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

Case No. ADJ7041227
Regular
Aug 09, 2017

GERALD PADDIO vs. CLEVELAND CAVALIERS, SEATTLE SUPERSONICS, INDIANA PACERS, WASHINGTON BULLETS/WASHINGTON WIZARDS, TIG INSURANCE, NEW YORK KNICKERBOCKERS, CHICAGO ROCKERS, LAS VEGAS SLAM/ CHICAGO SKYLINERS, TRAVELERS INDEMNITY COMPANY

The Workers' Compensation Appeals Board denied Travelers Indemnity Company's petition for reconsideration, affirming its subject matter jurisdiction over applicant Gerald Paddio's cumulative injury claim. The Board found that Paddio's hiring as a professional basketball player in California, through his agent accepting an offer in San Francisco, established jurisdiction under Labor Code sections 3600.5(a) and 5305. The Board also noted that the issue of potential exemption from California law, raised by the defendant, was not ripe for appeal and must be addressed at the trial level. All other issues remain deferred for determination by a Workers' Compensation Judge.

Subject matter jurisdictionLabor Code section 3600.5Labor Code section 5305Contract of hireProfessional basketball playerCumulative industrial injuryPetition for reconsiderationDenial of petitionAdministrative law judgeWorkers' Compensation Appeals Board
References
Case No. ADJ8509270
Regular
Oct 30, 2015

JAMES HORICK vs. JOHN T. MALLOY, INC., AIG

The Workers' Compensation Appeals Board (WCAB) denied reconsideration of a prior ruling that allowed an injured worker to pursue an Independent Medical Review (IMR). The Administrative Director (AD) had initially denied the IMR request because the injured worker did not personally sign the application, despite their attorney signing it and providing notice of representation. The WCAB found that an attorney, representing an injured worker, is authorized to sign an IMR request as a procedural matter, binding the client. Therefore, the AD's denial was in error, and the matter was properly remanded for IMR.

Independent Medical ReviewPetition for ReconsiderationAdministrative DirectorWorkers' Compensation Appeals BoardFindings and OrderUtilization ReviewLabor Code 4610.5Administrative Rule 9792.10.1Attorney representationMedical authorization
References
Case No. ADJ4289546 (SAL 0081125) ADJ1402741 (SAL 0108803) ADJ1957943 (SAL 0108004) ADJ2968816 (SAL 0108005) ADJ4583148 (SAL 0108006) ADJ3337827 (SAL 0101675)
Regular
Oct 11, 2013

PRISCILLA HIGUERA vs. MONTEREY PENINSULA UNIFIED SCHOOL DISTRICT, Permissibly Self-Insured, Adjusted by KEENAN & ASSOCIATES

The Workers' Compensation Appeals Board rescinded the prior findings and award and returned the case to the trial level due to insufficient medical evidence regarding apportionment of permanent disability. Both medical examiners failed to provide adequate explanations for their apportionment conclusions between multiple dates of injury and a cumulative trauma. The Board noted the duty to develop the record when medical evidence is insufficient to ensure substantial justice. Further proceedings will address applicant's contentions, including potential additional dates of injury and the timeliness of claims.

Workers Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilityApportionmentQualified Medical Examiner (QME)Specific Industrial InjuryCumulative TraumaSubstantial Medical EvidenceDate of Injury
References
Case No. ADJ9164133
Regular
Jun 03, 2014

KATHERINE MCGUIRE vs. ST. HELENA HOSPITAL; Permissibly SelfInsured, Administered by ADVENTIST HEALTH

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior award finding applicant sustained an industrial injury to her right knee. The defendant contended the award lacked substantial medical evidence and the judge improperly shifted the burden of proof. The WCAB found insufficient evidence to reconcile conflicting medical histories of the right knee injury. Therefore, the Board rescinded the award and returned the case for further proceedings to fully develop the record.

Petition for ReconsiderationFindings and AwardIndustrial InjurySubstantial Medical EvidenceBurden of ProofIndustrial CausationPreponderance of the EvidenceMedical HistoriesDiscrepancyAppeals Board
References
Case No. ADJ10002681
Regular
Sep 07, 2018

ALLISON WIGGINS vs. KERN VALLEY STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to address the applicant's claim of industrial heart injury, which was initially denied by the administrative law judge despite a finding of industrial hypertension. The Board found that the applicant, a correctional officer, is entitled to a rebuttable presumption of industrial causation for heart trouble under Labor Code § 3212.2. Crucially, the Court determined that the record needs further development to clarify industrial contribution to the applicant's valvular insufficiency, considering the absence of an anti-attribution clause in § 3212.2 which differs from other related statutes. Therefore, the case is returned to the trial level for further development of evidence and a decision on rebuttal of the presumption.

Labor Code section 3212.2heart trouble presumptioncorrectional officerbicuspid aortic valvevalvular diseaseindustrial injurypermanent disabilitycumulative periodrebuttal of presumptionagreed medical evaluator
References
Case No. ADJ7264915
Regular
Jul 15, 2013

ANA GONZALES vs. WAL-MART ASSOCIATES, INC., ACE AMERICAN INSURANCE

This case involves an applicant who sustained industrial psychiatric injury but whose orthopedic claims were denied due to insufficient medical evidence. The Appeals Board denied the applicant's petition for reconsideration, finding the applicant failed to present substantial medical evidence of industrial causation for her orthopedic complaints. A dissenting commissioner argued that the primary medical evaluator's report was deficient and lacked substantial evidence, warranting further development of the record on orthopedic injuries and other claims. The dissent emphasizes the Board's duty to ensure substantial justice, suggesting it should have ordered further investigation on the denied orthopedic issues.

WCABPetition for ReconsiderationFindings and Orderindustrial injurypsychelow backneckright shoulderright wristright elbow
References
Case No. ADJ6839103
Regular
Mar 28, 2013

MICHAEL DAVIS vs. BOSTON BREAKERS, THE NORTH RIVER INSURANCE CO., CINCINNATI BENGALS, TAMPA BAY BUCCANEERS

This case involves a former professional football player claiming cumulative industrial injury in California. The trial judge dismissed the case, finding no demonstrated injury sustained within California, thus divesting the Board of subject matter jurisdiction. The Appeals Board granted reconsideration to further study the issues. The Board rescinded the dismissal, returning the matter for further development of the record, particularly concerning the medical opinions' connection to California exposure and the mechanism of injury. The Board also noted that hearsay testimony from an investigator was permissible as the Board is not bound by strict rules of evidence.

Workers' Compensation Appeals BoardCumulative Trauma InjurySubject Matter JurisdictionProfessional Football PlayerCumulative Industrial InjuryMinimum ContactsSubstantial EvidenceMedical OpinionMechanism of InjuryApportionment
References
Case No. ADJ13111007
Regular
Oct 13, 2025

CHARLES MISERENDINO vs. CLUB DEMONSTRATION SERVICES, INC.; QBE SPECIALTY INSURANCE

Applicant filed a petition for removal from an order taking the matter off calendar, issued on September 10, 2024, by the WCJ. Applicant contended that the issue of additional panels was ripe for adjudication. The Appeals Board granted removal, finding that the WCJ's order violated due process by being issued without creating a record or explaining the need for further development, thus constituting irreparable harm. Consequently, the Board rescinded the September 10, 2024 order and returned the matter to the trial level to create a record, refraining from making a judgment on the warrant for additional panels without a formal record.

Petition for RemovalOrder Taking Matter Off CalendarAdjudicationDue Process ViolationIrreparable HarmSubstantial PrejudiceWCJ ReportRescind OrderReturn to Trial LevelCreate Record
References
Case No. ADJ16334598
Regular
Oct 13, 2025

ANTHONY REYES vs. XPO LOGISTICS SUPPLY CHAIN, INC.; EVEREST NATIONAL INSURANCE

Applicant Anthony Reyes filed a petition for removal challenging an order by the workers' compensation administrative law judge (WCJ) that took the matter off calendar. The WCAB granted removal, determining that the WCJ's order violated the parties' right to due process by failing to create a record or explain the deferral of the additional panels issue, thus constituting irreparable harm. As a Decision After Removal, the Appeals Board rescinded the April 24, 2025, order taking the matter off calendar and returned the case to the trial level to establish a proper record. The Board explicitly stated it made no judgment on the merits of additional panels at this stage due to the lack of a formal record.

Petition for RemovalOrder Taking Matter Off CalendarAdditional PanelsDue Process ViolationIrreparable HarmSubstantial PrejudiceRecord CreationTrial LevelWorkers' Compensation Appeals BoardRescind Order
References
Case No. ADJ2903829
Regular
Dec 01, 2012

CONSUELO DELGADO vs. RICO INTERNATIONAL, INC., ZENITH INSURANCE

The Workers' Compensation Appeals Board denied reconsideration of a prior decision, adopting the WCJ's report as its own reasoning. The Board also noted that the lien claimant's representative, Algene Nash, appears ineligible to practice before the Board and will initiate separate proceedings regarding this issue. Consequently, the Petition for Reconsideration was denied.

Workers' Compensation Appeals BoardReconsideration deniedLien claimantAlgene NashUnauthorized appearanceCal. Code Regs tit. 8 § 10779Benninghoff v. Superior CourtIn re Matter of Ramon PellicerIn Matter of John HoffmanAdministrative law judge report
References
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