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

Case No. ADJ441410
Regular
Oct 03, 2008

HAYDEE NUNEZ vs. FAIRMONT MIRAMAR HOTEL, COMMERCE & INDUSTRY INSURANCE COMPANY

The Appeals Board denied the lien claimant's petition for reconsideration, affirming the WCJ's denial of the remaining lien balance. The Board is returning the case to the trial level to investigate potential sanctions against the lien claimant for its actions in filing the petition for reconsideration, citing alleged procedural defects and bad faith. The WCJ's original finding was that the outpatient fusion surgery was not permitted under Medicare Guidelines and the defendant paid more than the reasonable value of the services.

Workers Compensation Appeals BoardFairmont Miramar HotelCommerce & Industry Insurance CompanyAIG Domestic ClaimsOutpatient Spine & Surgery CenterLien claimantIndustrial injuryLow back injuryOutpatient fusion surgeryMedicare Guidelines
References
1
Case No. ADJ234009 (OAK 0324352) ADJ3704382 (OAK 0335469)
Regular
Jan 12, 2010

Carole Young vs. IPC SECURITY, LIBERTY MUTUAL INSURANCE COMPANY, ABM adjusted by ESIS

The applicant sought removal and disqualification of the Workers' Compensation Judge (WCJ) alleging bias due to denied trial requests, refusal to consider evidence, and case delays. The Appeals Board denied the removal and disqualification, stating a subjective perception of bias is insufficient grounds. The Board returned the case to the Presiding WCJ to address the defendant's request to declare the applicant a vexatious litigant, requiring notice and an opportunity to be heard.

Workers' Compensation Appeals Boardremovaldisqualificationworkers' compensation judge (WCJ)biasvexatious litigantPWCJWCAB Rule 10782applicantdefendant
References
1
Case No. ADJ1393892
Regular
Aug 16, 2011

JOSE NAVARRO vs. LOCKHEED

The Appeals Board denied the applicant's Petition for Reconsideration regarding an alleged March 12, 1990 injury, upholding the WCJ's finding that no industrial injury occurred. The Board granted removal on its own motion to address potential sanctions against applicant's counsel for citing medical records not present in the official record, which is a violation of WCAB rules and attorney ethics. The Board issued a Notice of Intention to impose $1,000 in sanctions jointly against the attorney and his firm, and awarded attorney's fees to the defendant. Other outstanding issues in the consolidated cases are returned to the trial level for further proceedings by the WCJ.

Petition for ReconsiderationQualified Medical EvaluatorSubstantial EvidenceCredibility DeterminationMisleading PetitionSanctionsLabor Code Section 5813WCAB RulesAttorney's DutyEvidence Outside Record
References
4
Case No. ADJ7908593
Regular
Mar 19, 2012

LA WANNA MONTGOMERY vs. REACH LEARNING ACADEMY CENTER, SOUTHERN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to address a discrepancy in the applicant's average weekly wage and temporary disability rate. The defendant challenged the WCJ's calculation, highlighting a significant difference between the applicant's tax return and evidence presented at trial. The Board rescinded the WCJ's decision and returned the case for further proceedings to resolve this discrepancy, which impacts the applicant's credibility. The WCJ must have the applicant explain the differing earnings figures.

Average Weekly WageTemporary Disability RateEarnings DiscrepancyFederal Tax ReturnW-2s1099sApplicant CredibilityIndustrial InjuryFibula FractureCEO
References
2
Case No. ADJ2906412 (SJO 0241532) ADJ121679 (SJO 0241533) ADJ 405246 (SJO 0245064)
Regular
Dec 05, 2008

WANG LE vs. EL CAMINO HOSPITAL, TRISTAR RISK MANAGEMENT

The Appeals Board granted reconsideration, rescinded the prior decision, and returned the case for further proceedings due to the WCJ's inadequate findings on permanent disability and apportionment. The Board found the WCJ erred by relying on an AME's opinion that she acknowledged was insufficient without further medical record development or a clear explanation of how vocational expert testimony was integrated into the permanent disability rating. The matter will be returned to the trial level for the WCJ to obtain adequate apportionment and permanent disability assessments, potentially through further medical evaluations or a formal rating by the Disability Evaluation Unit.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardCumulative TraumaPermanent DisabilityApportionmentAgreed Medical Evaluator (AME)Vocational ExpertMedical Record DevelopmentLabor Code section 4663(c)
References
13
Case No. ADJ12674446
Regular
Jul 25, 2025

MICHAEL KREZA, SHANNA KREZA vs. CITY OF COSTA MESA FIRE DEPARTMENT, ADMINSURE

Applicant Shanna Kreza, guardian ad Litem for deceased Michael Kreza, sought reconsideration or, alternatively, removal and disqualification of a Workers' Compensation Administrative Law Judge (WCJ) after the WCJ issued an Order Suspending Action. The WCJ's order questioned the requested attorney's fees as excessive, which the applicant argued created an appearance of bias. The Workers' Compensation Appeals Board dismissed the petition for reconsideration, deeming the WCJ's order interlocutory. However, the Board granted the petitions for removal and disqualification, finding an appearance of bias by the WCJ due to unqualified opinions on attorney's fees. Consequently, the WCJ was disqualified, their May 12, 2025 Order was rescinded, and the case was returned for reassignment to a new WCJ.

Workers' Compensation Appeals BoardFirefighterDeath ClaimAttorney FeesExcessive FeesPetition for ReconsiderationPetition for RemovalPetition for DisqualificationWCJ BiasOrder Suspending Action
References
10
Case No. ADJ10813026
Regular
May 27, 2025

Noureddine Manser vs. Return-to-Work Supplement Program

Applicant Noureddine Manser sought reconsideration of a November 9, 2023 finding that he was not entitled to a second Return-to-Work Supplement Program (RTWSP) benefit under Rule 17302(b), which prohibits a second benefit unless for a subsequent injury. Applicant contended the word "injury" should include a continuing injury. The Appeals Board affirmed the November 9, 2023 Findings of Fact, declining to interpret "injury" as a continuing injury and noting that the validity of Rule 17302(b) is subject to judicial review in the Superior Court, not the Appeals Board. The Board also asserted its jurisdiction to review the WCJ's denial despite arguments to the contrary.

Return-to-Work Supplement ProgramRTWSPRule 17302(b)vocational rehabilitationsubsequent injurySJDBVQMEtemporary total disabilityWCABLabor Code section 139.48
References
8
Case No. ADJ7624426; ADJ8657421
Regular
Jun 18, 2013

NATHALIE AMEZQUITA vs. SCOTT ZIEHL an Individual, Co-Partner dba JEWELRY, Liquidation USA

The applicant petitioned for disqualification of WCJ Richard Shapiro, alleging enmity and prejudgment. The applicant's counsel stated the WCJ declared the applicant would "take nothing" and was "a liar" before trial. The WCJ did not deny these statements, suggesting they were to facilitate settlement and noting concerns about applicant's attorney's tactics. The Appeals Board granted the disqualification petition, finding the WCJ's statements demonstrated bias or the appearance of bias, and returned the case for reassignment to a new WCJ.

Petition for DisqualificationWorkers' Compensation Administrative Law Judgeenmityformed opinionprejudicedtake nothingliarinformal resolutionappearance of biasreassignment
References
0
Case No. ADJ2242917
Regular
Feb 09, 2011

HERIBERTO HERNANDEZ RODRIGUEZ, ROSALVA RODRIGUEZ vs. AA CONTRACTING, dba GARZA CONTRACTING, STATE COMPENSATION INSURANCE FUND

This case involves a fatal industrial injury where the initial award of death benefits was found to be internally inconsistent and ambiguous by the WCJ. The defendant sought reconsideration of the WCJ's subsequent decision, arguing the WCJ erred in denying jurisdiction to correct the erroneous award. The Appeals Board granted reconsideration, finding the WCJ's reserved jurisdiction and the ambiguity of the award allowed for correction. The Board rescinded the WCJ's decision and returned the matter for further proceedings to resolve the benefit and attorney fee amounts.

Workers' Compensation Appeals BoardDeath BenefitsPartial DependentsJudicial ErrorLabor Code Section 5803Reservation of JurisdictionReconsiderationRescindAmendFindings of Fact
References
1
Case No. ADJ10539204, ADJ10539208
Regular
Jul 17, 2017

JUAN LEMUS vs. AUNTIE EM'S KITCHEN, REPUBLIC UNDERWRITERS

The Workers' Compensation Appeals Board granted the applicant's petition for removal, vacating an order compelling attendance at a PQME evaluation. The applicant argued this attendance would cause irreparable harm due to the evaluation being improperly scheduled while a replacement QME panel was pending. The Board adopted the WCJ's recommendation to grant removal and return the case for further proceedings. The matter was returned to the WCJ for a decision after removal.

Petition for RemovalOrder Compelling AttendancePQME EvaluationQualified Medical EvaluatorWCJWorkers' Compensation Appeals BoardVacatedRescindedPrejudiceIrreparable Harm
References
4
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