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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ9160815
Regular
Jun 10, 2014

ALMA CEDILLO vs. CEDARS SINAI MEDICAL CENTER, TRISTAR RISK MANAGEMENT

This case involves an applicant, Alma Cedillo, seeking workers' compensation benefits from Cedars Sinai Medical Center and Tristar Risk Management. The Workers' Compensation Appeals Board (WCAB) issued an order denying a Petition for Removal filed in the case. The WCAB adopted the reasoning of the workers' compensation administrative law judge (WCJ) in reaching its decision to deny removal. Therefore, the applicant's request to remove the case from the current process was rejected.

Petition for RemovalWorkers' Compensation Appeals BoardCedars Sinai Medical CenterTristar Risk ManagementAdministrative Law JudgeADJ9160815Van Nuys District OfficeAlma Cedillodenying removalworkers' compensation
References
Case No. ADJ3698541 (VNO 0412457), ADJ3246761 (VNO 0416345), ADJ2731611 (VNO 0416346)
Regular
Feb 06, 2015

WEST GRIFFIN vs. HARBOR UCLA MEDICAL CENTER, TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board denied Tristar Risk Management's petition for removal, which sought to halt trial proceedings for the applicant's claim for home health care reimbursement. Tristar argued the trial was premature, preventing adequate discovery and the development of the evidentiary record concerning new statutes applicable to the claim. The Board found that removal is an extraordinary remedy not warranted here, as the applicant bears the burden of proof at trial and Tristar has remedies available if aggrieved by a post-trial decision. The Board also confirmed Tristar's petition was timely filed.

ADJ3698541ADJ3246761ADJ2731611HARBOR UCLA MEDICAL CENTERTRISTAR RISK MANAGEMENTPetition for RemovalWCJhome health care servicesNeri HernandezAugust 21
References
Case No. ADJ2987188 (LBO 0277672) ADJ6543172
Regular
Sep 15, 2015

LUPE CHAVEZ vs. COUNTY OF LOS ANGELES, TRISTAR RISK MANAGEMENT

This order denies Lupe Chavez's Petition for Reconsideration in her workers' compensation case against the County of Los Angeles and Tristar Risk Management. The Workers' Compensation Appeals Board adopted the reasoning of the workers' compensation administrative law judge's report. Therefore, the denial of reconsideration stands.

Petition for ReconsiderationWorkers' Compensation Appeals BoardAdministrative Law Judge ReportDenying ReconsiderationCounty of Los AngelesTristar Risk ManagementCase Number ADJ2987188Case Number ADJ6543172San FranciscoCalifornia
References
Case No. ADJ630889 (MON 0279182)
Regular
Dec 28, 2012

BARBARA ANN SHANN vs. CEDARS SINAI, TRISTAR RISK MANAGEMENT

This case involves Barbara Ann Shann seeking workers' compensation benefits from Cedars Sinai and Tristar Risk Management. The Workers' Compensation Appeals Board denied Shann's request for reconsideration of a prior decision. The order indicates the Board found no grounds to overturn its initial ruling regarding her claim.

WORKERS' COMPENSATION APPEALS BOARDBARBARA ANN SHANNCEDARS SINAITRISTAR RISK MANAGEMENTADJ630889ADJ224692ADJ3805845ORDER DENYING RECONSIDERATIONMON District Office
References
Case No. ADJ13571625
Regular
Apr 12, 2023

MARITZA CANALES vs. EAST WEST EYE INSTITUTE, INC., NOVA CASUALTY COMPANY, TRISTAR RISK MANAGEMENT

This case concerns a petition for reconsideration by Nova Casualty Company, the insurer for East West Eye Institute, Inc., challenging a finding of joint employment. The applicant, Maritza Canales, worked as a nanny/housekeeper, receiving simultaneous payments from East West/Premier Practice Management (PPM) and an individual, Naomi Kurata. The Workers' Compensation Appeals Board (WCAB) denied the petition, adopting the judge's report which found sufficient connection to East West/PPM to establish employment based on payroll and benefits provided. The judge also found Naomi Kurata credible, rejecting arguments of witness contradiction and mischaracterization of facts regarding overtime pay.

JOINT EMPLOYMENTALTER EGOEMPLOYMENT FOLLOWS PAYROLLCORPORATE ENTITIESRESIDENTIAL EMPLOYEEHOMEOWNER'S INSURANCEWITNESS CREDIBILITYCOMPENSATION JUDGEPETITION FOR RECONSIDERATIONWORKERS' COMPENSATION APPEALS BOARD
References
Case No. STK 0192198, STK 0192199(M)
Regular
Mar 27, 2008

DAVID FONSECA vs. ALAMEDA COUNTY SHERIFF'S DEPARTMENT, TRISTAR RISK MANAGEMENT, SEDGWICK CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board granted reconsideration and removal, rescinding the finding of no cumulative trauma injury and amending the finding regarding the applicable rating schedule for a 1992 knee injury. The case is returned to the trial level for further development of the record on cumulative trauma, permanent disability, and apportionment. Medical evaluators should be provided with the applicant's deposition transcript and a job description.

Workers Compensation Appeals BoardPermissibly Self-InsuredTristar Risk ManagementSedgwick Claims ManagementRemovalReconsiderationFindings Award and OrdersSchedule for Rating Permanent DisabilitiesCumulative Trauma InjuryFuture Medical Treatment
References
Case No. ADJ3614029 (STK 0192198) ADJ1670728 (STK 0192199)
Regular
Jan 09, 2009

DAVID FONSECA vs. ALAMEDA COUNTY SHERIFF'S DEPARTMENT, TRISTAR RISK MANAGEMENT, SEDGWICK CLAIMS MANAGEMENT

Reconsideration granted; rescinds prior Findings, Award and Orders; returns matter to trial level to determine applicable permanent disability rating schedule and Section 4850 benefits; and to determine defendant's insurance status at time of 1992 injury.

Workers' Compensation Appeals BoardDavid FonsecaAlameda County Sheriff's DepartmentTristar Risk ManagementSedgwick Claims Managementpermanent disabilitycumulative traumadate of injuryrating scheduleLabor Code section 4061
References
Case No. ADJ4634338 (MON 0262377)
Regular
Jun 24, 2009

NINA GOODRICH vs. UNILAB/QUEST DIAGNOSTICS, SEDGWICK CLAIMS MANAGEMENT SERVICES, AMERICAN CASUALTY CO. OF READING, PA, CNA CLAIMSPLUS, VALLEY HEALTH SYSTEMS, TRISTAR RISK MANAGEMENT, ZURICH INSURANCE CO.

This case concerns a dispute over contribution claims following a cumulative injury to the applicant. The Workers' Compensation Appeals Board granted reconsideration, rescinded an arbitration finding, and remanded the matter for further proceedings. The Board found that Sedgwick, which paid over $180,000 in benefits, was not required to file a petition for contribution under section 5500.5 because it was not a signatory to the Compromise and Release (C&R). Furthermore, the Board held that even if Sedgwick had been required to file, the co-defendant CNA would be estopped from asserting the statute of limitations due to stipulations in the C&R reserving contribution rights. The Board concluded Sedgwick's claim for reimbursement was not time-barred.

Workers' Compensation Appeals BoardNina GoodrichUnilabQuest DiagnosticsSedgwick Claims Management ServicesAmerican Casualty Co.CNA ClaimsplusValley Health SystemsTristar Risk ManagementZurich Insurance Co.
References
Case No. ADJ4634338 (MON 02262377) ADJ614711 (MON 0288710)
Regular
Dec 07, 2009

NINA GOODRICH vs. UNILAB/QUEST DIAGNOSTICS, SEDGWICK CLAIMS MANAGEMENT SERVICES, AMERICAN CASUALTY CO. OF READING, PA, CNA CLAIMSPLUS, VALLEY HEALTH SYSTEMS, TRISTAR RISK MANAGEMENT, ZURICH INSURANCE CO.

Zurich's petition for reconsideration of the June 24, 2009 Opinion and Order Granting Reconsideration and Decision After Reconsideration is denied for the reasons stated in prior opinions.

Workers' Compensation Appeals BoardNina GoodrichUnilab/Quest DiagnosticsSedgwick Claims Management ServicesAmerican Casualty Co.Valley Health SystemsTristar Risk ManagementZurich Insurance Co.Labor Code section 5500.5Arbitration Finding of Facts
References
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