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

Case No. ADJ4552593 (MON 0258406)
Regular
Mar 26, 2012

KIMBERLY DENOVA-JOY vs. SANTA PAULA ELEMENTARY SCHOOL DISTRICT, CIGA on behalf of FREMONT INSURANCE COMPANY in liquidation, as administered by CAMBRIDGE INTERGRATED SERVICES

This case concerns an applicant's due process claim regarding the denial of an expedited hearing for temporary disability benefits. The Workers' Compensation Appeals Board (WCAB) granted removal, finding the administrative law judge (WCJ) improperly removed the issue from the expedited hearing track. The WCAB held that the need for record development on permanent disability did not preclude an expedited hearing for temporary disability, which had been pending for over ten years. The Board rescinded the WCJ's order and returned the case for an expedited hearing.

Petition for RemovalExpedited HearingTemporary Disability IndemnityWCABWCJPWCJDue ProcessLabor Code Section 5502(b)Rule 10252(c)Permanent Disability
References
0
Case No. ADJ11235958
Regular
Jul 25, 2018

Scot Turknette vs. COUNTY OF SAN BERNARDINO

The Appeals Board granted removal of this workers' compensation case, rescinding the expedited hearing's cancellation. The applicant, a potential firefighter, sought an expedited hearing on entitlement to Labor Code section 4850 salary continuation benefits, which would provide full salary for up to one year, exceeding temporary and permanent disability payments. The Board found that denial of an expedited hearing for these benefits, which are paid in lieu of temporary disability, would cause significant prejudice and harm. The case is remanded for an expedited hearing on the applicant's section 4850 benefit claim.

Labor Code section 4850salary continuation benefitsfirefighter classificationexpedited hearingPetition for Removalsignificant prejudiceirreparable harmtemporary disability indemnityPresiding WCJMMI status
References
3
Case No. ADJ1122368 (SJO 0223390)
Regular
Mar 24, 2015

MINH LY vs. LORAL SPACE SYSTEMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE NATIONAL INDEMNITY COMPANY, in liquidation

The Appeals Board granted removal and rescinded the WCJ's order taking the case off calendar, holding that the applicant is entitled to an expedited hearing regarding the denial of Lyrica prescription refills. The WCJ erred by prematurely determining that utilization review (UR) was timely and jurisdictionally barred further proceedings, without allowing evidence and a hearing. The Board emphasized that the applicant has a right to an expedited hearing to contest UR decisions, challenge their applicability, or present evidence of changed circumstances. The case was returned to the trial level for an expedited hearing and a new decision based on the record.

Utilization ReviewIndependent Medical ReviewPetition for RemovalExpedited HearingOrder Taking Case Off CalendarPrescription MedicationLyricaDue ProcessLabor Code Section 5310Dubon II
References
10
Case No. ADJ1941485 (VNO 0263845) ADJ4137418 (VNO 0270976) ADJ1018222 (MON 0140131)
Regular
Dec 15, 2008

GERTRUDE CHISM vs. K-MART/SEARS HOLDING CORPORATION, Permissibly Self-Insured Administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

The Appeals Board dismissed the defendant's petition to remove WCJ Zarett as moot due to his retirement, and denied the request for a commissioner's hearing on sanctions as premature. The Board remanded the case to the trial level for a full evidentiary hearing on the defendant's allegations regarding the applicant's attorneys, as these factual issues are best addressed by a new Workers' Compensation Judge. The defendant's numerous petitions for removal, vacating hearings, and stays were largely dismissed or denied.

Workers' Compensation Appeals BoardGertrude ChismK-Mart/Sears Holding CorporationSedgwick Claims Management ServicesPetition for Commissioner's HearingRemoval of Judge ZarettVacate HearingStay ProceedingsImposition of SanctionsGuardian Ad Litem
References
1
Case No. ADJ7523380
Regular
Jul 17, 2015

SALVADOR ULLOA vs. PRAXAIR, INC.

The Appeals Board granted applicant's Petition for Removal, rescinding the WCJ's order taking the case off the expedited hearing calendar. The Board found that a dispute over medical treatment for a serious injury, despite a disputed psychiatric component, warrants expedited review. While a complexity may necessitate redesignation as a Mandatory Settlement Conference, the OTOC itself caused substantial prejudice due to delays in crucial psychiatric treatment. The matter is returned to the WCJ to be reset on the expedited hearing calendar.

RemovalOrder Taking Off CalendarExpedited HearingMandatory Settlement ConferenceDisputed Body PartMedical TreatmentPsychiatric ConditionSerious InjuryUpper ExtremitiesAOE/COE Dispute
References
2
Case No. ADJ9157742
Regular
Oct 23, 2015

ALBERT JEMES vs. GENERAL SECURITIES SERVICES, INC., TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The Workers' Compensation Appeals Board granted the defendant's petition for removal, rescinding the WCJ's order for trial briefs and submission. The WCJ improperly denied the defendant's right to present exhibits and witness testimony at an expedited hearing on the Medical Provider Network (MPN) issue. This denial constituted a violation of due process and fair hearing rights, causing significant prejudice. The case is returned to the WCJ for further proceedings and a new expedited hearing where evidence can be presented.

References
0
Case No. ADJ11085852
Regular
Nov 02, 2018

DEONTE WALKER vs. CITY AND COUNTY OF SAN FRANCISCO, INTERCARE HOLDINGS INSURANCE SERVICES

The applicant sought removal of a Notice of Hearing alleging prejudice from a full-day trial instead of an expedited hearing for his admitted industrial injury to the psyche and stress. The Workers' Compensation Appeals Board (WCAB) denied the petition, emphasizing that removal is an extraordinary remedy requiring a showing of irreparable harm. The WCAB found that the scheduled trial was justified by the complexity and witness testimony, and an expedited hearing was not guaranteed to be earlier. Therefore, the applicant failed to demonstrate significant prejudice or irreparable harm.

Petition for RemovalIndustrial InjuryPsycheStressWCJNotice of HearingExpedited HearingFull-Day TrialSignificant PrejudiceIrreparable Harm
References
2
Case No. ADJ2896668 (OAK 0224622)
Regular
Jan 31, 2013

MONICA GARRETSON MILLER vs. JACKSON CREEK DENTAL GROUP, ZENITH INSURANCE COMPANY

In this case, the defendant sought to remove the case from an expedited hearing, arguing certain issues were improperly included. The Appeals Board denied the Petition for Removal as moot because the hearing had been taken off calendar. However, the Board returned the case to the trial level for a full hearing on all issues raised, including medical treatment adequacy, and ordered the claims examiner to appear and testify. The Board noted that while MPN issues and attorney fees were not expedited issues in 2012, statutory amendments now include them.

Petition for RemovalExpedited HearingTreatment DenialsMPNAttorney's FeesDeclaration of ReadinessClaims ExaminerUtilization ReviewMedical Provider NetworkLabor Code Section 5502(b)
References
0
Case No. ADJ12080707
Regular
Sep 04, 2019

MICHAEL OLAGUE vs. CITY SECURITY COMPANY, NATIONAL LIABILITY & FIRE INSURANCE COMPANY

The Appeals Board granted applicant's petition for removal, rescinding the trial judge's order to take the case off calendar. The applicant requested additional Qualified Medical Evaluator (QME) panels, but the judge deferred this due to pending AOE/COE issues and an initial QME exam being set. The Board found that Labor Code section 5502 mandates an expedited hearing for disputes involving medical-legal examinations, entitling the applicant to a hearing on the request for additional panels. The case is returned to the trial level for further proceedings, potentially including placement back on the expedited hearing calendar.

Petition for RemovalExpedited HearingAOE/COEInitial Physical AggressorQualified Medical Evaluator (QME)PQME panelsMedical-legal evaluationLabor Code Section 5502Off-calendarRescind Order
References
0
Case No. MISSING
Regular Panel Decision

Matter of Maffei v. Russin Lumber Corp.

The claimant, a lumber company manager, filed a workers' compensation claim established for occupational asthma and consequential atrial fibrillation. The case was expedited for permanency hearings. The employer and its workers' compensation carrier had video surveillance but failed to bring it to a scheduled expedited hearing, requesting a continuance after the claimant testified. The Workers’ Compensation Law Judge (WCLJ) denied the adjournment request, finding no emergency and classifying the claimant with a permanent total disability. The Workers' Compensation Board, on full Board review, upheld the WCLJ's decision, concluding that no emergency existed to justify a continuance for the carrier to produce the video. The Appellate Division affirmed the Board's decision, stating that the carrier was afforded due process and waived arguments regarding misrepresentation and the propriety of the expedited calendar transfer.

Video SurveillanceExpedited HearingAdjournment DenialDue ProcessPermanent Total DisabilityWorkers' Compensation BoardAppellate ReviewEvidentiary RulesEmergency ExceptionWaiver of Issues
References
6
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