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

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. ADJ8217279
Regular
May 05, 2017

PETER BOURASSA vs. DOLLAR TREE, SEDGWICK

The Appeals Board affirmed the WCJ's decision regarding applicant Peter Bourassa's workers' compensation claim. The lien claimant, Monrovia Memorial Hospital, sought payment exceeding $\$58,272.00$ for services rendered. The Board clarified that facility fees for long-term care hospitals exempt from the Official Medical Fee Schedule (OMFS) must be paid on a "reasonable cost basis." The lien claimant failed to meet its burden of proving the reasonableness of its charges under relevant case law.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderLien ClaimantReasonable Cost BasisOMFSKunz studyAffirmAffirmAffirm
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ2203540
Regular
Jan 11, 2012

GORDON ANTHONY vs. COUNTY OF LOS ANGELES

This case involves a petition for reconsideration filed by the Applicant, Gordon Anthony. The Workers' Compensation Appeals Board granted reconsideration to correct a clerical error in the original decision dated October 18, 2011. Specifically, the Board amended the decision to change the applicant's name from "ANTHONY GORDON" to "GORDON ANTHONY" in multiple locations of the findings and order. Otherwise, the Board affirmed the original decision.

Workers' Compensation Appeals BoardReconsiderationClerical ErrorFindings of FactOrderOpinion on DecisionApplicantDefendantSelf-InsuredAmended Decision
References
Case No. ADJ7237157
Regular
Aug 15, 2013

JUAN ESTRADA vs. R&L BROSAMER, INC.; CHARTIS/AIG

The Workers' Compensation Appeals Board (WCAB) granted removal, rescinded an administrative law judge's (WCJ) order, and otherwise affirmed the WCJ's decision. The rescinded order compelled the applicant, Juan Estrada, to attend a medical examination on July 19, 2013. The WCAB adopted and incorporated the WCJ's report outlining the reasons for this action.

RemovalRescindedMedical ExaminationCompelling AttendanceWCJ OrderPetition for RemovalWorkers' Compensation Appeals BoardAdministrative Law JudgeReport of WCJDecision After Removal
References
Case No. ADJ8067157
Regular
Nov 30, 2012

MARISOL PERALTA vs. FROZEN YOGURT OF VALLEY VILLAGE, INC., STAR INSURANCE CO.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to further develop the record regarding applicant Marisol Peralta's alleged industrial injury. The WCAB rescinded the prior decision finding an injury, citing that the medical opinions were not substantial evidence as they lacked definitive causation findings and weren't based on complete medical histories. Crucially, neither physician reviewed applicant's full medical records, and one deferred causation due to pregnancy while the other awaited X-ray results. The case is returned to the trial level for further proceedings and a new decision by the WCJ.

Workers' Compensation Appeals BoardMarisol PeraltaFrozen Yogurt of Valley VillageInc.Star Insurance Co.Illinois Midwest Insurance AgencyLLCADJ8067157Opinion and Order Granting ReconsiderationDecision After Reconsideration
References
Case No. ADJ9725074
Regular
May 25, 2016

RAFAEL GIL vs. WEBCOR BUILDERS, ZURICH INSURANCE

The Workers' Compensation Appeals Board affirmed a prior decision finding the applicant sustained an industrial injury to his head, neck, back, and right shoulder. The Board upheld the award of temporary disability, finding the applicant's testimony credible, supported by medical evidence. Defendants argued insufficient evidence for temporary disability, but the Board found no contrary evidence of substantial weight. The WCJ's findings on credibility and factual determinations were given great weight and were affirmed.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardTemporary Disability IndemnityWCJCredibility DeterminationsIndustrial InjuryContrary EvidenceAffirm DecisionScott Co. v. Workers' Comp. Appeals Bd.
References
Case No. ADJ9028190
Regular
May 29, 2014

YE SUK KWAN KIM vs. B.C.D. TOFU HOUSE, INC., BERKSHIRE HATHAWAY on behalf of CYPRESS INSURANCE COMPANY

The Workers' Compensation Appeals Board affirmed a WCJ's decision finding applicant sustained industrial injury to her neck and upper extremities. The WCJ also ordered the employer to provide medical treatment outside the Medical Provider Network (MPN). Defendant sought reconsideration, arguing the WCJ erred in allowing out-of-MPN treatment despite proper notice, and in failing to rule on MPN transfer of care. The Board adopted the WCJ's report and denied the defendant's petition, affirming the original findings.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderIndustrial InjuryNeck InjuryUpper ExtremitiesMedical TreatmentMedical Provider NetworkMPNProper MPN Notices
References
Case No. ADJ1253728 SFO 0509604
Regular
Dec 04, 2012

KENNETH BUMGARNER vs. CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration in *Bumgarner v. California Highway Patrol*. The Board affirmed the original decision but amended Finding of Fact No. 2 to clarify that there is no legal apportionment of permanent disability, specifically regarding the neck injury. This amendment clarifies the non-apportionment principle for permanent disability in this case.

Workers' Compensation Appeals BoardCalifornia Highway PatrolState Compensation Insurance FundPetition for ReconsiderationWCJ ReportDecision After ReconsiderationFinding of FactLegal ApportionmentPermanent DisabilityNeck Injury
References
Case No. ADJ3015096 (STK 0200853)
Regular
Dec 10, 2009

SANDRA CONCEPCION vs. TRAVIS UNIFIED SCHOOL DISTRICT, NORTH BAY SCHOOLS INSURANCE AUTHORITY

Reconsideration granted for petition to disqualify WCJ and for Finding and Order of October 12, 2009 requiring payment of $23,165.00. WCJ to issue Report detailing evidence supporting decision.

Petition for ReconsiderationDisqualification of WCJFinding and OrderDue ProcessSubstantial EvidenceNotice of IntentionOpinion on DecisionReport and RecommendationWorkers' Compensation Appeals BoardDecision After Reconsideration
References
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