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

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. ADJ9664689
Regular
Apr 02, 2015

VICTOR LUO vs. PACIFIC PATHWAY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of a sanctions order against applicant's attorneys. The attorneys argued due process violations based on alleged ex parte contact by the judge. The Board found the applicant's attorneys' petition contained misrepresentations of fact, justifying sanctions. Therefore, the Board issued a notice of intention to impose a $500 joint and several sanction against the law firm and its associate for unprofessional conduct and misleading pleadings.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationOrder Imposing SanctionsWCJex parte contactdue processbad-faith actionsLabor Code section 5813Appeals Board Rule 10561(b)sanctions
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. ADJ9180559
Regular
Sep 18, 2015

JACKIE SUEHIRO (Dec'd), ALVIN SUEHIRO (Husband) vs. RALPHS GROCERY COMPANY, permissibly self-insured, adjusted by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Appeals Board granted the defendant's petition for removal, rescinding a prior Minute Order. The WCJ had found ex-parte communication by the defendant and ordered a new QME panel without a trial or sworn testimony. The Board found this violated the defendant's due process rights, as no evidence was presented to support the ex-parte communication finding. The case is returned to the trial level for a hearing on all issues, including alleged ex-parte communication, with parties afforded the chance to present evidence and witnesses.

Petition for RemovalMinute OrderQualified Medical EvaluatorEx-parte CommunicationDue ProcessWCJReplacement QME PanelLabor Code Section 5313Admitted EvidenceProof of Service
References
Case No. ADJ11584415
Regular
Sep 30, 2019

GUY SYLVA vs. CITY AND COUNTY OF SAN FRANCISCO

This case involves an applicant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that denied temporary disability benefits and a motion to strike a Qualified Medical Evaluator's (QME) reports. The applicant alleged ex parte communication between the defendant and the QME, violating Labor Code section 4062.3. The WCAB granted reconsideration, finding that the issue of ex parte communication was not adequately addressed due to conflicting dates and unadmitted evidence. The matter is remanded to the trial level for further proceedings to determine if ex parte communication occurred and to address the temporary disability issue.

WCABAOE/COEQMEex parte communicationLabor Code section 4062.3Petition for ReconsiderationFindings and Orderremovaltemporary disabilityprimary treating physician
References
Case No. ADJ8015424, ADJ8102669
Regular
Aug 01, 2018

ESPERANZA SANCHEZ vs. MCDONALD'S/MJD'S, INC., UNITED STATES FIDELITY & GUARANTY, BROADSPIRE

The Workers' Compensation Appeals Board granted applicant's petition for removal, rescinding the WCJ's order that deferred a discovery dispute regarding ex parte communication. The Board found that allegations of impermissible communication between the defendant and the court-appointed physician must be addressed before further discovery. The case is returned to the trial level for proceedings to determine if ex parte communication occurred and if a new physician is warranted.

Petition for RemovalRegular PhysicianEx Parte CommunicationWCJDepositionsAdmitted EvidenceSubstantial JusticeLabor Code § 5701WCAB Rules § 10324(d)Qualified Medical Evaluator (QME)
References
Case No. ADJ7452503
Regular
Sep 26, 2011

PATRICIA MAYORGA vs. MOUNT DIABLO UNIFIED SCHOOL DISTRICT, TRISTAR

The Appeals Board denied the defendant's Petition for Removal, which sought to overturn an order quashing the deposition of a treating physician. The defendant argued the communication wasn't an ex parte communication and was necessary for their defense and fraud investigation. However, the Board found the defendant failed to show substantial prejudice or irreparable harm. While ex parte communications with QMEs/AMEs are prohibited, they are not with treating physicians, and the communication was not barred by statute or case law.

Petition for RemovalPetition to Quash DepositionTreating PhysicianEx Parte CommunicationAgreed Medical EvaluatorQualified Medical EvaluatorSubstantial PrejudiceIrreparable HarmWorkers' Compensation Appeals BoardWCJ
References
Case No. ADJ2902954; ADJ2715753
Regular
Jan 14, 2014

DONALD GREEN vs. COMPTON UNIFIED SCHOOL DISTRICT

The Appeals Board dismissed the lien claimant's Petition for Reconsideration and granted removal on its own motion. It affirmed the Administrative Law Judge's order setting aside a prior lien allowance due to potential service and ex parte communication issues. The matter was returned to the trial level for reassignment to a new judge to address outstanding issues, including proper service, ex parte communication, the propriety of setting aside the lien order, and potential sanctions.

Workers' Compensation Appeals BoardLien claimantReconsiderationRemovalOrder Setting AsideEx parte communicationProper serviceNotice of Intent to Allow LienAmended Order Allowing LienSubstituted counsel
References
Case No. ADJ10305556
Regular
Sep 26, 2016

JOSE MACIEL vs. RP AUTOMOTIVE, INC. d/b/a PENSKE CHEVROLET, SAFETY NATIONAL CASUALTY CORPORATION

The Appeals Board granted reconsideration of an order that had mandated a new Qualified Medical Examiner (QME) panel due to a perceived ex parte communication. The Board found the communication was not ex parte as the applicant was unrepresented and acknowledged receipt, thus rescinding the original order. The case is returned to the trial level for further proceedings, allowing the WCJ to issue a new decision considering all arguments. This decision clarifies that petitions challenging QME determinations are subject to reconsideration, not removal.

WCABQMEex parte communicationpetition for reconsiderationpetition for removaladministrative law judgeLabor Codequalified medical examiner panelSB 899comprehensive evaluation
References
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