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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ7616554
Regular
Mar 30, 2012

MARCO ORTIZ, Deceased, LLUVIA DIAZ ORTIZ vs. COUNTY OF ALAMEDA, ALAMEDA COUNTY SHERIFF'S DEPARTMENT, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board has granted reconsideration of a January 9, 2012 decision concerning the deceased worker Marco Ortiz, with Lluvia Diaz Ortiz as applicant, against the County of Alameda and its Sheriff's Department. Reconsideration was sought by the defendant. The Board believes further study of the factual and legal issues is necessary to ensure a just and reasoned decision. All future communications regarding this case must be filed in writing with the Board's Office of the Commissioners.

Workers' Compensation Appeals BoardReconsiderationPetition for ReconsiderationAlameda County Sheriff's DepartmentSedgwick Claims Management ServicesDecision After ReconsiderationOffice of the CommissionersElectronic Adjudication Management SystemMarguerite SweeneyRaymond E. Frost & Associates
References
Case No. ADJ15681350; ADJ14443227
Regular
Sep 23, 2025

JOHNNY RAGASA vs. WASTE MANAGEMENT OF ALAMEDA COUNTY, INC., ACE AMERICAN INSURANCE COMPANY administered by GALLAGHER BASSETT SERVICES, INC.

In this workers' compensation case, the defendant petitioned for reconsideration of an award finding the applicant sustained bilateral knee injuries resulting in temporary total disability. The Appeals Board granted reconsideration and, following a stipulation between the parties, has rescinded the original award. The case is now remanded to the Workers' Compensation Judge for further proceedings based on the parties' agreement to select an Agreed Medical Evaluator and create a complete record.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and Awardtemporary total disabilityAgreed Medical EvaluatorStipulationrescindreturn to trial levelindustrial injurybilateral knees
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. ADJ15681350; ADJ14443327
Regular
Mar 24, 2025

JOHNNY RAGASA vs. WASTE MANAGEMENT OF ALAMEDA COUNTY, INC.; ACE AMERICAN INSURANCE COMPANY

Applicant Johnny Ragasa, employed as a mechanic by Waste Management of Alameda County, Inc., sustained industrial injuries to his bilateral knees. A Workers' Compensation Administrative Law Judge (WCJ) issued Findings and Award, prompting Defendant Ace American Insurance to file a Petition for Reconsideration, alleging the QME's report was not substantial medical evidence. The Appeals Board granted the Petition for Reconsideration but deferred a final decision, opting for further review of the merits and the complete record.

Petition for ReconsiderationQualified Medical Evaluator (QME)substantial medical evidencebilateral kneestemporary total disabilitycumulative traumaarising out of and in the course of employment (AOE/COE)workers' compensation administrative law judge (WCJ)Employment Development Department (EDD)section 5909
References
Case No. OAK 275181
Regular
Dec 28, 2007

LOIS SHELTON vs. COUNTY OF ALAMEDA, SEDGWICK CLAIMS MANAGEMENT

The Appeals Board rescinded the prior ruling and returned the case for further proceedings. The lien claimant, Bay Surgery Center, must prove its standing to pursue its claim by demonstrating compliance with fictitious business name filing requirements. Additionally, both parties must present further evidence regarding the reasonable value of the services provided, as the prior determination was based on a misunderstanding of precedent and the defendant provided substantial rebuttal evidence.

Workers Compensation Appeals BoardOAK 275181Lois SheltonCounty of AlamedaSedgwick Claims ManagementBay Surgery Centerlien claimantfictitious-name permitBusiness & Professions Code Section 2415Kunz v. Patterson Floor Coverings
References
Case No. OAK 0279116, OAK 0323541
Regular
May 02, 2008

BARBARA MCMILLER vs. COUNTY OF ALAMEDA, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Appeals Board granted the defendant's petition for reconsideration and rescinded the prior order approving a Compromise and Release. This action was taken because the defendant contested the validity of the settlement, alleging the applicant died prior to signing the agreement and that the signature was not authentic. The case is remanded to the trial level for further proceedings to determine the legitimacy of the settlement agreement.

McMillerCounty of AlamedaSedgwick Claims Management ServicesOAK 0279116OAK 0323541Petition for ReconsiderationOrder Approving Compromise and ReleaseWCJsettlementapplicant died
References
Case No. OAK 0249742
Regular
May 13, 2008

DIANE KENNEDY vs. COUNTY OF ALAMEDA WELFARE DEPARTMENT

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding industrial injury to the applicant's neck and upper extremities. The defendants argued errors regarding permissible self-insurance, evidence admission, temporary disability periods, and apportionment. The Board rescinded the original award and returned the case to the trial level for further proceedings and a new decision by the WCJ based on the WCJ's recommendations.

Workers' Compensation Appeals BoardCounty of Alameda Welfare DepartmentSedgwick Claims Management ServicesAIG Insurance CompanyTristar Risk Managementcumulative traumaeligibility technicianindustrial injuryneckbilateral upper extremities
References
Case No. ADJ10112147
Regular
Aug 01, 2025

STEVE BOTTO vs. WASTE MANAGEMENT OF ALAMEDA COUNTY, ACE AMERICAN INSURANCE COMPANY INC.

The Workers' Compensation Appeals Board considered a Petition for Removal, along with the Answer and the Workers' Compensation Judge's (WCJ) report. The Board concluded that the WCJ's underlying decision primarily resolved an intermediate procedural or evidentiary issue, rather than a final order determining substantive rights or liabilities, or a fundamental threshold issue. Consequently, the Petition was appropriately filed as one for removal, not reconsideration. However, the petitioner failed to demonstrate that substantial prejudice or irreparable harm would result from a denial of removal, or that reconsideration would not be an adequate remedy if an adverse final decision were ultimately issued. Based on these findings, the Petition for Removal was denied.

Petition for RemovalFinal OrderInterlocutory DecisionSubstantive RightThreshold IssueSubstantial PrejudiceIrreparable HarmReconsiderationAdministrative Law JudgeWorkers' Compensation Appeals Board
References
Case No. ADJ2675803 (OAK 0254082) ADJ4610228 (OAK 0130377)
Regular
Jul 11, 2017

MARK SOLJACK vs. WASTE MANAGEMENT OF ALAMEDA COUNTY, CIGA, FOR SUPERIOR NATIONAL INSURANCE COMPANY, INSOLENT, BY AND Through ITS ADJUSTING AGENCY BROADSPIRE CLAIMS SERVICES, ACE AMERICAN INSSURANCE COMPANY, GALLAGHER BASSETT SERVICES, INC

This order dismisses the petition for reconsideration because the appealed order was procedural and interlocutory, not a final order that determined substantive rights or liabilities. The Board cites precedent defining final orders as those resolving substantive issues. Reconsideration is only available for final decisions. Furthermore, the petition for removal was denied as the applicant failed to demonstrate substantial prejudice or irreparable harm.

WORKERS' COMPENSATION APPEALS BOARDPETITION FOR RECONSIDERATIONDENIAL OF REMOVALINTERLOCUTORY ORDERFINAL ORDERSUBSTANTIVE RIGHTSLIABILITIESARBITRATOR'S REPORTSUBSTANTIAL PREJUDICEIRREPARABLE HARM
References
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