CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. ADJ11039762
Regular
Aug 06, 2018

ALFRED GUILING vs. GODEFELLOW BROTHERS CONSTRUCTION, LLC, AMERICAN CONTRACTORS INSURANCE GROUP

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration and dismissed their Petition for Removal. The defendant argued the judge's finding of injury to specific body parts was premature and lacked substantial evidence, as the PQME process was incomplete. The Board found removal was inappropriate, as the injury finding is a final order subject to reconsideration. They adopted the WCJ's report, concluding the applicant met their burden of proof for industrial injury to the disputed body parts.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFindings of Factindustrial injurybody partssubstantial evidencePanel Qualified Medical EvaluationPQMEextraordinary remedy
References
Case No. ADJ473373 (ANA 0406381)
Regular
Feb 10, 2012

FERNANDO GUTIERREZ vs. SOCAL FRAMING aka BMHC; ACE AMERICAN INSURANCE, administered by ESIS, INC.

This case concerns applicant's claim for extended temporary disability (TD) benefits beyond 104 weeks due to a left eye injury. The Appeals Board affirmed the WCJ's denial of the "amputation" exception, ruling that the surgical removal of an eye does not fit the statutory definition. However, the Board remanded the case for further development of the record on the "high-velocity eye injury" exception, as the velocity and force of the object that struck the applicant's eye were unclear. The applicant's Petition for Removal was dismissed as reconsideration was the appropriate remedy.

Workers' Compensation Appeals BoardFernando GutierrezSoCal FramingBMHCACE American InsuranceESISInc.ADJ473373ANA 0406381Opinion and Decision
References
Case No. ADJ10771579
Regular
Aug 08, 2018

Gabriel Ruano vs. Mayekawa USA, SOMPO JAPAN INSURANCE COMPANY OF AMERICA, BROADSPIRE

This case involved a worker claiming industrial injury to multiple body parts. The Appeals Board granted the employer's petition for reconsideration to correct the Findings of Fact. The Board amended the Findings to accurately reflect all injured body parts, including the psyche, and removed an incorrectly listed body part. Ultimately, the Board affirmed the original decision with these specified amendments.

Petition for ReconsiderationFindings of Factsubstantial evidencemedical reportsprimary treating physicianBal S. Grewal Ph.D.Report and Recommendationinjured body partspsychecervical spine
References
Case No. LAO 0854553
Regular
Oct 01, 2007

DANIEL A. LONG vs. RYANS EXPRESS MOTORCOACH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration, upholding the finding that the applicant's temporary disability payments for a right shoulder injury terminated on February 28, 2007. The Board ruled that the surgical removal of a distal clavicle spur does not constitute an "amputation" under Labor Code Section 4656(c)(2), which requires severance of an external body part. Therefore, the applicant is not entitled to extended temporary disability benefits beyond the statutory 104-week limit.

Distal clavicleAmputation exceptionSection 4656(c)(2)Temporary disability termination104-week limitation240-week limitationRight shoulder surgeryRotator cuff tearJacob Tauber M.D.Hawkins v. Amberwood Products
References
Case No. ADJ12582828
Regular
Jan 03, 2023

TERRY KELLY vs. SAFEWAY

This case involves a workers' compensation claim where the defendant sought reconsideration of an award finding injury AOE/COE to multiple body parts. The primary dispute centers on the applicant's occupational group number, with the applicant claiming "butcher" (420) and the defendant arguing "meat cutter" (322), impacting permanent disability ratings. The Board granted reconsideration, finding insufficient evidence to determine the occupational group number and therefore deferring permanent disability for all affected body parts pending further development of the record. The finding of injury AOE/COE to the applicant's cervical spine, thoracic spine, lumbar spine, bilateral knees, bilateral elbows, and bilateral wrists was upheld.

Occupational Group NumberMeat CutterButcherCumulative TraumaPermanent DisabilityQualified Medical EvaluatorSubstantial EvidenceFurther DevelopmentBody PartsWPI Ratings
References
Case No. ADJ8533165
Regular
Mar 08, 2016

Margarito Trujillo vs. Cardenas Markets, Inc.

This case involves a worker claiming industrial injury to multiple body parts. The WCJ initially found injury only to the abdomen but applicant argued other claimed injuries were not addressed. The Appeals Board granted reconsideration to clarify the issues. They are rescinding the WCJ's decision and deferring the determination of injured body parts and the nature/extent of injury for further proceedings at the trial level.

Workers' Compensation Appeals BoardReconsiderationFindings of FactInjury AOE/COELabor Code section 5402Presumption of CompensabilityMandatory Settlement ConferencePre-Trial Conference StatementParts of Body InjuredNature and Extent of Injury
References
Case No. ADJ6507434
Regular
Jun 07, 2013

GABINO DANIEL MARTINEZ MONTES vs. MURRAY'S IRON WORKS, COMPWEST INSURANCE COMPANY

This case involves a lien claimant, Frontline Medical Associates, seeking reconsideration of the denial of their lien for medical treatment provided to an applicant, Gabino Daniel Martinez Montes. The lien was denied because the claimant failed to prove membership in the defendant's Medical Provider Network (MPN) or demonstrate the necessity of treatment for denied body parts. The Appeals Board adopted the WCJ's report, which found the lien claimant's evidence inadmissible due to non-disclosure and upheld the denial of reconsideration. The claimant also failed to establish that treatment for denied body parts was medically necessary or that the MPN process was properly bypassed.

Workers' Compensation Appeals BoardPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeFrontline Medical AssociatesLien ClaimantMedical Provider Network (MPN)Pre-Trial Conference StatementAdmissible EvidenceDue ProcessLabor Code Section 4062
References
Case No. ADJ10045939
Regular
Feb 05, 2016

Raymond Ames vs. Goodman Global, ACE American Insurance Company

This case involves an employer's petition to remove a workers' compensation matter to the Appeals Board for review of an order allowing the applicant to obtain additional Qualified Medical Evaluator (QME) panels. The employer argued that further QME panels were not permitted without a treating physician's determination supporting the disputed body parts injured. The Appeals Board denied the petition, finding the employer failed to demonstrate irreparable harm or significant prejudice. The majority affirmed the judge's order, concluding the record supported further development of disputed body parts. One commissioner dissented, arguing the applicant failed to establish a dispute with a treating physician's report as required by statute.

QME panelpetition for removaldisputed body partsmedical record developmentirreparable harmsubstantial prejudicetreating physicianDWC Rule 31.7Labor Code section 5310WCAB Rule 10843
References
Case No. ADJ9312928
Regular
Sep 11, 2019

Jeffrey DaVanon vs. Oakland Athletics, ACE Insurance Company, Sedgwick Claims Management

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration. The applicant, a former professional athlete, claimed cumulative trauma injury to multiple body parts, including gastrointestinal issues, neurological problems, and a sleep disorder not initially identified. The Board found that the WCJ erred by excluding medical evidence for these later-identified body parts, as they were included in the parties' stipulations and could have arisen or worsened after the applicant's deposition. The case is returned for further proceedings, allowing admission of relevant medical records and deferring final decisions on disputed body parts and permanent disability.

Mandatory Settlement ConferencePetition for ReconsiderationCumulative TraumaProfessional AthleteStatute of LimitationsLabor Code Section 5405Labor Code Section 5412Discovery CloseBifurcationIndependent Medical Evaluator
References
Case No. ADJ7288330
Regular
Oct 03, 2016

GLORIA BENITEZ vs. NEWPORT SUBACUTE HEALTH CARE CENTER, ALASKA NATIONAL INSURANCE COMPANY

The applicant, Gloria Benitez, sought to reopen her workers' compensation claim to include injury to additional body parts beyond her cervical spine and psyche. The original award found injury only to the cervical spine and psyche, with a 19% permanent disability rating for the cervical spine. While the WCJ's initial decision denied injury to additional body parts, the Board granted reconsideration. The Board amended the original findings to defer the issue of injury to the alleged additional body parts, while affirming other aspects of the WCJ's order, including the appointment of a regular physician to evaluate new and further disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderNew and Further DisabilityAgreed Medical ExaminerRegular PhysicianLabor Code Section 5410Petition to ReopenIndustrial InjuryCervical Spine
References
Showing 1-10 of 4,036 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational