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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Boyd v. Perales

The petitioner sought to expunge a 1976 child abuse report from the State Central Register, which alleged that her children were left bound and unsupervised, arguing it was irrelevant to her current child care employment. This challenge was initiated via a CPLR article 78 petition and transferred to the Appellate Division. An Administrative Law Judge had previously expunged two later reports but maintained the 1976 report. The court confirmed the respondents' determination, finding substantial evidence supported the ALJ's conclusion that the petitioner's serious lack of judgment in 1976 remained relevant to child care. Furthermore, the court dismissed the petitioner's due process argument as it was raised for the first time on appeal.

Child Abuse ReportState Central RegisterExpungementChild Care EmploymentAdministrative Law JudgeDue ProcessCPLR Article 78Social Services LawAppellate ReviewRehabilitation
References
1
Case No. ADJ4423159 (SAL 0118926)
Regular
Sep 20, 2016

ISIDRO CERVANTES vs. QUALITY FARMS LABOR, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted removal to review an administrative law judge's order precluding applicant from submitting non-medical records to the Qualified Medical Evaluator (QME). The Board determined that certain medical study abstracts and specific AMA Guides pages were relevant and permissible for submission to the QME, particularly concerning the disputed application of the Combined Values Chart. However, other submitted non-medical documents, such as panel decisions and index pages for abstracts, were deemed not sufficiently relevant or their authenticity was unclear, thus their submission was not permitted. Ultimately, the Board amended the original order to allow the applicant to provide only the specifically identified relevant medical abstracts and AMA Guides pages to the QME.

Petition for RemovalDecision After RemovalQualified Medical EvaluatorNon-medical recordsMedical study abstractsAMA GuidesCombined Values ChartLabor Code section 4062.3PrejudiceIrreparable harm
References
9
Case No. ADJ1225282 (VNO 0377064) ADJ3069813 (VNO 0377062)
Regular
May 05, 2015

CHERYL CASTRILLO vs. CATHOLIC HEALTH CENTER WEST dba. MARIAN MEDICAL CENTER

The Workers' Compensation Appeals Board affirmed a prior decision finding that the defendant properly completed and communicated utilization review decisions, and that the applicant failed to prove the Independent Medical Review (IMR) process was biased. The Board held that delays in IMR decisions do not invalidate them, citing a relevant appellate court opinion. Furthermore, the Board lacks the authority to rule on the constitutionality of the relevant Labor Code sections. Therefore, the original decision was upheld.

Workers' Compensation Appeals BoardUtilization ReviewIndependent Medical ReviewAdministrative DirectorPetition for ReconsiderationFindings of Fact and OrderWCJLabor Codeconstitutionalitytimeliness
References
3
Case No. ADJ9226272
Regular
Jul 31, 2014

LUIS MEJIA HERNANDEZ vs. NESTLE USA, INC., SEDGWICK CMS

The Appeals Board granted the defendant's Petition for Removal, rescinding the WCJ's order for the defendant to provide points and authorities on the relevance of each exhibit. While the WCJ believed this was necessary for the mandatory settlement conference, the Board found that such a requirement was not mandated by Labor Code section 5502(d)(3). Instead, the Board clarified that relevance objections are properly addressed at trial, allowing parties to object to proffered exhibits at that time. This procedure sufficiently protects against irrelevant or objectionable evidence.

Petition for RemovalWork Product PrivilegeMandatory Settlement ConferenceLabor Code section 5502(d)(3)Exhibit RelevanceDecision After RemovalRescinded OrderWCJAppeals BoardIndustrial Injury
References
0
Case No. ADJ11001912
Regular
Oct 19, 2019

LISA BEAN vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of a prior ruling that "sexual conduct" under Labor Code section 3208.4 does not encompass abortions. The Board rescinded the prior order, finding that the issue of abortion relevance to the applicant's psychiatric injury claim was not adequately addressed. The case is remanded for further proceedings, with the Board cautioning that the applicant is not obligated to disclose unrelated private medical information. Discovery regarding abortions must be strictly limited to what is relevant to the industrial injuries claimed.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderLabor Code section 3208.4sexual conductabortioncorrectional officerhypertensiondiabetesrheumatoid arthritis
References
6
Case No. ADJ9011624
Regular
Dec 13, 2019

ELISHA HARDEN vs. COUNTY OF SACRAMENTO

This case concerns whether specific medical reports obtained for a disability retirement claim are admissible in a workers' compensation proceeding. The Appeals Board rescinded the prior ruling, holding these reports are relevant and may be provided to the orthopedic Agreed Medical Evaluator (AME) and psychiatric Qualified Medical Evaluator (QME). The Board found the reports relevant to the medical issues, even though they were not obtained through the standard workers' compensation medical-legal evaluation process. Consequently, the applicant's objection to providing these reports to the evaluators was overruled.

RemovalReconsiderationAgreed Medical Evaluator (AME)Qualified Medical Evaluator (QME)Medical-legal evaluatorsMedical recordsLabor CodeFindings and Orders (F&O)Disability retirementPermanent impairment
References
9
Case No. ADJ7196811
Regular
May 17, 2012

ROBERTO LEDESMA vs. U.C. BERKELY, SEDGWICK CMS

Here's a summary for a lawyer: The Workers' Compensation Appeals Board denied the defendant's Petition for Removal, upholding a discovery order compelling production of non-privileged claims file notes from a specific prior period. The Board found these notes relevant to the time medical reports influencing the current Agreed Medical Evaluator were obtained. While one Commissioner concurred with allowing physician depositions, he dissented on the claims file notes, arguing their relevance and probative value were outweighed by undue consumption of time and questioning their necessity for the present admitted claim.

Petition for RemovalWorkers' Compensation Appeals BoardDiscovery OrderClaims File NotesAgreed Medical EvaluatorApportionmentFraudulent MeansDeposition of PhysiciansWCJ Report and RecommendationEvidence Code Section 352
References
1
Case No. ADJ4227582
Regular
Nov 18, 2011

BOBBY CLEMENTS vs. GEORGE REED, INC., TRISTAR RISK MANAGEMENT

This case involves an applicant seeking removal of a Workers' Compensation Judge (WCJ) after an order compelling disclosure of specific records. The applicant claimed bias, Fifth Amendment privilege against self-incrimination, and privacy rights for corporate records. The Appeals Board denied the petition, clarifying that removal requires more than disagreement with a ruling and that the Fifth Amendment privilege is waived when a party initiates litigation and the requested information is relevant to their claim. The Board found no evidence of bias and ruled that the applicant could not use the privilege to obstruct relevant discovery essential for the defendant's defense.

Petition for RemovalWCJ biasFifth Amendmentself-incriminationevidentiary privilegespatient-litigant exceptionwaiverdiscoveryadministrative law judgeworkers' compensation
References
9
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
3
Case No. ADJ7014135
Regular
Nov 29, 2010

VIANEY VARGAS vs. SELECT STAFFING, ESIS

This case involves an applicant who invoked her Fifth Amendment right against self-incrimination during a deposition, refusing to answer questions related to her identifying information and potential prior claims. The defendant sought to bar benefits, arguing the applicant's refusal hindered discovery necessary to determine liability. The Appeals Board granted reconsideration, recognizing that while the applicant cannot be compelled to incriminate herself, she also cannot use the privilege to shield herself from providing relevant information needed for the defense. The Board remanded the case for the WCJ to determine which specific questions are directly relevant to the litigation, allowing the applicant to answer them or face potential dismissal of her claim.

Petition for ReconsiderationPetition for Order Suspending Action and Barring BenefitsPetition for SanctionsFifth AmendmentSelf-incriminationDue ProcessCross-examinationDiscoveryDirectly RelevantLabor Code 4050
References
6
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