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

Case No. ADJ10298988
Regular
Jan 31, 2018

BRIAN BERRY vs. HOSPICE OF THE FOOTHILLS, ALPHA FUND

The Appeals Board rescinded the prior decision and returned the case to the trial level for further proceedings. The Board found that the record was insufficient to determine if the applicant voluntarily retired or was constructively terminated from his employment. Further development of evidence is needed to establish whether the applicant intended to permanently leave the labor force or if his industrial injury prevented him from continuing to work. This determination is crucial for assessing his entitlement to additional temporary disability benefits and potentially permanent disability benefits.

Workers' Compensation Appeals Boardindustrial injuryright shouldertemporary disability indemnityvoluntarily retiredlabor forcedue processself-representedadmission of evidenceexclusion of evidence
References
Case No. ADJ8727749
Regular
Sep 26, 2013

CINDY VARGAS vs. SEARS HOLDINGS CORPORATION, SEDGWICK CMS

This case concerns an employer's petition to remove a WCJ's order compelling them to provide a complete list of their Medical Provider Network (MPN) in specific specialties. The employer argued this was overly burdensome, preferring to limit the list to providers within 30 miles of the applicant's residence. The Appeals Board denied removal, finding the WCJ's order was not burdensome or harassing under Administrative Director Rule 9767.12(f)(3). The Board noted the employer could fulfill the order electronically via CD or website, even if limited to the requested specialties.

Workers' Compensation Appeals BoardPetition for RemovalMedical Provider NetworkMPN listingTitle 8 Cal. Reg. § 9767.12(f)(3)Administrative Director Ruleregional area listingcomplete provider listingelectronic listingCD
References
Case No. ADJ2519091 (LAO 0824930) ADJ4160066 (LAO 0824931) ADJ188382 (LAO 0828971)
Regular
Aug 18, 1941

MARIA MARXUACH vs. WESTIN BONAVENTURE HOTEL, ZURICH NORTH AMERICAN INSURANCE

The Workers' Compensation Appeals Board denied reconsideration in this case, upholding the judge's decision. Discovery closed by operation of law on September 12, 2007, and the applicant's attorneys failed to demonstrate due diligence in listing crucial medical reports as exhibits prior to this closure. Despite numerous continuances and attempts to amend the exhibit list, discovery was never formally reopened. The Board adopted the judge's reasoning that the applicant did not establish why the exhibits could not have been presented with reasonable diligence before discovery closed.

Mandatory Settlement ConferencePre-trial conference statementdiscovery closureadministrative law judgePetition for Reconsiderationreopen discoverydue diligenceexhibition listWCJ reportWorkers' Compensation Appeals Board
References
Case No. ADJ394613 (VNO 0530712) ADJ2266356 (VNO 0530710)
Regular
Apr 01, 2016

MARIA ESTRELLA vs. NATIONAL EXPRESS CORPORATION

The Workers' Compensation Appeals Board (WCAB) granted removal to a lien claimant after a judge excluded four exhibits. The WCAB found that two of the excluded exhibits, representing certifications and financial interest notifications, were sufficiently listed on the Pre-Trial Conference Statement. Therefore, the WCAB admitted these two exhibits into evidence, amending the judge's prior order. The remainder of the judge's order, excluding the other two exhibits, was affirmed.

Petition for RemovalLien ClaimantWorkers' Compensation Appeals BoardWCJExhibitsPrejudiceIrreparable HarmPre-Trial Conference StatementServiceNotification of Certification
References
Case No. ADJ8030860, ADJ8179533, ADJ8179544
Regular
Aug 02, 2017

MOEGAGOGO TAMASESE vs. CITY AND COUNTY OF SAN FRANCISCO, SAN FRANCISCO JUVENILE PROBATION DEPARTMENT, INTERCARE

The Workers' Compensation Appeals Board (WCAB) denied the Defendant's Petition for Reconsideration. The denial was based on the WCAB adopting the reasoning of the workers' compensation administrative law judge (WCJ). Specifically, the Defendant violated WCAB Rule 10842(c) by attaching an Exhibit List to their petition, which contained documents already in evidence. The Board also noted this likely was an attempt to circumvent page limits and admonished the Defendant for non-compliance.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationWCJ reportWCAB Rule 10842(c)Exhibit Listpage limitsLabor Code § 5813Cal. Code Regs.tit. 8§ 10561
References
Case No. ADJ7404124
Regular
Jun 06, 2012

ALFREDO AGUILAR vs. CANTAMAR PROPERTY MANAGEMENT, CHARTIS INSURANCE

In this workers' compensation case, the defendant sought removal of an order allowing the applicant to amend their exhibit list to include a Qualified Medical Evaluator (QME) report and the WCJ's intention to consider sanctions. The Appeals Board denied removal, finding no prejudice to the defendant from admitting the report, as it could be relevant to temporary disability and the defendant had not objected. Regarding sanctions, the Board noted the WCJ's order was a notice of intent, and the defendant would have an opportunity to be heard at trial. The Board also pointed out that the report wasn't in the electronic system for verification of service.

Petition for RemovalQualified Medical EvaluatorTemporary Total DisabilityLabor Code Section 5813SanctionsExhibit ListDue DiligenceMedical Provider NetworkDeclaration of Readiness to ProceedMandatory Settlement Conference
References
Case No. ADJ8944426, ADJ8942895
Regular
Dec 22, 2014

DAVID POSHOGLYAN vs. HOLLIDAY ROCK COMPANY, INC., INSURANCE COMPANY OF THE WEST, XL SPECIALTY INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a decision finding applicant sustained injury arising out of and in the course of employment. Defendants argued certain exhibits were improperly admitted due to lack of service and that the decision was vague. The Board adopted the WCJ's report, which found the exhibits were properly admitted or any error was harmless, and that the decision adequately addressed the stipulated facts. The WCJ's report detailed why the exhibits were admissible despite service issues and explained that further clarification on body parts or liability was not required at this stage of the proceedings.

ADJ8944426ADJ8942895PoshoglyanHolliday Rock CompanyInsurance Company of the WestXL Specialty Insurance CompanySedgwickPetition for ReconsiderationDeniedWCJ Report
References
Case No. ADJ7159838 ADJ7550047
Regular
Jul 29, 2014

ALMA PELAYO vs. ASSOCIATED LIEN SERVICES

Applicant Alma Pelayo sought reconsideration of a prior decision that found no violation of Labor Code section 132(a) and ordered her to take nothing further. Pelayo argued the judge erred in this finding and in failing to rule on the admissibility of her Exhibit 15. The Appeals Board granted reconsideration solely to admit Pelayo's Exhibit 15 and defendant's Exhibits A1, A2, and A3. The Board otherwise affirmed the original decision, meaning Pelayo still takes nothing further.

Workers' Compensation Appeals BoardLabor Code section 132(a)Findings and OrderPetition for ReconsiderationWCJApplicant's Exhibit 15Defendant's Exhibits A1A2A3admissible evidence
References
Case No. ADJ7212946
Regular
Dec 13, 2012

JOSE QUINTERO vs. CORPORATE PERSONNEL NETWORK, NEW HAMPSHIRE INSURANCE CO., administered by CHARTIS

The Appeals Board granted reconsideration to address the admissibility of Dr. Konstat's psychiatric evaluation. The Board found Dr. Konstat's report inadmissible because it was a medical-legal evaluation obtained in violation of statutory procedures for represented employees, bypassing the requirement for an Agreed Medical Evaluator or Qualified Medical Evaluator. Consequently, the Board amended the prior award to exclude industrial injury to the psyche due to lack of substantial medical evidence. The applicant's award for orthopedic injuries and medical treatment was affirmed.

Workers' Compensation Appeals BoardJose QuinteroCorporate Personnel NetworkNew Hampshire Insurance Co.ChartisAmended Findings and Awardindustrial injuryleft shoulderneckback
References
Case No. ADJ10443669
Regular
Oct 04, 2017

Donna Carter vs. Rose International Group, OneBeacon Insurance Group

The Appeals Board affirmed the Workers' Compensation Judge's finding that Donna Carter sustained an industrial injury to her right knee and left wrist on May 18, 2016. Despite inconsistencies in the applicant's testimony regarding a slip and fall incident, her account was corroborated by a witness who found her on the floor. Medical records from the day of the incident also supported the applicant's claim, establishing a clear mechanism of injury. The Board found that the common sense nature of a slip and fall does not require expert medical opinion to establish industrial causation for the incident itself.

ADJ10443669Rose International GroupOneBeacon Insurance GroupDonna CarterWorkers' Compensation Appeals BoardOpinion and Decision After Reconsiderationslip and fallindustrial injuryright kneeleft wrist
References
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