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

Case No. 2025-60-3038, 2025-60-3037, 40527-2024, 860132-2025
Regular Panel Decision
Aug 05, 2025

SMITH, KENDRA V. REGARD RECOVERY JP, LLC

Kendra Smith, an employee, sought a pulmonology panel, medical treatment, and continued temporary disability benefits, alleging a work-related aggravation of her preexisting asthma due to vape smoke exposure at work. The Court found she is likely to prevail at a final hearing on a pulmonology referral, as a treating physician had already made such a recommendation. She is also likely to prevail in proving entitlement to temporary disability benefits because her workplace restrictions were not accommodated by her employer, Regard Recovery JP, LLC. However, the request for specific medical treatment was denied due to a lack of expert medical evidence establishing its reasonableness and necessity. Furthermore, the insurer was referred to the Compliance Program for multiple violations of workers' compensation statutory and regulatory requirements, including inadequate panel offerings.

asthma aggravationvape exposuretemporary disability benefitspulmonology referralmedical treatment denialworkers' compensation law violationscompliance program referralpreexisting conditionunaccommodated workplace restrictionsexpedited hearing
References
5
Case No. ADJ18210611
Regular
May 08, 2025

ELENITA JOVER vs. COUNTY OF SAN BERNARDINO DEPARTMENT OF PUBLIC HEALTH

Elenita Jover, a licensed vocational nurse, sought reconsideration of a Findings and Award that denied her request for additional Qualified Medical Evaluation (QME) panels. The initial F&A found injuries to her cervical and lumbar spine, shoulders, and right thumb, but not to other claimed body parts like stress, psyche, or internal systems. The Appeals Board granted the petition, rescinded the original F&A, and ordered additional QME panels for pulmonology, internal medicine (diabetes), ophthalmology, ENT, and neurology, returning the case to the trial level for further proceedings. This decision was based on the original QME's recommendation for further evaluations and the need to develop the evidentiary record to ensure substantial justice.

Petition for ReconsiderationQualified Medical EvaluationLicensed Vocational NurseArising out of and in the course of employmentPermanent DisabilityDue ProcessPulmonologistInternistOphthalmologistOtolaryngologist
References
7
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