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Case Law Database

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

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. ADJ7580462; ADJ7580463; ADJ8813744
Regular
Mar 11, 2025

DORINA CORNEJO vs. SEARS HOLDINGS CORPORATION, ACE AMERICAN INSURANCE COMPANY

Lien claimant Supreme Copy Service, Inc., sought reconsideration of a workers' compensation administrative law judge's (WCJ) findings regarding its withdrawn lien and sanctionable conduct. The Workers' Compensation Appeals Board (WCAB) granted the petition for reconsideration, rescinding the previous findings. The Board determined that the lien was dismissed by operation of law on July 3, 2017, due to the lien claimant's failure to file a required declaration under Labor Code section 4903.05. Consequently, the defendant's petition for sanctions was rendered moot, as the WCAB no longer had jurisdiction over the dismissed lien.

Workers Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings of FactSanctionable ConductLabor Code Section 4903.05Dismissal by Operation of LawDeclaration Pursuant to Labor Code Section 4903.8Declaration Pursuant to Labor Code Section 4903.05(c)(3)Electronic Adjudication Management System
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. 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. 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. ADJ9835949; ADJ9835948; ADJ9860843
Regular
Sep 29, 2025

EDGAR ARAGON-ZARATE vs. MODERN AUTO CENTER, STATE COMPENSATION INSURANCE FUND

Lien claimant Joyce Altman Interpreting sought reconsideration of a Joint Findings and Order issued by a WCJ, which dismissed their lien for interpreting services due to alleged false or inaccurate information in their declaration under Labor Code section 4903.05(c). The Workers' Compensation Appeals Board (WCAB) rescinded the F&O, noting ambiguity in the record regarding whether the defendant denied all liability at the time the interpreting services were rendered. The WCAB emphasized that interpreting services are an integral part of medical treatment and returned the matter for further proceedings to develop the record.

Labor Code section 4903.05(c)Lien claimant declarationInterpreting services lienMedical treatment expensesDeclaration accuracyDue processExcusable neglectRescind OrderReturn to trial levelWCAB
References
Case No. ADJ7359102 ADJ7831301
Regular
Apr 05, 2017

VERONICA PEREZ vs. CLASSIC PARTY RENTALS, OLD REPUBLIC GENERAL INSURANCE CORP.

The lien claimant's Petition for Reconsideration was dismissed because it sought review of a dismissal by operation of law, which is not a final order subject to reconsideration. The Appeals Board granted removal to address the issue of whether the lien claimant timely filed a required declaration under Labor Code section 4903.05(c). This action is based on the principle that parties have a right to due process and a hearing to prove timely filing. The case is returned to the trial level for further proceedings on the timeliness of the declaration.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationPetition for RemovalLabor Code Section 4903.05(c)Declaration RequirementDismissal by Operation of LawJose Guillermina Rodriguez v. Garden Planting Co.Due ProcessFair Hearing
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
Case No. ADJ7133410
Regular
Dec 10, 2018

HUGO DIAZ vs. YOUTH CONNECTION OF VENTURA COUNTY, REDWOOD FIRE & CASUALTY COMPANY

The Workers' Compensation Appeals Board granted reconsideration, rescinded a prior order, and returned the case for further proceedings. The administrative law judge had dismissed a lien claimant's lien for failing to timely file a declaration under Labor Code section 4903.8. However, the Board found that section 4903.8, as amended, does not mandate dismissal for pre-2013 liens with untimely declarations. While the lien is not dismissed, the Board noted that the untimely filing could be grounds for sanctions under Labor Code section 5813.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationFindings and OrderLabor Code section 4903.8Mandatory dismissalSenate Bill 863Declaration of perjuryUntimely declarationInvalid lien
References
Case No. ADJ8324040
Regular
Mar 15, 2019

ISAIAS GARCIA vs. CERADYNE, INC.; XL INSURANCE c/o SEDGWICK CLAIMS MANAGEMENT SERVICE

The Workers' Compensation Appeals Board granted reconsideration to lien claimants Technical Surgical Support and Comprehensive Outpatient Surgery Center. The WCJ had disallowed their liens because their Labor Code section 4903.8(d) declarations were filed untimely and not considered part of the record. The Board found that while the declarations were indeed filed late, the liens themselves were filed before January 1, 2013, predating a stricter WCAB rule. The Board rescinded the WCJ's order, returning the case for further proceedings to allow the defendant to examine the declarant and for a merits-based consideration of the liens.

Labor Code section 4903.8(d)lien claimantsPetition for ReconsiderationFindings and OrderWCJDeclaration of Readinesslien hearinguntimely declarationWCAB Rule 10770(c)(8)Mendoza v. Oak Grove
References
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