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Case Law Database

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

Case No. ADJ8657415
Regular
Oct 06, 2017

Oliver Boutte IV (Deceased) vs. U.S. XPRESS ENTERPRISES, LIBERTY MUTUAL INSURANCE COMPANY

This Workers' Compensation Appeals Board case involved a petition for reconsideration filed by U.S. Xpress Enterprises and Liberty Mutual Insurance Company. The defendants argued that the medical report relied upon by the Workers' Compensation Judge (WCJ) was not substantial evidence, specifically regarding the timing of the employee's death from a pulmonary embolus. The Board denied the petition, adopting the WCJ's report which found the physician's opinion to be substantial medical evidence based on adequate examination and reasoning. The Board concluded the WCJ properly found this opinion more persuasive than the opposing medical opinion.

Oliver Boutte IVU.S. Xpress EnterprisesLiberty Mutual Insurance CompanyADJ8657415Petition for ReconsiderationWorkers' Compensation Appeals Boardsubstantial evidencemedical opinionpulmonary embolusreasonable medical probability
References
3
Case No. ADJ15605011 ADJ16563992
Regular
Sep 02, 2025

ATEFA SAMADI vs. AMAZON

The applicant, Atefa Samadi, filed a Petition for Disqualification against the WCJ following an expedited hearing. The Appeals Board reviewed the petition and the WCJ's Report and Recommendation. The Board adopted the WCJ's report and denied the petition on the merits, citing Labor Code section 5311 and Code of Civil Procedure section 641, which govern the grounds for disqualification. The WCAB found that the petition did not present sufficient facts to establish disqualification, and a judge's expressions of opinion or erroneous rulings in the discharge of official duties are not evidence of bias. The WCJ's report detailed past hearings where the applicant exhibited disruptive behavior and the WCJ's attempts to ensure due process while managing complex issues.

Petition for DisqualificationLabor Code section 5311Code of Civil Procedure section 641WCJ biasunqualified opinionenmitybiasWCAB Rule 10960affidavitdeclaration
References
14
Case No. ADJ9919365, ADJ9919392, ADJ10564628
Regular
Aug 25, 2017

ALFREDO JORDAN RAMOS vs. BEN'S ROOFING, INC., REDWOOD FIRE AND CASUALTY COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and rescinded the WCJ's decision due to improperly identified exhibits and a lack of specific record citations in the opinion. The WCJ improperly admitted grouped medical reports and failed to cite which specific reports formed the basis of the Findings and Award. While the Appeals Board acknowledges the potential admissibility of the applicant's treating physician's later report, the WCJ retains discretion over its admission. The case is returned for further proceedings to allow for proper development of the record and a clearer articulation of the WCJ's reasoning.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardQualified Medical EvaluatorTreating Physician ReportLabor Code Section 5703Develop the RecordAdmissibility of EvidencePermanent DisabilityPanel QME
References
5
Case No. ADJ9887809
Regular
Jan 29, 2019

JOSEPH CAGLIA vs. CALIFORNIA DEPARTMENT OF REHABILITATION, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration of a finding of five percent permanent partial disability. The Board adopted the Administrative Law Judge's (WCJ) report, which found the opinion of Dr. Pelton more persuasive than that of Dr. Purcell. The WCJ explained that Dr. Pelton's use of a Station and Gait Disorder rating was appropriate given the applicant's objective ligament tear and resulting subjective limitations, even if a conventional application of the AMA Guides yielded zero impairment. The WCJ's detailed report cured any potential defect under Labor Code § 5313, and the reliance on Dr. Pelton's report constituted substantial evidence.

WCABPetition for Reconsiderationsubstantial evidencemedical opinionsWCJ reportpermanent disabilityprimary treating physicianAMA GuidesAlmaraz-GuzmanStation & Gait Disorder
References
4
Case No. ADJ1232911
Regular
Jun 22, 2009

ADALBERTO OCHOA vs. SLATON & SON ROOFING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the original finding of industrial injury, temporary disability, need for further treatment, and 37% permanent disability for applicant Adalberto Ochoa. The defendant argued the WCJ erred by applying the 1997 permanent disability rating schedule, claiming no pre-2005 medical reports indicated permanent disability. However, the Board adopted the WCJ's report, denying reconsideration and affirming the original award. A dissenting opinion argued the 2005 rating schedule should apply as no pre-2005 medical reports indicated permanent disability, and the WCJ's interpretation of temporary disability advances was improper.

WCABADALBERTO OCHOASLATON & SON ROOFINGSTATE COMPENSATION INSURANCE FUNDFindings and Awardrooferlumbar spinetemporary disabilitypermanent disabilityLabor Code section 4909
References
5
Case No. ADJ16773219; ADJ16653843
Regular
Jun 03, 2025

LAKEISHA HOWARD vs. OPTUM 360 SERVICES, A UNITED HEALTH GROUP COMPANY; TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The applicant, Lakeisha Howard, sought reconsideration after the WCJ denied her claims for cumulative injury to her left knee and ankle, and deemed Dr. Granado's reports inadmissible. The Appeals Board affirmed the WCJ's decision, finding that Dr. Granado's reports were obtained to rebut the panel QME's opinion rather than for medical treatment and were therefore inadmissible. The Board also upheld the finding that the applicant failed to prove a cumulative injury arising out of her employment, citing Dr. Welborn's opinion that her sedentary job would not cause such trauma. Consequently, the Petition for Reconsideration was denied.

Labor Code Section 5909Petition for ReconsiderationAdmissibility of Medical ReportsCumulative Trauma InjuryCompensable Consequence InjurySubstantial EvidenceCausationPanel Qualified Medical EvaluatorTreating PhysicianMedical-Legal Evaluation
References
10
Case No. ADJ360205 (LBO 0384980)
Regular
Aug 05, 2010

Gurdev Malhotra vs. STATE OF CALIFORNIA, DEPARTMENT OF DEVELOPMENTAL SERVICES FAIRVIEW; Legally Uninsured, CONTRACT SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's advisory opinion concerning permanent disability rating for grip loss. Defendant argued the WCJ erred by allowing rating for grip loss when range of motion was present, and that the QME's reports did not support grip loss rating. The Board rescinded the WCJ's findings, remanding the case for further proceedings to ensure the WCJ follows the established process for issuing rating instructions based on substantial medical evidence, as clarified in *Blackledge v. Bank of America*. The ultimate determination of permanent disability requires a proper QME opinion and subsequent rating instructions from the WCJ.

Workers' Compensation Appeals BoardGurdev MalhotraState of California Department of Developmental ServicesLegally UninsuredContract ServicesPermanent Disability RatingGrip LossAMA GuidesQualified Medical EvaluatorQME
References
1
Case No. RDG 0114315
Regular
Nov 09, 2007

JANET HEYDENREICH vs. DEPARTMENT OF SOCIAL SERVICES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to address defendant's petition, which erroneously believed the WCJ had addressed irrelevant issues. After the WCJ provided a corrected report, the Board affirmed the original decision, finding the applicant entitled to ankle surgery and ongoing temporary disability. The Board corrected clerical dates on physician reports referenced in the WCJ's opinion while affirming the overall award.

WCABReconsiderationAdministrative Law JudgePetition for ReconsiderationTemporary Total DisabilityPermanent and StationaryQMESubstantial EvidenceLigamentous RepairOrthopedic Surgeon
References
0
Case No. ADJ3615708 (BAK 0147668) ADJ2881957 (BAK 0147353) ADJ1664277 (BAK 0147354)
Regular
Oct 27, 2015

FRANCISCO JAVIER CASILLAS vs. SAN JOAQUIN VALLEY TRANSPORTATION, STATE COMPENSATION INSURANCE FUND, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The applicant sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision, arguing that a key psychiatric AME report was unreliable and that the WCJ failed to address this in the opinion. The WCAB denied the reconsideration, finding that the WCJ properly relied on the reports of a different psychiatric AME, thus rendering the applicant's argument regarding the disputed report irrelevant. However, the WCAB granted reconsideration on its own motion to correct clerical errors in the original decision identified by the parties. The matter was then remanded to the WCJ to reissue a corrected decision.

California Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact Awards and OrdersAgreed Medical Evaluator (AME)Dr. John StalbergDr. Carl Marusaksubstantial medical evidencepsychiatric claimspermanent disabilitylabor code section 132a
References
4
Case No. ADJ10282606, ADJ10283736
Regular
Feb 06, 2019

DARLENE BATTLE vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and rescinded the WCJ's previous findings and awards in both consolidated cases, ADJ10282606 and ADJ10283736. The primary issue concerned the determination of permanent disability for the applicant's right knee injury, specifically whether the medical opinion of Dr. Glousman was substantial evidence. The Board found Dr. Glousman's report lacked sufficient explanation for his impairment ratings according to AMA Guides, and the WCJ improperly supplemented this opinion. Consequently, the matter was returned to the trial level for further proceedings and new decisions by the WCJ.

Workers' Compensation Appeals BoardPermanent DisabilityAMA GuidesQualified Medical EvaluatorSubstantial EvidenceApportionmentReconsiderationFindings and AwardMedical OpinionCorrectional Officer
References
7
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