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

Case No. ADJ2727301 (VNO 0483678) ADJ1089887 (VNO 0483679) ADJ3168287 (VNO 0487540)
Regular
Dec 13, 2011

ADOLFO SANDOVAL vs. NESTLE USA-PREPARED FOODS, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Appeals Board vacated its prior order granting reconsideration and dismissed lien claimant Ronco Drugs' petition. This dismissal is because Ronco Drugs' petition for reconsideration of a November 13, 2008 order dismissing their lien was filed on April 11, 2011, which is significantly past the 25-day statutory deadline. The Board found the petition untimely, lacking jurisdiction to consider it, despite Ronco Drugs' claims of lack of notice. Consequently, the prior grant of reconsideration was improvidently made.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationOrder of DismissalDismissed with PrejudiceNotice of HearingUntimely PetitionLabor Code § 5903Jurisdictional Time LimitVacated Order
References
Case No. ADJ10127986
Regular
May 28, 2019

SAMANTHA SILVA vs. HILMAR CHEESE, SAFETY NATIONAL INSURANCE

This case concerns the compensability of Voltaren gel prescribed for the applicant's bilateral hand, wrist, and trigger finger injuries. The Workers' Compensation Appeals Board granted reconsideration, rescinding the original findings. The Board found that the critical issue was whether the generic equivalent of Voltaren gel was exempt from utilization review (UR), not solely the brand name's formulary status. The matter was returned for further proceedings to clarify the issues and for a new decision on the eligibility of the generic Voltaren gel.

Workers' Compensation Appeals BoardUtilization ReviewMedical Treatment Utilization ScheduleMTUSDrug FormularyExempt DrugGeneric DrugBrand Name DrugVoltaren GelFindings of Fact
References
Case No. ADJ2727301/ADJ3168287
Regular
Apr 14, 2011

ADOLFO SANDOVAL vs. NESTLE USA-PREPARED FOODS, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

This case concerns a petition for reconsideration filed by a lien claimant, Ronco Drugs, regarding the dismissal of its lien for $4,022.79$. The lien claimant acknowledges the underlying case was settled in 2008 but argues its due process rights were violated as it never received settlement documents and its lien dismissal order was not responded to by the WCAB for years. However, the record shows significant delays, with the accidents occurring eight years prior and settlement over three years before the petition. The judge recommends dismissal due to the claimant's apparent delay in pursuing the matter.

Petition for ReconsiderationLien DismissalRonco DrugsWylie Lien SolutionsCompromise & ReleaseDue Process ViolationStatute of LimitationsTimelinessSettled Statement on AppealWorkers' Compensation Appeals Board
References
Case No. ADJ2212690 (RIV 048643)
Regular
Mar 20, 2009

JAMIE WOLDEN (deceased), PATRICIA WOLDEN, individually and as guardian ad litem for DAVID EYLER and ANITA WOLDEN vs. BRIGHT DEVELOPMENT, STATE COMPENSATION INSURANCE FUND

This case involves a widow seeking death benefits for her husband, who died from a multi-drug intoxication more than 240 weeks after his industrial injury. The Workers' Compensation Appeals Board denied reconsideration, upholding the administrative law judge's finding that the death benefit claim was untimely. The Board relied on *Massey v. Workers' Comp. Appeals Bd.*, holding that the 240-week period from the date of injury is a prerequisite for death benefits, which had expired before the decedent's death. Therefore, no death benefit claim could arise, and the applicant's claim was properly disallowed.

Death benefitsLabor Code section 5406(c)240-week limitationdate of injurydate of deathindustrial injurypermanent disabilitymedical treatmentprescription drugsmulti-drug intoxication
References
Case No. ADJ2503928 (MON 0358257)
Regular
Sep 16, 2022

STEVEN JIMENEZ vs. COUNTY OF LOS ANGELES, SEDGWICK CMS

The Workers' Compensation Appeals Board (WCAB) denied Whittier Drugs' Petition for Reconsideration to reinstate a dismissed lien. The judge dismissed the lien due to Whittier Drugs' untimely objection to a Notice of Intent to Dismiss and a pattern of late or missed appearances. The WCAB adopted the judge's report, which found Whittier Drugs' objection was significantly delayed and their explanation for missing a hearing, including an unreceived email, was insufficient. Therefore, the petition was denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationDenialWCJ ReportLien ClaimantWhittier DrugsOrder Dismissing LienTimelinessObjectionDeclaration of Readiness
References
Case No. ADJ9257767
Regular
Aug 28, 2014

JILL ALES vs. DRUG ABUSE ALTERNATIVE CENTER, CYPRESS INSURANCE, BERKSHIRE HATHAWAY HOMES STATE COMPANIES

The Workers' Compensation Appeals Board denied the defendant's Petition for Removal in the case of Jill Ales versus Drug Abuse Alternative Center. The Board adopted the WCJ's report as the basis for this denial. However, the Board noted that a change of venue might be considered if trial is required and specific listed witnesses must testify.

Petition for RemovalWorkers' Compensation Appeals BoardWCJ ReportChange of VenueDenial of RemovalDrug Abuse Alternative CenterCypress InsuranceBerkshire HathawayADJ9257767Anaheim District Office
References
Case No. ADJ799845
Regular
Sep 06, 2012

BOBBY RIVERA vs. STURGEON & SONS, INC., ZURICH NORTH AMERICA

This Workers' Compensation Appeals Board case denied a defendant's petition for reconsideration. The WCJ had awarded temporary total disability and further medical treatment for a knee injury. The defendant argued disability payments should cease after the applicant's termination for cause (positive drug test). However, the Board found no evidence the applicant could have returned to modified work within his restrictions, even if he had passed the drug test, thus upholding the temporary disability award.

Workers' Compensation Appeals BoardFindings and AwardReconsideration DeniedTemporary DisabilityFurther Medical TreatmentTermination for CauseDrug ScreenQualified Medical EvaluatorWork RestrictionsModified Work
References
Case No. ADJ3797268 (MON 0304228)
Regular
Jun 30, 2016

HECTOR RENTERIA vs. BROWN, BUNYAN, MOON & MOORE, INC., ZENITH INSURANCE COMPANY

This Workers' Compensation Appeals Board case involves two lien claimants, Whittier Drugs and University Imaging Center, seeking reconsideration of an administrative law judge's decision. The Board denied Whittier Drugs' petition, adopting the judge's reasoning. University Imaging Center's petition was dismissed as untimely, as it was filed beyond the 25-day statutory deadline. The Board emphasized that timeliness is jurisdictional and a petition must be *received* by the Board within the allowed period.

Workers Compensation Appeals BoardPetition for ReconsiderationLien ClaimantTimelinessJurisdictionalFindings and Order and AwardAdministrative Law JudgeWCAB Rule 10508Maranian v. Workers' Comp. Appeals Bd.Whittier Drugs
References
Case No. ADJ7689152
Regular
Jan 15, 2013

MARTINA IRAHETA vs. BAL SEAL ENGINEERING, INC., APPLIED RISK SERVICES, INC.

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board adopted the Administrative Law Judge's (ALJ) report, which found the applicant's exhibits inadmissible due to failure to meet service deadlines and inadequate medical reporting by Dr. Black. The ALJ also found the applicant's testimony not credible, failing to establish a prima facie case for injury. Therefore, the petition for reconsideration was denied.

WORKERS' COMPENSATION APPEALS BOARDORDER DENYING RECONSIDERATIONMandatory Settlement ConferenceLabor Code §46288 Cal. Code Reg. §10606credibilitydeveloping the recordprima facie burdencontinuous traumaDr. Black's reports
References
Case No. ADJ8189198
Regular
Jan 12, 2016

ODAYR LOPEZ vs. DOLLAR TREE, INC.

This case involves a lien claim by Dr. Charles Schwarz for dispensing medication. The original decision disallowed $4,443.00 of the lien, finding Dr. Schwarz failed to prove authorization to dispense medication. The Workers' Compensation Appeals Board granted reconsideration, finding the issue of authorization under Business and Professions Code § 4170 was not clearly raised. The Board deferred the issue of reimbursement for dispensed medication, requiring Dr. Schwarz to demonstrate compliance with the statute in further proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeLien ClaimantDispensing MedicationBusiness and Professions CodePhysician Dispensing DrugsAuthorization to DispenseBurden of ProofLabor Code
References
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