CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ10954204
Regular
Sep 15, 2022

MARIA FLORES vs. PINNACLE HEALTH CORP., SUMMARY OF EVIDENCE INSURANCE COMPANY OF THE WEST, AFFINITY HOME HEALTH CARE SERVICES, FALLS LAKE FIRE & CASUALTY INSURANCE, SEDGWICK CMS, HOME HEALTH CARE SOLUTIONS, INC.

The Workers' Compensation Appeals Board denied a petition for reconsideration filed by Home Health Care Solutions. The applicant, an LVN, was injured in a car accident while traveling between patients for multiple agencies. The Board adopted the WCJ's report, which found the injury arose out of and occurred in the course of employment for Home Health Care Solutions. This decision was based on the fact that the applicant was required to use her own vehicle, which extended the employer-employee relationship beyond direct service. The WCJ also found the going and coming rule did not bar the claim due to the required use of transportation between patient locations.

Workers' Compensation Appeals BoardPetition for ReconsiderationGoing and Coming RuleAOE/COELVNCar AccidentAutomobile ExceptionTransitEmployment RelationshipRequired Vehicle Use
References
Case No. ADJ 1513511 (LBO 0279490)
Regular
Apr 15, 2016

RIZALINA DERRO vs. KAISER PERMANENTE, WEST ANAHEIM MEDICAL CENTER, TERRACE VIEW CONVALESCENT HOSPITAL, COVENANT CARE, SOUTH GATE CARE CENTER, BROADSPIRE, SUN HEALTH CARE, AIG CLAIM SERVICES, CNA CLAIMS PLUS

The Workers' Compensation Appeals Board (WCAB) is issuing a notice to rescind a prior WCJ decision and remand the case to the WCJ for further record development. This action follows a Court of Appeal order directing the WCAB to address the causation issue regarding the applicant's left wrist injury and employment with Sun Health Care. The WCAB, in its response to the Court, indicated the need for further medical record development on this causation issue. The Court of Appeal dismissed the applicant's petition for review, granting the WCAB's request for remand.

Workers' Compensation Appeals BoardKaiser PermanenteWest Anaheim Medical CenterTerrace View Convalescent HospitalCovenant CareSouth Gate Care CenterBroadsireSun Health CareAIG Claim ServicesCNA Claims Plus
References
Case No. ADJ11059073
Regular
Jan 17, 2023

SHERRILL CLAYTOR vs. ALEXANDER R. LATTERI, M.D., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) affirmed a prior decision allowing the applicant to treat with Dr. Spencer outside the defendant's Medical Provider Network (MPN). The WCAB found insufficient evidence that Dr. Spencer, or the applicant's previously selected physician Dr. Small, were definitively part of the defendant's MPN at the time of the request. Therefore, without proper MPN notification and an established denial of care, the applicant retained the right to resume treatment with her non-MPN physician, Dr. Spencer. The defendant may still attempt to transfer the applicant's care into the MPN by following proper statutory procedures.

MPNPTPmedical provider networkprimary treating physicianreconsiderationfindings and ordertransfer of caredenial of caresubstantial evidenceadministrative director rules
References
Case No. ADJ3301572
Regular
Apr 12, 2011

Amelia Compton vs. Atwater Elementary School District

This case involves a lien claimant seeking reimbursement for chiropractic care exceeding the standard 24-visit limit. The lien claimant argued entitlement to these additional visits for care management, citing precedent that allows such extensions. Initially denied by the WCJ, the lien claimant's petition for reconsideration was granted by the Appeals Board. The Board rescinded the prior order and remanded the case for further proceedings to address the validity of the extended chiropractic care.

Workers' Compensation Appeals BoardLien claimantReconsiderationFindings of Fact and OrderChiropractic careLabor Code section 5313Jose Facundo-Guerrero v. Workers' Comp. Appeals Bd.Nurserymen'sSection 4604.5Manage patient care
References
Case No. ADJ232612 (LAO 0788310) ADJ2801338 (LAO 0778371)
Regular
Mar 05, 2020

JUAN BAUTISTA vs. DYNASTY CLEANERS, MID-CENTURY INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) rescinded a prior award of 16 hours per day of home health care services. The Board found that while the applicant's need for care was industrially caused, the prior decision improperly granted the award without fully addressing statutory requirements regarding prescriptions and the start date of employer liability. The case is returned to the trial level to determine when the employer's liability for home health care services commenced, considering the requirements of Labor Code section 4600(h) and prior case law. The WCAB emphasized the employer's duty to investigate and provide benefits promptly upon notice of injury.

Workers Compensation Appeals BoardReconsiderationHome Health Care ServicesAgreed Medical EvaluatorLabor Code Section 4600(h)Prescription RequirementDuty to InvestigateReasonable NecessityAOE/COEFuture Medical Treatment
References
Case No. AD 6745689
Regular
Aug 30, 2010

JORGE PEREZ vs. TK SYSTEMS, INC., INSURANCE COMPANY OF THE WEST

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior award, and remanded the case for further proceedings. The Board found that while family providing attendant care is compensable, crucial medical evidence was lacking to determine the appropriate rate for the services. Specifically, there was no medical evidence establishing the necessity of medication administration by the caregiver. The matter is returned to the trial level for development of the record on applicant's home care needs and the cost of such services.

attendant carereasonable valueindustrial injury24 hour caremedication administrationmedical evidencehome care needsLVNregistered nurselive-in caregiver
References
Case No. ADJ4446673 (AHM 0130995)
Regular
Oct 13, 2020

OCTAVIO ARTURO ANAYA vs. CARLOS SANDOVAL DBA SANDS TRANSPORT, STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the applicant sought an increased hourly rate for attendant care services provided since January 1, 2020. The defendant argued the Administrative Law Judge erred by modifying a 2013 stipulation award outside the five-year statutory period under Labor Code section 5804. The Appeals Board granted reconsideration, affirming the increased rate by distinguishing enforcement of awards under section 5803 from modification under section 5804. The Board clarified that the 2013 award's provision for ongoing attendant care allowed for adjustments based on reasonable costs, without violating the five-year limitation.

Workers' Compensation Appeals Boardattendant care serviceshourly rateStipulation Award OrderLabor Code section 5803Labor Code section 5804petition for reconsiderationadministrative law judgehome health carewage analysis report
References
Case No. ADJ7019734, ADJ7019744
Regular
Dec 21, 2015

WAJID KHAN vs. DAVITA, INC., INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

This Workers' Compensation Appeals Board case involves applicant Wajid Khan's petition for reconsideration of a prior award. The Administrative Law Judge found Khan's occupational group number to be 212, resulting in a 69% permanent disability rating. Khan argued for a higher rating based on his duties also fitting occupational group 340, but the Board denied reconsideration. The Board found insufficient evidence to support Khan's dual occupational classification and noted his procedural violation by attaching inadmissible evidence to his petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAdministrative Law JudgePermanent DisabilityOccupational Group NumberDialysis TechnicianPatient Care TechnicianConsultative Rating DeterminationWCAB Rule 10166(b)
References
Case No. ADJ7959316 ADJ8228747
Regular
Jul 05, 2018

ALAN LIVHITS vs. DEPENDABLE CARE TRANSPORTATION, DEPENDABLE CARE AMBULANCE, SUSSEX INSURANCE COMPANY, CALIFORNIA INSURANCE COMPANY, PRAETORIAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to address defendant California Insurance Company's (CIC) contentions. CIC disputes the arbitrator's finding that applicant was not employed by Dependable Care Ambulance and argues that certain insurance policies should provide coverage under equitable principles. The Board found the arbitrator's decision lacked an adequate evidentiary record, specifically noting the failure to admit and clearly identify documentary evidence. Therefore, the matter is returned to the arbitrator to create a complete record before issuing a new decision.

ADJ7959316ADJ8228747Dependable Care TransportationDependable Care AmbulanceCalifornia Insurance CompanyPraetorian Insurance CompanySussex Insurance CompanyPetition for ReconsiderationArbitratorLabor Code Section 5500.5
References
Showing 1-10 of 834 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational