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

Case No. ADJ7692621; ADJ7687042
Regular
May 17, 2012

FREDDY TORRES vs. SCOTT BROS DAIRY INC.; ILLINOIS MIDWEST SPRINGFIELD

This case involves a dispute over the selection of a Qualified Medical Evaluator (QME). The defendant attempted to strike a QME from the panel prematurely, violating Labor Code section 4062.2(c). The applicant's subsequent strike was timely, leaving only Dr. Katz on the panel. The Appeals Board denied the defendant's Petition for Removal, upholding the WCJ's order for an evaluation by Dr. Katz. The Board warned the defendant that denying benefits based on Dr. Katz's report would be at their peril.

Petition for RemovalQualified Medical EvaluationLabor Code Section 4062.2(c)QME PanelAgreed Medical EvaluatorStrike a NameTimely StrikePremature StrikeMedical DirectorDivision of Workers' Compensation
References
Case No. ADJ8835727
Regular
Oct 05, 2015

ELVIRA MAYA vs. WENTE VINEYARDS, ZENITH INSURANCE COMPANY

This case concerns the timeliness of a defendant's strike of a Qualified Medical Evaluator (QME) panel. The Appeals Board determined that the ten-day period to strike a QME from a panel, as per Labor Code section 4062.2(c), is extended by five days when service is by U.S. mail, consistent with Code of Civil Procedure section 1013(a). Consequently, the defendant's strike of Dr. Boyd was deemed timely, and the applicant must now be examined by the remaining panel member, Dr. Gardner. The prior WCJ decision finding the strike untimely was rescinded.

WCABReconsiderationRemovalPetition for RemovalPetition for ReconsiderationPQMEPanel QMELabor Code section 4062.2(c)Code of Civil Procedure section 1013(a)WCAB Rule 10507(a)(1)
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. ADJ19432813; ADJ19432814
Regular
Mar 24, 2025

Yeni Saenz vs. Kellermeyer Bergensons Services, LLC; Zurich American Dallas

Applicant Yeni Saenz sought reconsideration of a Workers' Compensation Administrative Law Judge's (WCJ) finding that her strike from a Qualified Medical Evaluator (QME) panel was untimely, granting the defendant the right to select the QME. The Workers' Compensation Appeals Board granted the petition for reconsideration, concluding that although the applicant's strike was indeed untimely, the defendant had subsequently waived its right to exclusively select a QME by failing to act within a reasonable time. Consequently, the Board rescinded the WCJ's decision and ordered the parties to proceed with Dr. Patrick S. Hill as the designated Qualified Medical Evaluator. Commissioner José H. Razo issued a dissenting opinion, arguing that the applicant had obfuscated the untimeliness of her strike and scheduled an appointment during the period when the defendant held the exclusive right to selection.

QME PanelUntimely StrikeLabor Code Section 4062.2WaiverTimely SelectionReconsiderationJoint Findings and OrderWCJAppeals BoardPetition for Reconsideration
References
Case No. ADJ7651955
Regular
Nov 08, 2012

ARTHUR LUCERO vs. CITY OF FRESNO, Permissibly Self-Insured, Administered by AMERICAN ALL RISK LOSS ADMINISTRATORS

This case concerns a dispute over the selection of a Qualified Medical Evaluator (QME) panelist in a workers' compensation claim. The applicant sought to remove Dr. Arora, arguing the defendant's notice to strike Dr. Cayton was insufficient. The applicant, a firefighter, alleged a heart and hernia injury. The Appeals Board denied the petition, agreeing with the WCJ that the defendant's notice of intent to strike was sufficient and timely under Labor Code section 4062.2(c).

Petition for RemovalPanel Qualified Medical EvaluatorNotice of Intent to StrikeLabor Code Section 4062.2Agreed Medical EvaluatorIndustrial InjuryHeart InjuryCardiovascular System InjuryHernia InjuryFirefighter
References
Case No. ADJ11139513
Regular
Jul 23, 2018

TEMPE EVERSON vs. STATE OF CALIFORNIA, CTF SOLEDAD, STATE COMPENSATION INSURANCE FUND

This case concerns the proper Qualified Medical Evaluator (QME) panel selection after an applicant became represented by an attorney. Initially unrepresented, applicant received QME panel #2194142, but no evaluation occurred before she retained counsel. A new panel, #2200955, was issued for represented cases, from which applicant timely struck a physician. However, the defendant's strike from this second panel was found to be untimely. The Appeals Board granted removal, amended the prior order, and directed the parties to proceed with an evaluation by Dr. Scheinbaum from the second panel, deeming it the appropriate one.

Petition for RemovalQualified Medical Evaluator (QME) panelrepresented vs. unrepresentedtimely strikeRomero v. CostcoLabor Code section 4062.1Labor Code section 4062.2Code of Civil Procedure section 1013Razo v. Las Posas Country Clubcomprehensive medical-legal evaluation
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. ADJ2023756 (SAC 0323234)
Regular
Aug 30, 2013

VICTORIA BRESHEARS vs. THE KROGER COMPANY DBA RALPH'S GROCERY COMPANY

The Workers' Compensation Appeals Board granted the employer's Petition for Reconsideration due to discrepancies regarding the timeliness of its filing. The Board issued a Notice of Intention to Dismiss, requiring the employer to provide proof of timely electronic filing via EAMS, specifically the Batch ID and submission date/time. If the employer fails to demonstrate the petition was filed before 5:00 PM on July 8, 2013, it will be dismissed as untimely.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardFindings and OrderWCJEAMSElectronic Adjudication Management SystemBatch IDTimely FiledProof of Service
References
Case No. ADJ9287010
Regular
Oct 22, 2015

Esther Rodriguez vs. MANUEL VILLA ENTERPRISE, NORGUARD INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the applicant's petition for removal, reversing a previous order that deemed her strike from a Qualified Medical Evaluator (QME) panel untimely. The Board found that the applicant's strike was timely under Labor Code section 4062.2(c) and Code of Civil Procedure section 1013(a), which extends the 10-day striking period by five days when the panel assignment is mailed. Consequently, Dr. James Shaw was designated as the proper QME, and the WCJ's prior order was rescinded.

Petition for RemovalQME paneluntimely strikesubstantial prejudiceirreparable harmLabor Code section 4062.2(c)Senate Bill 863Messele v. Pitco FoodsInc.Agreed Medical Evaluator
References
Case No. ADJ7472541
Regular
Sep 02, 2014

MIRNA REYES vs. PREMIER BUILDING MAINTENANCE SERVICES, ZURICH NORTH AMERICA

This case involves a petition for reconsideration that was dismissed by the Workers' Compensation Appeals Board. The dismissal was primarily based on the petition not being timely-filed, as the applicant's representative received personal service of the underlying order. Even if the petition had been considered timely, the Board indicated it would have been denied on the merits. Consequently, the Board formally ordered the dismissal of the petition for reconsideration.

Petition for ReconsiderationDismissing PetitionTimely-filedPersonal ServiceOrder Dismissing LienWCJ Report20-day time limitService by mailMeritsWorkers' Compensation Appeals Board
References
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