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

Case No. ADJ1850137
Regular
Aug 14, 2012

CARMEN GARCIA vs. MISSION HOSPITAL REGIONAL MEDICAL CENTER, SEDGWICK CMS

Here's a summary of the case for a lawyer, in four sentences: The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration, upholding the judge's decision that found no permanent disability. The applicant argued the judge improperly relied on Dr. Cook's medical reports, which she claimed lacked substantial evidence and admissibility. However, the Board adopted the judge's report, emphasizing the weight given to credibility findings and noting that Dr. Cook's reports were supported by other physicians' findings and subrosa video evidence. This video demonstrably challenged the applicant's claims of limitations, contradicting her testimony about needing wrist supports for routine activities.

Workers' Compensation Appeals BoardMission Hospital Regional Medical CenterSedgwick CMSReconsiderationLabor Code section 5313Smales v. Workers' Comp. Appeals Bd.Garza v. Workmen's Comp. Appeals Bd.CredibilitySupplemental PetitionSummary of Evidence
References
Case No. ADJ588686 (SDO 0309857) ADJ2275487 (SDO 0311854) ADJ1079800 (SDO 0309856)
Regular
Mar 12, 2014

GRAZYNA KOZAK vs. QUIDEL CORPORATION, CNA INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the petition for reconsideration, affirming the WCJ's decision. The Board found the defense exhibits, including surveillance videos and vocational expert reports, were properly admitted. They also upheld the use of the AMA schedule for permanent disability, finding the applicant's earlier reports did not qualify for the prior rating schedule. Finally, the Board gave great weight to the WCJ's credibility findings regarding the applicant and found the opinions of some expert witnesses to be unsubstantial.

Petition for ReconsiderationWorkers' Compensation Appeals BoardWCJ credibility findingvocational expert reportssubrosa filmscustodian of recordspermanent disability rating schedulePDRSpermanent and stationary statussubstantial evidence
References
Case No. ADJ15999814, ADJ16759614
Regular
Jun 24, 2025

JOSE GAMBOA vs. SAPUTO CHEESE USA, INC.; SEDGWICK

The Workers' Compensation Appeals Board considered and denied the Petition for Reconsideration filed by the defendants, Saputo Cheese USA, Inc. and Sedgwick. The petition challenged Dr. Mandell's alternative impairment rating, the exclusion of subrosa video evidence, and apportionment opinions. The Board adopted the WCJ's report, finding that the petition was timely acted upon and that defendant's arguments lacked foundation or substantial medical evidence. The WCJ's decision was ultimately supported by substantial medical evidence.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code section 5909Electronic Adjudication Management SystemSubrosa videoImpeachmentMedical evidenceFunctional capacity evaluationAlmaraz/Guzman analysisSubstantial medical evidence
References
Case No. ADJ15306840
Regular
May 27, 2025

RUBEN PEDROZA vs. OC JONES & SONS, INC.; NATIONAL UNION FIRE INSURANCE CO.

Applicant Ruben Pedroza sought reconsideration of a WCJ's Findings and Order (F&O) that denied his claim for industrial injury. The Appeals Board granted reconsideration, rescinded the F&O, and remanded the case for further proceedings. The Board found the WCJ erred by relying on a QME's summary of unadmitted subrosa video for credibility findings and identified an unaddressed conflict of interest regarding the QME. The Board determined that applicant's corrected statements about his work history did not significantly undermine his credibility.

Workers' Compensation Appeals BoardReconsiderationQualified Medical EvaluatorSubrosa VideoIndustrial InjuryCausationAOE/COELabor CodeMedical EvidenceConflict of Interest
References
Case No. ADJ9473601
Regular
Mar 10, 2016

BRIAN JONES vs. ARS INVESTMENT HOLDINGS, LLC, LIBERTY MUTUAL FIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration because the order under review was a discovery ruling, not a final order. Furthermore, the Board denied the applicant's petition for removal, finding it lacked specific legal support and failed to demonstrate substantial prejudice or irreparable harm. The Board noted that the admissibility of the subrosa video can be addressed at later evidentiary hearings. Additionally, the applicant's non-attorney representative's status and eligibility for fees remain unclear under current regulations.

Subrosa videoPetition for reconsiderationPetition for removalDiscovery orderFinal orderDue processRight to privacyWCJPQMELabor Code section 5900
References
Case No. ADJ10161297
Regular
Nov 17, 2017

LUIS CHAVEZ vs. SYSCO, AMERICAN ZURICH INSURANCE COMPANY, GALLAGHER BASSETT

The Workers' Compensation Appeals Board (WCAB) denied the applicant's petition for reconsideration, upholding the administrative law judge's (WCJ) findings. The WCJ found the applicant not to be a credible witness, largely due to discrepancies between his reported limitations and observed activities in subrosa video evidence. Consequently, the WCJ determined that the applicant failed to prove his injury arose out of and occurred in the course of his employment (AOE/COE). The WCAB gave great weight to the WCJ's credibility determination, finding no substantial evidence to warrant overturning it.

WCABPetition for ReconsiderationCredibility DeterminationSubrosa VideoAOE/COERange of MotionAMA GuidelinesSubstantial Medical EvidenceCausationModified Work
References
Case No. ADJ7319072
Regular
Nov 13, 2013

MARIO FABELA vs. STAFFMARK INVESTMENT, LLC, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

The Workers' Compensation Appeals Board denied Mario Fabela's petition for reconsideration of a decision that found he did not sustain an injury arising out of and in the course of employment. The Board adopted the judge's report, which found Fabela's testimony lacked credibility, particularly in light of surveillance video showing him performing various physical activities with little difficulty two months after the alleged fall. Medical evidence also questioned the extent of his reported symptoms, noting negative diagnostic tests. Therefore, the Board concluded the evidence did not justify the applicant's claim for an industrial injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedWCJGarza v. Workmen's Comp. Appeals Bd.Staffmark InvestmentLLCCannon CochranFabelaDate of Injury
References
Case No. ADJ1479326 (ANA 0411799) ADJ7233578
Regular
Oct 07, 2014

JONATHAN DUONG vs. AUTOMOBILE CLUB OF SOUTHERN CALIFORNIA, HARTFORD INSURANCE COMPANY OF THE MIDWEST

The Workers' Compensation Appeals Board overturned a WCJ's decision to exclude sub rosa surveillance video. The Board found no legal basis for excluding the video obtained in a mobile home park parking lot and a grocery store, as the applicant lacked a reasonable expectation of privacy in those public areas. The Board determined that the defendant would suffer significant prejudice from the exclusion, justifying removal of the case. Therefore, the sub rosa video was ruled admissible and may be provided to medical evaluators.

Sub rosa videoremovalreconsiderationadmissibilityinvasion of privacyreasonable expectation of privacycivil liabilityworkers' compensation fraudmedical-legal evaluatorworkers' compensation appeals board
References
Case No. ADJ9070509
Regular
Jan 05, 2018

GIHAN MOSAAD vs. WALMART STORES, INC., ACE AMERICAN INSURANCE COMPANY, YORK RISK SERVICES GROUP, INC.

This case concerns the admissibility of store surveillance video footage from the applicant's date of injury. The Workers' Compensation Appeals Board denied the applicant's Petition for Removal, an extraordinary remedy, finding no substantial prejudice or irreparable harm. The Board agreed with the Workers' Compensation Judge (WCJ) that reconsideration would be an adequate remedy if a future decision proves adverse. The WCJ determined the video was relevant to the nature, extent, and apportionment of the applicant's injury, noting it shows the applicant using a cane and stocking shelves before being removed on a stretcher. The Board concluded the applicant failed to demonstrate that removal was necessary before a final decision.

Petition for RemovalWorkers' Compensation Appeals BoardSubstantial PrejudiceIrreparable HarmReconsiderationAdmissibility of VideoStore Surveillance VideoDate of InjuryWorkers' Compensation JudgeFindings & Order
References
Case No. ADJ769451 (MON 0236205)
Regular
Apr 01, 2010

CLEMI BOUBLI vs. CAST & CREW PAYROLL, CNA

This case involves a defendant's petition for removal after the WCJ struck an Agreed Medical Evaluator's (AME) report and closed discovery. The AME reviewed surveillance videos suggesting the applicant's reported disability was feigned or exaggerated, recommending further evaluation. The Appeals Board granted removal, finding disputes regarding video admissibility require resolution at the trial level. The matter is returned for the WCJ to determine video admissibility and decide on further medical evaluations.

RemovalAgreed Medical EvaluatorSurveillance VideoExaggerated DisabilityNeuropsychological EvaluationUnfair DecisionAdmissible EvidenceEvidentiary RulingsReconsiderationTrial Level Proceedings
References
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