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

Case No. ADJ6929350, ADJ7133107, ADJ8881791
Regular
Aug 16, 2019

TIMOTHY RODRIGUEZ vs. DEPARTMENT OF CORRECTIONS, CALIFORNIA MEN'S COLONY, STATE COMPENSATION INSURANCE FUND

The Appeals Board rescinded the WCJ's decision, finding legal error in requiring proof of conspiracy for workers' compensation claims. The WCJ incorrectly applied the burden of proof and failed to adequately consider medical opinions regarding applicant's claims of physical and psychiatric injuries. The case is remanded for further proceedings and a new decision, requiring the WCJ to analyze each claimed injury and body part separately under the correct burden of proof and to further develop the medical record as necessary.

AOE-COEAgreed Medical Evaluatorhostile work environmentconspiracy theoryburden of proofpreponderance of the evidencespecific injurycumulative traumapsychiatric injurygood faith personnel action
References
Case No. ADJ12744384
Regular
Jul 25, 2025

CHEYANNE MORENO vs. CALSELECT INSURANCE SERVICES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a Findings and Order (F&O) issued on April 9, 2021. The F&O found that the applicant, Cheyanne Moreno, did not sustain a psychiatric injury due to a sudden and extraordinary event, thereby not qualifying for an exception to the six-month employment requirement of Labor Code section 3208.3(d). The WCAB determined that the Workers' Compensation Administrative Law Judge (WCJ) erroneously misassigned the burden of proof regarding the six-month employment period to the applicant. Consequently, the WCAB rescinded the F&O and returned the matter to the trial level for further proceedings to properly develop the record on whether the defendant can establish that the applicant's employment period was less than six months.

Labor Code section 3208.3(d)psychiatric injurysudden and extraordinary employment conditionsix-month employment requirementburden of proofrescinded Findings and Orderreturn to trial levelAOE/COEpreponderance of the evidencecumulative injury
References
Case No. ADJ6535842
Regular
May 04, 2012

HENRY PEREIRA vs. NND DESIGNS, INC., ENDURANCE INSURANCE CO.

Lien claimants sought reconsideration of an award disallowing their liens and imposing sanctions. Their petition was dismissed by the Appeals Board as untimely filed and lacking proof of service. The Board also noted that the underlying award found applicant did not sustain an industrial injury, making the lien claimants' arguments regarding burden of proof and sanctions meritless. The dismissal prioritized procedural defects over the substantive arguments raised.

WCABPetition for ReconsiderationLien ClaimantsJoint Amended Findings and AwardBurden of ProofIndustrial InjurySanctionsLabor Code Section 5813Compromise and ReleaseTimeliness
References
Case No. ADJ8452616
Regular
Sep 11, 2012

GUILLERMO SANDOVAL DE LA CRUZ vs. DMS FACILITY SERVICES, ZURICH NORTH AMERICA

This case concerns a Petition for Reconsideration filed by a lien claimant, Tri-County Medical Group, challenging an arbitrator's disallowance of its liens. The Appeals Board dismissed the petition because it was not timely filed with the Board and was instead mailed to the arbitrator. Furthermore, the Board noted the petition lacked proper verification and the proof of service was defective. Even if timely, the Board would have denied the petition on its merits due to insufficient evidence presented by the lien claimant.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationDisallowed LiensMedical Provider Network (MPN)Arbitrator's FindingsTimely FilingJurisdictionRule 10865Proof of Service
References
Case No. ADJ7224294; ADJ6597177
Regular
Dec 31, 2012

GIOVANNI MENDOZA vs. COBY ELECTRONICS CORP., CHUBB INSURANCE

The Workers' Compensation Appeals Board denied Dr. Nachman Brautbar's petition for reconsideration regarding the disallowance of his lien. The Board affirmed the finding that Dr. Brautbar failed to meet his evidentiary burden to prove the reasonableness and necessity of his services, and that he was not the applicant's treating physician. The Board clarified that lien claimants, like defendants, must prove their case by a preponderance of the evidence, and reliance on outdated case law like *Keifer* is misplaced due to legislative amendments. Furthermore, Dr. Brautbar's failure to appear at conferences and present evidence on raised issues, coupled with procedural errors in his petition, supported the denial.

Lien claimantPetition for ReconsiderationJoint Findings and OrdersWCJindustrial injurypsychelower extremityinternalherniacervical spine
References
Case No. ADJ2623740
Regular
Dec 13, 2010

MARTHA HERNANDEZ vs. MARRIOTT INTERNATIONAL, INC.

The Appeals Board rescinded its Notice of Intention to Impose Sanctions against CMS Network, Inc. and its representatives, Dominic D. Arguello and Randal Hollien. Initially, sanctions were considered due to repeated misstatements of law concerning a lien claimant's burden of proof in petitions for reconsideration. Although zealous advocacy is not an excuse for legal misstatements, the Board found no intent to mislead and acknowledged the respondents' understanding of correct legal precedent. The matter is returned to the trial level, with the Board emphasizing that lien claimants bear the burden of proving the reasonableness of their fees, citing precedent like *Kunz* and *Tapia*.

WCABRemovalSanctionsLien claimant burden of proofPetition for reconsiderationHearing representativesZealous advocacyMisstatements of lawEn banc decisionsBinding precedent
References
Case No. ADJ3934515 (MON 0271347) ADJ4001097 (LAO 0780370)
Regular
Feb 16, 2017

PRISCILLA DIAZ vs. PUBLIC HEALTH FOUNDATION ENTERPRISES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Dr. David Silver's Petition for Reconsideration. The Board affirmed the Administrative Law Judge's finding that the lien claimant take nothing on his lien. This was based on the lien claimant's failure to meet his burden of proof that the services rendered were reasonable and necessary for the applicant's industrial injury. Furthermore, the lien claimant failed to adequately establish the costs of his services with sufficient supporting evidence.

Lien claimantPetition for ReconsiderationJoint Findings and OrderWorkers' Compensation Appeals BoardAdministrative Law Judgemedically necessaryburden of proofsubstantial evidenceLabor Code section 4903.8(d)reasonable and necessary medical treatment
References
Case No. ADJ7281695
Regular
Feb 02, 2017

MARIA COSME HERNANDEZ vs. CARDENAS MARKET, INC., PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE GROUP, GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board affirmed the WCJ's finding that the applicant was not a credible witness, giving great weight to the WCJ's observation of her demeanor. The Board also found no substantial evidence to overturn the credibility determination and noted the applicant's failure to meet her burden of proof by a preponderance of the evidence. Furthermore, any objection to the admissibility of defendant's Exhibit A was deemed waived due to the lack of objection at trial.

Petition for ReconsiderationCredibility DeterminationDemeanor on the StandSubstantiality of EvidenceBurden of ProofPreponderance of EvidenceIndustrial InjuryAdmissibility of EvidenceWaived ObjectionWorkers' Compensation Appeals Board
References
Case No. ADJ1781281 (MON 0350482) ADJ4191242 (MON 0350483)
Regular
Aug 11, 2011

ANGEL ACOSTA vs. GUILDCRAFT FURNITURE MANUFACTURING COMPANY, AMERICAN CASUALTY

This case involves a lien claimant seeking payment for interpreting services provided to an injured worker. The Workers' Compensation Appeals Board affirmed the WCJ's decision to disallow the lien claimant's claim for $25,573.00. The Board found that the lien claimant failed to meet its burden of proof to establish that the interpreting services were reasonably necessary, that the interpreters were qualified, and that the fees were reasonable. Crucially, no evidence was presented demonstrating a need for an interpreter for effective doctor-patient communication or that the interpreters were certified as required by law.

Lien claimantInterpreting servicesQualified interpreterBurden of proofReasonableness of feesIndustrial injuryMedical treatmentLabor Code section 4600(f)Compensable servicesWorkers' compensation administrative law judge
References
Case No. ADJ7800321
Regular
Apr 21, 2014

MARIA BERRIOS vs. NEWSWAYS DISTRIBUTORS, TOWER SELECT INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of an order dismissing the lien of California Sleep Apnea Center (CSAC). CSAC's lien was dismissed for failure to appear at a lien conference, and the WCJ found this reason sufficient even without defendant's direct notification of the conference. Furthermore, the Board noted that even if the lien had not been dismissed for non-appearance, it would have been denied because the applicant's underlying injury claim had already been decided against them. This prior ruling prevents CSAC from meeting its burden of proof that the treatment provided was for a compensable injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Dismiss LienLien ClaimantLien ConferenceFailure to AppearProof of ServiceReport and RecommendationFindings and OrderBurden of Proof
References
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