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Case Law Database

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

Case No. ADJ10800397

Regular

May 20, 2019

MARILYN RAMIREZ GALVEZ vs. NIAGARA BOTTLING LLC, SAFETY NATIONAL INSURANCE CO.

The applicant sought a QME panel in psychology for a claimed psychiatric injury after orthopedic and internal medicine evaluations. The WCJ denied the request, finding no substantial medical evidence for a psychological QME. The Appeals Board granted removal, rescinded the WCJ's order, and found good cause for a psychological QME panel. This decision allows the applicant to pursue necessary medical-legal discovery regarding her disputed psychological injury claim.

Petition for RemovalFindings and OrderQualified Medical EvaluatorQME panelpsychologypsychiatric injurydiscoveryinternal medicineorthopedic QMEhypertension

References

Case No. ADJ9549773

Regular

Nov 13, 2015

EDWARD BAUTISTA vs. ARLON GRAPHICS, TRAVELERS

The Appeals Board dismissed the applicant's petition for reconsideration or removal, finding the WCJ's order was not a final determination. The WCJ correctly ordered the applicant to first discuss his anxiety symptoms and need for psychological referral with his primary treating orthopedist. Applicant is not entitled to a second opinion from a psychologist until the primary treating physician has diagnosed the anxiety or determined a referral is unnecessary. Commissioner Sweeney dissented, believing the applicant had an absolute right to an MPN second opinion for his psychiatric condition without first obtaining a referral from his orthopedist.

ADJ9549773Arlon GraphicsTravelersPetition for ReconsiderationPetition for RemovalWorkers' Compensation Appeals BoardWCJLabor Code Section 4616.3Labor Code Section 4616.4Administrative Director Rules

References

Case No. ADJ13030119

Regular

Apr 28, 2023

MARIA YESENIA JARAMILLO JIMENEZ vs. EL POLLO LOCO, TECHNOLOGY INSURANCE administered by AMTRUST

Lien claimant Nogales Psychological Counseling appealed an administrative law judge's decision disallowing its lien for services. The Workers' Compensation Appeals Board granted reconsideration to further review the matter. Subsequently, the parties entered into a stipulation, agreeing to settle the lien claim for $6,500.00. The Board rescinded the original decision and approved the stipulation as the final resolution of the dispute.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings of Fact and OrderWCJDisallowed LienStipulationSettlementRescindedApproved

References

Case No. ADJ9368263, ADJ9380293

Regular

Sep 15, 2015

JOSE MELCHOR vs. BRUTOCAO VINEYARDS, STAR INSURANCE COMPANY

This case involves a defendant's petition for removal regarding an order for a second Qualified Medical Examiner (QME) panel concerning the applicant's head injury. The Workers' Compensation Appeals Board (WCAB) granted removal to correct a clerical error in the original order. The WCAB affirmed the necessity of a second QME to further develop the medical record on the head injury claim, specifically in the specialty of Psychology-Clinical Neuro Psychology.

Petition for RemovalSecond QME PanelHead InjuryMedical Record DevelopmentWCJ Duty to Develop RecordPQME SpecialtyPSNPsychology-Clinical Neuro PsychologyMandatory Settlement ConferenceLack of Diligence

References

Case No. ADJ7197363

Regular

Feb 11, 2014

NARCISO NOVA vs. JC SALES, dba SHIMS BARGAIN, LIBERTY MUTUAL INSURANCE COMPANY

This case concerns a lien claimant, California Psychological Associates, seeking reconsideration for disallowed costs of psychological treatment for applicant Narciso Nova. The Workers' Compensation Appeals Board denied the petition, adopting the Administrative Law Judge's report. The judge found no evidence of an injury to the psyche or that the psychological treatment was medically necessary for the admitted cervical spine injury. Furthermore, the psychological reports were not incorporated into any primary treating physician reports, and treatment began nearly two years after the applicant reached maximum medical improvement.

WCABPetition for ReconsiderationPsychological treatmentMedical necessityPrimary treating physicianMaximum medical improvementLien claimantStipulations with Request for AwardPermanent disabilityReferral

References

Case No. ADJ2972614 (VNO 0551694) ADJ3199572 (VNO 0558860)

Regular

Jan 31, 2012

ALI POURFARZAD vs. PALMIRA ASSOCIATES, INC., PREFERRED EMPLOYERS INSURANCE COMPANY

This case involves an applicant claiming industrial injuries to his spine, psychological system, and central nervous system (sleep disorder) from two separate dates of employment. The administrative law judge initially found injury to the psychological and central nervous systems but required further development of the record for permanent disability and apportionment. The Appeals Board determined that neither party presented substantial evidence regarding the causation and permanency of the claimed psychological and central nervous system injuries. Consequently, these issues are deferred, and the record will be developed further, potentially through an Agreed Medical Evaluator or a court-appointed physician.

Petition for ReconsiderationPartial Joint Findings of FactPanel Qualified Medical Evaluator (QME)Substantial EvidenceDevelop the RecordAgreed Medical Evaluator (AME)Regular PhysicianLabor Code Section 5701CausationPsychological Injury

References

Case No. ADJ1824746 (AHM 0146484) ADJ3300397 (AHM 0146486)

Regular

May 06, 2013

DIONISIO VASQUEZ vs. V CLAD LAMINATES, INC., PENNSYLVANIA MANUFACTURES ASSOC. INSURANCE CO., VIRGINIA SURETY

The Workers' Compensation Appeals Board affirmed the prior award for applicant Dionisio Vasquez's psychological injury, upholding the lien of Psychological Assessment Services for $22,772.71 plus penalties and interest. The Board also affirmed the lien of Royal Medical Group for treatment and reports dated December 8, 2007, and January 5, 2008, but excluded payment for a September 27, 2008 report. While the majority found substantial evidence supported the psychological treatment, a dissenting opinion argued that the number and intensity of therapy sessions, and the delay in treatment, lacked sufficient evidentiary support.

Workers Compensation Appeals BoardReconsiderationIndustrial InjuryPsycheHandsV Clad LaminatesPennsylvania ManufacturersVirginia SuretyPsychological Assessment ServicesRoyal Medical Group

References

Case No. SAC 355392

Regular

Jan 29, 2008

JANELL J. HASTINGS vs. GEORGE VISMAN dba HIGH HILL RANCH, ZENITH INSURANCE COMPANY

The Appeals Board denied the applicant's Petition for Removal, which sought to compel a psychiatric or psychological consultation. The Board adopted the Workers' Compensation Judge's reasoning that a panel for psychological issues is provided by the Division of Workers' Compensation if parties do not agree on a Qualified Medical Evaluator. Therefore, the applicant's request for removal to obtain this specific consultation was denied.

Petition for RemovalPsychiatric consultationPsychological consultationQualified Medical EvaluatorAdministrative Director Rule 32(c)Agreed Medical EvaluatorDivision of Workers' CompensationMedical UnitPanelWorkers' Compensation Appeals Board

References

Case No. ADJ9802798

Regular

Sep 14, 2016

Jorge Gonzalez vs. Wire Tech, Inc., Everest National Insurance Co.

Applicant sought to vacate a Compromise and Release (C&R) agreement, alleging he changed his mind about settling his psychological claims before obtaining a psychological evaluation. The Appeals Board granted reconsideration, finding the applicant may have been denied due process by not having his Petition to Vacate fully heard. The case is returned to the trial level for an evidentiary hearing on the applicant's Petition to Vacate the C&R, with all other proceedings stayed pending resolution.

Petition to VacateOrder Approving Compromise and ReleaseDuressUndue InfluencePetition for ReconsiderationPsychological EvaluationVerified PetitionGood CauseEvidentiary HearingDue Process

References

Case No. ADJ9339421 ADJ9275614 ADJ9339395

Regular

Jan 05, 2018

ROBERT LEITHISER vs. MICROSOFT, GALLAGHER BASSETT RANCHO CUCAMONGA

This case involves a lien claimant seeking reconsideration of a decision denying an applicant's psychological injury claim. The Workers' Compensation Appeals Board (WCAB) granted reconsideration and affirmed the original finding that the applicant did not sustain an industrial psyche injury. Consequently, the lien claimant is not entitled to recover costs for psychological medical treatment. However, the WCAB deferred the issue of whether the lien claimant can recover for medical-legal costs, returning it to the trial level for further proceedings.

Lien claimantPetition for ReconsiderationJoint Findings of Fact and Orderindustrial injurypsychepsychological treatmentmedical-legal costscontested claimpreponderance of the evidencemedical-legal expenses

References

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Updated Daily

Case Law Database

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

Case No. ADJ10800397

Regular

May 20, 2019

MARILYN RAMIREZ GALVEZ vs. NIAGARA BOTTLING LLC, SAFETY NATIONAL INSURANCE CO.

Petition for RemovalFindings and OrderQualified Medical EvaluatorQME panelpsychologypsychiatric injurydiscoveryinternal medicineorthopedic QMEhypertension

References

Case No. ADJ9549773

Regular

Nov 13, 2015

EDWARD BAUTISTA vs. ARLON GRAPHICS, TRAVELERS

ADJ9549773Arlon GraphicsTravelersPetition for ReconsiderationPetition for RemovalWorkers' Compensation Appeals BoardWCJLabor Code Section 4616.3Labor Code Section 4616.4Administrative Director Rules

References

Case No. ADJ13030119

Regular

Apr 28, 2023

MARIA YESENIA JARAMILLO JIMENEZ vs. EL POLLO LOCO, TECHNOLOGY INSURANCE administered by AMTRUST

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings of Fact and OrderWCJDisallowed LienStipulationSettlementRescindedApproved

References

Case No. ADJ9368263, ADJ9380293

Regular

Sep 15, 2015

JOSE MELCHOR vs. BRUTOCAO VINEYARDS, STAR INSURANCE COMPANY

References

Case No. ADJ7197363

Regular

Feb 11, 2014

NARCISO NOVA vs. JC SALES, dba SHIMS BARGAIN, LIBERTY MUTUAL INSURANCE COMPANY

References

Case No. ADJ2972614 (VNO 0551694) ADJ3199572 (VNO 0558860)

Regular

Jan 31, 2012

ALI POURFARZAD vs. PALMIRA ASSOCIATES, INC., PREFERRED EMPLOYERS INSURANCE COMPANY

References

Case No. ADJ1824746 (AHM 0146484) ADJ3300397 (AHM 0146486)

Regular

May 06, 2013

DIONISIO VASQUEZ vs. V CLAD LAMINATES, INC., PENNSYLVANIA MANUFACTURES ASSOC. INSURANCE CO., VIRGINIA SURETY

Workers Compensation Appeals BoardReconsiderationIndustrial InjuryPsycheHandsV Clad LaminatesPennsylvania ManufacturersVirginia SuretyPsychological Assessment ServicesRoyal Medical Group

References

Case No. SAC 355392

Regular

Jan 29, 2008

JANELL J. HASTINGS vs. GEORGE VISMAN dba HIGH HILL RANCH, ZENITH INSURANCE COMPANY

References

Case No. ADJ9802798

Regular

Sep 14, 2016

Jorge Gonzalez vs. Wire Tech, Inc., Everest National Insurance Co.

Petition to VacateOrder Approving Compromise and ReleaseDuressUndue InfluencePetition for ReconsiderationPsychological EvaluationVerified PetitionGood CauseEvidentiary HearingDue Process

References

Case No. ADJ9339421 ADJ9275614 ADJ9339395

Regular

Jan 05, 2018

ROBERT LEITHISER vs. MICROSOFT, GALLAGHER BASSETT RANCHO CUCAMONGA

References

Showing 1-10 of 220 results

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