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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ2635006 (STK 0206833)
Regular
Nov 01, 2010

SAMUEL B. JOHNSON, III vs. CHEVRON ENVIRONMENTAL MANAGEMENT COMPANY

The Workers' Compensation Appeals Board dismissed the applicant's Petition for Reconsideration because the WCJ's order denying discovery requests was not a final order. The Board also denied the applicant's Petition for Removal, finding no substantial prejudice or irreparable harm justifying this extraordinary remedy. The Board affirmed the WCJ's discovery ruling as reasonable and returned the matter to the trial level. The applicant may seek reconsideration of a final order.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalWCJdiscovery requestsRequest for AdmissionsRequest for Authenticationfinal ordersubstantial prejudiceirreparable harm
References
Case No. ADJ6816825
Regular
Jun 14, 2010

KAI CHRISTOPHER vs. TIME WARNER CABLE, ESIS

The Appeals Board granted defendant's petition for removal, finding the WCJ erred in denying a QME panel request. This denial was based on Administrative Director Rule 30(d)(3), which previously stated only the employee could request a QME panel after a total denial of injury. However, the Board's recent en banc decision in *Mendoza v. Huntington Hospital* invalidated this rule as conflicting with Labor Code sections 4060(c) and 4062.2, which allow either party to request a QME panel. Therefore, the prior order was rescinded, and the matter returned to the trial level with instructions to issue a QME panel.

Petition for RemovalQualified Medical Evaluator (QME)Administrative Director RuleInvalid RuleMendoza v. Huntington HospitalLabor Code sections 4060(c)Labor Code sections 4062.2Denial of InjuryEither Party RequestMedical Director
References
Case No. ADJ2488411 (RIV 0017588)
Regular
Jun 30, 2011

ROBERT DOODY vs. MERLI CONCRETE PUMPING COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

Defendant Merli Concrete Pumping Company petitioned for removal, arguing insufficient discovery time regarding the applicant's petition for third-party credit and restitution. However, prior to the Appeals Board ruling on the petition, the parties jointly requested and the judge granted a continuance off the trial calendar. Consequently, the defendant's petition for removal became moot. The Workers' Compensation Appeals Board dismissed the petition as moot.

Petition for RemovalThird-party CreditRestitutionDiscoveryOff CalendarMootWorkers' Compensation Appeals BoardPro Tempore JudgeContinuanceJoint Request
References
Case No. ADJ3785318 (LBO 0365737)
Regular
Apr 01, 2020

ANDRES MARIN vs. SANTEE DAIRIES, INC., SENTRY INSURANCE GROUP

The Workers' Compensation Appeals Board (WCAB) granted applicant Andres Marin's Petition for Removal. The WCAB rescinded an order by the WCJ which stated future medical treatment would be handled by Liberty Mutual with a right to contribution. This order was inconsistent with the Stipulations with Request for Award, which only named Santee Dairies/Sentry Insurance Group as a party and did not involve Liberty Mutual. The WCAB found that the erroneous order created prejudice by assigning future medical treatment responsibility to a non-party carrier.

Petition for RemovalWalk Through Appearance SheetStipulations with Request for Awardfuture medical treatmentLiberty MutualSentry Insurance GroupOrder on Walk Through Appearance Sheetinconsistency with stipulationscarrier not party to agreementRESCINDED
References
Case No. ADJ1973537 (SRO 0141664)
Regular
Jun 24, 2019

KENT WARD vs. TIMEC COMPANY, INC., ZURICH AMERICAN INSURANCE COMPANY

The applicant sought reconsideration of an arbitration decision that found his employer, Timec, 25% comparatively negligent for his injury, reducing Timec's credit from a third-party settlement. The applicant argued for a higher employer negligence percentage to increase his potential workers' compensation benefits. The Board denied reconsideration, adopting the Arbitrator's findings and reasoning. The Board found the applicant failed to present evidence to overcome the Arbitrator's negligence determination.

Third-party creditComparative negligenceArbitrator's findingsPetition for reconsiderationLabor Code section 3861Employer's liabilityThird-party claim valueNet settlement amountCredit against workers' compensationEmployer's breach of duty
References
Case No. ADJ308368 (SAC 0337296)
Regular
Feb 24, 2011

JENNIFER ROBERSON vs. BEYER PONGATZ & ROSEN, STATE COMPENSATION INSURANCE FUND INSURED SACRAMENTO

In this workers' compensation case, the applicant sought reconsideration of a finding that the defendant insurer was not obligated to serve the applicant or her attorney with a request for additional information sent to the applicant's physician. The applicant argued this lack of service prevented her from knowing if timely requests were made. However, the Board dismissed the petition because the underlying issue was moot, as the requested medical treatment had already been authorized. Therefore, the applicant was no longer aggrieved by the service dispute.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissalMootnessAggrieved PartyWCJTreating PhysicianTreatment RequestAdditional InformationService of Process
References
Case No. ADJ7199986 ADJ7399845
Regular
Oct 03, 2011

ELMIRA SMITH vs. PACIFIC AUTISM CENTER FOR EDUCATION, TRI- STAR RISK MANAGEMENT

The applicant sought removal to challenge a finding that defendant's requested Qualified Medical Evaluator (QME) panel was properly assigned. The Appeals Board granted removal, rescinded the finding, and determined that *neither* panel was properly assigned. Both panel requests were found to be premature as they were made before the statutory 10-day period for agreeing on an Agreed Medical Evaluator had expired, plus an additional five days for mail service. This decision clarifies the timing requirements for QME panel requests following an unsuccessful attempt to select an AME.

Petition for RemovalQualified Medical Evaluator (QME)Agreed Medical Evaluator (AME)Labor Code section 4062.2(b)WCAB Rule 10507Messele v. Pitco FoodsInc.Premature RequestPanel AssignmentMedical Unit
References
Case No. ADJ1871643 (SDO 0291759)
Regular
Oct 23, 2017

JOSE GOMEZ vs. DEPARTMENT OF CORRECTIONS, REHABILITATION PAROLE & COMMUNITY SERVICES, Legally Uninsured, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, affirming the WCJ's award of medical treatment. The defendant's Utilization Review denial was deemed untimely because their Request for Information was served more than five business days after the initial request, excluding the day after Thanksgiving. The Board clarified that the day after Thanksgiving is considered a normal business day for UR purposes under Labor Code section 4600.4. Therefore, the defendant's untimely RFI did not extend the UR deadline, and the requested medical treatment was properly authorized.

Workers' Compensation Appeals BoardUtilization ReviewRequest for AuthorizationRequest for InformationTimelinessBusiness DayLabor Code Section 4600.4Petition for ReconsiderationFindings and AwardPrimary Treating Physician
References
Case No. ADJ302560
Regular
Jan 10, 2012

DAVID COE vs. PROFESSIONAL ASSOCIATION OF DIVING INSTRUCTORS, MISSION INSURANCE COMPANY, IN LIQUIDATION, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Appeals Board granted reconsideration on its own motion to correct a clerical error in a prior decision regarding a Labor Code section 5710 attorney's fee. The original award of $1,903.75 was twice the applicant's attorney's requested fee of $1,093.75, which the WCJ and the Board's prior decision acknowledged. The Board corrected its decision to reflect the accurate attorney fee of $1,093.75, while reaffirming that CIGA has no liability for this fee due to a credit against the applicant's third-party recovery, which is reduced by the corrected fee amount.

Workers' Compensation Appeals BoardProfessional Association of Diving InstructorsMission Insurance CompanyCalifornia Insurance Guarantee Association (CIGA)Labor Code section 5710attorney's feeclerical errorpetition for reconsiderationthird-party recoverynet third party recovery
References
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