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

Case No. ADJ8789952
Regular
Nov 16, 2017

LISA STROTHER vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

This case involves Lisa Strother's claim for psychiatric injury due to cumulative trauma as a correctional officer. The Appeals Board granted reconsideration because the Agreed Medical Evaluator's (AME) report lacked specificity regarding the actual employment events causing the psyche injury and failed to properly apportion permanent disability. The Board found the AME's opinion on causation was not adequately detailed to determine if work events were the predominant cause. Therefore, the matter was returned to the trial level for further development of the record on these critical issues.

Workers' Compensation Appeals BoardLisa StrotherState of California Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8789952Fresno District OfficePetition for ReconsiderationFindings of Fact and AwardCorrectional Officer
References
Case No. ADJ663546
Regular
Oct 01, 2009

Sudha Rajender vs. TOBIN LUCKS, MALMQUIST, FIELDS & CAMASTRA

The WCJ found insufficient evidence of significant stress to support a conclusion that work stress contributed to applicant's coronary heart disease. The Board affirmed the WCJ's determination and denied the petition for reconsideration.

Workers' Compensation Appeals BoardSudha RajenderTobin LucksMalmquist Fields Camastracumulative trauma injurymyocardial infarctionQualified Medical EvaluatorDr. Gerald Bessespetition for reconsiderationindustrial causation
References
Case No. ADJ15763825
Regular
Sep 16, 2025

CLAUDIO CARDOZO vs. ROCK AND ROLL CAR WASH, REDWOOD FIRE AND CASUALTY INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the Petition for Reconsideration filed by Redwood Fire and Casualty Insurance Company dba Berkshire Hathaway Homestate Companies. The petition challenged a lien trial decision concerning a medical-legal evaluation performed by Dr. Michaels of Premier Psychological Services. The WCJ found that a medical dispute regarding psyche existed at the time of the evaluation, Dr. Michaels was validly designated as the Primary Treating Physician, and the evaluation was not barred by the 60-day rule for new claims as it was an amendment to an already accepted claim. The Appeals Board adopted the WCJ's reasoning and denied the petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code Section 5909Adjudication NumberOpinion and Order Denying PetitionWCJ ReportEAMS TransmissionNotice of TransmissionProof of ServiceFindings and Order
References
Case No. ADJ3874896 (LAO 0806283)
Regular
Feb 17, 2015

JESUS VERA vs. RELIABLE ENERGY CONCEPTS, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior decision disallowing a lien claimant's expenses. The Board found that Dr. Konstat's psychological evaluation constituted reasonable and necessary medical-legal expenses incurred due to a contested claim arising from the applicant's admitted injury and subsequent psychological distress. Consequently, Dr. Konstat is entitled to payment for her services, including penalties and interest pursuant to Labor Code section 4622. The original award for the applicant's physical injury had previously been approved.

Medical-legal expensesPetition for ReconsiderationFindings and AwardCompromise and ReleasePrimary Treating PhysicianPsychological injuryMajor Depressive Single Episode DisorderPosttraumatic Stress DisorderLabor Code section 4622Penalties and interest
References
Case No. ADJ10800397
Regular
May 20, 2019

MARILYN RAMIREZ GALVEZ vs. NIAGARA BOTTLING LLC, SAFETY NATIONAL INSURANCE CO.

The applicant sought a QME panel in psychology for a claimed psychiatric injury after orthopedic and internal medicine evaluations. The WCJ denied the request, finding no substantial medical evidence for a psychological QME. The Appeals Board granted removal, rescinded the WCJ's order, and found good cause for a psychological QME panel. This decision allows the applicant to pursue necessary medical-legal discovery regarding her disputed psychological injury claim.

Petition for RemovalFindings and OrderQualified Medical EvaluatorQME panelpsychologypsychiatric injurydiscoveryinternal medicineorthopedic QMEhypertension
References
Case No. ADJ9549773
Regular
Nov 13, 2015

EDWARD BAUTISTA vs. ARLON GRAPHICS, TRAVELERS

The Appeals Board dismissed the applicant's petition for reconsideration or removal, finding the WCJ's order was not a final determination. The WCJ correctly ordered the applicant to first discuss his anxiety symptoms and need for psychological referral with his primary treating orthopedist. Applicant is not entitled to a second opinion from a psychologist until the primary treating physician has diagnosed the anxiety or determined a referral is unnecessary. Commissioner Sweeney dissented, believing the applicant had an absolute right to an MPN second opinion for his psychiatric condition without first obtaining a referral from his orthopedist.

ADJ9549773Arlon GraphicsTravelersPetition for ReconsiderationPetition for RemovalWorkers' Compensation Appeals BoardWCJLabor Code Section 4616.3Labor Code Section 4616.4Administrative Director Rules
References
Case No. ADJ1863446 (AHM 0098759)
Regular
Jun 05, 2014

LAURA KOSCKI vs. CONSOLIDATED FREIGHTWAYS, INC., FIDELITY & GUARANTY INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to address apportionment of the applicant's psychiatric permanent disability. The Board rescinded the original award and substituted a new one, finding 15% of the applicant's psychiatric disability is due to nonindustrial litigation stress. The matter was returned to the WCJ to obtain a new rating reflecting this apportionment and to resolve deferred issues regarding permanent disability payments and life pension amounts. Clerical errors concerning injury location and temporary disability dates were also corrected.

Petition for ReconsiderationFindings Award and OrderQualified Medical Evaluatorapportionmentpsychiatric injuryindustrial injurynonindustrial stresslitigation stresstemporary disabilitypermanent disability
References
Case No. ADJ13030119
Regular
Apr 28, 2023

MARIA YESENIA JARAMILLO JIMENEZ vs. EL POLLO LOCO, TECHNOLOGY INSURANCE administered by AMTRUST

Lien claimant Nogales Psychological Counseling appealed an administrative law judge's decision disallowing its lien for services. The Workers' Compensation Appeals Board granted reconsideration to further review the matter. Subsequently, the parties entered into a stipulation, agreeing to settle the lien claim for $6,500.00. The Board rescinded the original decision and approved the stipulation as the final resolution of the dispute.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings of Fact and OrderWCJDisallowed LienStipulationSettlementRescindedApproved
References
Case No. ADJ2901317 (FRE0226671)
Regular
May 02, 2011

Connie Mehia vs. CITY OF FRESNO C/O AMERICAN ALL RISK LOSS ADMINISTRATORS (AARLA)

The applicant sought workers' compensation benefits for a stroke, claiming it arose out of and in the course of employment due to workplace stress. The Administrative Law Judge (WCJ) denied the claim, finding no credible evidence that a workplace incident caused the stroke. The Workers' Compensation Appeals Board (WCAB) affirmed the WCJ's decision, concluding that the applicant failed to prove the crucial element of a work-related precipitating event. Both QMEs opined the stroke could be industrially related, but their opinions relied on the applicant's account of a specific workplace argument that the WCJ found unsubstantiated.

AOE/COEindustrial strokeworkers' compensationreconsiderationcausationpre-existing conditionQualified Medical Examinercredibilitysubstantial evidencework-related stress
References
Case No. ADJ9368263, ADJ9380293
Regular
Sep 15, 2015

JOSE MELCHOR vs. BRUTOCAO VINEYARDS, STAR INSURANCE COMPANY

This case involves a defendant's petition for removal regarding an order for a second Qualified Medical Examiner (QME) panel concerning the applicant's head injury. The Workers' Compensation Appeals Board (WCAB) granted removal to correct a clerical error in the original order. The WCAB affirmed the necessity of a second QME to further develop the medical record on the head injury claim, specifically in the specialty of Psychology-Clinical Neuro Psychology.

Petition for RemovalSecond QME PanelHead InjuryMedical Record DevelopmentWCJ Duty to Develop RecordPQME SpecialtyPSNPsychology-Clinical Neuro PsychologyMandatory Settlement ConferenceLack of Diligence
References
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