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. ADJ1735018
Significant
Jun 03, 2010

CYNTHIA BLACKLEDGE vs. BANK OF AMERICA, ACE AMERICAN INSURANCE COMPANY

This en banc decision clarifies the distinct roles of the evaluating physician, the workers’ compensation administrative law judge (WCJ), and the disability rater in determining whole person impairment (WPI) under the AMA Guides, and remands the specific case for reassessment of the permanent disability.

AMA GuidesWhole Person ImpairmentPhysician's RoleWCJ's RoleRater's RoleFormal RatingPermanent DisabilitySubstantial EvidenceDRE Lumbar Category IIPatellofemoral Pain Syndrome
References
33
Case No. ADJ3540065
Significant

Bradley Maxham, Applicant vs. California Department of Corrections and Rehabilitation, State Compensation Insurance Fund

The Appeals Board granted the employer's petition for removal, holding that a 'communication' to an Agreed Medical Evaluator (AME) can be considered 'information' under Labor Code § 4062.3 if it contains, references, or encloses medical or non-medical records, and returned the matter to the trial level for reassessment.

RemovalPetition for RemovalAgreed Medical EvaluatorAMELabor Code § 4062.3WCAB Rule 35InformationCommunicationAdvocacy LetterSubstantial Evidence
References
20
Case No. SFO 0459179
Regular
Feb 25, 2008

MELINDA COSTELLO vs. ASCENSION HEALTH/MOUNT ST. JOSEPH/ST. ELIZABETH, SEDGWICK CLAIMS MANAGEMENT SERVICES, GLIDE MEMORIAL UNITED METHODIST CHURCH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to address issues regarding the date of injury and cumulative exposure periods for applicant Melinda Costello. The Board rescinded the prior order and remanded the case for further development of the record concerning whether there were one or two cumulative injuries. This is necessary to properly reassess liability between Ascension Health and State Compensation Insurance Fund under Labor Code Section 5500.5.

Workers' Compensation Appeals BoardAscension HealthSedgwick Claims Management ServicesState Compensation Insurance FundGlide Memorial United Methodist ChurchLabor Code Section 5500.5Labor Code Section 5412Cumulative InjuryDate of InjuryInjurious Exposure
References
7
Case No. ADJ4157066 (FRE 0207236)
Regular
Jul 01, 2009

PORFIRIO ABRAJAN vs. JOSE OCHOA FARM LABOR SERVICES, INC., VARIOUS EMPLOYERS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted SCIF's petition for reconsideration, rescinding the Arbitrator's prior order. The Board found the Arbitrator erred by incorrectly shifting the burden of proof to SCIF to disprove the reasonableness of the facility fees. Instead, the Board clarified that lien claimants, as the affirmative party, always bear the burden of proving their charges are reasonable. The case was returned to the Arbitrator to apply the correct legal standard and reassess the evidence.

Workers' Compensation Appeals BoardPorfirio AbrajanJose Ochoa Farm Labor ServicesState Compensation Insurance FundADJ4157066ReconsiderationFacility FeesOutpatient Surgical ProceduresIngenix methodologyLien Claimants
References
14
Case No. ADJ187555
Regular
Dec 06, 2011

IGNACIO ZENDEJAS vs. SALSBURY ENGINEERING & GRADING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board dismissed the applicant's Petition for Removal and granted his Petition for Reconsideration. The Board found the original decision lacked proper documentation in the EAMS system and failed to address several key issues. Consequently, the Board rescinded the original Findings and Award and returned the case to the trial level for further proceedings and a new decision by the WCJ. This includes reassessing the Cost of Living Allowance, attorney's fees, penalties, and a child support lien.

Petition for RemovalPetition for ReconsiderationFindings and AwardWorkers' Compensation Judge (WCJ)Labor Code section 5313Cost of Living Allowance (COLA)Labor Code section 4659Permanent Total DisabilityChild Support LienAttorney's Fees
References
6
Case No. ADJ7399938 ADJ7068967
Regular
Jun 23, 2015

OLENA GARCIA vs. RESIDENCE INN, NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PENNSYLVANIA

The Appeals Board granted reconsideration, rescinded the prior award, and returned the case for further development of the record. The initial award found permanent total disability based on a vocational expert's opinion, but the Board found this opinion lacked substantial medical evidence. Specifically, the medical expert's supplemental report was not based on a current evaluation, and the vocational expert's conclusions, relying on that report, were therefore also flawed. The matter is remanded to allow for a current medical evaluation and reassessment of vocational rehabilitation and diminished earning capacity.

Workers' Compensation Appeals BoardPermanent Total DisabilityJoint Findings and AwardVocational ExpertSubstantial EvidenceScheduled RatingFunctional Capacity EvaluationAgreed Medical ExaminerApportionmentModified Work
References
0
Case No. MISSING
Regular Panel Decision

Commissioners of the State Insurance Fund v. Gem Steel Erectors Inc.

The Supreme Court initially awarded the plaintiff, the State Insurance Fund, summary judgment for $776,261.12 in unpaid workers' compensation premiums. Following a motion for reargument, the court maintained its original decision. The appellate court subsequently modified this order, affirming summary judgment on liability but remanding the case for a reassessment of the precise amount of premiums owed. The defendants' claims lacked sufficient admissible evidence to warrant a trial on material facts, and the court found inconsistencies in the recorded premium amounts.

Workers' Compensation PremiumsSummary JudgmentLiabilityRemandReassessment of DamagesInsurance LawCorporate LiabilityJoint and Several LiabilityAppellate ReviewNew York Law
References
3
Case No. MISSING
Regular Panel Decision

Richards v. Stolzenberg

Petitioner, an employee at Westchester County Medical Center, challenged a determination by the Commissioner of Hospitals of Westchester County that terminated her employment for misconduct. The misconduct involved two incidents where she allegedly attempted to pull down male co-workers' trousers, violating sexual harassment policy and the Ethics Code. While the court upheld findings related to the sexual harassment policy, it found no basis for violating the Ethics Code, as the code lacked relevant provisions. Consequently, two specifications were dismissed, and the case was remitted for a reassessment of the penalty.

Employment TerminationMisconductSexual Harassment PolicyEthics CodeCPLR Article 78Judicial ReviewAdministrative LawAppellate CourtWestchester CountyCredibility Assessment
References
3
Case No. ADJ11092342
Regular
Sep 16, 2019

TAMARA SPIVA vs. THE BABY CONNECTION, MID-CENTURY INSURANCE COMPANY

This case involves an applicant seeking reconsideration of a denial of additional temporary disability indemnity. The Workers' Compensation Appeals Board granted reconsideration, finding the administrative law judge applied the incorrect legal standard regarding temporary partial disability. The Board determined the focus should be on whether the applicant's conduct actually disqualified them from employment, not the employer's belief or investigation. The matter is returned for the judge to determine if the applicant engaged in misconduct leading to a justified termination, and to reassess temporary total disability entitlement regardless of the termination reason.

Temporary disability indemnityPetition for ReconsiderationFindings and OrderSonogram techCumulative injuryRight shoulderTemporary total disabilityModified dutyTermination for causeCompeting business
References
7
Case No. ADJ3259433 (GOL 0088786) ADJ1074235 (GOL 0094396)
Regular
Aug 28, 2009

Sonnia Waugh vs. FRANCISCAN FRIARS OF CALIFORNIA, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE INSURANCE COMPANY, In Liquidation

This case involves a workers' compensation claim for industrial injuries to the back, lower extremities, and heart, with a dispute over psyche injury. The Appeals Board affirmed the finding of industrial heart injury, relying on medical evidence that the prescribed pain medication contributed to the heart attack. However, the Board deferred the issue of psyche injury, remanding it for further proceedings to determine if it arose from the industrial injury and to potentially reassess permanent disability and attorney's fees. The matter of cumulative trauma injury in a separate claim was also left unresolved at the trial level.

CIGAReliance Insurance CompanyWCJindustrial injuryspecific injurycumulative traumareconsiderationsubstantial evidenceapportionmentmedical treatment
References
8
Showing 1-10 of 27 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