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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ599176 (SAC 0333692) ADJ2396484 (RDG 0122019) ADJ7950339
Regular
Mar 21, 2017

Fernando Muniz Villalpando vs. Doherty Brothers, Martin Dusters, State Compensation Insurance Fund

This case involves an applicant seeking to self-administer his Medical Set-Aside Account (MSA) after previously agreeing to third-party administration by Bridge Pointe/NuQuest. The Appeals Board granted reconsideration, rescinded the prior order, and returned the matter to the trial level. The Board found that the trial judge needs to review the original agreement to determine if it allows for a change of administration or if applicant has contractual rights to pursue this. Further proceedings will assess applicant's competency for self-administration and any opposition from the defendant.

Medical Set-Aside AccountMSAPetition for ReconsiderationJoint Findings and OrderMedical Set-Aside Account administrationself-administrationBridge PointeNuQuestState Compensation Insurance FundCompromise and Release Agreement
References
Case No. ADJ6729351
Regular
Jul 06, 2012

TERESA MALDONADO vs. SUNRISE SENIOR LIVING, SEDGWICK CMS

This case, *Maldonado v. Sunrise Senior Living*, involved an applicant seeking reconsideration of a prior decision by the Workers' Compensation Appeals Board (WCAB). The WCAB reviewed the petition for reconsideration and the administrative law judge's report. Finding no grounds to overturn the initial decision, the WCAB formally denied the petition for reconsideration. The order adopting the judge's reasoning implies the original ruling was affirmed.

Workers' Compensation Appeals BoardSunrise Senior LivingSedgwick CMSADJ6729351Long Beach District OfficeDenying ReconsiderationPetition for ReconsiderationAdministrative Law Judge ReportRecord ReviewAdopt and Incorporate
References
Case No. ADJ9316584
Regular
May 12, 2014

FRANCISCO BAEZ vs. JOHN CRAVENS PLASTERING, INC., INSURANCE COMPANY OF THE WEST

The Workers' Compensation Appeals Board (WCAB) denied the applicant's Petition for Removal, upholding the administrative law judge's decision. The WCAB clarified that "satellite offices," like the one in Santa Barbara, do not qualify as "district offices" for venue purposes under Labor Code Section 5501.5. This distinction is based on the greater resources and staffing available at full-fledged district offices, supported by administrative interpretation and practical necessity. The WCAB affirmed its authority to calendar hearings at various locations based on available resources, regardless of the applicant's preferred venue.

Petition for RemovalWorkers' Compensation Appeals BoardDivision of Workers' CompensationDistrict OfficeSatellite OfficeVenueLabor CodeAdministrative ConstructionContemporaneous Administrative ConstructionJudicial Resources
References
Case No. ADJ9316587
Regular
May 13, 2014

TORI BLEVINS vs. ELIZABETH J. TILLEY, STATE FARM INSURANCE COMPANY

This case concerns applicant Tori Blevins' petition to change venue from the San Luis Obispo District Office to the Santa Barbara satellite office. The Workers' Compensation Appeals Board (WCAB) denied the petition, affirming the administrative law judge's decision. The WCAB concluded that only "district offices," not "satellite offices," are considered for venue determination under Labor Code section 5501.5. This distinction is based on the full staffing, extensive facilities, and daily operations of district offices, contrasting with the limited resources of satellite offices. The WCAB found no basis to overturn the administrative construction that Santa Barbara's office is a satellite, not a district, office.

Petition for RemovalVenueDistrict OfficeSatellite OfficeWorkers' Compensation Appeals BoardLabor Code Section 5501.5Department of Workers' CompensationAdministrative ConstructionContemporaneous Administrative ConstructionDWC Newsline
References
Case No. ADJ1409625 (LBO 0360295) ADJ1382588 (MON 0239533)
Regular
Apr 16, 2015

MELBOURNE BARDOWELL vs. GI TRUCKING COMPANY, GALLAGHER BASSETT SERVICES, ATHENS ADMINISTRATORS

The Workers' Compensation Appeals Board granted reconsideration to clarify the applicant's date of injury for cumulative trauma. The original award found industrial injury to the neck and low back for a trailer mechanic but did not address liability division between two third-party administrators, Athens Administrators and Gallagher Bassett Services. The Board deferred the issue of the period of injurious exposure to the Workers' Compensation Judge. The matter is returned to the WCJ for further proceedings and a new decision on this specific issue.

Petition for ReconsiderationDivision of LiabilityPeriod of Injurious ExposureLabor Code sections 54125500.5Cumulative TraumaDate of InjuryTrailer MechanicPermissibly Self-InsuredThird-Party Administrator
References
Case No. ADJ8509270
Regular
Oct 30, 2015

JAMES HORICK vs. JOHN T. MALLOY, INC., AIG

The Workers' Compensation Appeals Board (WCAB) denied reconsideration of a prior ruling that allowed an injured worker to pursue an Independent Medical Review (IMR). The Administrative Director (AD) had initially denied the IMR request because the injured worker did not personally sign the application, despite their attorney signing it and providing notice of representation. The WCAB found that an attorney, representing an injured worker, is authorized to sign an IMR request as a procedural matter, binding the client. Therefore, the AD's denial was in error, and the matter was properly remanded for IMR.

Independent Medical ReviewPetition for ReconsiderationAdministrative DirectorWorkers' Compensation Appeals BoardFindings and OrderUtilization ReviewLabor Code 4610.5Administrative Rule 9792.10.1Attorney representationMedical authorization
References
Case No. ADJ9405272
Regular
Feb 03, 2015

JACQUELINE LOTT vs. UNIVERSITY OF CALIFORNIA LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration, overturning a prior decision that barred the applicant's claim under the going and coming rule. The Board found the applicant sustained an industrial injury on March 19, 2014, while employed as an administrative assistant. The injury occurred as she slipped and fell in a parking structure while on an unpaid lunch break, on the shortest route from her office to a snack bar. The Board determined this incident fell within the "reasonable margin of time and space" for ingress and egress from the employer's premises.

going and coming ruleindustrial injuryworkers' compensationadministrative assistantoffice complexparking structureunpaid lunch breakingress and egresspremises line rulecompensable
References
Case No. ADJ4199705
Regular
Oct 28, 2010

JUAN BURCIAGA vs. CONCO COMPANIES, ATHENS ADMINISTRATORS

The Workers' Compensation Appeals Board (WCAB) denied Juan Burciaga's Petition for Reconsideration and Removal. The WCAB adopted the findings and recommendations of the administrative law judge's report in its entirety. Additionally, the WCAB admonished the petitioner for violating WCAB Rule 10842 by attaching irrelevant or already submitted evidence, warning of potential sanctions. This denial means the prior decision in the case remains in effect.

Petition for ReconsiderationRemovalWCAB Rule 10842SanctionsLabor Code Section 5813Administrative Law JudgeWorkers' Compensation Appeals BoardConco CompaniesAthens AdministratorsJuan Burciaga
References
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