § 4062.3Ex parte communicationQualified Medical EvaluatorQME panelInformation to QMERemoval petitionReconsiderationEn banc decisionWCABAdministrative law judge
References
Case No. ADJ473373 (ANA 0406381)
Regular
Feb 10, 2012

FERNANDO GUTIERREZ vs. SOCAL FRAMING aka BMHC; ACE AMERICAN INSURANCE, administered by ESIS, INC.

This case concerns applicant's claim for extended temporary disability (TD) benefits beyond 104 weeks due to a left eye injury. The Appeals Board affirmed the WCJ's denial of the "amputation" exception, ruling that the surgical removal of an eye does not fit the statutory definition. However, the Board remanded the case for further development of the record on the "high-velocity eye injury" exception, as the velocity and force of the object that struck the applicant's eye were unclear. The applicant's Petition for Removal was dismissed as reconsideration was the appropriate remedy.

Workers' Compensation Appeals BoardFernando GutierrezSoCal FramingBMHCACE American InsuranceESISInc.ADJ473373ANA 0406381Opinion and Decision
References
Case No. LAO 0805956, LAO 0775121, LAO 0786377
Regular
Feb 04, 2008

ROY T. TORRES vs. CITY OF LOS ANGELES

The applicant sought to disqualify the Workers' Compensation Judge (WCJ) due to alleged prejudicial statements made at a hearing concerning his attorney's request to be relieved. The WCJ denied having any bias or forming an unqualified opinion on the merits of the attorney's petition, explaining his comments were based on the attorney's usual practice. The Workers' Compensation Appeals Board (WCAB) found no reason to doubt the WCJ's statements and denied the disqualification petition, remanding the case for further proceedings.

Petition for DisqualificationLabor Code Section 5311WCAB Rule 10452WCJ RecusalPrejudicial StatementsPetition to Be Relieved of CounselIndustrial InjuriesManagement AnalystWorkers' Compensation Appeals BoardCode of Civil Procedure Section 641
References
Case No. SFO 0475100
Regular
May 01, 2008

KEVIN HEUMANN vs. FEELY TRUCKING CORPORATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration and denied removal, finding that the WCJ's order denying disqualification of an Agreed Medical Evaluator was not a final order subject to reconsideration. The Board also concluded that removal was not warranted as the applicant failed to show substantial prejudice or irreparable harm from a brief ex parte communication between the opposing counsel and the AME. The Board adopted the WCJ's reasoning that no substantive issues were discussed and the communication did not impact the AME's conclusions.

Agreed Medical EvaluatorDisqualificationEx Parte CommunicationLabor Code 4062.3Petition for ReconsiderationDenying RemovalWCJ ReportFinal OrderSubstantive RightInterlocutory Order
References
Case No. ADJ6674097
Regular
Jul 09, 2012

GLENDORA PARKS vs. ST. VINCENT MEDICAL CENTER, SEDGWICK CMS

The Workers' Compensation Appeals Board denied the defendant's Petition for Removal, upholding the administrative law judge's decision to proceed to trial. The defendant sought to have the agreed medical evaluator reexamine the applicant due to allegedly "stale" medical reports and to file new applications for specific injuries. However, the Board found that the defendant had not demonstrated significant prejudice and that the trial judge could properly address the issues, including the impact of surveillance videos not shown to the AME. The Board concluded that the case should proceed to trial as scheduled.

Petition for RemovalAgreed Medical Evaluator (AME)stale reportsurveillance videospecific injurycontinuous traumatrial judgedevelop medical recordprejudicial errorirreparable harm
References
Case No. ADJ9549383
Regular
Jul 10, 2017

JUANA ZELEDON DE TREMINIO vs. ESPOSTOS FINE FOODS INC. dba BOX LUNCH CO.

The defendant sought removal of the WCJ's orders to reopen discovery and take the case off calendar, arguing the applicant lacked due diligence. The Appeals Board granted removal, rescinded the WCJ's minute orders, and returned the case for trial without further discovery. The Board found the WCJ erred by taking the case off calendar and reopening discovery before trial, as there was no established record of deficient medical reports to justify such actions. The question of due diligence and substantial evidence should be determined based on admitted evidence at trial.

Workers' Compensation Appeals BoardPetition for RemovalMinute OrdersReopening DiscoveryOff CalendarDue DiligencePrejudicialIrreparably HarmfulMedical Provider Network (MPN)Continuity of Care
References
Case No. ADJ552778 (LBO 0362055)
Regular
May 10, 2015

PROYLAND CAMARILLO HURTADO vs. APL LOGISTICS

The Workers' Compensation Appeals Board denied the applicant's petition for removal, which sought to continue the trial date. The applicant wished to undergo further surgery and reevaluations to assess his final disability after an industrial injury to his back and knee. The Board found that these issues could be addressed by the trial judge on the scheduled trial date, who has the discretion to continue the matter if further discovery is deemed necessary. Therefore, the applicant's request to remove the case from the trial calendar was denied.

Petition for RemovalAgreed Medical EvaluatorQualified Medical EvaluatorWCJoff calendarrevaluationsfinal disabilityindustrial injuryforklift operatordriver
References
Case No. ADJ3225136
Regular
Apr 21, 2011

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

The Workers' Compensation Appeals Board granted removal and rescinded a prior order that denied the defendant's motion for a new Qualified Medical Examiner (QME). The Board found that the applicant's post-evaluation, unserved letter to the QME constituted an ex parte communication, which is prohibited by statute and requires a new QME panel. Consequently, the QME's reports were stricken, and a new panel was ordered. The defendant's petition for reconsideration was dismissed as the original order was procedural, not final.

Panel Qualified Medical ExaminerPQMEEx parte communicationLabor Code Section 4062.3RemovalReconsiderationAdministrative law judgeWCJPain managementAutomobile accident
References
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