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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. SRO 0139219
Regular
Aug 11, 2008

JENNIFER BALKOWITSCH vs. HOME DEPOT

This case involves an applicant denied self-procured medical treatment by her employer, Home Depot, after failing to secure an MPN physician within reasonable proximity who would accept her. The Appeals Board reversed the initial finding, holding Home Depot liable for self-procured treatment. This decision was based on Home Depot's failure to prove it reasonably provided an MPN physician in accordance with accessibility standards, constituting a neglect or refusal to provide reasonable medical treatment.

Medical Provider NetworkMPN access standardsself-procured medical treatmentreasonable medical treatmentneglect or refusalapplicant's residenceemployment dutiesadministrative regulationemployer's obligationphysician availability
References
Case No. ADJ10954204
Regular
Sep 15, 2022

MARIA FLORES vs. PINNACLE HEALTH CORP., SUMMARY OF EVIDENCE INSURANCE COMPANY OF THE WEST, AFFINITY HOME HEALTH CARE SERVICES, FALLS LAKE FIRE & CASUALTY INSURANCE, SEDGWICK CMS, HOME HEALTH CARE SOLUTIONS, INC.

The Workers' Compensation Appeals Board denied a petition for reconsideration filed by Home Health Care Solutions. The applicant, an LVN, was injured in a car accident while traveling between patients for multiple agencies. The Board adopted the WCJ's report, which found the injury arose out of and occurred in the course of employment for Home Health Care Solutions. This decision was based on the fact that the applicant was required to use her own vehicle, which extended the employer-employee relationship beyond direct service. The WCJ also found the going and coming rule did not bar the claim due to the required use of transportation between patient locations.

Workers' Compensation Appeals BoardPetition for ReconsiderationGoing and Coming RuleAOE/COELVNCar AccidentAutomobile ExceptionTransitEmployment RelationshipRequired Vehicle Use
References
Case No. ADJ8541832
Regular
Oct 20, 2016

JOE JOHN VENTURA vs. THE HOME DEPOT, INC.

The Workers' Compensation Appeals Board denied Joe John Ventura's petition for reconsideration in this case against The Home Depot, Inc. The Board adopted and incorporated the reasoning of the workers' compensation administrative law judge. Therefore, the petition was denied, and the previous decision stands.

Ventura v. Home DepotHelmsman Management ServicesPetition for ReconsiderationDeniedWorkers' Compensation Appeals BoardWCJ ReportAdoptedIncorporatedADJ8541832Stockton District Office
References
Case No. VNO 0446654 VNO 0446655 VNO 0446656 VNO 0447607
Regular
Aug 18, 2008

CLARA LOSURDO vs. LAS VIRGENES UNIFIED SCHOOL DISTRICT, KEENAN & ASSOCIATES

Defendant Las Virgenes Unified School District successfully petitioned for removal, vacating a trial date and rescinding an order to proceed on three family-filed home health care liens totaling $299,500. The Board found the applicant's case, including the liens, was not ready for trial due to a lack of evidence and disclosed witnesses, and that the defendant was denied essential discovery rights. The Board remanded the case to allow for discovery on the necessity, reasonableness, and actual performance of the claimed home health care services. Furthermore, the liens will not be tried until the disputed body parts injured are resolved.

RemovalHome Healthcare LiensApplicant's RelativesDiscovery RightsReasonableness and NecessityBurden of ProofPretrial Conference StatementDeclaration of Readiness to ProceedMandatory Settlement ConferenceParts of Body Injured
References
Case No. ADJ1378934 (VNO 0542019), ADJ7423562
Regular
Nov 07, 2013

VICTORIA BARNETT vs. COUNTY OF LOS ANGELES; Permissibly Self-Insured, Administered by TRISTAR RISK MANAGEMENT

The Appeals Board granted the applicant's Petition for Removal, rescinding the WCJ's order to take the case off calendar. The WCJ improperly deferred the issue of home health care entitlement and reimbursement, which Applicant contended SB 863 did not preclude. The Board remanded the case for an expedited hearing to determine entitlement to home health care, whether SB 863 applies, and to resolve lien reimbursement issues afterward.

Petition for RemovalSB 863home health careexpedited hearingLabor Code § 4610applicant's entitlementretroactive reimbursementstipulated awardpetition to reopenApplication for Adjudication of Claim
References
Case No. ADJ7636863
Regular
Apr 02, 2012

KARINE GABRIYELYAN vs. STATE OF CALIFORNIA, SOCIAL SERVICES-IHSS, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation claim for injuries sustained by a home care provider while transporting her client, who was experiencing a medical emergency, to the client's daughter's home on Christmas Eve. The applicant testified she acted out of concern for the client's well-being, not for personal reasons, and that the injury occurred when the client fell on her on the stairs. The Workers' Compensation Appeals Board denied the petitioner's request for reconsideration, finding substantial evidence that the applicant's actions were within the course and scope of her employment and that their request for a continuance was improperly handled. The WCJ's credibility findings were given significant weight in the decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationJudge's ReportApplicant's OccupationHome Care ProviderDate of InjuryLumbar SpineCervical SpinePsycheSleep Disorder
References
Case No. ADJ7726177
Regular
Feb 08, 2019

DEMETRIUS CERRILLO vs. THE HOME DEPOT

The applicant sought reconsideration of a compromise and release agreement settling his workers' compensation claim for $15,000. He alleged he was pressured by an Information and Assistance officer and the WCJ to settle, and that the settlement terms were not adequately explained. The Appeals Board dismissed the petition as premature because the applicant failed to verify the petition and did not provide sworn testimony to support his allegations of duress or manipulation. The matter was remanded to the trial level for a hearing on the applicant's contentions to establish an evidentiary record.

Workers' Compensation Appeals BoardDemetrius CerrilloThe Home DepotLiberty Mutual Insurance CompanyHelmsman Management ServicesADJ7726177Petition for ReconsiderationCompromise & ReleaseInformation and Assistance (I&A) officerWCJ
References
Case No. ADJ2721048 (LAO 0875064), ADJ3692164 (LAO 0875063)
Regular
Jun 06, 2014

MYRON LANDON vs. STATE BOARD OF EQUALIZATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to address the defendant's contention that the medical reports did not establish causation between the applicant's industrial injury and the need for home health care services. The Board found that while the physician recommended home care, he failed to link this need to specific industrially injured body parts or explain how the care would cure/relieve the effects of the industrial injury. Consequently, the Board rescinded the prior order awarding home health care and returned the matter to the WCJ for further proceedings to establish this crucial causal connection.

Petition for ReconsiderationFindings and Orderhome health care servicesindustrial injurycausationmedical reportssubstantial evidenceWCJapplicantdefendant
References
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