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

Case No. ADJ8691809
Regular
Apr 14, 2017

NICOLE BORAGNO vs. STATE OF CALIFORNIA, CDCR - CENTRAL CALIFORNIA WOMEN'S FACILITY CHOWCHILLA, STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

This case involves Nicole Boragno's workers' compensation claim against the State of California, CDCR. The applicant sought reconsideration of a decision denying the admission of a supplemental medical report. The WCAB denied reconsideration, adopting the WCJ's report which found the supplemental report inadmissible. This was because discovery had closed at the mandatory settlement conference, and the defendant failed to establish good cause for introducing evidence not previously disclosed. The WCJ noted there was no change in circumstances to warrant the late-filed report, distinguishing it from precedent that allows such reports.

WORKERS' COMPENSATION APPEALS BOARDPetition for Reconsiderationmandatory settlement conferencediscovery closureLabor Code section 5502(d)(3)good causesupplemental reportPQMEapportionmenttimeliness
References
2
Case No. ADJ7568484
Regular
Nov 14, 2014

CHERISH ORANJE vs. CRESTWOOD BEHAVIORAL HEALTH, NATIONAL UNION FIRE INSURANCE COMPANY

This case involves a workers' compensation applicant residing in Nevada who was receiving telephonic therapy from a California-licensed Marriage and Family Therapist. The defendant sought reconsideration, arguing that the telephonic therapy violated Nevada law as the therapist was not licensed in Nevada. The Workers' Compensation Appeals Board denied the petition, holding that California law governs treatment for injuries sustained in California, and the teletherapy in question complied with California's telehealth statutes. The Board concluded that the therapist's location in California while providing services to a Nevada resident did not violate California law, and any potential violation of Nevada law was irrelevant to the California workers' compensation claim.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderMedical TreatmentTelephonic TherapyMarriage and Family TherapistTelemedicine Development ActTelehealth Advancement ActBusiness and Professions CodeSynchronous Interaction
References
0
Case No. MISSING
Regular Panel Decision

Official Committee of Unsecured Creditors of 360networks (USA) Inc. v. Public Utilities Commission of California (In Re 360networks (USA) Inc.)

The Official Committee of Unsecured Creditors of 360networks (USA) Inc. (Debtors) initiated an adversary proceeding against the Public Utilities Commission of the State of California (CPUC) seeking to avoid certain fee payments as preferential transfers under the Bankruptcy Code. The CPUC moved to dismiss the action, asserting Eleventh Amendment sovereign immunity and arguing the court lacked jurisdiction. Judge Allan L. Gropper denied the CPUC's motion, concluding that the court holds in rem jurisdiction over the debtor's property in a preference action. The Court determined that the exercise of this jurisdiction would not offend state sovereignty, citing various forms of potential relief available, including the disallowance of claims by other California state instrumentalities.

Bankruptcy LawSovereign ImmunityEleventh AmendmentIn Rem JurisdictionPreference ActionMotion to DismissPublic Utilities CommissionCalifornia Environmental Quality ActDebtor-Creditor RelationsFederal Jurisdiction
References
45
Case No. ADJ1888124 (SAL 0111884) ADJ3322590 (SAL 0079903)
Regular
Oct 20, 2016

MARIA NUNEZ vs. MANN PACKING COMPANY, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For FREMONT COMPENSATION INSURANCE COMPANY, In Liquidation; STATE OF CALIFORNIA

This case concerns the California Insurance Guarantee Association's (CIGA) liability for an applicant's workers' compensation claims after Fremont Compensation Insurance Company became insolvent. CIGA argued it should be relieved of liability because the State of California, as the applicant's employer through IHSS, constituted "other insurance" under Insurance Code Section 1063.1. The Appeals Board affirmed the WCJ's decision, holding that the State of California does not qualify as "other insurance" under the relevant statutes. This distinction is based on the State not being required to obtain workers' compensation insurance or a certificate of self-insurance like private or other public employers.

CIGAFremont Compensation Insurance Companyliquidationlegally uninsuredother insuranceInsurance Code Section 1063.1covered claimsIn-Home Supportive Services (IHSS)statutory limitationsself-insurance
References
5
Case No. ADJ8649434
Regular
Apr 15, 2015

Carlos Delgado vs. New York Mets, ACE AMERICAN INSURANCE COMPANY

This case involves a professional baseball player's cumulative injury claim against the New York Mets. The Workers' Compensation Appeals Board (WCAB) reversed a prior ruling, finding California lacks jurisdiction. The applicant, a non-resident, played only 138 games out of over 2,000 in California, with no employment contracts or residence in the state. The Board applied the *Johnson* precedent, determining California's connection to the injury was insufficient to support jurisdiction, and the applicant took nothing.

WCAB jurisdictioncumulative industrial injuryprofessional baseball playerFederal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)legitimate and substantial interestseasonal employeeemployment contracts outside Californiaresident of Puerto Ricomajor league games in Californiaquantitative factor
References
4
Case No. ADJ17068636
Regular
May 19, 2025

KATHLEEN ZEPEDA vs. CALIFORNIA BAPTIST UNIVERSITY, CALIFORNIA RESTAURANT MUTUAL BENEFIT CORPORATION

Applicant Kathleen Zepeda claimed injury to her abdomen, back, and lower extremities while employed by California Baptist University. Lien claimant Medland Medical Group and defendant California Baptist University both sought reconsideration of a February 19, 2025 Findings and Award (F&A). The F&A entitled Medland Medical Group to payment for medical-legal costs related to an April 26, 2023 report but did not find an injury arising out of and in the course of employment (AOE/COE). The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration, granted the lien claimant's petition for reconsideration, and affirmed the F&A with an amendment to explicitly state that the lien claimant failed to meet its burden of establishing injury AOE/COE.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and AwardMedical-Legal ReportPrimary Treating PhysicianInjury AOE/COESubstantial EvidenceContested ClaimMedical Treatment Costs
References
5
Case No. ADJ4332905 (SAL 0109881)
Regular
Jan 20, 2016

JESUS RODRIGUEZ vs. BUD OF CALIFORNIA

California Physicians Network (CPN) and its representative, Dennise Mejia, were sanctioned $2,500.00 jointly and severally for filing a frivolous and untimely petition for reconsideration that lacked proper verification and contained erroneous facts. The Board dismissed their reconsideration request because it did not challenge a final order and was procedurally deficient. CPN and Mejia failed to respond to the Board's notice of intent to impose sanctions. The defendant's claim for additional trial-level costs and attorney's fees was deferred to the workers' compensation administrative law judge for initial determination.

ADJ4332905SAL 0109881Opinion and Decision After RemovalSanctionCalifornia Physicians NetworkDennise MejiaLien ClaimantLabor Code section 5813(a)Appeals Board Rule 10561Frivolous
References
6
Case No. ADJ2842535
Regular
May 27, 2011

JANE HUTZELL vs. UNIVERSITY OF CALIFORNIA at BERKELEY, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a Petition for Reconsideration by applicant Jane Hutzell against the University of California at Berkeley. The Workers' Compensation Appeals Board denied reconsideration, adopting the judge's report. The judge found that vocational experts' opinions did not adequately address the impact of medical apportionment or the specifics of part-time work availability on the overall industrial disability rating. Therefore, the judge's rating, based on established schedules, was upheld.

Workers' Compensation Appeals BoardPetition for ReconsiderationVocational ExpertsLumbar Spine ConditionCumulative TraumaNon-Industrial FactorsObesityApportionmentBilateral Carpal Tunnel SyndromeBilateral Cubital Tunnel Syndrome
References
0
Case No. 2018 NY Slip Op 08980
Regular Panel Decision
Dec 27, 2018

Matter of Ricci v. Maria Regina Residence

This case involves an appeal by the Special Disability Fund from a Workers' Compensation Board decision. The Board had ruled that the workers' compensation carrier for Maria Regina Residence was entitled to reimbursement from the Special Disability Fund for a claim related to Cyndia Ricci's work-related knee injury, asserting Ricci had pre-existing heart and arthritis conditions. The Appellate Division, Third Department, found that the record lacked substantial evidence to support the Board's finding that Ricci's preexisting conditions hindered her employment potential. The court concluded that the medical opinion relied upon was based on generalities and speculation, and that conditions controlled by medication do not, without more, constitute a hindrance to employability. Consequently, the Board's decision was reversed, and the matter was remitted for further proceedings.

Workers' CompensationSpecial Disability FundReimbursement ClaimPreexisting ImpairmentEmployabilityMaterially and Substantially Greater DisabilityMedical OpinionOrthopedic SurgeonAppellate ReviewSubstantial Evidence
References
11
Case No. ADJ9433946
Regular
Feb 19, 2015

ELLEN REED vs. STATE OF CALIFORNIA, CDCR CALIFORNIA CORRECTIONAL CENTER, Legally Uninsured; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES, Adjusting Agency

In *Reed v. State of California, CDCR California Correctional Center*, the applicant, Ellen Reed, petitioned for reconsideration of a prior decision. The Workers' Compensation Appeals Board (WCAB) has granted this petition. The Board believes reconsideration is necessary to allow further study of the factual and legal issues to ensure a just and reasoned decision. Pending the decision after reconsideration, all filings must be submitted in writing directly to the WCAB Commissioners in San Francisco, not to any district office or via e-filing.

Workers' Compensation Appeals BoardPetition for ReconsiderationGranting PetitionStatutory Time ConstraintsFactual and Legal IssuesJust and Reasoned DecisionFurther ProceedingsOffice of the CommissionersElectronic Adjudication Management SystemRedding District Office
References
0
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