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

Case No. ADJ3910048 (VNO 0417016)
Regular
Jul 30, 2010

NAHID JAVADI vs. SIMI VALLEY HOSPITAL, ADVENTIST HEALTH SYSTEMS WEST

This case involves an employer, Simi Valley Hospital/Adventist Health Systems West, seeking to prevent the joinder of AIG as a defendant in a workers' compensation claim. The employer argues it is permissibly self-insured and self-administered, and joining AIG, an excess carrier, would cause irreparable harm. The Appeals Board found that since there is no third-party administrator involved, the precedent relied upon for joinder is inapplicable. Consequently, the Board rescinded all orders joining AIG and returned the case to the trial level.

Workers' Compensation Appeals BoardPetition for RemovalJoinder of DefendantReinsurance CarrierExcess CarrierPermissibly Self-InsuredSelf-AdministeredIndustrial InjuryFindings and AwardPetition to Reopen
References
Case No. ADJ13227834
Regular
Oct 10, 2025

Efren Sifuentes Nava vs. San Carlos Roofing Company, State Compensation Insurance Fund

Defendant SCIF filed a petition for removal challenging an order to serve medical records issued on December 2, 2024, by a workers' compensation administrative law judge (WCJ). The WCJ recommended dismissal because the defendant's objection to the order included a self-destruct clause, rendering the original order moot upon objection. The Appeals Board agreed that there was no active order to challenge and further noted the permissibility of a WCJ rescinding an offending order to promote judicial economy. Therefore, the Petition for Removal was dismissed as moot.

Petition for RemovalWCJ OrderSelf-Destruct ClauseMootRescissionJudicial EconomyAppeals BoardCost PetitionerMedical RecordsAdjudication Number
References
Case No. ADJ3714425 (FRE 0234250) ADJ896033 (FRE 0171714)
Regular
Aug 22, 2014

MICHAEL WRIGHT vs. STAR MEDIA, TRAVELERS INDEMNITY COMPANY OF CONNECTICUT

The Workers' Compensation Appeals Board granted reconsideration, rescinding a WCJ's order that enforced a reimbursement order against Travelers Indemnity Company. The Board found the reimbursement order void *ab initio* due to procedural due process infirmities. Specifically, the "self-destruct" clause in the order did not comport with due process protections outlined in precedent cases like *Mitchell v. Golden Eagle Ins.*, failing to guarantee a review of objections or automatically void the order upon valid objection. Therefore, Travelers' due process rights were violated, necessitating the rescission of the WCJ's findings.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder for ReimbursementCalifornia Insurance Guarantee Association (CIGA)Cumulative Trauma InjuryAgreed Medical Examiner (AME)ApportionmentDue ProcessSelf-Destruct ClauseVoid Ab Initio
References
Case No. ADJ19199519; ADJ19199522
Regular
Feb 18, 2025

LAURA RODRIGUEZ vs. 99 CENTS ONLY STORES, SELF-INSURER'S SECURITY FUND

The Self-Insurers' Security Fund (SISF) petitioned for reconsideration or removal of a Workers' Compensation Judge's (WCJ) order denying its joinder in a case involving injured applicant Laura Rodriguez and the bankrupt 99 Cents Only Stores. The WCJ had ruled that SISF, having assumed the insolvent employer's liabilities, only needed to file a notice of change in administrator, not a joinder petition. The Appeals Board dismissed the petition for reconsideration as the order was not final, but granted the petition for removal. As its Decision After Removal, the Appeals Board rescinded the WCJ's December 2, 2024 order, finding due process violations due to the summary denial without a hearing, and returned the matter to the trial level for further proceedings.

Self-Insurers' Security Fundjoinderremovalreconsiderationinsolvent self-insurerliquidationadministrative law judgeorderdue processsubstantial evidence
References
Case No. SRO 0121152
Regular
Dec 12, 2007

GINGER DUNLAP-FENTON vs. EEL RIVER SAWMILLS, SELF-INSURERS' SECURITY FUND

This case involved a defendant's petition for reconsideration of an award for an applicant's industrial neck injury. The appeals board granted reconsideration, amending the original award to reduce the permanent disability rating from 23% to 17% and adjusting the applicant's attorney fees. The board adopted the WCJ's report, which specified the revised permanent disability indemnity, the calculation of attorney fees on remaining temporary disability and self-procured medical expenses, and affirmed other aspects of the original award.

Workers Compensation Appeals BoardEel River SawmillsSelf-Insurers' Security Fundindustrial injuryblock stackerbankruptcytemporary total disabilitypermanent disabilityapportionmentself-procured medical treatment
References
Case No. ADJ9438610
Regular
Sep 26, 2014

LUIS MENDIZABAL vs. C. E. LIMITED, INC., dba CENTRAL ENTERPRISES, ZENITH NORTH AMERICAN COMMERCIAL INSURANCE

The Workers' Compensation Appeals Board granted reconsideration, rescinding prior findings that the defendant failed to provide MPN information and that the applicant properly self-procured care. The Board found the defendant timely provided MPN notice in May 2014, not May 2013 as initially determined. Consequently, the defendant is not liable for self-procured treatment, and the case is returned to the trial level.

Medical Provider NetworkMPN transfer of careself-procured medical treatmentreconsiderationFindings of FactWCJadministrative law judgeindustrial injuryright kneenotice of transfer
References
Case No. ADJ2849802 (MON 0335685) ADJ2615302 (MON 0335686)
Regular
Dec 07, 2012

FEDERICO PARDO vs. FELIX MANUFACTURING COMPANY, INC., VIRGINIA SURETY COMPANY, APPLIED RISK SERVICES

This case involves a worker injured in an industrial eye injury who also claims psychological injury and a consequential shoulder injury. The Appeals Board granted reconsideration to address the employer's challenge to the psychological injury finding, agreeing that the medical evidence for it was not substantial. The Board also noted that the award for reimbursement to EDD requires clarification due to the potential reduction in permanent disability. The matter is returned to the trial judge for further proceedings and a new final decision on these issues.

Workers' Compensation Appeals BoardFelix Manufacturing CompanyVirginia Surety CompanyApplied Risk ServicesFederico Pardoforklift operatorindustrial injuryleft eye injurypsyche injurycompensable consequence injury
References
Case No. LBO 0375714
Regular
Jul 09, 2008

VICENTE CARMEN vs. SKB CORPORATION

This case involves a lien claim by California Pharmacy Management for medication provided to an injured worker, Vicente Carmen. The Workers' Compensation Appeals Board denied reconsideration, upholding the finding that the pharmacy's lien was invalid because the medication was not prescribed by a physician within the defendant employer's Medical Provider Network (MPN). The Board reiterated that once an employer provides a MPN, an employee's self-procured treatment outside that network is not compensable, and the pharmacy's reliance on Labor Code section 4600.2 was misplaced as there was no evidence of a contract with the employer.

MPNLien claimMedical treatmentSelf-procuredPharmacy benefit networkLabor Code section 4600.2Treating physicianWorkers' Compensation Appeals BoardFindings and OrderReconsideration
References
Case No. SRO 0088351
Significant
Mar 20, 2002

Cheryl Coldiron vs. Compuware; Permissibly Self-Insured, by And through Gallagher Bassett Services, Inc., Adjusting Agent

The board issues a notice of intent to sanction a third-party administrator for failing to disclose the correct insurance carrier for over six years and schedules a conference to clarify the employer-insurer relationship.

Workers' Compensation Appeals BoardEn BancPetition for ReconsiderationFindings and AwardPermissibly Self-InsuredThird-Party AdministratorHigh Self-Insured RetentionSanctionsLabor Code Section 5813Excusable Error
References
Case No. ADJ2980699 (MON 0351671) ADJ1220548 (MON 0351672)
Regular
Jul 16, 2013

AURA DE LEON vs. MARRIOTT INTERNATIONAL, PSI and Self-Administered

This case involves a Petition for Removal filed by an applicant against Marriott International, PSI, and Self-Administered. The petitioner subsequently withdrew the petition. Consequently, the Workers' Compensation Appeals Board has ordered the Petition for Removal dismissed as no further action will be taken.

Petition for RemovalWithdrawn PetitionDismissed PetitionWorkers' Compensation Appeals BoardAura De LeonMarriott InternationalPSISelf-AdministeredADJ2980699ADJ1220548
References
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