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

Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ11225851
Regular
Oct 18, 2019

SUZAN ELSHAMI vs. C & A RESTAURANTS INC.; SAFETY NATIONAL CASUALTY CORPORATION, administered by BROADSPIRE

This case involves an applicant challenging a WCJ's decision regarding a Medical Provider Network (MPN) issue. The Appeals Board granted reconsideration solely to amend the order vacating submission, instructing further record development without vacating submission. The Board affirmed the WCJ's finding of injury AOE/COE, a threshold issue, while deeming the MPN development order interlocutory. The Board clarified that for MPN compliance, the network only needs at least three available primary treating physicians of an appropriate specialty within access standards.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalVacating SubmissionFurther Development of RecordThreshold IssueFinal DecisionInterlocutory IssueInjury Arising Out of and in the Course of Employment (AOE/COE)Medical Provider Network (MPN)
References
Case No. SAU8813471
Regular
Feb 07, 2023

KIMBERLY KENNEY vs. SEGUOYAH, INC., FARMERS INSURANCE EXCHANGE

The Workers' Compensation Appeals Board denied a lien claimant's petition for removal of an order consolidating liens and imposing a temporary stay. The consolidation aims to resolve a common legal issue regarding whether the lien claimant is controlled by a criminally charged physician, which would trigger an automatic stay under Labor Code section 4615. The Board found no due process violation, as the order only stays other lien issues pending the common issue's adjudication. Furthermore, the consolidation serves judicial efficiency by avoiding duplicate rulings on this critical threshold matter.

WCABPetition for RemovalOrder of Consolidation and StayLien ClaimantLabor Code section 4615Due ProcessIssue PreclusionConsolidation OrderWCJFarmers Insurance Exchange
References
Case No. ADJ8620013, ADJ10761228
Regular
Jun 08, 2017

MARK EBERWEIN vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration because it was not filed from a "final" order. The WCAB further denied the applicant's Petition for Removal, finding no showing of substantial prejudice or irreparable harm from denial. The WCJ's decision addressed an intermediate procedural or evidentiary issue, not a substantive right or threshold issue. Therefore, neither reconsideration nor removal was deemed appropriate at this stage.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFinal OrderSubstantive RightThreshold IssueInterlocutory DecisionProcedural IssueEvidentiary IssueExtraordinary Remedy
References
Case No. ADJ10652805
Regular
Nov 16, 2018

JESUS ARELLANO vs. RJP FRAMING, INC.; REDWOOD FIRE AND CASUALTY INSURANCE COMPANY, administered by BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The Workers' Compensation Appeals Board dismissed a petition for reconsideration because it was taken from a non-final interlocutory order. The order at issue, which closed discovery, did not determine substantive rights, liabilities, or a threshold issue fundamental to the claim. Therefore, it was not a final order as required for reconsideration under Labor Code sections 5900(a), 5902, and 5903. The Board also found no substantial prejudice or irreparable harm if the petition were treated as a request for removal.

Workers' Compensation Appeals BoardPetition for ReconsiderationFinal OrderInterlocutory OrderProcedural IssueEvidentiary IssueSubstantive RightLiabilityThreshold IssueRemoval
References
Case No. ADJ12384017
Regular
Jan 31, 2020

WESLEY VAUGHN vs. THE KROEGER COMPANY dba RALPHS GROCERY COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Appeals Board granted reconsideration and rescinded the WCJ's finding that the applicant did not properly predesignate his physician. The Board determined that the sole issue presented to the WCJ was too narrowly framed, failing to address the applicant's arguments regarding substantial compliance and the defendant's alleged failure to provide proper notice of predesignation rights. The case is remanded for further proceedings to address the issues of proper notice and denial of care, which are crucial for determining treatment outside the Medical Provider Network.

PredesignationPrimary Treating PhysicianMedical Provider Network (MPN)Notice RequirementsDenial of CareSubstantial ComplianceThreshold IssueInterlocutory IssueRemoval StandardPetition for Reconsideration
References
Case No. ADJ11446545
Regular
Dec 03, 2019

ROSA LOPEZ RODRIGUEZ vs. UNIVERSAL BUILDING SERVICES SUPPLY COMPANY, INSURANCE COMPANY OF THE WEST

This case concerns a dispute over the appropriate medical specialty for a Qualified Medical Evaluator (QME) panel. The applicant, Rosa Lopez Rodriguez, initially requested a chiropractic QME panel, which was issued first. The defendant objected, arguing that chiropractic was inappropriate due to the applicant's prior surgery and lack of full recovery. The Medical Unit then invalidated the chiropractic panel and issued an orthopedic surgery panel. The Workers' Compensation Appeals Board granted reconsideration, overturning the WCJ's decision. The Board held that the party who first requests a QME panel has the right to designate the specialty and that the defendant failed to provide sufficient grounds to invalidate the chiropractic panel. Therefore, the Board amended the findings to sustain the applicant's objection and affirm chiropractic as the appropriate panel specialty.

AD Rule 31.5(a)(10)AD Rule 31.5(a)(9)AD Rule 31.1(b)Labor Code section 4062Labor Code section 4062.2Qualified Medical Evaluator (QME)QME panel specialtyPetition for RemovalPetition for ReconsiderationMedical Unit determination
References
Case No. ADJ12205724
Regular
Jul 03, 2019

DENISSE LOPEZ vs. CHINO VALLEY UNIFIED SCHOOL DISTRICT, HCMS

The Workers' Compensation Appeals Board dismissed the Applicant's petition for reconsideration because it was not filed from a "final" order, as it only addressed an intermediate procedural or evidentiary issue. The Board also denied the petition for removal, finding no evidence of substantial prejudice or irreparable harm, nor that reconsideration would be an inadequate remedy. Consequently, the case proceeds as if no reconsideration or removal was granted.

WCABPetition for ReconsiderationPetition for RemovalFinal OrderSubstantive RightLiabilityThreshold IssueInterlocutory DecisionProcedural IssueEvidentiary Issue
References
Case No. ADJ10648626
Regular
Apr 27, 2018

LUBIA CASTANEDA vs. ELITE SUBLIMATION, INC., REPUBLIC UNDERWRITERS INSURANCE COMPANY

The Appeals Board dismissed Lubia Castaneda's petition for reconsideration because the WCJ's decision on venue was an interlocutory procedural issue, not a final order determining substantive rights or liabilities. Therefore, it was not a proper subject for reconsideration. The petition for removal was also denied as Castaneda failed to demonstrate substantial prejudice, irreparable harm, or that reconsideration would be an inadequate remedy.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFinal OrderSubstantive RightThreshold IssueInterlocutory DecisionProcedural IssueEvidentiary IssueExtraordinary Remedy
References
Case No. ADJ3521523 (OAK0322592), ADJ1332416 (WCK 0031685), ADJ4017994 (WCK 0029276)
Regular
Oct 25, 2016

PAMELA ZEILSTRA vs. TARGET STORES

The Workers' Compensation Appeals Board (WCAB) dismissed Pamela Zeilstra's petition for reconsideration because it was not filed from a "final" order. The WCAB determined that the workers' compensation judge's decision only addressed an intermediate procedural or evidentiary issue. Furthermore, the petition for removal was denied, as Zeilstra failed to demonstrate substantial prejudice or irreparable harm, or that reconsideration would not be an adequate remedy.

WCABPetition for ReconsiderationPetition for RemovalFinal OrderSubstantive RightThreshold IssueInterlocutory DecisionProcedural IssueEvidentiary IssueExtraordinary Remedy
References
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