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

Case No. ADJ10104251 ADJ10104255
Regular
Aug 01, 2017

MARCELINO PALMA vs. EVAN HUMPHREYS LANDSCAPE DEVELOPMENT, FIRST COMP dba MARKEL INSURANCE SERVICES

The Workers' Compensation Appeals Board denied a petition for removal by defendant Markel Insurance Company. The defendant sought removal due to the WCJ ordering two additional Qualified Medical Evaluation (QME) panels in ophthalmology and psychology, arguing it caused prejudice and cost. However, the Board found no substantial prejudice or irreparable harm, noting the defendant's counsel explicitly stated "No, your Honor" when asked for objections to the orders. The decision to develop the record via additional QMEs was within the WCJ's discretion.

Petition for RemovalWorkers' Compensation Appeals BoardQualified Medical EvaluationOphthalmologyPsychologyWCJ discretionsubstantial prejudiceirreparable harmLabor Code Section 3600(a)(10)specific injury
References
Case No. ADJ2472893 (MON 0312714)
Regular
Jul 07, 2009

GABRIEL VALDEZ vs. KNOLLS ASSOCIATES, LLC, STATE COMPENSATION INSURANCE FUND

This case concerns the applicable permanent disability rating schedule for an admitted industrial injury that occurred in 2003. The defendant sought reconsideration, arguing the 2005 Schedule should apply. However, the Board denied reconsideration, upholding the Workers' Compensation Judge's decision to use the 1997 Schedule. This was based on a pre-2005 medical report by Dr. Richlin, which provided substantial evidence of the existence of permanent ophthalmological disability factors and work restrictions. The defendant's selective quoting of Dr. Richlin's report was found to be an incomplete representation of the evidence.

Workers' Compensation Appeals BoardIndustrial InjuryPermanent Disability1997 Schedule2005 ScheduleMedical-Legal ReportSubstantial EvidenceLabor Code Section 4660(d)Ocular DisabilitySubjective Factors
References
Case No. ADJ10583010
Regular
Mar 14, 2019

BLANCA RUANO vs. JACKSON ENGINEERING CO., MIDDLESEX INSURANCE CO.

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the WCJ's Finding and Award. The applicant sought additional QME panels in internal medicine and ophthalmology, claiming the existing record lacked substantial evidence for injury AOE/COE to her eyes and digestive system. However, the Board found no good cause for further development, noting neither the AME nor treating physicians recommended these specialties, and the applicant failed to demonstrate due diligence in pursuing discovery for these body parts. Therefore, the applicant's petition for reconsideration was denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAOE/COEUpper ExtremitiesBilateral ElbowsBilateral WristsQualified Medical Evaluator (QME)Internal MedicineOphthalmology
References
Case No. ADJ591396 (SAC 0355722)
Regular
Jan 25, 2019

MARY LOU TUFTS vs. WISHING WELL ENTERPRISES INC., STATE COMPENSATION INSURANCE FUND

This case involves cross-petitions for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision. The original decision found the applicant sustained injury to her back, eyes, and psyche, awarding permanent disability and temporary total disability, but no wage loss. The WCAB granted reconsideration to both parties, rescinded the original Findings and Award, and returned the case for further development of the record. This was primarily due to issues with the substantiality of evidence regarding the applicant's psychiatric injury and disagreements over temporary disability for cataract surgeries.

Petition for ReconsiderationFindings and AwardWorkers' Compensation Appeals BoardAdministrative Law JudgeTemporary Total DisabilityPermanent Partial DisabilityFuture Medical TreatmentSubstantial EvidencePsychiatric InjuryOphthalmology
References
Case No. ADJ12202677
Regular
Jun 18, 2025

ANA MONZON vs. IHOP, TECHNOLOGY INSURANCE COMPANY

Applicant Ana Monzon sought reconsideration of an April 1, 2025 Findings, Awards and Order (F&A) regarding an industrial injury sustained while employed as a waitress for IHOP. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, rescinded the F&A, and deferred issues related to permanent disability, apportionment, and attorney fees. The matter was returned to the trial level for further development of the record, particularly concerning psychiatric impairment. The WCAB affirmed the WCJ's original finding that the applicant did not sustain injuries to her eyes or internal systems.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Awards and OrderQualified Medical Evaluatortreating physicianindustrial injurycervical spineright shoulderpsycheophthalmology
References
Case No. ADJ15406376
Regular
Nov 03, 2025

Francisco Mendoza Olivares vs. Barrett Business Services, Inc.; Ace American Insurance Company

Applicant Francisco Mendoza Olivares sought reconsideration of a WCJ's Findings of Fact and Order dated July 25, 2025, which determined he did not sustain an injury arising out of and in the course of employment to multiple body parts. The applicant argued the WCJ applied an incorrect legal standard for causation and requested further medical evaluations. The Workers' Compensation Appeals Board granted the petition for reconsideration, concluding that the record requires further development to ascertain if substantial evidence supports the WCJ's initial decision regarding the injury's causation and to clarify whether the claim involves a specific injury or a cumulative injury. A final decision on the merits of the reconsideration is deferred.

Chagas diseasecumulative injuryinsect bitecardiacneurologyophthalmologyENTgastritisneuropathychronic pain
References
Case No. ADJ461140 (MON 0313465) ADJ7648143
Regular
Jul 10, 2013

MARIA MARTIN vs. KAISER PERMANENTE

The Workers' Compensation Appeals Board denied Kaiser Permanente's petition for reconsideration. The Board adopted the WCJ's report, finding the defendant's factual misstatement regarding Dr. Sohn's apportionment testimony significant. Despite Kaiser's assertions, the Board affirmed the applicant's 100% permanent total disability after applying a small portion of non-industrial apportionment to the lumbar spine. This apportionment did not alter the applicant's inability to compete in the open labor market.

Workers' Compensation Appeals BoardKaiser PermanentePetition for ReconsiderationDeniedWCJDr. SohnLumbar SpineNon-Industrial ApportionmentPermanently Totally DisabledBenson Case
References
Case No. ADJ1498865 (WCK 0071162) ADJ3989369 (WCK 0071163)
Regular
Sep 20, 2013

Michelle Livengood vs. State of California, National Union Fire Insurance Company

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of a decision terminating temporary disability benefits. The applicant's medical condition stemming from three 2000 injuries has been complex, with a history of extensive litigation. The Administrative Law Judge found no evidence of ongoing temporary disability, concluding the applicant's condition was permanent and stationary. The Board adopted the judge's reasoning, denying reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary Disability IndemnityPark AideSomatoform ReactionMedical EvaluationNeurological ConsultationDiscogramEEGOphthalmological Evaluation
References
Case No. ADJ1457992 (AHM 0084718)
Regular
Dec 26, 2014

DARLENE HELLER vs. COWELL BAKER'S STRIPPING SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, SEDGWICK CMS, FREMONT INSURANCE COMPANY

This case concerns a dispute over the correct procedure for obtaining medical reevaluations for a worker's injury with a date prior to January 1, 2005. The Appeals Board denied the applicant's petition for reconsideration, reversing an earlier decision that had directed the parties to use the panel QME process. The Board clarified that for pre-2005 injuries, the pre-Senate Bill 899 AME/QME procedures apply, not the current section 4062.2 QME process. One Commissioner dissented, arguing the prior award should be reinstated.

Workers' Compensation Appeals BoardPetition for ReconsiderationOpinion and Order DenyingFindings and AwardLabor Code section 4062.2panel qualified medical examinationQMEdisputed body partsadmitted liabilitydate of injury
References
Case No. SAL SJO 252436 (MF); SJO 246192
Regular
Jul 02, 2007

NIHAL HORDAGODA vs. State Compensation Insurance Fund

This case involves an employer's petition for reconsideration of an order authorizing medical treatment and admitting the Qualified Medical Examiner's (QME) reports. The employer argued the QME reports were inadmissible due to an alleged ex parte communication between the applicant and the QME, and that the awarded treatments were improper. The report recommends denying the petition, finding the communication was permissible under LC § 4062.3(h) and that the QME's opinions and awarded treatments for chronic pain were reasonable and not governed by ACOEM guidelines.

Workers' Compensation Appeals BoardPetition for ReconsiderationQualified Medical EvaluatorLabor Code Section 4062.3Ophthalmological evaluationFunctional capacity evaluationUtilization ReviewACOEM GuidelinesChronic spinal conditionTreating physician
References
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