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

Case No. ADJ3433658 (SRO 0118954)
Regular
Mar 17, 2011

FRANK VONADA vs. GAMBRO HEALTHCARE, SUNNYSIDE REHABILITATION, ESIS, CIGA

The applicant sought removal of an Order Closing Discovery to re-examine disputed medical treatment issues. The Workers' Compensation Appeals Board (WCAB) considered the case based on the applicant's petition for removal and the defendants' answer. The WCJ recommended dismissal as the applicant had previously withdrawn their petition to remove. The WCAB agreed with the WCJ and dismissed the petition for removal because it had been withdrawn.

Petition for RemovalOrder Closing DiscoveryMandatory Settlement ConferenceAgreed Medical ExaminerDue ProcessWCJWithdrawal of PetitionWorkers' Compensation Appeals BoardDismissalRe-examination
References
Case No. ADJ11258859
Regular
Jan 23, 2020

Allen, Melanie vs. Stockton Unified School District

The Board rescinded the Finding of Fact, Order and Award due to the Qualified Medical Examiner's (QME) report's non-compliance with Labor Code section 4628. The QME falsely claimed to have personally reviewed all medical records when deposition testimony revealed a third party performed this task. This violation renders the QME's report inadmissible evidence. Consequently, the matter is returned to the WCJ for further proceedings, including potential re-trial and a new decision after a replacement QME evaluation or an agreed medical examiner. The WCJ must also address previously unresolved evidentiary issues.

Workers' Compensation Appeals BoardPetition for ReconsiderationFinding of Fact Order and AwardQualified Medical ExaminerLabor Code section 4628medical-legal reportsubstantial evidenceinadmissible evidenceAgreed Medical Examinerappointed physician
References
Case No. ADJ6622799
Regular
Oct 18, 2013

TERRY A. WIRTH vs. STATE OF CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

This case concerns the denial of a Petition for Reconsideration filed by the defendant, the State of California Highway Patrol. The applicant, Terry A. Wirth, suffered a continuous trauma injury (prostate cancer) leading to urinary and erectile dysfunction. The Appeals Board adopted the Workers' Compensation Judge's report, finding that the date of injury was in 2008, determining the applicable permanent disability compensation rate based on that date. The Board also found ample evidence supporting the agreed medical examiner's impairment ratings for the applicant's post-surgical conditions, dismissing the defendant's objections.

Workers' Compensation Appeals BoardState of California Highway PatrolState Compensation Insurance FundPetition for ReconsiderationPermanent disability compensation rateLabor Code section 5412Urinary incontinenceErectile dysfunctionCommon postprostatectomy symptomsWhole person impairment ratings
References
Case No. ADJ8051978
Regular
Jan 26, 2016

LUISA LOPEZ vs. SAN JOAQUIN COUNTY

The Workers' Compensation Appeals Board denied the defendant's Petition for Removal regarding an order taking the matter off calendar. The defendant argued that the applicant lacked medical evidence of new and further disability to support re-examinations with medical evaluators. The Board found the defendant failed to demonstrate significant prejudice or irreparable harm absent removal. Therefore, the petition was denied, and the WCJ's decision to take the case off calendar was upheld.

Petition for RemovalOff Calendar OrderNew and Further DisabilityRe-examinationAgreed Medical Evaluator (AME)Qualified Medical Evaluator (QME)Stipulations with Request for AwardWCJWCABIrreparable Harm
References
Case No. ADJ3355286 (SAC 0369062)
Regular
Jun 24, 2010

Dale E. Hansen vs. EL DORADO TRUSS COMPANY, INC., ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration, finding no final order existed subject to review. The Board also denied the applicant's petition for removal, as no significant prejudice or irreparable harm was demonstrated. The applicant had sought to disqualify a psychiatric QME and argued the WCJ erred on multiple procedural and evidentiary grounds. The WCJ's order for the parties to confer on an Agreed Medical Examiner was found not to be a final determination.

Workers Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalQualified Medical Examiner (QME)Agreed Medical Examiner (AME)Reporting RequirementsFinal OrderSubstantive RightsPrejudiceIrreparable Harm
References
Case No. ADJ7264010, ADJ7498085
Regular
Mar 16, 2017

SANDRA CATLIN vs. J.C. PENNEY, INC., AMERICAN HOME ASSURANCE CO.

This case involves a defendant's petition for removal of a WCJ's order requiring the applicant to undergo a treatment consultation with an Agreed Medical Evaluator (AME) under Labor Code § 4050 and directing the defendant to provide a nurse case manager. The defendant argued that § 4050 grants them the right to select a physician for examination and that the AME consultation order was improper, as was the indefinite appointment of a nurse case manager. The Appeals Board granted the petition for removal, affirming the WCJ's orders except for the AME re-evaluation, which was deferred due to a lack of statutory basis and evidence presented. The Board found that § 4050 has been largely subsumed by more specific statutes governing medical evaluations and treatment disputes.

Petition for RemovalAgreed Medical Evaluator (AME)Labor Code § 4050Nurse Case ManagerMedical TreatmentUtilization Review (UR)Compromise and Release (C&R)Declarations of Readiness to Proceed to Expedited Hearing (DOR)Medical ExaminationQualified Medical Examination
References
Case No. ADJ4707980 (VNO 0543260) ADJ3907003 (VNO 0543258) ADJ7500629
Regular
Apr 05, 2012

RAMON SALAZAR vs. CONSOLIDATED DISPOSAL SERVICE, ACE USA Administered By CANNON COCHRAN MANAGEMENT SERVICES INC.

The Appeals Board granted removal, rescinding the WCJ's order for a sanctions hearing and the appearance of the defendant's claims examiner. While acknowledging the duty to disclose evidence before a trial, the Board found no authority requiring pre-expedited hearing disclosure of sub rosa films, thus negating grounds for sanctions. The Board also determined an affidavit from the claims examiner would suffice, making her live appearance unnecessary. The order for the sub rosa films to be sent to the Agreed Medical Examiner was affirmed.

sub rosa filmsexpedited hearingsanctionsPetition for RemovalAgreed Medical Examinertemporary disability indemnitymedical treatmentclaims examineraffidavitLabor Code section 5813
References
Case No. ADJ8106886
Regular
Sep 12, 2013

HECTOR VAZQUEZ vs. DEUEL VOCATIONAL INSTITUTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of an administrative law judge's decision that applicant Hector Vazquez's heart disease was not industrially caused. The majority adopted the judge's report, noting a clerical error in identifying the medical examiner as an Agreed Medical Examiner (AME) instead of a Panel Qualified Medical Examiner, but found this did not affect the judge's analysis. Commissioner Brass dissented, arguing the record was undeveloped regarding job stress's contribution to the heart disease, and that the medical examiner's opinion was not substantial evidence to rebut the statutory presumption of industrial causation for correctional officers.

Workers' Compensation Appeals BoardPetition for ReconsiderationQualified Medical ExaminerAgreed Medical Examinerheart diseasejob stresscorrectional officerpresumptionrebuttalsubstantial evidence
References
Case No. ADJ7688956
Regular
Jan 31, 2012

SHARON FRINK vs. SHASTA-TEHAMA-TRINITY JOINT COMMUNITY COLLEGE

The Workers' Compensation Appeals Board granted removal, rescinded prior orders, and returned the case for further proceedings. The issue was whether the applicant must attend a re-evaluation with the same Qualified Medical Evaluator (QME) after he moved his office a short distance. The Board found that Labor Code section 4062.3(j) requires parties to utilize the same QME for subsequent disputes if possible. They clarified that Administrative Director Rule 34(b) regarding the QME's office location applies only to initial evaluations, not re-evaluations. Therefore, the applicant's refusal to travel a short distance for re-evaluation was not grounds for a new panel QME.

Workers' Compensation Appeals BoardPetition for RemovalQualified Medical Examiner (QME)Re-evaluationLabor Code Section 4062.3(j)Administrative Director Rule 34(b)Administrative Director Rule 36(d)Medical Office LocationUnavailable QMECompel Attendance
References
Case No. ADJ273405 (WCK 0060645)
Regular
Nov 09, 2011

MARILANI WRIGHT vs. CPN CORPORATION, FARMERS INSURANCE

The applicant sought reconsideration to cross-examine a Disability Evaluator regarding a prior permanent disability rating. The Appeals Board granted reconsideration, rescinded its previous award, and ordered a hearing for the cross-examination. However, this hearing did not occur, and the Workers' Compensation Judge (WCJ) improperly approved a stipulated award. The Appeals Board, while acknowledging the WCJ exceeded their authority, will affirm the stipulated award to finalize the settlement.

Workers' Compensation Appeals BoardReconsiderationDisability EvaluatorCross-examinationPetition to ReopenPermanent Disability RatingStipulations with Request for AwardRule 10862Excess of JurisdictionInterlocutory Orders
References
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