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

Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ3863284 (OXN 0147713)
Regular
May 13, 2013

ISAIAS ORTIZ vs. WATERWAY PLASTICS, SAFETY NATIONAL INSURANCE

This case involves two lien claimants whose liens were dismissed for failing to pay an activation fee prior to trial. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, finding that Labor Code section 4903.06 only requires proof of payment of the fee at a "lien conference," not a subsequent trial. Because the lien conference occurred in 2012 and the trial in 2013, the lien claimants were not required to pay the fee prior to trial. The WCAB rescinded the dismissal orders and returned the matter for further proceedings.

Lien activation feeWCABPetition for ReconsiderationLien ConferenceLien TrialLabor Code section 4903.06Declaration of Readiness to ProceedDismissal with prejudiceRescind OrderReturn to trial level
References
Case No. ADJ6733950
Regular
Jul 25, 2012

ANTHONY AVILA vs. MARK EVERETTE DRYWALL CO., EVEREST NATIONAL INSURANCE CO., AMERICAN CLAIMS MANAGEMENT

This case concerns an applicant's Petition for Reconsideration of a dismissal order. The applicant argues his due process rights were violated because the dismissal for failure to appear was improper since his counsel was present at trial dates. The Appeals Board found that as the applicant was represented by counsel at trial, dismissal was erroneous. The Board granted reconsideration, rescinded the dismissal, and returned the matter to the trial level, also noting the unresolved request for counsel to withdraw.

Petition for ReconsiderationOrder Dismissing CaseWCJdue processMandatory Settlement ConferencetrialMinutes of Hearingrelieved as counselNotice of Intention to Dismiss Casefailure to appear
References
Case No. ADJ9436553
Regular
Nov 03, 2014

ANA MARIA PENA, vs. SHREE AGASHIMATA INC.; dba BUDGET INN MOTEL; ILLINOIS MIDWEST INSURANCE AGENCY,

Defendant petitioned for removal after the WCJ took the case off calendar, citing the need for a Qualified Medical Evaluator. Defendant argued that a post-termination defense did not require medical evidence and the case should proceed to trial. The Appeals Board granted removal, rescinded the WCJ's order, and returned the case to the trial level. This was done because the WCJ had not yet judicially determined good cause to bifurcate the post-termination defense issue, which is a prerequisite to deciding if a QME is necessary.

Petition for Removalpost-termination defenseLab. Code § 3600(a)(10)discoveryexpert medical evidencetrialWCJoff calendarQMEbifurcate
References
Case No. ADJ2061639 (VNO 0553366) ADJ4481677 (VNO 0553364)
Regular
Sep 25, 2013

ARACELY MENJIVAR vs. NESTLE USA, INC., AMERICAN HOME ASSURANCE CO.

Here's a summary of the case for a lawyer, in four sentences: The Appeals Board granted the defendant's Petition for Removal, rescinding the WCJ's orders to take the matters off calendar for medical record development prior to trial. The Board found the WCJ prematurely ordered record development without first establishing deficiencies in existing medical opinions after evidence admission. Consequently, the cases are returned to the trial level for proper trial proceedings. The Board denied the defendant's request to remove the WCJ, as it failed to meet statutory disqualification requirements.

Petition for RemovalOff CalendarMedical Record DevelopmentThreshold MatterDeficient Medical OpinionsTrial LevelDisqualification of WCJSection 5311WCAB Rule 10452Affidavit/Declaration
References
Case No. ADJ4550848 (VNO 0550810) ADJ6977793
Regular
Oct 22, 2013

KIM WILLIS vs. PALMDALE SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied Palmdale School District's Petition for Removal, which sought to rescind a trial setting order pending a QME's supplemental report. The Board found that removal is an extraordinary remedy and the defendant failed to demonstrate substantial prejudice or irreparable harm, as reconsideration would be an adequate remedy. The Board noted the trial had already been taken off calendar and anticipated the report would be received before the rescheduled trial. The case was returned to the trial level for further proceedings.

Petition for RemovalPanel Qualified Medical EvaluatorSupplemental ReportWCJTrial DateReconsiderationExtraordinary RemedySubstantial PrejudiceIrreparable HarmAdverse Order
References
Case No. ADJ11329990
Regular
Jan 07, 2020

SANDRA CLARA vs. BURGERS N BREWS, AMTRUST NORTH AMERICA

The Appeals Board granted reconsideration, rescinding the trial judge's decision that applicant failed to prove cumulative injury to her wrists and hands. The Board found the prior panel qualified medical evaluator's report insufficient as it predated the application, lacked medical record review, and did not address cumulative trauma. This decision returns the matter to the trial level for further development of the medical evidence regarding the claimed cumulative injury.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and OrderPanel Qualified Medical EvaluatorCumulative Trauma InjurySubstantial EvidenceLabor CodeSpecific InjuryRepetitive Traumatic ActivitiesMedical Evidence
References
Case No. ADJ7817182
Regular
Dec 24, 2012

PEGGY ALEXANDER vs. KAISER FOUNDATION HOSPITALS, KAISER PERMANENTE MEDICAL CARE PROGRAM

The Workers' Compensation Appeals Board (WCAB) granted removal and rescinded an order setting a trial date. This action was taken because the defendant employer argued they were prejudiced by being forced to trial without QME medical evidence they had diligently sought. The WCAB found that both parties failed to notify the Board that the QME panels had issued after a trial date was set but before removal was granted. Consequently, the matter is returned to the trial level for further proceedings, and no sanctions were imposed.

WCABRemovalPetition for ReconsiderationMandatory Settlement ConferenceQualified Medical ExaminerQME PanelDiscovery ClosureOrder Setting for TrialRescindReturn to Trial Level
References
Case No. ADJ7278127
Regular
Nov 15, 2013

MARTHA ZAZUETA-GARCIA vs. SPHERION CORPORATION, AMERICAN HOME ASSURANCE, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration and rescinded two orders compelling the defendant to pay medical liens. The original orders were issued after the defendant failed to appear at a lien trial, but the defendant argued they did not receive proper notice. The Board found the defendant's failure to appear was due to mistake, inadvertence, or excusable neglect, supported by evidence of a late-filed substitution of counsel and alleged lack of notification. Consequently, the case was returned to the trial level for a new lien trial, with proper notice to be served on all parties.

Workers Compensation Appeals BoardLien TrialPetition for ReconsiderationOrder to Pay LienWCJFailure to AppearNotice of HearingSubstitution of AttorneysExcusable NeglectLabor Code Section 5506
References
Case No. ADJ8067157
Regular
Nov 30, 2012

MARISOL PERALTA vs. FROZEN YOGURT OF VALLEY VILLAGE, INC., STAR INSURANCE CO.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to further develop the record regarding applicant Marisol Peralta's alleged industrial injury. The WCAB rescinded the prior decision finding an injury, citing that the medical opinions were not substantial evidence as they lacked definitive causation findings and weren't based on complete medical histories. Crucially, neither physician reviewed applicant's full medical records, and one deferred causation due to pregnancy while the other awaited X-ray results. The case is returned to the trial level for further proceedings and a new decision by the WCJ.

Workers' Compensation Appeals BoardMarisol PeraltaFrozen Yogurt of Valley VillageInc.Star Insurance Co.Illinois Midwest Insurance AgencyLLCADJ8067157Opinion and Order Granting ReconsiderationDecision After Reconsideration
References
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