CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. ADJ6502775, ADJ6498620, ADJ8109003, ADJ8115890
Regular
May 09, 2014

MARIA POHYAR vs. DEY LP, AMERICAN ZURICH INSURANCE COMPANY, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration because the challenged order was not a "final order" subject to reconsideration. The WCAB also denied the Petition for Removal, agreeing with the Administrative Law Judge that the issue of whether the defendant Zurich is entitled to a new Qualified Medical Evaluator (QME) panel was only before the WCJ based on a procedural rule regarding appointment notification forms, not ex parte communications. The WCAB clarified that issues of ex parte communications and the applicability of related statutes and rules were not yet properly before the Board. Therefore, the applicant's request for the WCAB to assert jurisdiction and rule against Zurich on the QME panel issue was denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalJurisdictionQualified Medical Evaluator (QME)Panel QMEDivision of Workers' Compensation (DWC) RulesLabor Code section 4062.3Ex parte communicationMedical Director
References
7
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 The Workers' Compensation Appeals Board (WCAB) rescinded a prior order that denied the defendant's petition to vacate new QME panels.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
1
Case No. ADJ9606568
Regular
Oct 12, 2017

Rodrigo Bautista vs. SA RECYCLING, CORVEL CORPORATION

The Workers' Compensation Appeals Board affirmed a prior decision, amending it only to correct a clerical error regarding injured body parts. The defendant sought reconsideration, arguing they were entitled to a replacement Qualified Medical Evaluator (QME) panel due to an incorrect address being used for appointment notification to their attorney. The Board found that this de minimis error did not warrant a replacement panel, especially since the insurer received proper notice and the defendant otherwise participated in discovery with the QME. Therefore, the original finding that the defendant was not entitled to a replacement QME panel was upheld.

WCABReconsiderationQME PanelAppointment NoticeClerical ErrorDe Minimis MistakeAOE/COEFindings and OrderPetition for ReconsiderationMedical Unit
References
5
Case No. ADJ7532290
Regular
Aug 28, 2012

MAXINE BROWN VIRGIL vs. LUNCH STOP, INC., EMPLOYERS COMPENSATION INSURANCE

This case involves a dispute over obtaining a Qualified Medical Evaluator (QME) panel. The applicant requested a new panel because a QME on the initial panel could not provide an appointment within 60 days. However, the applicant failed to properly strike a physician from the original panel after the defendant did. As a result, the defendant was authorized to schedule an appointment with a remaining physician, and the applicant was not entitled to a new QME panel. The Appeals Board granted removal to amend the prior order to reflect a rescheduled appointment with the original QME.

Workers' Compensation Appeals BoardPetition for RemovalQualified Medical EvaluatorpanelstrikeLabor Code section 4062Administrative Director Rule 31.5section 4062.2(c)medical evaluatorappointment
References
1
Case No. MISSING
Regular Panel Decision

Union Appointed Trustees of the Tapers Industry Insurance & Annuity Funds v. Employer-Appointed Trustees of the Tapers Industry Insurance & Annuity Funds

A dispute arose between the Employer-Appointed Trustees and Union-Appointed Trustees of the Tapers Industry Insurance and Annuity Funds concerning delinquent employer contributions. An arbitrator issued an award, which the Employer-Appointed Trustees sought to confirm and the Union-Appointed Trustees cross-moved to vacate. Judge Walker of the District Court reviewed the arbitration award, noting the arbitrator based his findings on prior judicial decisions rather than independently interpreting the collective bargaining agreement. The Court determined that the arbitrator failed to apply the contract as bargained for by the parties, thus exceeding his authority. Consequently, the Court vacated the arbitration award and remanded the dispute for proceedings consistent with its order.

Arbitration AwardVacate Arbitration AwardConfirm Arbitration AwardCollective Bargaining AgreementTrust FundsDelinquent ContributionsRes JudicataManifest Disregard of LawScope of Judicial ReviewLabor Dispute
References
12
Case No. ADJ1692556 (STIK 0207020) ADJ2977889 (STK 0208240)
Regular
Aug 06, 2009

CATHY HAWKINS vs. SUTTER HEALTH CORPORTION (dba) SUTTER TRACY COMMUNITY HOSPITAL

The Workers' Compensation Appeals Board (WCAB) granted removal and reversed a WCJ's order to appoint a new QME. The WCAB found the WCJ erred in concluding the applicant was entitled to a new QME panel for a slight delay in scheduling an examination. They reasoned that the applicant's allegations did not definitively prove Dr. Choi "could not" schedule an earlier appointment or that a waiver was violated. The WCAB determined that requiring a new QME process for minor scheduling delays, especially with an established QME, would be wasteful.

Petition for removalQualified Medical Evaluator (QME)60-day time limitappointment schedulingwaiverprejudiceirreparable harmfinal orderreconsiderationsubstantiative issue
References
4
Case No. ADJ3570526 (VNO 0553441) ADJ3614404 (VNO 0552970)
Regular
May 22, 2014

BIYAZEN JEMBERE vs. AMERIPARK, INC.; NATIONAL LIABILITY & FIRE INSURANCE; OAK RIVER INSURANCE CO., Adjusted by ACCA

The applicant petitioned for removal, seeking to rescind an order compelling attendance at a QME examination due to an alleged lack of opportunity to respond and a valid excuse for a prior missed appointment. The applicant's brother died in Ethiopia, causing him to be out of the country and miss an initial QME appointment. Although the applicant subsequently attended the rescheduled QME exam, rendering the removal petition moot regarding attendance, the Appeals Board dismissed the petition.

Petition for RemovalOrder Suspending ProceedingsPetition to Compel AttendanceMedical EvaluationQualified Medical Evaluator (QME)Excusable NeglectBureaucratic ReasonsEAMSMootWorkers' Compensation Appeals Board (WCAB)
References
0
Case No. ADJ345248 (RDG 0128229)
Regular
Oct 26, 2011

JEREMY CHISSIE vs. REIBES AUTO PARTS, LLC, PACIFIC COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board granted removal and rescinded the WCJ's order to appoint an Independent Medical Examiner (IME). The Board found the WCJ improperly bypassed the established procedure for selecting a Qualified Medical Evaluator (QME) when the original QME became unavailable. Instead, the matter must return to the trial level to follow the Administrative Director's rules for appointing a replacement QME. This ensures the defendant's right to participate in the physician selection process.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalIndependent Medical Examiner (IME)Qualified Medical Evaluator (QME)Labor Code section 4062.2Administrative Director's Rule 31.5Rule 32.6Medical UnitPanel QME
References
3
Case No. ADJ8939533
Regular
Dec 23, 2019

MAURICIO FLORES vs. MERCY HOUSING, INC., FEDERAL INSURANCE COMPANY

This case concerns an employer's petition for reconsideration regarding the denial of a new Qualified Medical Evaluator (QME) panel. The applicant amended his claim to include a cumulative trauma injury and additional body parts, but he did not file a new claim form. The Board denied the petition, holding that because the applicant amended an existing application and did not file a new claim form, the employer was not entitled to a new QME panel. The ruling relies on the principle that the filing date of the claim form determines which evaluator considers the injury claim.

Cumulative traumaQualified Medical EvaluatorQME panelAmendment of ApplicationDWC-1 Claim FormNavarro v. City of MontebelloThreshold issueInterlocutory decisionRemovalReconsideration
References
5
Case No. MISSING
Regular Panel Decision

Massachusetts Mutual Life Insurance v. Avon Associates, Inc.

This case addresses a motion by defendants mortgagors to vacate an ex parte order appointing a receiver during a mortgage foreclosure action. Defendants asserted that the lack of notice for the receiver's appointment violated CPLR 6401 and their Federal constitutional due process rights, citing Fuentes v Shevin. The court found that New York's Real Property Actions and Proceedings Law § 1325 (subd 1) permits ex parte receiver appointments when the mortgage contract explicitly waives notice. Furthermore, the court distinguished the present case from Fuentes, concluding that the sophisticated business operators involved had knowingly and voluntarily waived their right to notice, akin to the circumstances in Overmyer Co. v Frick Co. Based on these findings, the court affirmed the validity of the ex parte order and denied the defendants' motion to vacate the appointment of the receiver.

Mortgage ForeclosureReceiver AppointmentEx Parte OrderDue ProcessWaiver of NoticeContractual WaiverCPLRReal Property Actions and Proceedings LawConstitutional LawBusiness Disputes
References
9
Showing 1-10 of 1,908 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational