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. 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. ADJ7267845
Regular
Feb 21, 2012

JOSE ACEVEDO vs. TREND PERSONNEL, CHARTIS INSURANCE, GALLAGHER BASSETT SERVICES

This case concerns whether medical liens for treatment rendered after December 18, 2008, are valid. The primary treating physician, Dr. Hoegel, released the applicant from care on that date, and the applicant failed to object to this determination under Labor Code sections 4061 and 4062. Therefore, the applicant could not designate a new primary treating physician and any subsequent treatment liens are barred. The Appeals Board granted reconsideration to clarify that the applicant's failure to follow statutory objection procedures invalidates post-release medical liens.

Workers' Compensation Appeals BoardReconsiderationDecision After ReconsiderationFindings of Facts Re: LiensTenet/Centinela Hospital Medical Center v. Workers' Comp. Appeals Bd. (Rushing)Primary Physician's Permanent and Stationary ReportCompromise and ReleaseLien ClaimantsLabor Code section 4061(b)Labor Code section 4062(a)
References
Case No. ADJ9099900
Regular
May 04, 2015

JESSEKA BETTS vs. YMCA OF THE EAST VALLEY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, affirming a prior award. The applicant, a YMCA site director, sustained injuries in a car accident while en route to a work-related meeting. The Board found that the "required vehicle exception" to the going and coming rule applied, as the applicant was required to use her personal vehicle for her job duties, for which she was reimbursed mileage. Therefore, her injuries were deemed to have arisen out of and in the course of employment.

Workers' Compensation Appeals Boardgoing and coming defenserequired vehicle exceptionmaterial deviationwork-related meetingmileage reimbursementsplit shiftssite directorcar insurancelicensing inspection
References
Case No. ADJ2186877 (VNO 0522117)
Regular
Jan 07, 2011

JODY LATOUF vs. STUMBAUGH & ASSOCIATES, INC., TIG SPECIALTY INSURANCE COMPANY as administered by RISK ENTERPRISE MANAGEMENT, LTD., STATE COMPENSATION INSURANCE FUND.

The Workers' Compensation Appeals Board denied TIG Specialty Insurance Company's petition for reconsideration. TIG claimed its policy only covered non-carpenter employees at the LAUSD site. However, TIG failed to present the policy as evidence at either arbitration hearing. Therefore, the Board inferred the policy did cover the applicant's employment, upholding the arbitrator's decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationArbitrator's ReportSite-Specific PolicyEvidenceCoverage IssueInferenceTIG Specialty Insurance CompanyStumbaugh & AssociatesInc.
References
Case No. ADJ11314069
Regular
Nov 20, 2018

LUIS TOLENTINO vs. LUKE'S ROOFING, REDWOOD FIRE INSURANCE COMPANY

This case concerns the proper designation of a primary treating physician within a Medical Provider Network (MPN). The applicant selected Dr. Huang, who was employed by Casa Colina. The defendant argued this was improper because Casa Colina was only listed for ancillary services and Dr. Huang was not individually listed in the MPN. The Board affirmed the WCJ's decision, holding that Dr. Huang's designation was proper as long as he acted through Casa Colina, which was included in the MPN without restriction. Regulations permit an entity in the MPN to have its employee physicians considered part of the network, unless specifically excluded.

Workers' Compensation Appeals BoardPetition for ReconsiderationPrimary Treating PhysicianMedical Provider Network (MPN)Ancillary ServicesEmployee PhysicianNon-natural personApplicable RegulationsEntityEmployee
References
Case No. ADJ7039301
Regular
Mar 16, 2011

ROBLY HART vs. LA JOLLA PACIFIC/DRR NEFF & ASSOCIATES, OAKS RIVER INSURANCE/BERKSHIRE HATHAWAY HOMESTATE COMPANIES

This case concerns Robly Hart's workers' compensation claim for an injury sustained in a motorcycle accident. The applicant was a construction consultant who used his motorcycle for work, traveling between home, job sites, and interviews. The primary dispute centers on whether the accident occurred during the course and scope of his employment, with conflicting evidence regarding his activities and timeline leading up to the incident. The Workers' Compensation Appeals Board denied reconsideration, adopting the judge's report that found the applicant's testimony lacked credibility due to inconsistent statements and timeline discrepancies.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJGarza v. Workers' Comp. Appeals Bd.Findings and OrderCourse of EmploymentConstruction ConsultantBuilding InspectorMotorcycle TravelJob Sites
References
Case No. ADJ9145724
Regular
Jun 01, 2015

ARZAGA, JOSE vs. CROWN AUTOMOTIVE, INC., AMTRUST NORTH AMERICA

This case involves an applicant seeking to select a pain management specialist outside his employer's Medical Provider Network (MPN). The applicant argued the MPN failed to provide a qualifying specialist within the required 15-mile/30-minute access standard for a primary treating physician. The Board denied the employer's petition for reconsideration, affirming the applicant's right to choose an out-of-network physician and reimbursement for investigative costs. The majority reasoned that the MPN must meet the closer access standard for a primary treating physician, even if that physician is a specialist. A dissenting opinion argued that a specialist, when chosen as a primary treating physician, should fall under the 30-mile/60-minute access standard for specialists.

Medical Provider NetworkMPNprimary treating physicianpain management specialistaccess standardAdministrative Director's Rule 9767.5investigative costsLabor Code section 5703Lescallett v. Wal-MartMartinez v. New French Bakery
References
Case No. ADJ7422993
Regular
Apr 06, 2015

SHIRLEY LESCALLETT vs. WAL-MART, ACE AMERICAN INSURANCE, YORK RISK SERVICES

In this workers' compensation case, the applicant sought to select a pain management specialist as her primary treating physician. The employer's Medical Provider Network (MPN) did not have any pain management specialists within the 15-mile/30-minute access standard for primary physicians, though it did have specialists within a 30-mile/60-minute radius. The Appeals Board affirmed the WCJ's decision, holding that if an applicant chooses a specialist for their primary care, the MPN must provide at least three physicians of that specialty within a 15-mile/30-minute radius. Since the defendant's MPN failed to meet this standard for pain management specialists, the applicant was permitted to choose one outside the MPN. A dissenting opinion argued that the 30-mile/60-minute standard for specialists should apply, allowing the applicant to select a physician within that broader radius from the MPN.

MPNMedical Provider NetworkPrimary Treating PhysicianSpecialistAccess StandardsAdministrative Director's RulePain Management PhysicianGeographic RadiusLabor CodeWorkers' Compensation Appeals Board
References
Case No. ADJ7568484
Regular
Nov 14, 2014

CHERISH ORANJE vs. CRESTWOOD BEHAVIORAL HEALTH, NATIONAL UNION FIRE INSURANCE COMPANY

This case involves a workers' compensation applicant residing in Nevada who was receiving telephonic therapy from a California-licensed Marriage and Family Therapist. The defendant sought reconsideration, arguing that the telephonic therapy violated Nevada law as the therapist was not licensed in Nevada. The Workers' Compensation Appeals Board denied the petition, holding that California law governs treatment for injuries sustained in California, and the teletherapy in question complied with California's telehealth statutes. The Board concluded that the therapist's location in California while providing services to a Nevada resident did not violate California law, and any potential violation of Nevada law was irrelevant to the California workers' compensation claim.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderMedical TreatmentTelephonic TherapyMarriage and Family TherapistTelemedicine Development ActTelehealth Advancement ActBusiness and Professions CodeSynchronous Interaction
References
Case No. SFO 0496923
Regular
Jan 15, 2008

ROBERT THOMPSON (Deceased) NATALIA THOMPSON (Widow) vs. STATE OF CALIFORNIA, CALIFORNIA HIGHWAY PATROL, Legally Uninsured; STATE COMPENSATION INSURANCE FUND, Adjusting Agency

This case concerns a California Highway Patrol officer who died from melanoma. The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior award of death benefits, and found the injury was not industrial. The Board concluded the applicant failed to demonstrate a reasonable link between his employment and the melanoma, citing non-industrial risk factors such as childhood sun exposure and family history.

Workers' Compensation Appeals BoardRobert ThompsonNatalia ThompsonCalifornia Highway PatrolLegally UninsuredState Compensation Insurance FundSFO 0496923Opinion and Order Granting ReconsiderationDecision After ReconsiderationFindings and Award
References
Showing 1-10 of 884 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