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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. ADJ12788878
Regular
Dec 10, 2020

MARIO LUPERCIO PEREZ vs. ARMANDO CHAN dba CHAN DRAINAGE, MARKEL INSURANCE CO.

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration because it was filed as a removal petition challenging interlocutory issues. Although the WCJ's decision contained a final threshold finding of injury AOE/COE, the defendant only disputed the specialty of a QME and the timeliness of an objection, which are interlocutory. The Board found no significant prejudice or irreparable harm to justify removal, and that reconsideration would be an adequate remedy later if a final adverse decision issues.

Workers' Compensation Appeals BoardPetition for ReconsiderationThreshold IssueInterlocutory IssueInjury AOE/COEQualified Medical Evaluator (QME)Treating Physician ReportRemoval StandardSignificant PrejudiceIrreparable Harm
References
Case No. ADJ11344091
Regular
Sep 23, 2019

GRISELDA GONZALEZ vs. G6 HOSPITALITY, LIBERTY MUTUAL INSURANCE COMPANY

This case concerns a defendant's Petition for Removal, which the Appeals Board treated as a Petition for Reconsideration and denied. The WCJ's initial decision included a finding of injury arising out of and in the course of employment, a threshold issue making it a final order. While the defendant's petition only disputed an interlocutory issue regarding the qualified medical evaluator, the Board found no significant prejudice or irreparable harm to warrant removal. Therefore, the defendant's request was denied, affirming the WCJ's prior decision.

Petition for ReconsiderationPetition for Removalthreshold issueinterlocutory issueinjury arising out of and in the course of employmentAOE/COEqualified medical evaluatorQME panelsignificant prejudiceirreparable harm
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. ADJ16089938
Regular
Jan 25, 2023

ALEJANDRO PRADO vs. COSTCO WHOLESALE CORPORATION, HELMSMAN MANAGEMENT SERVICES

This case involves an applicant's petition for removal challenging a WCJ's decision validating the defendant's request for a Qualified Medical Evaluator (QME) panel. The applicant argued the panel request was invalid because it was based on Labor Code section 4061 before permanent and stationary status was reached. The Appeals Board denied the petition, finding the WCJ's decision addressed a threshold issue, making it a final order. However, because the petitioner only challenged an interlocutory finding within that order, the Appeals Board applied the stricter removal standard. Removal was denied as the applicant failed to demonstrate significant prejudice or irreparable harm, and that reconsideration would not be an adequate remedy.

ALEJANDRO PRADOCOSTCO WHOLESALE CORPORATIONHELMSMAN MANAGEMENT SERVICESADJ16089938PETITION FOR RECONSIDERATIONTHRESHOLD ISSUEFINAL DECISIONINTERLOCUTORY ISSUEREMOVAL STANDARDSIGNIFICANT PREJUDICE
References
Case No. ADJ1478308 (MON 0350963) ADJ2388916 (MON 0350964)
Regular
Nov 19, 2015

GALO ALARCON vs. CFHS HOLDINGS, INC dba KERLAN-JOBE ORTHOPEDIC CLINIC, AMERICAN HOME ASSURANCE CO., administered by AIG CLAIM SERVICES, INC.

This case involves a defendant seeking removal of a Workers' Compensation Appeals Board (WCAB) order for a second Qualified Medical Evaluator (QME) panel in urology. The defendant argued the WCJ improperly issued the order before their objection was considered, violating due process. The WCAB granted removal, rescinded the order, and remanded the case for the WCJ to consider the defendant's objection and issue a new decision. This decision was based on the defendant demonstrating potential for significant prejudice and irreparable harm due to the denial of their right to be heard.

Petition for RemovalQualified Medical EvaluatorQME PanelDue ProcessWCJ DecisionAdditional QMEUrologyMedical Legal EvaluationWCAB Rule 31.7Significant Prejudice
References
Case No. AD111893254
Regular
Dec 30, 2019

MORENO, GREYOTTO vs. F&S BRASIL DAIRY, ZENITH INSURANCE

The Workers' Compensation Appeals Board denied a petition for reconsideration, adopting the reasoning of the administrative law judge. Although the WCJ's decision addressed a threshold issue, making it a final order, the petitioner was only challenging an interlocutory finding. Removal was denied because the petitioner failed to demonstrate significant prejudice or irreparable harm, and reconsideration was deemed an adequate remedy.

Petition for ReconsiderationRemovalThreshold IssueInterlocutory IssueFinal DecisionExtraordinary RemedySignificant PrejudiceIrreparable HarmAdequacy of ReconsiderationWCJ Report
References
Case No. ADJ2038785 (VNO 0426080), ADJ900602 (VNO 0426045), ADJ2562931 (VNO 0494371), ADJ7032939, ADJ7045667
Regular
Aug 01, 2019

JOSEPH PROTHRO vs. STATE COMPENSATION INSURANCE FUND as administered by ACCLAMATION INSURANCE MANAGEMENT SERVICES

This Workers' Compensation Appeals Board case, involving multiple claim numbers for Joseph Prothro against State Compensation Insurance Fund, has been granted reconsideration. The Board rescinded the prior WCJ's decision because a settlement has been proposed. The case is now returned to the WCJ to evaluate the settlement, with the option to reinstate the original decision if the settlement is not approved. This decision is not a final determination on the merits.

Workers' Compensation Appeals BoardPetition for ReconsiderationGrant ReconsiderationRescind DecisionReturn to Trial LevelWorkers' Compensation Administrative Law JudgeProposed SettlementApproval of SettlementReinstating Original DecisionFinal Decision
References
Case No. ADJ916063 (VNO 0541860)
Regular
Jun 02, 2011

TERRY SCUDDER vs. VERIZON CALIFORNIA, INC., SEDGWICK CMS

The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for reconsideration of its prior decision. This action was necessary because the WCAB had issued its decision without considering the applicant's timely filed answer to the defendant's petition. The prior decision, which excluded certain medical reports, is rescinded to allow the WCAB to fully review the case. The WCAB will then issue a just and reasoned decision after considering all filings and further proceedings.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationOpinion and DecisionFindings and AwardAdmissible Medical ReportsElectronic Adjudication Management SystemEAMSTimely FiledRescindedSignificant Panel Decision
References
Case No. ADJ11350784
Regular
Jan 13, 2020

LUIS RODRIGUEZ vs. BRAD NYMAN DBA LIVE OAK DAIRY, ZENITH INSURANCE COMPANY

This case concerns a workers' compensation applicant challenging a finding that he waived his right to a replacement Qualified Medical Evaluator (QME) panel. The applicant requested a replacement panel after the initially appointed QME could not schedule an exam within 60 days, but the exam was ultimately scheduled within 90 days. The Workers' Compensation Appeals Board denied the applicant's petition, finding that by accepting an appointment within the 90-day window, he waived his right to a replacement panel. The Board also found the applicant's due process claims unpersuasive, as he had a full opportunity to litigate the issue.

QME panel disputewaiver of replacement panelAOE/COEdue processthreshold issueinterlocutory decisionremoval standardirreparable harmsignificant prejudiceAD Rule 31.3
References
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