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

Case No. ADJ13511723
Regular
Mar 29, 2023

SOFIA SEVILLANO vs. STATE OF CALIFORNIA, IHSS, LEGALLY UNINSURED, ADMINISTERED BY YORK RISK SERVICES GROUP, A SEDGWICK COMPANY

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, upholding a prior decision that found COVID-19 related illness to be industrially caused. The Board found the employer failed to rebut the statutory presumption of industrial causation under Labor Code section 3212.86 with sufficient "other evidence." Arguments regarding mask use, lack of proof of employer infection, and alleged roommate illness were deemed insufficient to overcome the presumption.

Labor Code 3212.86presumption of industrial causationCOVID-19 illnessrebuttal burdenaffirmative burden of proofnon-occupational risksclose interpersonal contactSan Antonio Regional Hospitalcredibility determinationsADJ13511723
References
Case No. MON 310553
Regular
Sep 05, 2007

, LAZARO MARTINEZ vs. , WEDGESTONE CORP.;, CRUM & FORSTER

The Appeals Board granted the applicant's petition for removal, rescinding the WCJ's order closing discovery. The applicant argued that discovery should not have been closed as their serious and willful misconduct claim was not addressed at the Mandatory Settlement Conference (MSC) and the case was subsequently taken off calendar. The Board agreed that the closure of discovery was improper, particularly since the case was taken off calendar, and the relevant statute does not mandate closure in such circumstances.

Petition for removalSerious and willful misconductLabor Code section 4553Mandatory settlement conferenceDiscovery closedTaken off calendarIndustrial injuryIncreased benefitsWCJ orderRescind order
References
Case No. ADJ7680121
Regular
Jun 06, 2011

CARLOS ANDRADE vs. WELLS FARGO & COMPANY, SPECIALTY RISK SERVICES

The Workers' Compensation Appeals Board (WCAB) dismissed Wells Fargo's petition for reconsideration of an order closing discovery and setting the case for trial. The WCAB found the order was procedural, not a final determination of substantive rights, and therefore not subject to reconsideration. The WCAB also denied Wells Fargo's petition for removal, adopting the WCJ's reasoning. Given the trial date has passed, the WCAB ordered the WCJ to reschedule trial with discovery remaining closed.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalClosing DiscoveryProcedural OrderFinal OrderSubstantive RightsDeclaration of ReadinessMandatory Settlement ConferenceGood Faith Efforts
References
Case No. ADJ8497883
Regular
Jan 27, 2014

ANGEL ROBLES vs. UKANI ENTERPRISES INC. \& MIRMAR ENTERPRISES INC.; THE HANOVER INSURANCE COMPANY

In this workers' compensation case, the defendant sought to remove an order that placed the matter off calendar, arguing discovery should have closed and the case proceed to trial. The Appeals Board denied the petition, explaining that the administrative law judge correctly took the case off calendar because a pretrial conference statement was not filed, a requirement for proceeding to trial after a mandatory settlement conference. The Board noted that discovery closes at the mandatory settlement conference, and if the case is not resolved at the next one, a pretrial statement must be filed, and the case will then be continued to trial.

Petition for RemovalWorkers' Compensation Appeals BoardMandatory Settlement ConferenceDiscovery ClosingPretrial Conference StatementLabor Code Section 5502(d)(3)Off Calendar OrderDeclaration of Readiness to ProceedAdministrative Law JudgePermanent Disability Rating
References
Case No. ADJ850295 (GRO 0035125)
Regular
May 24, 2010

Corey Abel vs. BEST BUY COMPANY, GALLAGHER BASSETT

The Workers' Compensation Appeals Board granted Best Buy's petition for removal, rescinding the administrative law judge's order closing discovery and setting trial. Defendant Best Buy argued the judge erred by closing discovery before a crucial deposition of the Agreed Medical Evaluator (AME), Dr. Strait, which was scheduled to clarify inconsistencies and permanent disability opinions. The Board found the deposition necessary for a complete record and to facilitate a fair decision or potential settlement. The case is returned to the trial level for further proceedings, including completion of the AME's deposition.

Petition for RemovalAgreed Medical EvaluatorDepositionClosing DiscoveryRescind OrderLumbar Spine InjuryStock ClerkPermanent DisabilityWhole Person ImpairmentUnorthodox Basis
References
Case No. ADJ8595467
Regular
Sep 29, 2015

JESSICA RIVERA vs. GOOD SAMARITAN HOSPITAL, ACE AMERICAN INSURANCE COMPANY

This case involves a Petition for Removal filed by the defendant, Good Samaritan Hospital and Ace American Insurance Company, seeking to rescind an order closing discovery. The defendants argued that the order closing discovery would cause them substantial prejudice and irreparable harm by preventing them from obtaining a rebuttal vocational expert evaluation. The Workers' Compensation Appeals Board (WCAB) denied the petition, agreeing with the WCJ's report, but noted the defendant could request to proceed with the evaluation at trial. However, one Commissioner dissented, arguing the defendant's actions were diligent and the due process right to discovery was violated.

Petition for RemovalOrder Closing DiscoveryVocational ExpertRebuttal EvaluationDue ProcessSubstantial PrejudiceIrreparable HarmMandatory Settlement ConferenceAgreed Medical EvaluatorsGainfully Employed
References
Case No. ADJ16326594
Regular
Oct 31, 2025

Peter Pham vs. Southern California Edison

Defendant sought removal of a WCJ's December 12, 2023 Findings of Fact and Order (F&O), which denied their motion for a replacement Qualified Medical Evaluator (QME). The defendant argued that the applicant's email to the QME constituted impermissible ex parte contact. The Appeals Board granted the petition for removal, rescinding the F&O, and substituting new Findings of Fact that the email was indeed impermissible ex parte contact, thereby ordering a replacement QME panel. Additionally, while earlier QME reports and deposition testimony by Dr. Weiss remain in evidence, her report dated July 22, 2023, was stricken to preserve the appearance of impartiality in the medical evaluation process.

Ex parte contactQualified Medical EvaluatorRemoval petitionFindings of Fact and OrderLabor Code Section 4062.3Appearance of impartialityMedical evaluation processReplacement QME panelPsychiatric injuryStipulated facts
References
Case No. ADJ10266237; ADJ10401171
Regular
Aug 15, 2025

WILLIAM AREY vs. MAGIC MOUNTAIN, LLC; HARTFORD ACCIDENT AND INDEMNITY COMPANY

The Workers' Compensation Appeals Board denied defendant Hartford Accident & Indemnity Company's petition for reconsideration. The defendant challenged the April 22, 2025 Joint Findings of Fact and Order, which found that applicant William Arey sustained industrial injuries to his brain, head, nervous system, and circulatory system. Defendant contended the Agreed Medical Evaluator (AME) Dr. Roger Bertoldi's report was not substantial medical evidence and that ex parte contact occurred due to applicant's sister's participation in the evaluation. The Board affirmed the WCJ's decision, finding Dr. Bertoldi's report to be substantial medical evidence and concluding that the sister's assistance was necessary and permissible due to applicant's significant memory impairment, thus not constituting impermissible ex parte contact.

AMEAgreed Medical Evaluatorex parte contactsubstantial medical evidenceindustrial injurycumulative injuryspecific injuryres judicatacollateral estoppelPetition for Reconsideration
References
Case No. ADJ6408456
Regular
May 17, 2010

KENNETH M. HOOVER vs. CITY OF POMONA

The Appeals Board granted reconsideration of the WCJ's award of 100% permanent total disability. The Board found that the WCJ's decision was not supported by substantial evidence, primarily due to deficiencies in Dr. Grodan's medical reporting regarding the applicant's skin and cardiovascular conditions. The matter was returned to the trial level for further development of the record and a new decision. The Board confirmed the application of the 1997 Permanent Disability Rating Schedule and the admission of Dr. Shirman's report.

WORKERS' COMPENSATION APPEALS BOARDADJ6408456KENNETH M. HOOVERCITY OF POMONAreconsiderationFindings and Award and Orderworkers' compensation administrative law judgeWCJMay 172010
References
Case No. ADJ8613780
Regular
Jan 12, 2017

GLENN PARKER vs. KANSAS CITY CHIEFS, TIG/FAIRMONT PREMIER INSURANCE COMPANY, NEW YORK GIANTS, GULF/TRAVELERS INSURANCE COMPANY, BUFFALO BILLS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE INSURANCE COMPANY

This case concerns whether California has sufficient jurisdiction to hear a workers' compensation claim for cumulative injury filed by a former professional football player. The applicant played 12 out of 176 total games in California, which the majority found to be a de minimis contact insufficient for California to assert jurisdiction due to due process concerns, citing the *Johnson* case. The Board affirmed the trial judge's decision to deny jurisdiction, while also correcting a clerical error regarding the insurer. A dissenting commissioner argued that California's interest in protecting workers injured within the state is substantial and that the applicant's contacts were not de minimis.

WCABcumulative industrial injuryprofessional athletede minimis California contactsdue processsubject matter jurisdictionFederal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)constitutional due processextraterritorial provisionsstatutory exemption
References
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