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

Case No. ADJ13303390
Regular
Feb 15, 2023

JULIO PINEDA vs. CITY OF RANCHO CUCAMONGA, LWP CLAIMS SOLUTIONS, INC.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to review the administrative law judge's (WCJ) finding of a compensable psychiatric injury. The defendant argued the psychiatric Qualified Medical Examiner's (QME) opinion lacked substantial evidence and that a "good faith personnel action" defense applied. The WCAB rescinded the award, finding the WCJ's decision failed to include a detailed analysis of the "good faith personnel action" defense as required by *Rolda v. Pitney Bowes*. The matter is returned to the WCJ to issue a new decision addressing all relevant issues under the preponderance of evidence standard.

Psychiatric injuryGood faith personnel action defenseRolda analysisSubstantial causePredominant causeQualified Medical Examiner (QME)Findings and Award (F&A)RescindReturn to WCJLabor Code section 3208.3
References
2
Case No. ADJ6775950
Regular
Jun 22, 2017

MARTIN MENDOZA vs. W&M TEXTILE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted a petition for reconsideration filed by lien claimant Physician Funding Solutions, LLC. The Board rescinded the prior order dismissing the lien of Physician Funding Rancho Cucamonga and Rx Funding Solutions Rancho Cucamonga. The WCJ's report, which was adopted by the Board, provided the reasoning for this decision. This order reinstates the dismissed liens.

Physician Funding SolutionsLLCRx Funding SolutionsLLCPetition for ReconsiderationOrder Dismissing LienWorkers' Compensation Appeals BoardWCJ ReportGrant ReconsiderationRescind Order
References
0
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
4
Case No. ADJ540138 (LAO 0879553)
Regular
Apr 26, 2005

GEORGE RODRIGUEZ vs. USF BESTWAY, GALLAGHER BASSETT RANCHO CUCAMONGA

This is an Order Denying Reconsideration from the Workers' Compensation Appeals Board. The Board reviewed the petition for reconsideration and the WCJ's report. It adopted and incorporated the WCJ's reasoning in its decision to deny the petition. Therefore, the applicant's request for reconsideration has been formally denied.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationWorkers' Compensation Administrative Law Judgedenied reconsiderationUSF BESTWAYGALLAGHER BASSETTGEORGE RODRIGUEZADJ540138LAO 0879553
References
0
Case No. ADJ6830729
Regular
Apr 21, 2010

ALFONSO ESCOBAR vs. BIMBO BAKERIES USA, GALLAGHER BASSETT RANCHO CUCAMONGA

The Workers' Compensation Appeals Board dismissed the defendant's Petition for Reconsideration because the order suspending action was not a final order. However, the Board treated the filing as a Petition for Removal, granted it, and rescinded the judge's order suspending action. This action allows the matter to return to the trial level for further proceedings regarding the defendant's Petition to Compel Deposition. The WCJ's observation that the deponent should not be deposed again was clarified as merely an observation, not a binding ruling.

Petition for ReconsiderationPetition for RemovalOrder Suspending ActionPetition to Compel DepositionProof of ServiceProof of NoticeDue ProcessAdministrative Law JudgeWorkers' Compensation Appeals BoardFinal Order
References
1
Case No. ADJ7476556
Regular
Nov 09, 2010

MAXIMA ANDRES vs. MATCHED CAREGIVERS, INC., HEALTH CARE INDUSTRY SELF INSURANCE, PRIVATE ADJUSTING RANCHO CUCAMONGA

This case involves a petition for reconsideration filed by the defendant after an Order Approving Compromise and Release (OACR). However, the Workers' Compensation Appeals Board (WCAB) dismissed the petition as moot. This is because the Administrative Law Judge (ALJ) had already rescinded the OACR on October 21, 2010, prior to the defendant's petition. Therefore, the action sought by the defendant's petition had already been taken.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Approving Compromise and ReleaseOrder RescindingWCJMootDismissalMatched CaregiversInc.Health Care Industry Self Insurance
References
0
Case No. ADJ1088185 (SAC 0369416)
Regular
May 25, 2012

DEBORAH COIL vs. CITY OF RANCHO CORDOVA

The Workers' Compensation Appeals Board (WCAB) dismissed Deborah Coil's petition for reconsideration because the WCJ's order was procedural, not a final determination of substantive rights. The WCAB reasoned that Coil's contentions about the PQME's familiarity with the AMA Guides were misplaced as those guides are not relevant to psychiatric impairment ratings. Therefore, the WCAB denied removal and dismissed the petition, allowing the PQME another opportunity to re-evaluate the applicant without her husband present. A concurring and dissenting opinion argued for removal, citing the PQME's repeated inability to produce substantial medical evidence.

Panel Qualified Medical EvaluatorPQMEPetition for ReconsiderationRemovalLabor Code Section 5900Labor Code Section 5310Final OrderSubstantial Medical EvidenceAMA GuidesAlmaraz/Guzman
References
7
Case No. ADJ8482506
Regular
Sep 19, 2016

VANESSA OLVERA vs. RANCHO HARVEST, STAR INSURANCE COMPANY

The Appeals Board granted reconsideration to amend the Findings and Award, primarily to correct the permanent disability indemnity rate to align with the parties' stipulation, as the original judge altered it without sufficient evidence or good cause. The Board also deferred the issue of liability for self-procured medical treatment, finding no evidence was presented to support the original award of reimbursement for such costs. Furthermore, a clerical error regarding the body parts affected by the injury was corrected. The original determination of a 30% permanent disability rating, supported by medical evidence, was otherwise affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent Disability Indemnity RateStipulationWCJ AuthorityWhole Person ImpairmentSelf-Procured Medical TreatmentAdmitted EvidenceSubstantial Evidence
References
6
Case No. ADJ8015232
Regular
Oct 17, 2017

ROSA RAMIREZ vs. RANCHO HARVEST, INC., STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to determine the validity of a lien for interpreting services. The Board affirmed the lien claimant's entitlement to $1,905.00 for services rendered prior to January 1, 2013. However, they rescinded the original decision regarding services after January 1, 2013, finding them not subject to Independent Bill Review. The case is returned to the trial level to determine the reasonable value of services provided after that date.

Workers' Compensation Appeals BoardLien ClaimantInterpreting ServicesOfficial Medical Fee Schedule (OMFS)Independent Bill Review (IBR)Senate Bill 863 (SB 863)Labor CodeStatute of LimitationsExplanation of ReviewAdministrative Director
References
0
Case No. ADJ3083946
Regular
Sep 21, 2009

PATRICIA GRAYKOWSKI vs. MERCY HEALTHCARE OF SACRAMENTO, SEDGWICK 3110 RANCHO CORDOVA

The Workers' Compensation Appeals Board denied Patricia Graykowski's Petition for Reconsideration in case ADJ3083946. The Board adopted and incorporated the reasoning provided in the workers' compensation administrative law judge's report. Therefore, the applicant's request for reconsideration of the prior decision was unsuccessful.

Workers' Compensation Appeals BoardMercy HealthcareSedgwickPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeWCJdenial of reconsiderationADJ3083946SAC 0366283Patricia Graykowski
References
0
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