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. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
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. ADJ9625407
Regular
Sep 12, 2018

KEITH FIELD vs. CITY OF PINOLE

This case involves a firefighter who sustained bilateral carpal tunnel syndrome after retirement. The Appeals Board reversed the trial judge, holding that Labor Code section 4458.5 applies, entitling the applicant to permanent disability benefits calculated at the maximum indemnity rate. This applies regardless of the applicant's actual earnings or the fact that carpal tunnel syndrome is not a specifically enumerated presumptive injury. The case is remanded for determination of the precise date of injury to calculate the benefit rate.

Workers' Compensation Appeals BoardKeith FieldCity of PinolePermissibly Self-InsuredMunicipal Pooling AuthorityADJ9625407Opinion and Decision After Reconsiderationindustrial injuryfirefighterbilateral upper extremities
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ10908110
Regular
Mar 06, 2019

SHAKE KHACHATRIAN vs. STATE OF CALIFORNIA ATTORNEY GENERAL'S OFFICE, CALIFORNIA DEPARTMENT OF JUSTICE, Legally Uninsured, Adjusted by STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's claim for psychiatric injury. The defendant did not deny liability within 90 days, creating a presumption of compensability under Labor Code section 5402(b). However, the Board held that this presumption does not preclude the defendant from presenting evidence to support a lawful, good faith personnel action defense under Labor Code section 3208.3(h). This defense is considered exempt from the 90-day investigatory limitation, allowing the defendant to present all competent evidence regardless of when it was obtained. The case is therefore returned to the trial level for a new decision on the merits of the personnel action defense.

Labor Code section 5402presumption of compensabilityLabor Code section 3208.3(h)good faith personnel actionreasonable diligencecumulative industrial injurypsychiatric injuryDWC-1 claim formsubstantial causejudicial interpretation
References
Case No. ADJ10791219
Regular
Oct 05, 2018

JUDY FRANKLIN vs. COVENANT TRANSPORT, NEW HAMPSHIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, affirming the WCJ's finding that her injury claim is barred by the statute of limitations. The applicant's own testimony indicated she knew her injuries were work-related and caused disability by September 2014, making her claim filed after April 18, 2013, untimely. The Board also found that the presumption of compensability under Labor Code section 5402(b) did not apply due to a lack of evidence regarding the claim form's filing. Consequently, all other issues, including the request for a new QME, were rendered moot.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrderAdministrative Law JudgeLabor Code Section 5405Injury AOE/COEQualified Medical ExaminerLabor Code Section 5402(b)Statute of LimitationsCompromise and Release
References
Case No. ADJ7060020
Regular
May 11, 2015

JOSEFINA PAMPLONA vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, Permissibly Self-Insured

The Workers' Compensation Appeals Board granted reconsideration of a decision that denied a claim for an applicant who was not found to be employed by LAUSD at the time of injury. The Board rescinded the original findings and returned the case for further proceedings. Key issues to be addressed include whether the injury is presumed compensable under Labor Code section 5402(b) due to the employer's failure to reject the claim within 90 days, and alternatively, the applicability of Labor Code section 3368 regarding student employees. The parties and WCJ must determine if the applicant was enrolled in a qualifying educational program as defined by statute.

Josefina PamplonaLos Angeles Unified School DistrictLabor Code section 3368work experience educationcooperative vocational educationcommunity classroomsstudent apprenticeship programDivision of Apprenticeship Standardsregistered student apprenticesLabor Code section 5402(b)
References
Case No. ADJ3849140 (RDG 0119253)
Regular
Apr 04, 2011

THEMAS TRESLER vs. MOUNTAIN SATELLITE, STATE COMPENSATION INSURANCE FUND

This case involves a dispute over workers' compensation jurisdiction regarding a left shoulder injury. The defendant, SCIF, sought reconsideration of a WCJ's award of treatment for the shoulder, arguing lack of jurisdiction. The Appeals Board granted reconsideration, rescinded the prior award, and returned the matter for further proceedings. This decision acknowledges that the left shoulder claim may not have been definitively resolved by prior stipulations and requires the WCJ to determine if Labor Code section 5815 applies, potentially leading to a full hearing on the shoulder injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryLow Back InjuryLeft Shoulder InjuryStipulation with Request for AwardDeclaration of Readiness to ProceedContinuing JurisdictionLabor Code Section 5909
References
Case No. ADJ8642319
Regular
Apr 24, 2015

ISABEL RAMIREZ-RAMOS (spouse), ANGEL RAMIREZ (deceased) vs. OSTERIA COPPA, LLC, TRUCK INSURANCE EXCHANGE (FARMERS INSURANCE)

This case involves a deceased worker whose employer, Osteria Coppa, LLC, is challenging the Workers' Compensation Appeals Board's award of death benefits. The employer argued the WCJ erred by disallowing cross-examination and excluding a medical report. The Board denied reconsideration, affirming the original award because the employer failed to reject the claim within 90 days, thus triggering a presumption of compensability under Labor Code section 5402(b). Furthermore, the employer could not rebut this presumption with the excluded medical report, as the information it contained was discoverable within the 90-day period through reasonable diligence.

WCABIsabel Ramirez-RamosAngel RamirezOsteria CoppaLLCTruck Insurance ExchangeADJ8642319Opinion and Order Denying Petition for Reconsiderationindustrial injurydeath benefits
References
Case No. ADJ11254123
Regular
Oct 28, 2019

SAMANTHA HANSEN vs. ALERE HEALTH SYSTEMS, INC., THE HARTFORD INSURANCE GROUP

This case concerns a workers' compensation claim for a neck and spine injury. The applicant's attorney provided proof of service for the claim form on the defendant employer on March 16, 2018, and later sent a copy to the defendant insurance carrier. The defendant denied the claim on April 29, 2019, and argued that the claim should not be presumed compensable as the applicant did not prove receipt of the claim form. The Board upheld the WCJ's decision, finding that the proof of service created a presumption of receipt that the defendant failed to rebut. Therefore, the applicant's claim is presumed compensable under Labor Code Section 5402 as the defendant did not reject liability within 90 days.

Workers' Compensation Appeals BoardLabor Code Section 5402Presumption of CompensabilityReconsiderationFindings of Fact and OrdersPetition for ReconsiderationRN Case ManagerCumulative InjuryProof of ServiceClaim Form
References
Showing 1-10 of 7,999 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