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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. 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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ1988796 (OXN 0126081) ADJ4225705 (OXN 0126083)
Regular
May 09, 2012

JULIE ANN CABEZA vs. MARY HEALTH OF THE SICK, REDLAND INSURANCE

Attorney Hannan petitioned to disqualify WCJ Glass based on allegations of a conspiracy with other WCJs to penalize her and her clients. The Appeals Board denied the petition, finding insufficient specific facts and evidence to support the claims of bias. Hannan failed to provide required witness declarations and her allegations largely repeated prior contentions. The Board concluded the petition was untimely and lacked the necessary evidentiary support for disqualification.

Petition for disqualificationWCJ biasconspiracy allegationslien claimantattorney misconducttimely filingevidencejudicial impartialityADA accommodationwitness declarations
References
Case No. ADJ11080934
Regular
Oct 28, 2025

JUAN MARTINEZ vs. CREAM OF THE CROP AG SERVICE, INC.; CA FARM MANAGEMENT, INC.

The applicant, Juan Martinez, sought reconsideration of a prior decision that reversed a Workers' Compensation Administrative Law Judge's (WCJ) order imposing sanctions against the defendant for alleged frivolous tactics. The Appeals Board originally found insufficient evidence of bad-faith conduct by the defendant, Cream of the Crop AG Service, Inc. and CA Farm Management, Inc. In this petition, the applicant sought clarification on the standard of review and claimed certain issues were not addressed. The Board denied the applicant's petition, reiterating its finding that the defendant's actions did not constitute bad-faith litigation tactics under Labor Code section 5813, and confirmed that the responsibility for pursuing discovery, such as a neuropsychological evaluation recommended by Dr. Bhatia in 2018, did not rest solely on the defendant.

WCABPetition for ReconsiderationLabor Code Section 5813SanctionsAttorneys' FeesFrivolous TacticsBad Faith ConductNeuropsychology EvaluationAdditional PanelsReconsideration Proceedings
References
Case No. ADJ7432904
Regular
Sep 24, 2012

NEDA MOTAVAKEL vs. FANTASTIC SAM'S, TOWER SELECT INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, STAR INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, ENDURANCE WORKERS' COMPENSATION, SOUTHERN INSURANCE CO., FIRSTCOMP OMAHA

This case involves an appeal by Star and Tower Insurance Companies regarding a workers' compensation award. The primary issue is the applicant's average weekly earnings, specifically the inclusion of tip income, which was not adequately substantiated by documentary evidence. The Appeals Board found the initial decision lacked substantial evidence regarding earnings and rescinded the award. The matter is remanded for further proceedings to properly develop the evidentiary record on earnings and insurance coverage dates before a new decision is issued.

Workers' Compensation Appeals BoardNeda MotavakelFantastic Sam'sTower Select Insurance CompanyStar Insurance CompanyIllinois Midwest Insurance AgencyLLEndurance Workers' CompensationSouthern Insurance CompanyFirstComp Omaha
References
Case No. ADJ9145724
Regular
Jun 01, 2015

ARZAGA, JOSE vs. CROWN AUTOMOTIVE, INC., AMTRUST NORTH AMERICA

This case involves an applicant seeking to select a pain management specialist outside his employer's Medical Provider Network (MPN). The applicant argued the MPN failed to provide a qualifying specialist within the required 15-mile/30-minute access standard for a primary treating physician. The Board denied the employer's petition for reconsideration, affirming the applicant's right to choose an out-of-network physician and reimbursement for investigative costs. The majority reasoned that the MPN must meet the closer access standard for a primary treating physician, even if that physician is a specialist. A dissenting opinion argued that a specialist, when chosen as a primary treating physician, should fall under the 30-mile/60-minute access standard for specialists.

Medical Provider NetworkMPNprimary treating physicianpain management specialistaccess standardAdministrative Director's Rule 9767.5investigative costsLabor Code section 5703Lescallett v. Wal-MartMartinez v. New French Bakery
References
Case No. ADJ9052223
Regular
Aug 05, 2016

Joel Rodriguez Luna vs. The Home Depot, Helmsman Management

Here's a summary of the case for a lawyer in a maximum of four sentences: The Workers' Compensation Appeals Board denied Joel Rodriguez Luna's Petition for Removal, affirming the WCJ's finding that Home Depot's Medical Provider Network (MPN) complied with access standards. The WCJ determined that for a specialist, like an orthopedist, the MPN only needed to meet the 30-mile/60-minute access standard, not the stricter 15-mile/30-minute standard for a general primary treating physician. The Board agreed, concluding that since there was at least one orthopedic surgeon within the 30-mile radius, the MPN satisfied its obligations, despite the applicant's preference for a specialist within a closer distance. The dissenting opinion argued the MPN failed by not having at least three specialists readily available to serve as primary treating physicians for the applicant's specific orthopedic injuries.

Workers' Compensation Appeals BoardPetition for RemovalMedical Provider Network (MPN)Access StandardsPrimary Treating PhysicianSpecialistGeographic AreaAdministrative Director's RuleLabor CodeIndustrial Injury
References
Case No. ADJ7422993
Regular
Apr 06, 2015

SHIRLEY LESCALLETT vs. WAL-MART, ACE AMERICAN INSURANCE, YORK RISK SERVICES

In this workers' compensation case, the applicant sought to select a pain management specialist as her primary treating physician. The employer's Medical Provider Network (MPN) did not have any pain management specialists within the 15-mile/30-minute access standard for primary physicians, though it did have specialists within a 30-mile/60-minute radius. The Appeals Board affirmed the WCJ's decision, holding that if an applicant chooses a specialist for their primary care, the MPN must provide at least three physicians of that specialty within a 15-mile/30-minute radius. Since the defendant's MPN failed to meet this standard for pain management specialists, the applicant was permitted to choose one outside the MPN. A dissenting opinion argued that the 30-mile/60-minute standard for specialists should apply, allowing the applicant to select a physician within that broader radius from the MPN.

MPNMedical Provider NetworkPrimary Treating PhysicianSpecialistAccess StandardsAdministrative Director's RulePain Management PhysicianGeographic RadiusLabor CodeWorkers' Compensation Appeals Board
References
Case No. ADJ9798663
Regular
Sep 02, 2015

ALEJANDRO SAUCEDO SAHAGUN vs. TXC LOUTER'S DAIRY, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, rescinding the previous award. The applicant sought to change treating physicians outside the defendant's Medical Provider Network (MPN), arguing the MPN failed to meet access standards for primary treating physicians within 15 miles or 30 minutes of his home or work. The Board found the trial judge applied an incorrect, less stringent access standard, and remanded the case for application of the proper standard. The applicant's injury and initial treatment within the MPN were admitted.

Workers' Compensation Appeals BoardMedical Provider NetworkMPN access standardsAdministrative Director's Rule 9767.5rural areasprimary treating physicianorthopedic physiciansoccupational health servicesLab. Code § 4600Lab. Code § 4616
References
Case No. ADJ8759396
Regular
Feb 27, 2015

Jose Diaz vs. Timber Works Construction, Berkshire Hathaway

This Workers' Compensation Appeals Board case involves applicant Jose Diaz seeking reconsideration of a prior order regarding his employer's Medical Provider Network (MPN). The primary issue is whether the MPN's physician accessibility standards, which are tied to the "workplace" or residence, are met. The Board granted reconsideration, rescinded the previous order, and remanded the case, finding the MPN may be defective if it doesn't comply with physician access standards relative to the applicant's residence, given the employer's failure to meet the "workplace" standard. The Board also noted that the applicant's inability to travel, while a factor, was not the deciding point in this decision to remand.

Workers' Compensation Appeals BoardMedical Provider NetworkMPNWorkplaceResidencePhysician Access StandardsTitle 8 Section 9767.5Pain ManagementPhysical MedicineCannot Travel Exception
References
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