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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. SAC 0355949
Regular
Dec 14, 2007

DAVID DOLCINI vs. PACIFIC GAS AND ELECTRIC (PG&E)

The Workers' Compensation Appeals Board denied reconsideration, upholding the WCJ's finding that the applicant's injury was not caused by intoxication. The Board affirmed that the WCAB, not a physician, is the ultimate trier of fact and is not bound by the opinion of an agreed medical examiner. The WCJ's conclusion was based on the credible testimony of an investigating CHP officer who observed no signs of intoxication, and the applicant's own account of the accident, which indicated inattention rather than impairment.

Workers' Compensation Appeals BoardPetition for ReconsiderationAgreed Medical ExaminerTrier-of-factExpert OpinionCivil Law PrinciplesJudicial Council Civil Jury InstructionsBAJIEvidence CodeCHP Officer
References
Case No. ADJ3024777 (VNO 0554063) ADJ3354319 (VNO 0554059)
Regular
Jan 06, 2012

Bernard Durazo vs. ANTELOPE VALLEY HOSPITAL, ALPHA FUND

The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration. The WCAB affirmed the trial judge's decision to rely on the applicant's treating physicians' reports over the Panel Qualified Medical Evaluators (PQMEs). This reliance was based on the principle that the WCAB, as the trier-of-fact, is not bound by PQME opinions but must give them consideration. The WCAB found no error in prioritizing credible and well-reasoned medical opinions that addressed all aspects of the claimed injuries, even if from treating physicians.

WCABPetition for ReconsiderationTreating PhysicianPQMESubstantial EvidenceTrier-of-FactCarpal Tunnel SyndromeLow Back InjuryOrthopedic ComplaintsPsychiatric Complaints
References
Case No. ADJ7031117
Regular
Feb 27, 2013

JAMIE XELOWSKI, JENNIFER CAMPBELL vs. CITY AND COUNTY OF SAN FRANCISCO, COMMUNITY HEALTH NETWORK

This case concerns dependent benefits for the adult daughter of a deceased employee. The applicant argued that a Social Security Administration (SSA) Notice of Award conclusively presumed her dependency for death benefits under Labor Code section 3501(a). The Appeals Board reversed the WCJ's decision, finding the SSA's disability determination constitutes an administrative finding by a trier of fact that the applicant was incapacitated from earning. This finding, occurring prior to the mother's death, satisfies the statutory requirement for conclusive presumption of dependency.

Workers' Compensation Appeals BoardDependent benefitsLabor Code section 3501(a)Conclusive presumption of dependencyTrier of factSocial Security AdministrationIncapacitated from earningAdult daughterMotor vehicle accidentIndustrial injury
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. ADJ10954606
Regular
Mar 09, 2020

DORIT DAVIDOFF vs. UCLA MEDICAL CENTER, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to clarify findings of fact regarding industrial injury AOE/COE. The Board rescinded the previous decision and substituted a new Findings and Award to specifically address the stipulated injury to the lumbar spine, ensuring the award of permanent disability benefits was properly supported. The Board clarified that stipulations agreed upon by the parties should be treated as findings of fact to meet statutory requirements. The decision confirms permanent disability for the left ankle, thoracic spine, and lumbar spine, denies claims for neck and knee injuries, and orders further medical treatment and attorney fees.

Petition for ReconsiderationFindings and AwardIndustrial InjuryLumbar SpineThoracic SpineLeft AnkleAOE/COEStipulationJurisdictional FactsFindings of Fact
References
Case No. ADJ1566624 (MON 0329177) ADJ4125360 (MON 0329180)
Regular
Jul 19, 2011

LAURA LINDQUIST vs. SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE; CORVEL CORPORATION

This case concerns the correct permanent disability rating schedule to apply for an injury occurring before January 1, 2005. The Board affirmed the WCJ's decision to use the 1997 PDRS, finding an exception applied due to prior medical reporting indicating permanent disability. However, the Board amended the permanent disability indemnity award and attorney's fee amount based on the WCJ's correction of a mathematical error. The case is returned to the trial level for further proceedings reflecting this corrected award.

WORKERS' COMPENSATION APPEALS BOARDFindings and AwardPetition for ReconsiderationFindings of Factpermanent disabilitypermanent disability indemnity2005 Permanent Disability Rating Schedule1997 Permanent Disability Rating ScheduleLabor Code section 4660(d)treating physician
References
Case No. ADJ7371382
Regular
Jun 02, 2014

EARL SMITH vs. TIME WARNER CABLE; CHARTIS, administered by ACE USA

This case involves a worker claiming psychiatric injury. The defendant seeks to dismiss the claim based on the "good faith personnel action" defense under Labor Code section 3208.3(h). The Workers' Compensation Appeals Board (WCAB) granted reconsideration because the administrative law judge (WCALJ) failed to address the elements of this defense. The WCAB rescinded the previous findings and returned the case for further proceedings, requiring the WCALJ to specifically address whether the personnel actions were lawful, nondiscriminatory, and in good faith, and if they substantially caused the injury.

Workers' Compensation Appeals BoardPsychiatric injuryLabor Code section 3208.3(h)Good faith personnel actionPetition for ReconsiderationFindings of FactWCJPanel Qualified Medical ExaminerPredominant causeSubstantial cause
References
Case No. ADJ3751392
Regular
Sep 02, 2017

SANTIAGO FLORES vs. OC COMPLETE PERSONNEL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a finding that applicant Santiago Flores sustained an industrial back injury in 2003 and that the claim was contested until 2014. The defendant argued the claim was accepted, not contested, and that a regulation defining a contested claim based on disputed medical facts conflicted with the Labor Code. The Board affirmed the finding, concluding the regulation correctly interpreted the Labor Code by including disputed medical facts as a basis for a contested claim.

Contested claimPetition for ReconsiderationAgreed Medical EvaluatorCalifornia Code of RegulationsLabor CodeWCJWorkers' Compensation Appeals BoardIndustrial injuryMedical-legal expensesDisputed medical fact
References
Case No. ADJ16326594
Regular
Oct 31, 2025

Peter Pham vs. Southern California Edison

Defendant sought removal of a WCJ's December 12, 2023 Findings of Fact and Order (F&O), which denied their motion for a replacement Qualified Medical Evaluator (QME). The defendant argued that the applicant's email to the QME constituted impermissible ex parte contact. The Appeals Board granted the petition for removal, rescinding the F&O, and substituting new Findings of Fact that the email was indeed impermissible ex parte contact, thereby ordering a replacement QME panel. Additionally, while earlier QME reports and deposition testimony by Dr. Weiss remain in evidence, her report dated July 22, 2023, was stricken to preserve the appearance of impartiality in the medical evaluation process.

Ex parte contactQualified Medical EvaluatorRemoval petitionFindings of Fact and OrderLabor Code Section 4062.3Appearance of impartialityMedical evaluation processReplacement QME panelPsychiatric injuryStipulated facts
References
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