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

Case No. ADJ473373 (ANA 0406381)
Regular
Feb 10, 2012

FERNANDO GUTIERREZ vs. SOCAL FRAMING aka BMHC; ACE AMERICAN INSURANCE, administered by ESIS, INC.

This case concerns applicant's claim for extended temporary disability (TD) benefits beyond 104 weeks due to a left eye injury. The Appeals Board affirmed the WCJ's denial of the "amputation" exception, ruling that the surgical removal of an eye does not fit the statutory definition. However, the Board remanded the case for further development of the record on the "high-velocity eye injury" exception, as the velocity and force of the object that struck the applicant's eye were unclear. The applicant's Petition for Removal was dismissed as reconsideration was the appropriate remedy.

Workers' Compensation Appeals BoardFernando GutierrezSoCal FramingBMHCACE American InsuranceESISInc.ADJ473373ANA 0406381Opinion and Decision
References
Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
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. ADJ4093711 (AHM 0140492)
Regular
Jul 14, 2010

ROBERTO DELGADILLO vs. CONSTRUCTION FORKLIFT SERVICES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted petitions for reconsideration filed by both the applicant and the defendant. This decision arose from the April 27, 2010 ruling in the case of Roberto Delgadillo v. Construction Forklift Services; State Compensation Insurance Fund. The WCAB cited statutory time constraints and the need for further study of the factual and legal issues as reasons for granting reconsideration. This action is intended to ensure a complete understanding of the record and to enable a just and reasoned decision after further proceedings.

Workers' Compensation Appeals BoardReconsiderationPetitions for ReconsiderationApplicantDefendantConstruction Forklift ServicesState Compensation Insurance FundStatutory time constraintsFactual and legal issuesDecision After Reconsideration
References
Case No. ADJ4359205
Regular
Aug 07, 2013

HECTOR GONZALEZ vs. DIMAS ERNESTO RAMOS, BZZZ CONSTRUCTION, STATE COMPENSATION INSURANCE FUND, PACIFIC SPECIALTY INSURANCE COMPANY, TRISTAR RISK MANAGEMENT

This case concerns a petition for reconsideration in a workers' compensation matter where the applicant, Hector Gonzalez, claimed injury while working on a construction project. The defendant, Dimas Ernesto Ramos, contested that he was the employer, arguing Gonzalez was an independent contractor or a residential employee. The Administrative Law Judge found Ramos to be the employer based on extensive contradictions in Ramos's testimony and the credible testimony of others, establishing an employer-employee relationship. The Workers' Compensation Appeals Board denied the petition for reconsideration, upholding the WCJ's findings and giving them great weight.

WCABPetition for ReconsiderationWCJ reportcredibility findingGarza v. Workmen's Comp. Appeals Bd.construction projectbuilder-ownerlicensed general contractorBZZZ ConstructionState Compensation Insurance Fund
References
Case No. SAL 0113062
Regular
Jan 02, 2008

, Maria LOURDES TAPIA, vs. REGENT ASSISTED LIVING, ALASKA NATIONAL INSURANCE

The Workers' Compensation Appeals Board denied reconsideration of a decision upholding a 24-visit limit for chiropractic treatment per industrial injury. The applicant argued that the statutory cap conflicted with the liberal construction mandate of Labor Code section 3202, but the Board found no ambiguity in the clear language of Labor Code section 4604.5(d)(1). The Board further clarified that the provision allowing employers to authorize additional visits in writing (LC 4604.5(d)(2)) did not remove the cap, nor did it render chiropractors meaningless within the workers' compensation system.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code Section 4604.5(d)(1)chiropractic visitsoccupational therapyphysical therapyLiberal constructionLabor Code Section 3202employer authorizationFindings & Order
References
Case No. ADJ9419247
Regular
Aug 09, 2016

GUADALUPE ALVAREZ vs. CITY WALL CONSTRUCTION, THE HARTFORD INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a prior order finding the applicant was not an employee of City Wall Construction. The applicant claimed a work injury to his back and foot, but the judge found his testimony regarding employment lacked credibility against the defendant's consistent testimony. The Board also rejected the applicant's request to reopen based on newly discovered evidence, as he failed to demonstrate due diligence in discovering and presenting this information at trial. Therefore, the applicant did not meet his burden of proof to establish an employer-employee relationship.

Workers' Compensation Appeals BoardGuadalupe AlvarezCity Wall ConstructionThe Hartford Insurance CompanyADJ9419247denial of reconsiderationindustrial injuryconstruction workeremployment statusnewly discovered evidence
References
Case No. GOL 0098741
Regular
Jun 06, 2008

CARLOS DAVIS vs. PRAJA CONSTRUCTION COMPANY, STATE COMPENSATION INSURANCE FUND

This Workers' Compensation Appeals Board case, **Davis v. Praja Construction Company**, involves a defendant's petition for reconsideration of a prior decision. The Board has granted reconsideration to allow for further review of the factual and legal issues presented. This action is taken to ensure a complete understanding of the record and facilitate a just and reasoned decision.

Petition for ReconsiderationPraja Construction CompanyState Compensation Insurance FundWorkers' Compensation Appeals BoardStatutory time constraintsFactual and legal issuesJust and reasoned decisionDecision After ReconsiderationReconsideration UnitRonnie G. Caplane
References
Case No. ADJ1458450
Regular
Apr 02, 2013

CESAR PEREZ vs. DOMINGUEZ CONSTRUCTION, INC., STATE COMPENSATION INSURANCE FUND

This case involves a Petition for Reconsideration filed by Cesar Perez (Applicant) against Dominguez Construction, Inc. and State Compensation Insurance Fund (Defendants). The Workers' Compensation Appeals Board (WCAB) dismissed the petition because it was not filed within the statutory time limits. Even if timely, the WCAB would have denied the petition on the merits based on the administrative law judge's report. Therefore, the WCAB ordered the Petition for Reconsideration dismissed.

Petition for ReconsiderationDismissedTimely-filedReport and RecommendationWorkers' Compensation Appeals BoardWCJDominguez ConstructionState Compensation Insurance FundADJ1458450LAO 0877997
References
Case No. ADJ5744485 ADJ6979008 ADJ6979031
Regular
Sep 16, 2010

BRIAN MENICUCCI vs. STATE OF CALIFORNIA, DEPARTMENT OF TRANSPORTATION, STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

This Workers' Compensation Appeals Board decision clarifies that injured employees are not geographically restricted when selecting a physician within a defendant's Medical Provider Network (MPN). While general treatment under Labor Code section 4600(c) has a reasonable geographic limitation, this restriction does not apply to MPN physicians. The Board affirmed the ALJ's decision, holding that an employee can choose any MPN physician, regardless of distance, after their initial visit. The case specifically avoided ruling on travel expense reimbursement or injuries sustained during travel to the chosen physician.

Medical Provider NetworkMPNreasonable geographic areaLabor Code section 4600(c)Labor Code section 4616 et seq.Administrative Director Rule 9780(h)Administrative Director Rule 9767.6(e)physician of his or her choicestatutory constructionstatutory omission
References
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