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

Case No. ADJ7873790
Regular
Jun 27, 2013

LAURA BERNAL vs. RINCON TAURINO RESTAURANT, INC., CALIFORNIA RESTAURANT MUTUAL BENEFIT CORPORATION

The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for removal, overturning a prior ruling that allowed the applicant to refuse a Qualified Medical Evaluator (QME) examination based on the QME's refusal to allow audio recording. The WCAB found the applicant's attorney had made "unusual efforts to obstruct the QME process." Applicant is now ordered to attend the QME examination with a court reporter present at the defendant's expense. Failure to comply will result in suspension or barring of disability payments.

QMEAMEremovalreconsiderationtape recordingcourt reporterobstructionsanctionsLabor Code section 4062.2Labor Code section 5813
References
Case No. ADJ8580851
Regular
Feb 26, 2018

JOSE RODRIGUEZ (Dec'd), MARCELA RODRIGUEZ (Wife), ANDREA RODRIGUEZ (Daughter), ISAAC ESPINOZA (Grandson) vs. KENAN ADVANTAGE GROUP, INC., AMERICAN ZURICH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration. The Board affirmed the administrative law judge's order requiring the agreed medical evaluator (AME) to interview the deceased employee's spouse and daughter to assess causation for his suicide. The Board found the employer acted in bad faith by obstructing these interviews, warranting sanctions, attorney's fees, and costs. The employer's arguments against the interviews and sanctions lacked legal merit.

Workers' Compensation Appeals BoardAgreed Medical EvaluatorSuicideCompensable ConsequenceLabor Code Section 4062.3SanctionsBad FaithDiscovery ObstructionReconsiderationPetition for Reconsideration
References
Case No. ADJ6766189
Regular
Jul 03, 2012

MIRNA CERRATO AGUILAR vs. BEVERLY PAVILION ASSOCIATES, FIRSTCOMP OMAHA

This case involves a petition for reconsideration filed by Anna Montes, a hearing representative, regarding a $1,500 sanction imposed by the WCJ. Montes was sanctioned for her "insolent, obstructive, disrespectful and frivolous" conduct during a workers' compensation trial involving her client, Dr. Anguizola. The Appeals Board denied Montes' petition, adopting the WCJ's report which detailed how her behavior caused unnecessary delay and wasted Board resources. The Board reiterated that representatives must conduct themselves professionally and ethically, adhering to rules against bad faith tactics that cause delay.

Workers' Compensation Appeals BoardSanctionsPetition for ReconsiderationIndustrial InjuryRoom AttendantLien ClaimantMedical TreatmentPenaltyInterestInsolent Conduct
References
Case No. ADJ3149625 (FRE 0249956)
Regular
May 21, 2015

RODOLFO MALTOS vs. SUPERIOR AIR HANDLING CORP, THE HARTFORD INSURANCE COMPANY

The applicant sustained a respiratory injury, specifically chronic obstructive pulmonary disease, during a cumulative exposure period ending November 4, 2007. The Workers' Compensation Appeals Board (WCAB) reconsidered an award that had been issued against Superior Air Handling Corp.'s insurer. While Liberty Mutual was involved, the applicant had elected to pursue the claim against The Hartford Insurance Company. The WCAB amended the decision to clarify that the award was specifically against Hartford, as applicant had elected to proceed against them.

Workers' Compensation Appeals BoardReconsiderationFindings Award and OrderAdministrative Law JudgeCumulative TraumaChronic Obstructive Pulmonary DiseaseSheet Metal WorkerInsurer ElectionStipulation of CoverageMedical Treatment
References
Case No. ADJ3190249 (SFO 0500553)
Regular
Mar 24, 2010

Quintella Eutsey vs. CITY & COUNTY OF SAN FRANCISCO, Permissibly Self-Insured

The Workers' Compensation Appeals Board granted removal, dismissing the defendant's petition for reconsideration. The Board found the prior administrative law judge's order improperly limited discovery into the applicant's psychiatric injury claim. The Board rescinded the previous order, allowing further deposition to explore the applicant's full medical history relevant to her psyche claim, as this is discoverable when a psychological injury is at issue. Both parties were admonished to conduct themselves professionally during future discovery.

removalpetition for reconsiderationdiscovery disputepsyche injurydeposition testimonyright lower extremityindustrial injurypersonal lifefamily lifepast history
References
Case No. ADJ7037201
Regular
Apr 22, 2013

Eddie Avakian vs. CITY OF BALDWIN PARK, ADMINSURE

This case involves an applicant police officer seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that awarded 72% permanent partial disability. The applicant contended the WCJ erred by excluding sleep disturbances and sexual dysfunction from the disability rating and by apportioning his cardiovascular disability. The WCAB granted reconsideration, rescinded the original award, and found the applicant's sexual dysfunction and sleep disorder compensable. The matter was returned to the trial level for a new decision, with the WCAB stating it would not disturb other findings, including the hypertension apportionment.

Workers' Compensation Appeals BoardEddie AvakianCity of Baldwin ParkPermissibly Self-InsuredAdministered By ADMINSUREADJ7037201Opinion and Order Granting ReconsiderationDecision After ReconsiderationFindings and Award and OrderAdministrative Law Judge
References
Case No. ADJ8240882; ADJ8240881; ADJ8615401
Regular
Apr 21, 2025

ROBERT S. HAPPENY vs. STATE OF CALIFORNIA, CALIFORNIA INSTITUTE FOR WOMEN

Applicant Robert S. Happeny sustained industrial injuries during his employment as a correctional officer, leading to a finding of permanent and total disability by the WCJ due to his inability for vocational retraining. The WCJ also issued an unapportioned award, concluding that apportionment to nonindustrial factors was not proven. Defendant challenged this decision via a petition for reconsideration, disputing the method of combining disabilities and the reliability of vocational reports. The Appeals Board granted reconsideration, affirming the WCJ's determination of permanent and total disability based on vocational infeasibility and the lack of established apportionment, ultimately rescinding the original decision and substituting new findings of fact.

ADJ8240882ADJ8240881ADJ8615401correctional officerindustrial injuryheartpsycheright wristrespiratory systemlumbar spine
References
Case No. ADJ9533148
Regular
Apr 17, 2019

ANTHONY TAYLOR (deceased) vs. MERCED COUNTY SHERIFF’S DEPARTMENT

The Workers' Compensation Appeals Board granted reconsideration to reverse a prior finding of bad faith against the defendant, Merced County Sheriff's Department. The Board determined that the defendant acted within its legal rights to dispute the medical specialty for a Qualified Medical Evaluator (QME) and sought a replacement panel. Because the defendant's actions were permissible under regulations, they were not considered bad faith, thus rescinding the attorney's fees award. The Board otherwise affirmed the original decision regarding the appropriateness of an internal medicine specialist.

Workers' Compensation Appeals BoardMerced County Sheriff’s DepartmentAnthony Taylordeath benefitspancreatic cancercorrectional sergeantsepticemiabiliary tract obstructionQME panelinternal medicine
References
Case No. ADJ94 70576
Regular
Jun 26, 2017

CARLOS CAMARGO vs. COX PETROLEUM TRANSPORT, EM OIL TRANSPORT, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the applicant's Petition for Reconsideration, rescinded the original Finding and Order, and returned the case for further proceedings. The WCAB found that the primary medical evaluator's (QME) reports were not substantial evidence because they were based on incomplete and inaccurate history, and failed to consider the impact of industrial stress on the applicant's internal medicine conditions. Additionally, the WCAB determined that a separate evaluation by a psychology or psychiatry QME was warranted to address the applicant's psychiatric injury claim, as the internal medicine QME deferred to mental health specialists. Therefore, the record requires further development regarding both the physical and psychiatric aspects of the applicant's claimed industrial injuries.

AOE/COEQMEhypertrophic obstructive cardiomyopathyindustrial stresspsychiatric injuryDSM-IVLabor Code section 3208.3preponderance of the evidenceaggravated conditionsupplementation of the record
References
Case No. ADJ3453347
Regular
Jul 02, 2013

ARSHED QAZI vs. THE BOEING COMPANY, ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted Boeing's petition for reconsideration regarding a finding of 100% permanent disability for Arshed Qazi. The original award in April 2013 found Qazi sustained his injuries, including multiple physical conditions, while employed as a precision parts inspector. The Board is granting reconsideration to allow further study of the factual and legal issues to ensure a just and reasoned decision. Pending this review, all communications must be filed in writing with the Board's Commissioners.

WCABPetition for ReconsiderationFindings and Awardpermanent disabilitylumbar spinethoracic spinehypertensiondiabetesGERDobstructive sleep apnea
References
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