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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ3525697 (LAO 0534774) ADJ2342373 (LAO 0512482) ADJ1310306 (LAO 0568035) ADJ2645702 (LAO 0519888) ADJ1384751 (LAO 0568036) ADJ2871875 (ANA 0235799)
Regular
Feb 03, 2017

ALICE BRYANT vs. REGENTS OF THE UNIVERITY OF CALIFORNIA, permissibly self-insured, UCLA MEDICAL CENTER; SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves applicant Alice Bryant's petition for reconsideration of prior dismissed workers' compensation claims and a Labor Code section 132a retaliation claim. The Workers' Compensation Appeals Board (WCAB) denied reconsideration, upholding the administrative law judge's findings. The WCAB concluded that Bryant's claims were previously dismissed, with some dismissed by her own request and others for failure to prosecute. Furthermore, the WCAB found that Bryant failed to demonstrate extrinsic fraud and lacked the required diligence to reopen these final dismissals, even with newly discovered evidence.

Workers' Compensation Appeals BoardRegents of the University of CaliforniaSedgwick Claims Management ServicesPetition for ReconsiderationFindings and OrdersWorkers' Compensation Administrative Law JudgeLabor Code section 132aRetaliation claimExtrinsic fraudDismissed claims
References
Case No. ADJ4634338 (MON 0262377)
Regular
Jun 24, 2009

NINA GOODRICH vs. UNILAB/QUEST DIAGNOSTICS, SEDGWICK CLAIMS MANAGEMENT SERVICES, AMERICAN CASUALTY CO. OF READING, PA, CNA CLAIMSPLUS, VALLEY HEALTH SYSTEMS, TRISTAR RISK MANAGEMENT, ZURICH INSURANCE CO.

This case concerns a dispute over contribution claims following a cumulative injury to the applicant. The Workers' Compensation Appeals Board granted reconsideration, rescinded an arbitration finding, and remanded the matter for further proceedings. The Board found that Sedgwick, which paid over $180,000 in benefits, was not required to file a petition for contribution under section 5500.5 because it was not a signatory to the Compromise and Release (C&R). Furthermore, the Board held that even if Sedgwick had been required to file, the co-defendant CNA would be estopped from asserting the statute of limitations due to stipulations in the C&R reserving contribution rights. The Board concluded Sedgwick's claim for reimbursement was not time-barred.

Workers' Compensation Appeals BoardNina GoodrichUnilabQuest DiagnosticsSedgwick Claims Management ServicesAmerican Casualty Co.CNA ClaimsplusValley Health SystemsTristar Risk ManagementZurich Insurance Co.
References
Case No. ADJ4634338 (MON 02262377) ADJ614711 (MON 0288710)
Regular
Dec 07, 2009

NINA GOODRICH vs. UNILAB/QUEST DIAGNOSTICS, SEDGWICK CLAIMS MANAGEMENT SERVICES, AMERICAN CASUALTY CO. OF READING, PA, CNA CLAIMSPLUS, VALLEY HEALTH SYSTEMS, TRISTAR RISK MANAGEMENT, ZURICH INSURANCE CO.

Zurich's petition for reconsideration of the June 24, 2009 Opinion and Order Granting Reconsideration and Decision After Reconsideration is denied for the reasons stated in prior opinions.

Workers' Compensation Appeals BoardNina GoodrichUnilab/Quest DiagnosticsSedgwick Claims Management ServicesAmerican Casualty Co.Valley Health SystemsTristar Risk ManagementZurich Insurance Co.Labor Code section 5500.5Arbitration Finding of Facts
References
Case No. ADJ2906378
Regular
May 24, 2011

NORMA ALONSO vs. PRECISION CAST PARTS CORPORATION AKA AVIBANK MANUFACTURING, INC.; SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves Norma Alonso's workers' compensation claim against Precision Cast Parts Corporation and Sedgwick Claims Management Services. Alonso filed a Petition for Reconsideration and Removal, seeking to overturn a prior decision. The Workers' Compensation Appeals Board reviewed the petition and the administrative law judge's report. Ultimately, the Board denied both reconsideration and removal, adopting the reasoning of the administrative law judge's report.

ReconsiderationRemovalPetitionWorkers' Compensation Appeals BoardAdministrative Law JudgeDeniedPrecision Cast Parts CorporationSedgwick Claims Management ServicesADJ2906378LAO 0881297
References
Case No. ADJ3765992 (SRO 0132531) ADJ2072207 (SRO 0140061)
Regular
Apr 29, 2009

Lorraine O'Keefe vs. Surgical Staff North, Inc., CAL COMP, In Liquidation, CIGA, Adjusted by BROADSPIRE, COMMUNITY HOSPITAL OF MONTEREY PENINSULA, Permissibly Self-Insured, Adjusted by CLAIMS MANAGEMENT, INC. (ADJ3765992), QUEEN OF THE VALLEY HOSPITAL, Permissibly Self-Insured, Adjusted by SEDGWICK CLAIMS MANAGEMENT SERVICE (ADJ2072207)

This case involves applicant Lorraine O'Keefe's workers' compensation claims for left knee injury. The Workers' Compensation Appeals Board denied reconsideration of the finding that applicant sustained an industrial injury on December 15, 1999, while employed by Community Hospital of the Monterey Peninsula (CHOMP). However, the Board granted reconsideration regarding attorney fees, rescinding the prior award against CHOMP. The issue of CHOMP's liability for applicant's attorney fees under Labor Code section 4064(c) will be returned for further proceedings due to insufficient notice.

Workers' Compensation Appeals BoardSurgical Staff NorthCal CompCIGACommunity Hospital of Monterey PeninsulaClaims Management Inc.Queen of the Valley HospitalSedgwick Claims Management ServiceFindings Award OrdersPetition for Reconsideration
References
Case No. ADJ7874883
Regular
Apr 10, 2013

ENRIQUE ESPINOZA vs. MARTIN PROPERTIES, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board dismissed Enrique Espinoza's Petition for Reconsideration against Martin Properties and Sedgwick Claims Management Services. The dismissal was primarily due to the petition not being timely filed. Even if it had been timely, the Board would have denied it on the merits, adopting the reasoning of the administrative law judge. Therefore, the petition is dismissed.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissalTimely FiledWCJ ReportAdministrative Law JudgeSedgwick Claims Management ServicesMartin PropertiesEnrique EspinozaAnaheim District Office
References
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. ADJ11369357, ADJ11369329
Regular
May 21, 2025

GLORIA DAVIS vs. KAISER FOUNDATION HOSPITAL, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

Gloria Davis, the applicant, sought reconsideration of Findings and Orders issued on February 7, 2025. The original orders found she sustained a lumbar spine injury but denied her Labor Code section 132a claim for discrimination. Davis contended that the F&O was a result of fraud and WCJ bias, specifically regarding her termination from Kaiser Foundation Hospital for alleged HIPAA violations. The Workers' Compensation Appeals Board reviewed the petition, the defendant's answer, and the WCJ's report. The Board denied reconsideration, upholding the WCJ's credibility determination and finding no evidence that Davis was discriminated against due to her industrial injuries.

WORKERS' COMPENSATION APPEALS BOARDGLORIA DAVISKAISER FOUNDATION HOSPITALSEDGWICK CLAIMS MANAGEMENT SERVICESINC.ADJ11369357ADJ11369329Oakland District OfficeOPINION AND ORDER DENYING PETITION FOR RECONSIDERATIONpatient care technician
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
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