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

Case No. ADJ7035137, ADJ7035142
Regular
Jul 18, 2018

Carmen Martinez vs. Casa Guadalupe Family Clinic, Inc.

The Workers' Compensation Appeals Board granted reconsideration and rescinded nine Orders approving settlements with lien claimants because the defendant's counsel did not receive notice of the lien conference. This lack of notice resulted in the settlements being negotiated and approved without defense counsel's participation, constituting a procedural irregularity. The Board adopted the WCJ's report finding good cause to set aside the orders due to these procedural flaws. The matter was returned to the trial level for further proceedings.

Petition for ReconsiderationStipulations and Orders to Pay Lien ClaimantProcedural IrregularitiesLien ConferenceLack of NoticeAttorney RepresentationCalifornia State Bar Rules of Professional ConductGood CauseRescind OrderWCAB
References
Case No. ADJ9541996 ADJ9631286 ADJ9542033
Regular
Oct 05, 2016

SOFIA PIOTROWSKI vs. BLUE BANNER COMPANY, APPLIED RISK

The Workers' Compensation Appeals Board (WCAB) rescinded an order approving a $50 settlement for a $13,340 lien claim. The Board found sufficient procedural irregularities, including the lien claimant's representative's alleged mistake regarding the statute of limitations and the lack of clear authorization for the representative to settle. The case was remanded to the trial level for further proceedings, with the WCAB noting potential sanctions due to the apparent neglect of the parties involved.

Workers' Compensation Appeals BoardLien ClaimantStipulation & OrderReconsiderationPetition for ReconsiderationUtilization ReviewLabor Code Section 4903.6(d)Due ProcessProcedural IrregularitiesGood Cause
References
Case No. ADJ9532869; ADJ9532720
Regular
Feb 15, 2019

JORGE AGUILAR vs. ALTMAN SPECIALTY PLANTS, TRAVELERS INSURANCE COMPANY

The WCAB granted the defendant's Petition for Removal and rescinded a prior order that had vacated a venue transfer. The Board found that the original judge who approved stipulations should retain jurisdiction for subsequent proceedings, consistent with Labor Code section 5700 and WCAB Rule 10346. Venue for both cases was transferred to the Los Angeles District Office, the applicant's attorney's principal place of business, also supporting jurisdiction under Labor Code section 5501.5. The WCAB noted that procedural irregularities justified setting aside the parties' stipulation regarding Riverside venue.

Petition for RemovalOrder RescindingOrder Transferring VenueWCABWCJVenue TransferLabor Code 5700WCAB Rule 10346Stipulations with Request for AwardMutual Mistake of Fact
References
Case No. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
Case No. ADJ4274323 (ANA 0387677), ADJ1601669 (ANA 0388466)
Significant
Feb 27, 2014

Jose Dubon, Applicant vs. World Restoration, Inc. and State Compensation Insurance Fund

The Appeals Board held that disputes over the timeliness and procedural compliance of utilization review (UR) are legal issues for the WCAB to decide, not matters for independent medical review (IMR). A UR decision is invalid if it has material procedural defects, such as failing to review adequate medical records.

Workers' Compensation Appeals BoardUtilization ReviewIndependent Medical ReviewProcedural DefectsMedical NecessityEn Banc DecisionAdministrative Director's RulesSubstantial Medical EvidenceTimelinessMaterial Procedural Defects
References
Case No. ADJ4274323 (ANA 0387677), ADJ1601669 (ANA 0388466)
En Banc
Feb 27, 2014

JOSE DUBON vs. WORLD RESTORATION, INC.; STATE COMPENSATION INSURANCE FUND

The WCAB holds that it has jurisdiction over disputes regarding the procedural validity and timeliness of utilization review (UR) decisions, while Independent Medical Review (IMR) is solely for resolving medical necessity. A UR decision with material procedural defects is invalid, and in such cases, the WCAB, not IMR, will determine the medical necessity of the treatment.

Utilization ReviewIndependent Medical ReviewEn Banc DecisionWCAB JurisdictionProcedural DefectsMedical NecessityLabor Code Section 4610Substantial Medical EvidenceMaterial Procedural DefectsInvalid UR Decision
References
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. ADJ9922433
Regular
Dec 08, 2015

PAUL BIXBY vs. CITY OF LAGUNA BEACH

This case concerns an applicant's petition for removal of the Workers' Compensation Judge (WCJ) based on alleged bias. The applicant's petition, though unverified and procedurally deficient, was treated as a disqualification request. The WCJ acknowledged inappropriate behavior and recused himself from the case, rendering the applicant's requested relief moot. Consequently, the Appeals Board dismissed the petition for removal as moot, while cautioning the applicant about future procedural compliance.

Petition for RemovalWorkers' Compensation Appeals BoardWCJ disqualificationOrder taking matter off calendarOrder Quashing Subpoena Duces Tecumbiasmootnessrecusalprocedural requirementsunverified petition
References
Case No. ADJ8255413, ADJ8255415, ADJ8255416, ADJ8684388
Regular
Nov 02, 2016

LERHONE WILLIAMS vs. STATE OF CALIFORNIA, IN HOME SUPPORTIVE SERVICES, YORK RISK SERVICES GROUP

Here's a summary of the case for a lawyer, in four sentences: The applicant, LeRhone Williams, filed a Petition for Disqualification seeking a new judge, alleging bias due to a factual error in a prior report and denial of an examination. The Workers' Compensation Appeals Board (WCAB) reviewed the petition, the judge's report, and the applicant's supplemental response. The WCAB found the petition procedurally deficient for lacking a sworn declaration and substantive merit, as alleged errors do not establish bias. Consequently, the WCAB denied the Petition for Disqualification on both procedural and substantive grounds.

WCABPetition for DisqualificationLabor Code section 5311Code of Civil Procedure section 641WCJin pro peraffidavitdeclarationbiasprejudice
References
Case No. ADJ1631280
Regular
Sep 02, 2025

FAREED ROSHANDELL vs. TRANSFORM SR HOLDING MANAGEMENT LLC/TRANSFORMCO, ACE AMERICAN INSURANCE COMPANY

Applicant Fareed Roshandell, who previously sustained injuries, sought reconsideration of a June 3, 2025 decision by a Workers' Compensation Administrative Law Judge (WCJ). The WCJ had taken the matter off calendar and made findings without an evidentiary record, including deeming a medical report invalid and noting service irregularities. The Workers' Compensation Appeals Board dismissed the petition for reconsideration but granted the petition to treat it as a petition for removal. Citing due process violations and the lack of an evidentiary record, the Board rescinded the WCJ's June 3, 2025 decision and returned the case to the trial level for further proceedings consistent with their opinion.

RemovalPetition for ReconsiderationUtilization ReviewRequest for AuthorizationMedical-Legal ReportSanctionsHome Health AidePhysician's AssistantDue ProcessEvidentiary Hearing
References
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