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

Case No. SFO 500569
Regular
Jun 02, 2008

MARIA LUISA LOPEZ vs. UCSF, ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board granted reconsideration of a prior finding that applicant sustained a cumulative injury to her neck and shoulders. While the defendant argued the injury was to a different body part and dated earlier, the Board affirmed the WCJ's decision, amending it to explicitly include an award for necessary medical treatment. The decision acknowledges the defendant's arguments but ultimately upholds the applicant's entitlement to benefits for the industrial injury.

WCABPetition for ReconsiderationFindings and OrderIndustrial Cumulative InjuryMedical TechnicianNeck and ShouldersAugust 122006Zurich North AmericaUCSF
References
0
Case No. ADJ11913752
Regular
Nov 19, 2019

LAURA DOW vs. UCSF, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

This case concerns a dispute over the proper procedure for requesting a Qualified Medical Evaluator (QME) panel after a workers' compensation claim was denied. The Workers' Compensation Appeals Board (WCAB) granted removal, reversing a WCJ's decision. The WCAB found that the defendant's request for an orthopedic surgery QME panel was valid, initiated after the denial notice and statutory waiting period. They also determined that orthopedic surgery was an appropriate specialty, overriding the WCJ's order for a pain medicine panel. The parties are now directed to proceed with the orthopedic surgery QME panel.

QME panelPetition for RemovalOpinion and OrderFindings and OrdersMedical UnitPain MedicineOrthopedic SurgeryDenial NoticeQualified Medical EvaluatorLabor Code Section 4060
References
4
Case No. OAK 0315547
Regular
Jan 24, 2008

CECILE DJAFAR vs. UCSF MEDICAL CENTER, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to address the lien claimant's (Bay Area Surgery Center) claim for unpaid medical services. The Board rescinded the previous order disallowing the lien and remanded the case to the trial level. This action was taken because the lien claimant's crucial evidence of accreditation, which was believed to have been submitted and admitted, was missing from the official file, and further review is necessary to ensure substantial justice.

Workers' Compensation Appeals BoardUCSF Medical CenterSedgwick Claims Management ServicesBay Area Surgery CenterLien claimantCarpal tunnel releaseCompromise and release agreementAccreditation Association for Ambulatory Health CareOutpatient settingDue process
References
11
Case No. ADJ3097538 (SFO 0446365) ADJ2535723 (SFO 0482694)
Regular
Oct 13, 2009

YOLANDA ORTIZ vs. UCSF STANFORD HEALTH CARE, CIGA, RELIANCE NATIONAL INSURANCE, INTERCARE HOLDINGS INSURANCE SERVICES INC.

The WCAB affirmed the WCJ's decision, amending it to clarify that VRMA continues until applicant meets with a QRR. The court addressed the effect of the repeal of Labor Code section 139.5 on applicant's vocational rehabilitation benefits.

CIGAVocational Rehabilitation Maintenance AllowanceRehabilitation UnitVesting of RightsLabor Code Section 139.5Timeliness of AppealFinal DeterminationQualified Rehabilitation RepresentativeInchoate RightsStatutory Repeal
References
2
Case No. ADJ1654619
Regular
Jun 29, 2011

PATRICIA MEEHAN vs. KAISER FOUNDATION, COMPREHENSIVE COMM. HOME HEALTH, UCSF, FRANKLIN BENEVOLENT CENTER; INTERCARE ROSEVILLE, KAISER OAKLAND, COUNTY OF CONTRA COSTA, SEDGWICK UC 14533 OAKLAND

This case, ADJ1654619, concerns Patricia Meehan's workers' compensation claim against Kaiser Foundation and other entities. The Workers' Compensation Appeals Board has issued an order denying reconsideration of a prior decision. The Board adopted and incorporated the report of the workers' compensation administrative law judge as the basis for this denial. Therefore, the petitions for reconsideration are denied.

Patricia MeehanKaiser FoundationWorkers' Compensation Appeals BoardReconsideration DeniedAdministrative Law Judge ReportADJ1654619WCK 0059968Comprehensive Comm. Home HealthUCSFFranklin Benevolent Center
References
0
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