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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ8396609
Regular
Sep 20, 2013

KELLY SNOW vs. HEALTH NET, INC., SEDGWICK CMS

The Appeals Board granted the applicant's Petition for Removal, rescinding prior orders that compelled the release of her psychotherapist's records and quashed subpoenas. The applicant argued these records were privileged psychotherapist-patient communications, and the therapist was not a physician or psychologist, thus their records were not discoverable for QME review. The Board found that while the psychotherapist-patient privilege exists, it is subject to waiver when mental condition is placed in issue by the patient, but this waiver is limited to relevant records. The case was returned to the trial level to determine if Ms. Bradley's records are relevant to the disclosed psychiatric injury or unrelated.

Petition for RemovalPetition to Quash Subpoena Duces TecumPsychotherapist-patient privilegeQualified Medical EvaluatorLabor Code section 3209.3Administrative Director Rule 35Evidence Code section 1010Holder of the privilegeEvidence Code section 1013Evidence Code section 1014
References
Case No. ADJ8424952
Regular
Sep 10, 2014

ALFONSO CRUZ vs. SIERRA CIRCUITS, INC.; THE HARTFORD

This case involves an applicant's petition for removal regarding deposition questions about medical history and insurance coverage. The Workers' Compensation Appeals Board (WCAB) granted the petition in part, allowing questions about medical insurance and personal doctors, as these are discoverable under CCP § 2017.010. However, the WCAB found questions about past medical treatment paid by others and prior hospitalizations to be overbroad, as they could infringe on the physician-patient privilege regarding unrelated conditions. The Board ordered the applicant to answer specific questions but requires defendants to reframe broader questions concerning medical history to avoid privileged information.

Petition for RemovalFifth AmendmentFirst Amendmentphysician-patient privilegeconfidential communicationindustrial injurymedical historydeposition questionsCode of Civil Procedure section 2017.010Evidence Code sections 990
References
Case No. POM 234030
Regular
Jul 18, 2008

CAROL ALLISON vs. DEL AMO MOBILE ESTATES, SUPERIOR PACIFIC CASUALTY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the administrative law judge's finding that Labor Code section 5710 does not allow attorney's fees for appellate work. The WCAB ruled that attorney fees are permissible under section 5710 for successfully litigating the scope of a deposition, including appellate proceedings, to protect an applicant's privacy and privilege. The case was returned to the trial level for a determination of a reasonable attorney fee amount.

Labor Code section 5710attorney feesdeposition scopeprivilegepatient-physician privilegemotion to compelpetition for removalCourt of Appealappellate reviewvocational rehabilitation maintenance allowance (VRMA)
References
Case No. ADJ9750218
Regular
Oct 07, 2015

RAMIRO LOPEZ vs. PENTERMAN FARMING COMPANY, INSURANCE COMPANY OF THE WEST

The Workers' Compensation Appeals Board denied the defendant's petition for removal, upholding a WCJ's order limiting discovery of medical records to the applicant's musculoskeletal system. The defendant argued this limitation denied due process and prejudiced their defense, but the Board found that the applicant only waives physician-patient privilege for conditions put in issue by the claim. Discovery beyond the claimed injury must be demonstrably relevant and justified by specific information, which the defendant failed to establish. The Board concluded the WCJ's order appropriately balanced the applicant's privacy with the defendant's discovery needs.

Petition for RemovalSubpoenas Duces TecumOrder Limiting SubpoenasMusculoskeletal SystemDue ProcessMotion to QuashDeclaration of ReadinessPatient-Litigant ExceptionPhysician-Patient PrivilegeScope of Discovery
References
Case No. ADJ7685567
Regular
Feb 12, 2015

KATHLEEN O'NEAL vs. HALE ALOHA/MARK ONE CORPORATION, CALIFORNIA SELF-INSURERS' SECURITY FUND

This case involves a dispute over authorization for cervical surgery for applicant Kathleen O'Neal. The defendant argued that Dr. McCormack, who recommended the surgery, was a one-time consultant, not a treating physician, and thus his request for authorization was not subject to utilization review (UR). The Workers' Compensation Appeals Board (WCAB) affirmed the judge's order, finding Dr. McCormack acted as a treating physician by undertaking to obtain authorization and proceed with the surgery. Therefore, the defendant's failure to submit Dr. McCormack's request for authorization to UR in a timely manner meant the UR denial was invalid. The WCAB concluded the defendant was obligated to provide the surgery as it was supported by substantial medical evidence and reasonably necessary.

Utilization ReviewAuthorization RequestTreating PhysicianConsulting PhysicianPrimary Treating PhysicianSecondary Treating PhysicianWorkers' Compensation Appeals BoardAdministrative Director's RuleTimelinessJurisdiction
References
Case No. ADJ262420 (ANA0302091)
Regular
Nov 15, 2011

ROBERT ORNELAS vs. SANTA ANA UNIFIED SCHOOL DISTRICT

Both the applicant and the defendant petitioned for reconsideration of the original Findings and Award concerning a lien for living expenses. The applicant argued the judge relied on privileged physician-patient information, while the defendant claimed the lien claimant failed to meet her burden of proof. The Workers' Compensation Appeals Board denied both petitions, adopting the judge's reports which recommended denial. This decision follows previous appeals and remands, reaffirming the original award.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPhysician-Patient PrivilegeLien HolderLiving ExpensesBurden of ProofWCJ ReportDenial of PetitionAdministrative Law Judge
References
Case No. ADJ10975151
Regular
Jan 06, 2020

RUSSELL CAMARA vs. TESLA, INC., AMERICAN ZURICH INSURANCE COMPANY

In this workers' compensation case, the Applicant sustained an admitted industrial injury to the lumbar spine. The Applicant's primary treating physician (PTP) designated a secondary physician to evaluate permanent and stationary status and impairment, whose report the PTP adopted. The defense challenged the validity of this secondary physician's report, arguing only the Panel Qualified Medical Examiner's (PQME) report was properly obtained. The Workers' Compensation Appeals Board denied the Petition for Reconsideration, affirming that the PTP, or a physician designated by the PTP, is authorized to render opinions on medical issues, provided proper notice and procedural requirements are met. The Board found the designation and subsequent report were compliant with Labor Code and Administrative Director Regulations.

Workers' Compensation Appeals BoardPetition for ReconsiderationPrimary Treating PhysicianQualified Medical ExaminerLabor Code Section 4061.5Permanent and Stationary ReportMedical-Legal EvaluationSecondary PhysicianAdministrative Director Rule 9785Designation of Physician
References
Case No. ADJ18027061
Regular
Sep 10, 2025

HEATHER TILLER KELLEY vs. SACRAMENTO CITY UNIFIED SCHOOL DISTRICT

Defendant Sacramento City Unified School District sought reconsideration of a WCAB decision that found applicant Heather Tiller Kelley sustained industrial injuries and that reports from her treating physicians (Mark Zuber, D.C., Adrienne Pasek, Psy.D., and Kasra Maasumi, M.D.) were admissible. Defendant argued these physicians lacked a proper treatment relationship and that the reports were improperly obtained. The Workers' Compensation Appeals Board denied the petition for reconsideration, affirming that defendant relinquished medical control by denying liability, allowing applicant to self-procure treatment, and thus the treating physician reports were admissible in proceedings.

WCABPetition for ReconsiderationOpinion and Order Granting PetitionAdmissible EvidenceTreating PhysiciansMedical-Legal ReportsLabor Code Section 4062.2Self-Procured TreatmentRemoval StandardPermanent and Stationary Status
References
Case No. SBR 0338656
Regular
May 27, 2008

BRYAN YOUNG vs. CITY OF BEAUMONT, Permissibly Self-Insured c/o S.C.R.M.A.

The Workers' Compensation Appeals Board vacated its prior order granting reconsideration, dismissed the applicant's petition, and granted removal. The Board rescinded the administrative law judge's order requiring the applicant to choose a physician from the employer's network. This decision clarifies that an employee has the right under Labor Code section 4605 to select and pay for their own physician, independent of employer-provided medical care.

Workers' Compensation Appeals BoardBryan YoungCity of BeaumontPetition for ReconsiderationPetition for RemovalLabor Code Section 5902Labor Code Section 4605Medical Provider NetworkPrimary Treating PhysicianConsulting Physician
References
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