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

Case No. ADJ547219 (OAK 0284707) ADJ2031085 (OAK 0291936)
Regular
Apr 15, 2010

SHARON TAKAHASHI vs. COUNTY OF ALAMEDA (C/O SEDGWICK) and AIG (C/O TRISTAR)

The Workers' Compensation Appeals Board denied Tristar's petition for reconsideration while granting those of the applicant and Sedgwick. The Board affirmed the original Joint Findings and Award, but with specific amendments. These amendments clarify responsibility for Dr. Carr's medical-legal evaluation, assigning sole liability to Tristar. The decision also clarifies the administration of future medical treatment, delineating responsibilities between Tristar and Sedgwick for upper extremity versus lower extremity injuries.

ADJ547219ADJ2031085OAK 0284707OAK 0291936ReconsiderationJoint Findings and AwardIndustrial InjuryUpper ExtremitiesLeft KneeRight Ankle
References
0
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 The Workers' Compensation Appeals Board granted reconsideration, rescinded an arbitration finding, and remanded the matter for further proceedings.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
2
Case No. ADJ2309063, 2603988
Regular
Jun 24, 2010

RAINIE JAEGER vs. APOTHE-CARE, INC., dba OWENS PHARMACY, FIREMAN'S FUND INSURANCE COMPANY, AMERICAN AUTO INSURANCE COMPANY, RISK ENTERPRISE MANAGEMENT, WALGREEN'S, AMERICAN MOTORISTS INSURANCE COMPANY, SEDGWICK CMS, Fairmont Premier Insurance Company, American Motorist Insurance Company adjusted by Sedgwick

This case involves a dispute over a worker's compensation claim for a low back injury determined to be a compensable consequence of a prior bilateral carpal tunnel injury. The Board granted reconsideration to correct the date of the compensable consequence injury to October 5, 2004. Furthermore, Fireman's Fund was ordered to reimburse Sedgwick CMS for benefits paid after that date, with the right to seek contribution from Fairmont Premier/REM. The Board rescinded prior findings and substituted new ones, clarifying liability for medical treatment and benefits.

compensable consequence injurybilateral carpal tunnellow back injuryspinal surgeryAgred Medical Evaluator (AME)Fireman's FundSedgwick CMSjoint and several liabilityreimbursementcontribution
References
0
Case No. AHM 81069 AHM 81103 AHM 81104
Regular
Jan 14, 2008

SHEILA RAY vs. RALPHS GROCERY COMPANY, SEDGWICK DMS, INC.

The Workers' Compensation Appeals Board granted reconsideration, reversing a prior order that had set aside a 2001 stipulated award. The Board found the judge lacked jurisdiction under Labor Code section 5804 to grant the applicant's petition to set aside the award due to a supposed mutual mistake regarding permanent disability rating. Consequently, the applicant's petitions to set aside the award and to reopen for new and further disability were denied.

WCABRalphs Grocery CompanySedgwick DMSSheila RayReconsiderationStipulated AwardMutual MistakeDisability Evaluation SpecialistPetition to Set AsideJurisdiction
References
0
Case No. ADJ6476038
Regular
Sep 18, 2013

RISHI DHIRI vs. WALGREENS, SEDGWICK

This case involves a petition for reconsideration filed by the applicant, Rishi Dhiri, against Walgreens and Sedgwick. The Workers' Compensation Appeals Board (WCAB) dismissed Dhiri's petition because it was filed from an interlocutory order granting reconsideration, not a final order. California law, supported by case precedent, establishes that petitions for reconsideration are only permissible after a final decision or award. The WCAB noted that the Workers' Compensation Judge may consider sanctions for failure to appear.

Petition for ReconsiderationFinal OrderInterlocutory OrderLabor Code section 5900DismissedWorkers' Compensation Appeals BoardWCJSanctionsGumilla v. Industrial Acc. Com.Safeway Stores v. Workers' Comp. Appeals Bd. (Pointer)
References
6
Case No. ADJ2842535
Regular
May 27, 2011

JANE HUTZELL vs. UNIVERSITY OF CALIFORNIA at BERKELEY, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a Petition for Reconsideration by applicant Jane Hutzell against the University of California at Berkeley. The Workers' Compensation Appeals Board denied reconsideration, adopting the judge's report. The judge found that vocational experts' opinions did not adequately address the impact of medical apportionment or the specifics of part-time work availability on the overall industrial disability rating. Therefore, the judge's rating, based on established schedules, was upheld.

Workers' Compensation Appeals BoardPetition for ReconsiderationVocational ExpertsLumbar Spine ConditionCumulative TraumaNon-Industrial FactorsObesityApportionmentBilateral Carpal Tunnel SyndromeBilateral Cubital Tunnel Syndrome
References
0
Case No. ADJ7047735
Regular
Jun 17, 2013

ANGELO TOTA vs. VERIZON SERVICES, SEDGWICK

This case involves a Petition for Reconsideration regarding an Order allowing costs for applicant's former attorneys. The petition was filed by defendants Verizon Services and Sedgwick CMS, objecting to interpreter fees, but it failed to address the actual costs ordered. Crucially, the petition was not served on all adverse parties, a procedural defect that alone warrants dismissal. The Board dismissed the petition, also noting deficiencies in its substance and attorney representation.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Allowing CostsLabor Code Section 5811Interpreter FeesDepositionService of ProcessAdverse PartiesDismissalVerification
References
0
Case No. ADJ8138407
Regular
Nov 19, 2014

SCOTT LOWE vs. ADT, SEDGWICK CMS

The applicant is Scott Lowe, and the defendants are ADT and Sedgwick CMS. The defendants sought Social Security earnings records from 2005 to the present, claiming it was proper discovery. The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for removal of the judge's order denying this discovery. The WCAB found that the requested earnings information, starting seven years prior to the injury, was not relevant and removal is an extraordinary remedy requiring a showing of substantial prejudice or irreparable harm.

Petition for RemovalSocial Security earnings recordsdiscoverydue processtemporary total disabilitysubstantial prejudiceirreparable harmreconsiderationadministrative law judgeWorkers' Compensation Appeals Board
References
2
Case No. ADJ9330427
Regular
Feb 22, 2016

ANNABELLE PENARUBIA vs. WELLS FARGO, SEDGWICK

The Workers' Compensation Appeals Board granted reconsideration of a prior decision concerning Annabelle Penarubia and Wells Fargo/Sedgwick. This action was taken due to statutory time constraints and an initial review indicating further study of the factual and legal issues is necessary for a just decision. All future filings related to this petition for reconsideration must be submitted directly to the Appeals Board Commissioners in San Francisco and not to the district office or through EAMS. Pending the decision after reconsideration, any proposed settlements must be promptly communicated to the Appeals Board as a WCJ cannot act on them during this period.

Workers' Compensation Appeals BoardPetition for ReconsiderationGrant of ReconsiderationStatutory Time ConstraintsFactual IssuesLegal IssuesJust and Reasoned DecisionOffice of the CommissionersElectronic Adjudication Management System (EAMS)District Office
References
0
Case No. ADJ1332416 (WCK 0031685), ADJ3521523 (WCK 0322592), ADJ4017994 (WCK 0029276)
Regular
May 16, 2014

PAMELA ZEILSTRA vs. TARGET STORES, SEDGWICK CMS

This case involves a Petition for Reconsideration filed by Pamela Zeilstra against Target Stores and Sedgwick CMS. The Workers' Compensation Appeals Board dismissed the petition because it was untimely and not filed from a final order, as required by Labor Code section 5900. The Board clarified that interlocutory procedural orders, which do not determine substantive rights, are not subject to reconsideration. Therefore, the petition was dismissed.

Petition for ReconsiderationUntimely PetitionFinal OrderInterlocutory OrderSubstantive RightLiability DeterminationWCABWorkers' Compensation Appeals BoardAdministrative Law JudgeReport and Recommendation
References
5
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