CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. ADJ1378934 (VNO 0542019), ADJ7423562
Regular
Nov 07, 2013

VICTORIA BARNETT vs. COUNTY OF LOS ANGELES; Permissibly Self-Insured, Administered by TRISTAR RISK MANAGEMENT

The Appeals Board granted the applicant's Petition for Removal, rescinding the WCJ's order to take the case off calendar. The WCJ improperly deferred the issue of home health care entitlement and reimbursement, which Applicant contended SB 863 did not preclude. The Board remanded the case for an expedited hearing to determine entitlement to home health care, whether SB 863 applies, and to resolve lien reimbursement issues afterward.

Petition for RemovalSB 863home health careexpedited hearingLabor Code § 4610applicant's entitlementretroactive reimbursementstipulated awardpetition to reopenApplication for Adjudication of Claim
References
Case No. ADJ608436 (RDG 0067603)
Regular
Jul 30, 2013

JERRY MIRES vs. SHASTA COUNTY SHERIFF'S DEPARTMENT

The Appeals Board granted reconsideration of the WCJ's order concerning a lien claim's statute of limitations. The defendant argued SB 863 retroactively barred the lien, a contention the WCJ recommended denying. The Board found the record incomplete, lacking formal minutes and admitted evidence, thus preventing a meaningful review. Consequently, the Board ordered a new hearing to establish a proper record before further consideration of the lien claim's validity.

Workers' Compensation Appeals BoardShasta County Sheriff's DepartmentPHI Air MedicalPetition for ReconsiderationStatute of LimitationsSB 863Labor Code Section 4904Labor Code Section 4903.5Hingtgen v. County of San BernardinoAdministrative Law Judge
References
Case No. ADJ4274323 (ANA 0387677), ADJ1601669 (ANA 0388466)
En Banc
Feb 27, 2014

JOSE DUBON vs. WORLD RESTORATION, INC.; STATE COMPENSATION INSURANCE FUND

The WCAB holds that it has jurisdiction over disputes regarding the procedural validity and timeliness of utilization review (UR) decisions, while Independent Medical Review (IMR) is solely for resolving medical necessity. A UR decision with material procedural defects is invalid, and in such cases, the WCAB, not IMR, will determine the medical necessity of the treatment.

Utilization ReviewIndependent Medical ReviewEn Banc DecisionWCAB JurisdictionProcedural DefectsMedical NecessityLabor Code Section 4610Substantial Medical EvidenceMaterial Procedural DefectsInvalid UR Decision
References
Case No. ADJ6757406
Regular
Apr 08, 2013

ESPERANZA CARRILLO vs. INTEGRATED HEALTHCARE HOLDINGS, INC. (formerly WESTERN MEDICAL CENTER), REDWOOD FIRE & CASUALTY INSURANCE COMPANY

In this workers' compensation case, the Appeals Board denied reconsideration of an order dismissing several lien claims. The dismissal was due to the lien claimants' failure to pay the required lien activation fee as mandated by Labor Code section 4903.06(a)(4). The Board also admonished certain lien claimants for failing to properly notify the employer and the Board of changes in their representatives as required by Labor Code section 4903.6(b). The WCJ's report, incorporated by the Board, found the lien claimants' arguments regarding constitutionality and procedural due process to be without merit.

Workers' Compensation Appeals BoardReconsiderationLien ClaimantsLabor Code section 4903.06Lien Activation FeeDismissal of LiensDue ProcessSB 899SB 863EAMS
References
Case No. ADJ8182087
Regular
Jan 18, 2018

Darin Day vs. CITY OF LOS ANGELES, TRISTAR

The Workers' Compensation Appeals Board affirmed a prior decision allowing a medical lien by VQ Orthocare against the City of Los Angeles. The Board found VQ's lien was valid despite late filing of a required declaration, as the lien was filed before the relevant statute's effective date. Defendant's arguments regarding the timeliness and form of the declaration were rejected, with the Board noting compliance with procedural rules for electronic filing and declarations under penalty of perjury. The lien was thus permitted to proceed on its merits.

Labor Code section 4903.8(d)Declaration requirementLien validityStatute of limitationsReconsiderationFindings and OrderMedical treatment lienSB 863SB 1160Declaration of readiness
References
Case No. ADJ7004131
Regular
Apr 09, 2014

ALBERTO BARBOSA vs. GREENHART FARMS, PACIFIC COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) rescinded the original Findings and Order, returning the case to the WCJ for further proceedings. The WCAB found that the initial decision improperly struck evidence and testimony without sufficient justification. The newly enacted Labor Code Section 5703(j), effective January 1, 2013, regarding vocational expert reports, was deemed applicable to this non-final matter. The WCAB instructed the WCJ to reconsider the vocational expert evidence and applicant's request for medical-legal reimbursement in light of this new statute and relevant case law.

OgilvieHertzDiminished Future Earning CapacityDFECPermanent Disability Rating SchedulePDRSVocational ExpertMedical-Legal ExpensesFindings and OrderF&O
References
Case No. ADJ6483062
Regular
Apr 05, 2013

ANITA WASHINGTON vs. STATE OF CALIFORNIA, DEPARTMENT OF PUBLIC HEALTH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Anita Washington's petition for reconsideration of an approved Compromise and Release agreement. The Board found her allegations of fraud regarding SB 863 and its application insufficient due to a lack of specific details. The agreement itself, which dismissed a serious and willful misconduct claim, also stipulated that any potential Civil Code rights were not settled. Consequently, the Board adopted the WCJ's report and denied the reconsideration request.

Petition for ReconsiderationOrder Approving Compromise and ReleasefraudmisrepresentationsSenate Bill 863Civil CodeSerious and Willful PetitionGood Faith Personnel ActionPQMEAME
References
Case No. ADJ3327542, ADJ7143228
Regular
Apr 12, 2018

ABIGAIL FURGOL vs. UCLA MEDICAL CENTER, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves an injured worker, Abigail Furgol, and her employer, UCLA Medical Center. The defendant sought reconsideration, arguing a specific 104-week limit on temporary disability payments from *Brower v. David Jones Construction* should apply. However, the Appeals Board denied reconsideration, finding that the cumulative injury date predates the statutory limit, making *Brower* inapplicable. The Board affirmed that Labor Code section 4650(b), as amended by SB 863, dictates payment calculations from the permanent and stationary date, which was stipulated in this case.

Labor Code § 4656(c)Brower v. David Jones Constructiontemporary disability indemnity104-week limitLabor Code § 4650(b)Senate Bill 863permanent disability indemnitypermanent and stationary dateVillagio Inn & Spa v. Workers' Comp. Appeals Bd. (Soto)cumulative injury
References
Case No. ADJ2806916 (SDO 0271727)
Regular
Oct 30, 2013

SOVEIDA MAGANA vs. CENTER FOR EMPLOYMENT TRAINING, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE INSURANCE COMPANY

This case consolidates numerous claims involving unresolved lien claims for ambulatory surgical center facility fees. The Workers' Compensation Appeals Board affirmed the Administrative Law Judge's decision establishing reasonable facility fees by averaging the January 1, 2004, Official Medical Fee Schedule for ASCs with the average amount paid to San Diego hospitals under an older inpatient fee schedule. The Board found this methodology appropriately considered extensive evidence and relevant factors for determining reasonable fees. Defendants' arguments that only the January 1, 2004, OMFS should apply or that SB 863's independent bill review process was mandatory were rejected.

Workers' Compensation Appeals BoardSoveida MaganaCenter for Employment TrainingCalifornia Insurance Guarantee AssociationReliance Insurance CompanyLien ClaimantsPoint Loma Surgical CenterElite Surgical CentersAmbulatory Surgical CenterFacility Fees
References
Case No. ADJ8381652
Regular
Feb 07, 2014

CARLOS CABRERA RAZO vs. LAS POSAS COUNTRY CLUB, HARTFORD INSURANCE CO.

This case concerns the timeliness of an applicant's strike from a Qualified Medical Evaluator (QME) panel. The Appeals Board vacated its previous grant of reconsideration, dismissed the defendant's Petition for Reconsideration, and denied their Petition for Removal. The Board determined that Labor Code section 4062.2, as amended by SB 863 effective January 1, 2013, applies to pending matters, including this case with a 2012 date of injury. Applying the amended statute and Code of Civil Procedure section 1013(a), the applicant had 15 days from the Administrative Director's assignment of the QME panel to strike a name. The applicant's strike on the 12th day was therefore timely, affirming the Workers' Compensation Judge's decision.

Workers' Compensation Appeals BoardQualified Medical EvaluatorPetition for ReconsiderationPetition for RemovalLabor Code Section 4062.2(c)Senate Bill 863Administrative DirectorCumulative Trauma InjuryQME Panel AssignmentCode of Civil Procedure 1013
References
Showing 1-10 of 287 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational