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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. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
Case No. ADJ9625407
Regular
Sep 12, 2018

KEITH FIELD vs. CITY OF PINOLE

This case involves a firefighter who sustained bilateral carpal tunnel syndrome after retirement. The Appeals Board reversed the trial judge, holding that Labor Code section 4458.5 applies, entitling the applicant to permanent disability benefits calculated at the maximum indemnity rate. This applies regardless of the applicant's actual earnings or the fact that carpal tunnel syndrome is not a specifically enumerated presumptive injury. The case is remanded for determination of the precise date of injury to calculate the benefit rate.

Workers' Compensation Appeals BoardKeith FieldCity of PinolePermissibly Self-InsuredMunicipal Pooling AuthorityADJ9625407Opinion and Decision After Reconsiderationindustrial injuryfirefighterbilateral upper extremities
References
Case No. ADJ12248957
Regular
Oct 06, 2025

QUINTON THORN vs. FORBIX CAPITAL CORP.; EMPLOYERS COMPENSATION INSURANCE FUND; THE HARTFORD

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's finding that applicant Quinton Thorn's psychiatric claim was barred by a post-termination defense. The Board determined the WCJ incorrectly applied Labor Code Section 3600(a)(10) instead of Section 3208.3(e) for psychiatric injuries. Applicant alleged psychiatric injury from sexual harassment and discrimination based on gender identity during his employment with Forbix Capital Corp. The Board rescinded the WCJ's findings and remanded the case to the trial level, directing the WCJ to properly analyze the post-termination defense, the date of injury, and consider the good faith personnel action defense if raised.

Workers' Compensation Appeals BoardReconsiderationFindings of FactLabor Code Section 3600(a)(10)Labor Code Section 3208.2(c)Labor Code Section 3208.3(c)Labor Code Section 3208.3(e)Psychiatric InjuryPost-Termination DefenseGender Identity Discrimination
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
Case No. ADJ4151507 (SFO 0487197)
Regular
Feb 02, 2020

Tracy Sullivan vs. Café Amsterdam, State Compensation Insurance Fund

The Appeals Board granted reconsideration and amended the previous award, finding the applicant's burn injury did not qualify for the "severe burns" exception to the temporary disability indemnity limit under Labor Code section 4656(c)(3)(D). Consequently, temporary disability indemnity is limited to 104 weeks from the commencement of payments on August 10, 2004. The Board affirmed the WCJ's finding that the applicant's psychiatric injury was compensable, meeting the "sudden and extraordinary" employment condition exception. Clerical errors in the original findings were also corrected.

ADJ4151507SFO 0487197Tracy SullivanCafé AmsterdamState Compensation Insurance FundPetition for ReconsiderationFindings Award and OrderWCJindustrial injurycervical spine
References
Case No. ADJ3817836 (SJO 0250881)
Regular
May 31, 2012

ZUFAN A. REDA vs. FRY'S ELECTRONICS, INC., ZURICH NORTH AMERICAN INSURANCE

This case concerns applicant Zufan A. Reda's claim for permanent total disability due to a psychiatric injury. The Workers' Compensation Appeals Board (WCAB) is ordering the development of the record because neither the applicant's QME, Dr. Sidle, nor the defendant's QME, Dr. Keins, provided substantial evidence regarding the apportionment of psychiatric permanent disability. The WCAB found that Dr. Sidle's report incorrectly addressed causation of injury rather than apportionment of disability, and Dr. Keins' report was rejected as non-substantial due to prior rulings on industrial causation. Therefore, the WCAB has appointed Dr. Roy Curry as a "regular physician" to conduct a new evaluation on the issue of psychiatric permanent disability.

Petition for ReconsiderationDevelopment of RecordLabor Code section 5701Industrial InjuryPsychiatric InjuryCompensable ConsequenceSection 5803Section 5804Section 5410Permanent Total Disability
References
Case No. ADJ4205101
Regular
Jul 23, 2013

SUSAN HECHT vs. WARNER BROTHERS, INC.

This case involved an applicant claiming an industrial injury to her psyche, digestive system, and head, stemming from a change in overtime policy. The defendant argued the psychological injury was non-compensable under Labor Code sections 3208.3(b)(2) and 3208.3(h), as it arose from a good faith personnel action. However, the Board affirmed the WCJ's award, adopting the WCJ's report which found the injury compensable despite the personnel action. The Board also ordered the matter returned to the WCJ to determine the reasonable value of medical treatment provided by lien claimants.

Workers' Compensation Appeals BoardReconsiderationIndustrial InjuryPsycheDigestive SystemHeadSleep DisorderTemporary DisabilityEmployment Development DepartmentLien Claimants
References
Case No. ADJ5836855
Regular
Dec 11, 2012

Malory Wheat vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) rescinded a prior award allowing a lien for living expenses claimed by the CCPOA Benefits Trust Fund. The WCAB held that liens in workers' compensation are strictly statutory and the CCPOA's claim for reimbursement of benefits advanced did not fit within the specific provisions of Labor Code sections 4903 or 4903.1 for "living expenses" or benefits provided by a "self-insured employee welfare benefit plan." The Board clarified that liens for living expenses are intended for those who loan money or extend credit, not for contractual obligations of insurance or benefit plans.

Workers' Compensation Appeals BoardMalory WheatState Compensation Insurance FundCCPOA Benefits Trust Fundlien claimantLabor Code section 4903(c)Labor Code section 4903.1(a)(1)Labor Code section 4903.1(a)(2)Labor Code section 4903.1(a)(3)living expenses
References
Case No. ADJ6766619 (MF) ADJ6766620
Regular
Feb 28, 2018

MARIA DURAN vs. FOREVER 21 RETAIL, INC., CHUBB GROUP

This case involves Maria Duran's request for home health care services, which was initially denied by utilization review (UR) and upheld by Independent Medical Review (IMR). The applicant argued that her need for assistance with household chores and personal hygiene fell outside the scope of the Medical Treatment Utilization Schedule (MTUS) guidelines as applied. While the Board acknowledges that the specific MTUS guideline used in this case was later found to be an invalid regulation in a related case, it affirmed the original decision. This affirmance was based on the finding that the initial request for services was too vague, lacking specific details on the type, frequency, and duration of care, and that a revised request could be made.

Workers' Compensation Appeals BoardMaria DuranForever 21 RetailInc.Chubb GroupOpinion and Decision After ReconsiderationIndependent Medical ReviewIMRUtilization ReviewUR
References
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