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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. ADJ8501790
Regular
Jul 29, 2015

Kelly Chase vs. St. Louis Blues Hockey Club, Federal Insurance Company

The Workers' Compensation Appeals Board (WCAB) reversed a prior finding of industrial injury for a professional hockey player against the St. Louis Blues. The WCAB found insufficient connection to California for jurisdiction, citing the player's limited games in the state compared to his overall career. This decision followed the precedent set in *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)*, which requires a legitimate and substantial connection to the state for jurisdiction. The WCAB concluded that 21 games out of 485 did not meet this standard for a cumulative injury claim.

WCABSt. Louis Blues Hockey ClubFederal Insurance CompanyADJ8501790Opinion and Decision After Reconsiderationcumulative industrial injuryprofessional hockey playersubject matter jurisdictionstatute of limitationssubstantial medical evidence
References
Case No. ADJ9845740
Regular
Dec 18, 2019

RICHARD OKUNIEWICZ vs. CHRISTOFFERSON TRANSPORTATION, QBE-PRAETORIAN INSURANCE COMPANY

This case concerns an employer's petition for removal challenging a judge's order denying a motion to compel an in-person vocational evaluation. The Appeals Board denied the petition, treating it as a reconsideration request because the underlying order resolved threshold issues. Although the decision was final regarding threshold matters, the Board reviewed the discovery dispute under the extraordinary removal standard. The majority found no significant prejudice or irreparable harm from denying the in-person evaluation, as a remote evaluation was deemed sufficient.

Petition for ReconsiderationPetition for RemovalFindings and OrderMedical-Legal EvaluationCompelSignificant PrejudiceIrreparable HarmThreshold IssueInterlocutory IssueVocational Evaluation
References
Case No. ADJ9011624
Regular
Dec 13, 2019

ELISHA HARDEN vs. COUNTY OF SACRAMENTO

This case concerns whether specific medical reports obtained for a disability retirement claim are admissible in a workers' compensation proceeding. The Appeals Board rescinded the prior ruling, holding these reports are relevant and may be provided to the orthopedic Agreed Medical Evaluator (AME) and psychiatric Qualified Medical Evaluator (QME). The Board found the reports relevant to the medical issues, even though they were not obtained through the standard workers' compensation medical-legal evaluation process. Consequently, the applicant's objection to providing these reports to the evaluators was overruled.

RemovalReconsiderationAgreed Medical Evaluator (AME)Qualified Medical Evaluator (QME)Medical-legal evaluatorsMedical recordsLabor CodeFindings and Orders (F&O)Disability retirementPermanent impairment
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. ADJ3565194 (BAK 0139614)
Regular
Dec 04, 2015

TAMMY AGOSTA vs. VONS, A SAFEWAY COMPANY

The applicant sought reconsideration of a workers' compensation award of $61\%$ permanent disability for an industrial injury. She argued that the administrative law judge erred and that she should be found permanently totally disabled ($100\%$) based on vocational expert and medical evaluations. The Workers' Compensation Appeals Board denied her petition, adopting the WCJ's report. However, one commissioner dissented, arguing that the applicant's significant medical restrictions and vocational expert's opinion supported a finding of $100\%$ permanent disability.

AgostaVonsSafewayWorkers' Compensation Appeals BoardPetition for ReconsiderationFindings Orders and Awardadministrative law judgecumulative injuryright shoulderright upper extremity
References
Case No. ADJ6736604
Regular
Sep 26, 2013

WHITNEY DITLEVSEN vs. GOLD COUNTRY TRUE VALUE, BERKSHIRE HATHAWAY

In this workers' compensation case, the applicant has been unable to secure a timely QME evaluation after four attempts due to scheduling issues with chosen physicians. The Appeals Board granted the applicant's petition for removal, overturning the WCJ's decision to issue another QME panel. The Board invoked its inherent powers to appoint a physician directly, deeming it necessary to expedite the resolution of permanent disability. A dissenting opinion argued this violated regulations and precedent by prioritizing expediency over established procedures.

Petition for RemovalQualified Medical EvaluatorPanel of QMEsAdministrative DirectorLabor Code Section 4062.2AD Rule 31.5(a)(2)Substantial EvidenceTimely EvaluationAgreed Medical EvaluatorWCJ
References
Case No. ADJ7074256
Regular
May 23, 2014

ALFONSO RODRIGUEZ vs. DANDEE TRANSPORTATION, STATE COMPENSATION INSURANCE FUND

This case involves a dispute over whether the applicant, Alfonso Rodriguez, adequately pursued medical evaluations before a mandatory settlement conference. The applicant sustained an injury in 2009 and has undergone evaluations by an Agreed Medical Evaluator and Qualified Medical Evaluators. However, at the settlement conference, the applicant claimed he still required treating physician reports in psychiatry and internal medicine, leading the trial judge to take the case off calendar. The Appeals Board granted the defendant's petition for removal, finding the applicant waived objections to proceeding by not objecting to the defendant's Declaration of Readiness to Proceed or the QME panels. The Board rescinded the order and returned the case to the trial level for another settlement conference and potential trial, emphasizing the applicant's lack of diligence in discovery.

Petition for RemovalRescind OrderOff CalendarAgreed Medical EvaluatorQualified Medical EvaluatorMandatory Settlement ConferenceDeclaration of Readiness to ProceedLabor Code section 4061(i)Due DiligenceDiscovery
References
Case No. ADJ13061844
Regular
Dec 28, 2020

RON PETTWAY vs. TRILLIUM STAFFING SOLUTIONS, CORVEL CORPORATION

The Workers' Compensation Appeals Board granted the defendant's petition for removal, rescinding a prior order that denied the defendant's request to compel the applicant's attendance at an in-person medical evaluation. The WCAB found that the administrative law judge improperly denied the petition solely due to the Shelter in Place Order. The Board clarified that emergency regulations permit medical-legal evaluations during the state of emergency and returned the matter to the trial level to determine if the evaluation could proceed under these regulations.

Workers' Compensation Appeals BoardPetition for RemovalMedical Legal EvaluationQualified Medical EvaluatorShelter in Place OrderLabor CodeCompel AttendanceRescind OrderReturn to Trial LevelTelehealth
References
Case No. ADJ9 636706; ADJ9636707 ADJ9447837
Regular
Aug 09, 2016

RICK PARKER vs. DSC LOGISTICS, ZURICH NORTH AMERICA

This case concerns whether a Qualified Medical Evaluator (QME) must address all claimed industrial injuries filed prior to their initial evaluation. The Workers' Compensation Appeals Board (WCAB) rescinded a prior order that denied the defendant's petition to vacate new QME panels. The WCAB held that Labor Code section 4062.3(j) requires a QME to evaluate all contested medical issues arising from injuries reported on one or more claim forms prior to the employee's initial appointment. Therefore, the applicant must return to the original QME, Dr. Steinmann, to evaluate the disputed medical issues in all relevant case numbers.

Workers' Compensation Appeals BoardReconsiderationPetition to Vacate QME PanelsLabor Code section 4062.3Qualified Medical EvaluatorPanel QMEDuplicative Medical EvaluationsDoctor ShoppingNavarro v. City of MontebelloContested Medical Issues
References
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