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

Case No. ADJ7264915
Regular
Jul 15, 2013

ANA GONZALES vs. WAL-MART ASSOCIATES, INC., ACE AMERICAN INSURANCE

This case involves an applicant who sustained industrial psychiatric injury but whose orthopedic claims were denied due to insufficient medical evidence. The Appeals Board denied the applicant's petition for reconsideration, finding the applicant failed to present substantial medical evidence of industrial causation for her orthopedic complaints. A dissenting commissioner argued that the primary medical evaluator's report was deficient and lacked substantial evidence, warranting further development of the record on orthopedic injuries and other claims. The dissent emphasizes the Board's duty to ensure substantial justice, suggesting it should have ordered further investigation on the denied orthopedic issues.

WCABPetition for ReconsiderationFindings and Orderindustrial injurypsychelow backneckright shoulderright wristright elbow
References
Case No. ADJ8128282
Regular
Jan 23, 2014

ANGELA EGBIKUADJE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings. The defendant, California Department of Corrections and Rehabilitation, argued that the applicant's psychiatric injury claim was preempted by the ADA and not proven under Labor Code section 3208.3. The Board found the original decision lacked proper analysis regarding predominant industrial causation and the good faith personnel action defense. Therefore, the case was remanded for further development of the record, including expert medical opinion on these issues.

Workers' Compensation Appeals BoardAngela EgbikuadjeCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8128282Van Nuys District OfficeReconsiderationFindings and AwardIndustrial cumulative trauma injury
References
Case No. ADJ3885172 (SAC 0357351)
Regular
Nov 14, 2016

LINDA O'BRIEN vs. GOLD HARVEST MARKET, STATE FARM INSURANCE

The Workers' Compensation Appeals Board denied Linda O'Brien's petition for reconsideration. O'Brien sought to challenge a prior finding that her former attorney, William J. Carlisle, had "substantially complied" with an order to deliver her workers' compensation file. The Board adopted the administrative law judge's report, which found sufficient evidence, including letters from Carlisle, to support substantial compliance despite O'Brien's claims of non-receipt. The Board also rejected O'Brien's supplemental response.

Workers' Compensation Appeals BoardPetition for ReconsiderationWorkers' compensation administrative law judgeSpecific injurySubstantial complianceSanctionsDeclaration of Readiness to ProceedMinutes of HearingFinding of FactPetitioners Contentions
References
Case No. ADJ7282444
Regular
Aug 19, 2015

ROSA RANGEL vs. CALIFORNIA DEPARTMENT OF SOCIAL SERVICES, IN HOME SUPPORT SERVICES

The California Workers' Compensation Appeals Board denied the defendant's Petition for Removal, upholding the judge's decision to set the case for trial. Removal is an extraordinary remedy granted only upon a showing of substantial prejudice or irreparable harm. The defendant failed to demonstrate such harm or that reconsideration would be an inadequate remedy. The WCJ properly deferred the issue of medical record development to the trial judge.

Removal PetitionExtraordinary RemedySubstantial PrejudiceIrreparable HarmReconsideration Adequate RemedyWCJ ReportAgreed Medical EvaluationQualified Medical EvaluatorDevelop the RecordMandatory Settlement Conference
References
Case No. ADJ6579284
Regular
Oct 09, 2025

Paul Smith III vs. Denver Broncos Football, Great Divide Insurance Company

The Denver Broncos Football filed a petition for removal contesting a joinder order issued by a Workers' Compensation Administrative Law Judge (WCJ). The Workers' Compensation Appeals Board reviewed the petition, the applicant's answer, and the WCJ's Report and Recommendation. The Board denied the petition for removal, emphasizing that removal is an extraordinary remedy. It concluded that the petitioner failed to demonstrate substantial prejudice or irreparable harm, and that reconsideration would not be an inadequate remedy if an adverse final decision were to be issued.

Petition for RemovalOrder of JoinderWorkers' Compensation Appeals BoardWCJSubstantial PrejudiceIrreparable HarmReconsiderationAdmitted EvidenceSubstantial EvidenceHolmberg
References
Case No. ADJ11039762
Regular
Aug 06, 2018

ALFRED GUILING vs. GODEFELLOW BROTHERS CONSTRUCTION, LLC, AMERICAN CONTRACTORS INSURANCE GROUP

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration and dismissed their Petition for Removal. The defendant argued the judge's finding of injury to specific body parts was premature and lacked substantial evidence, as the PQME process was incomplete. The Board found removal was inappropriate, as the injury finding is a final order subject to reconsideration. They adopted the WCJ's report, concluding the applicant met their burden of proof for industrial injury to the disputed body parts.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFindings of Factindustrial injurybody partssubstantial evidencePanel Qualified Medical EvaluationPQMEextraordinary remedy
References
Case No. ADJ394613 (VNO 0530712); ADJ2266356 (VNO 0530710)
Regular
Jun 25, 2015

MARIA ESTRELLA vs. DURHAM SCHOOL SERVICES/NATIONAL EXPRESS CORPORATION, FIDELITY AND GUARANTY INSURANCE COMPANY

The Workers' Compensation Appeals Board denied a Petition for Removal filed by a lien claimant. The lien claimant argued substantial prejudice due to the employer's non-attorney representative. However, the Board found that the non-attorney representative complied with relevant regulations, and the lien claimant failed to demonstrate substantial prejudice or irreparable harm. Therefore, removal was deemed an extraordinary remedy not warranted in this case, with reconsideration serving as an adequate remedy if necessary.

Petition for RemovalWorkers' Compensation Appeals BoardWCJ ReportSubstantial PrejudiceIrreparable HarmReconsiderationRule 10773Non-Attorney RepresentativeHearing RepresentativeLien Claimant
References
Case No. ADJ445617
Regular
Apr 07, 2017

EVA PALOMARES vs. ROWLAND UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board dismissed a lien claimant's petition for reconsideration and denied their petition for removal. The Board found that the Administrative Law Judge's order was not a final determination of substantive rights, therefore not ripe for reconsideration. The Board also determined that the lien claimant failed to demonstrate substantial prejudice or irreparable harm required for removal. Consequently, the matter was returned to the parties to further develop the record regarding the lien's validity and compliance with relevant statutes.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalLabor Code Section 4903.8Lien ClaimantAssignment of LienDeclaration RequirementsFinal OrderInterlocutory DecisionSubstantial Prejudice
References
Case No. ADJ12384017
Regular
Jan 31, 2020

WESLEY VAUGHN vs. THE KROEGER COMPANY dba RALPHS GROCERY COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Appeals Board granted reconsideration and rescinded the WCJ's finding that the applicant did not properly predesignate his physician. The Board determined that the sole issue presented to the WCJ was too narrowly framed, failing to address the applicant's arguments regarding substantial compliance and the defendant's alleged failure to provide proper notice of predesignation rights. The case is remanded for further proceedings to address the issues of proper notice and denial of care, which are crucial for determining treatment outside the Medical Provider Network.

PredesignationPrimary Treating PhysicianMedical Provider Network (MPN)Notice RequirementsDenial of CareSubstantial ComplianceThreshold IssueInterlocutory IssueRemoval StandardPetition for Reconsideration
References
Case No. ADJ10030458
Regular
Mar 12, 2019

Rachel Osorio vs. Agilent Technologies, Inc.

This case involves applicant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision. The WCAB denied the applicant's request for a replacement Qualified Medical Evaluator (QME) panel, finding that the original QME's failure to serve the applicant directly with his report, despite serving her attorney, constituted substantial compliance. The Board reasoned that the applicant was not significantly prejudiced as she retained rights for further discovery and that a replacement panel was not warranted. Ultimately, the WCAB denied the petition for reconsideration, upholding the prior order.

Workers Compensation Appeals BoardAgilent TechnologiesInc.Sedgwick Claims Management ServicesRachel OsorioFindings and OrderInjury AOE/COEBilateral Hands and WristsQualified Medical Evaluator (QME)Substantial Compliance
References
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