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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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. ADJ6573692
Regular
May 09, 2016

Gloria Mares vs. 99 Cents Only Stores, Broadspire

This Workers' Compensation Appeals Board case involved a petition for reconsideration filed by lien claimants. The petition was dismissed because the lien claimants' representative, Frank Ureno, failed to file a proper Notice of Representation with the Board. This procedural defect, the failure to comply with notice requirements for representation, was grounds for dismissal. The Board also noted that the petition would have been denied on its merits if not for the procedural issue.

Petition for ReconsiderationLien claimantsNotice of RepresentationHearing RepresentativeCalifornia Code of Regulations 10774.5DismissalWorkers' Compensation Appeals BoardWCJ ReportUn-numbered pagesOrder Dismissing Lien Balance
References
Case No. ADJ8173186
Regular
Jun 07, 2013

NATHAN LITTLE vs. DIVERSIFIED UTILITY SERVICES, OLD REPUBLIC GENERAL INSURANCE CORPORATION

The Workers' Compensation Appeals Board denied Nathan Little's Petition for Removal concerning a Qualified Medical Examiner (QME) panel. The Board adopted the WCJ's report, which found the QME process was initiated correctly under Labor Code section 4062.2 while the applicant was represented. Although the applicant later became unrepresented, the Board stated the original procedure should be followed for this QME panel. The denial means the applicant must proceed with the designated QME process.

Petition for RemovalQME PanelLabor Code section 4062.1Labor Code section 4062.2unrepresented applicantrepresented applicantsubstantial prejudiceirreparable harmpanel QMEdermatology
References
Case No. ADJ3256331
Regular
Jul 10, 2009

Benjamin W. Mills vs. State Compensation Insurance Fund

The Appeals Board granted the applicant's petition for removal, rescinding the order compelling attendance at a medical examination and returning the matter to the trial level for further proceedings. The WCJ is to consolidate three cases and determine whether applicant is represented by counsel to proceed accordingly.

Petition for RemovalQualified Medical Evaluator (QME)Medical ExaminationIndustrial InjuryPsyche InjuryMultiple InjuriesUnrepresented ApplicantRepresented ApplicantLabor Code Section 4062.1Labor Code Section 4062.3
References
Case No. ADJ3910048 (VNO 0417016)
Regular
Jul 30, 2010

NAHID JAVADI vs. SIMI VALLEY HOSPITAL, ADVENTIST HEALTH SYSTEMS WEST

This case involves an employer, Simi Valley Hospital/Adventist Health Systems West, seeking to prevent the joinder of AIG as a defendant in a workers' compensation claim. The employer argues it is permissibly self-insured and self-administered, and joining AIG, an excess carrier, would cause irreparable harm. The Appeals Board found that since there is no third-party administrator involved, the precedent relied upon for joinder is inapplicable. Consequently, the Board rescinded all orders joining AIG and returned the case to the trial level.

Workers' Compensation Appeals BoardPetition for RemovalJoinder of DefendantReinsurance CarrierExcess CarrierPermissibly Self-InsuredSelf-AdministeredIndustrial InjuryFindings and AwardPetition to Reopen
References
Case No. ADJ7485185, ADJ9885267
Regular
Sep 18, 2017

LAURA ORTIZ vs. FARMERS INSURANCE GROUP, MID CENTURY INSURANCE

This Workers' Compensation Appeals Board decision denies a petition for reconsideration, affirming the applicant's timely invocation of jurisdiction to seek additional benefits. The Board adopted the WCJ's reasoning that the applicant's filings of an Application for Adjudication of Claim and an Amended Application, along with documented medical evidence of worsening condition, satisfied the requirements for reopening and seeking further compensation. These actions put the defendants on notice of the applicant's intent to pursue increased benefits, even without a formal petition to reopen.

Petition for ReconsiderationLabor Code section 5410Application for Adjudication of ClaimRiel v. State of CaliforniaBeaida v. Workers' Comp. Appeals Bd.stipulated awardpro perfuture medical treatmentincreased symptomsworsening condition
References
Case No. ADJ2524386 (LAO 0803654) ADJ2571077 (LAO 0803655)
Regular
Oct 02, 2020

RAUL MARINO vs. COCA-COLA ENTERPRISES, BROADSPIRE

This case concerns a minor amendment to an already approved Compromise and Release agreement between Raul Marino and Coca-Cola Enterprises. The defendant sought to increase the net payment to the applicant by $47.14 and correct the date of injury for one of the cases. The applicant agreed to these changes, and the Board found them to be in the applicant's best interest. Consequently, the Board amended its previous decision to incorporate these agreed-upon modifications.

Compromise and ReleaseAmendmentNet Amount PayableDate of InjuryReconsiderationWorkers' Compensation Appeals BoardSelf-InsuredApplicantDefendantOpinion and Order
References
Case No. ADJ2060741 (RJV 0068035)
Regular
Apr 13, 2009

GAIL ARITA vs. STATE OF CALIFORNIA, CDCR-CALIFORNIA REHABILITATION CENTER, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration to address petitions from both the applicant and defendant concerning the WCJ's decision. The applicant disputed the finding that she failed to prove entitlement to self-procured medical care. The defendant argued the claim was time-barred, but agreed with the applicant on the self-procured treatment issue. The Board affirmed the WCJ's original decision as amended, finding the applicant's self-procured treatment contention moot due to deferral.

Workers' Compensation Appeals BoardReconsiderationSelf-procured medical careBurden of proofAOE/COEStatute of limitationTemporary disabilityWCJ decisionAdministrative law judgeDefendant petition
References
Case No. ADJ11073243
Regular
Aug 01, 2018

MARTINA RODRIGUEZ OCOTECATL vs. GROLINK PLANT COMPANY, INC., HOUSEHOLD INDUSTRIES SELF INSURED GROUP, ATHENS ADMINISTRATORS, ARCH INSURANCE COMPANY, GALLAGHER BASSETT SERVICES

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration of an order declaring the case moot due to a settlement. The Board granted removal on its own motion to address whether the applicant's claim against Household Industries Self Insured Group was actually settled by the Compromise and Release (C&R). The Board found the WCJ's order was not a final decision and rescinded it. The matter was returned to the WCJ for further proceedings to determine the scope of the C&R and its impact on the claim against Household Industries.

Workers Compensation Appeals BoardPetition for ReconsiderationDismissalRemovalCompromise and ReleaseApplicant's AttorneySelf-Insured EmployerInjury ClaimCumulative InjuryDeclarations of Readiness to Proceed
References
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