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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ8931511
Regular
Sep 04, 2014

DOUGLAS FEUTZ vs. COUNTY OF SACRAMENTO

The Workers' Compensation Appeals Board denied the applicant's petition for removal, affirming the WCJ's decision. The applicant's attorney objected to a supplemental QME report being untimely, but did not request a new QME panel until after reviewing the report. The Board found this action constituted a waiver of the objection because the request was not made contemporaneously with the objection to the violation. Allowing such a delay would undermine efficient dispute resolution and permit doctor shopping.

Petition for RemovalSupplemental ReportPanel Qualified Medical EvaluatorPQMEMedical UnitReplacement QME PanelTimely Supplemental ReportProcedural ViolationWaiverDoctor-Shopping
References
Case No. ADJ7242422
Regular
Sep 24, 2013

TRACIE WHITE vs. COUNTY OF SACRAMENTO, DEPARTMENT OF FINANCE

The Workers' Compensation Appeals Board denied the County of Sacramento's Petition for Removal. The County sought to replace a Qualified Medical Evaluator (QME) due to an allegedly untimely supplemental report. The Board affirmed the administrative law judge's denial, interpreting Administrative Director Rule 38(h) to grant QMEs sixty days for supplemental reports. The Board also noted the County objected to the report before receiving it.

Petition for RemovalQualified Medical EvaluatorQME panelsupplemental reportuntimely reportAdministrative Director Rule 38Report and RecommendationFajardo v. Workers' Comp. Appeals Bd.WCJoff calendar
References
Case No. ADJ9292791
Regular
Sep 29, 2015

HIEP LE NGOC NGUYEN vs. OAKS CLUB ROOM, NATIONAL CASUALTY COMPANY, NATIONWIDE AGRIBUSINESS INSURANCE COMPANY

This case concerns applicant's petition for removal after the WCJ denied their request for a new Qualified Medical Examiner (QME) panel. The denial was based on the original QME's failure to issue a timely supplemental report despite two requests. Although the QME claimed non-receipt of the requests, the supplemental report has now been provided. The Appeals Board denied removal, finding that issuing a new panel would only cause further delay given the report is now available.

Petition for RemovalQualified Medical ExaminerSupplemental ReportRule 38(i)Administrative Law JudgeWCJ ReportPrejudiceIrreparable HarmUntimely ReportPanel Qualified Medical Examiner
References
Case No. ADJ6704462
Regular
Sep 26, 2013

GÉRARDO ALVAREZ vs. SC ASSOCIATES, INC., STATE COMPENSATION INSURANCE FUND

This case involves a defendant's petition for removal challenging an order for supplemental medical reports. The Appeals Board denied removal, holding that the WCJ acted appropriately in allowing QME reports to be supplemented due to potential deficiencies in their adherence to regulations concerning the review of prior medical records and reporting of information considered. The Board found that the alleged non-compliance with specific procedural rules related to report preparation does not automatically render the reports inadmissible, and that further development of the record is permissible when no substantial evidence exists. Furthermore, the defendant failed to demonstrate irreparable harm or substantial prejudice required for the extraordinary remedy of removal.

Petition for RemovalOrder Re Supplemental ReportsDr. Ronald ZlotolowDr. Noel LustigQME reportsLabor Code Section 4628WCAB Rule 10606medical-legal reportinadmissibilityprior medical records
References
Case No. ADJ10590233
Regular
Apr 29, 2019

MARTIN VASQUEZ vs. CR LAURENCE COMPANY, INC., LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Liberty Mutual's petition for reconsideration, upholding the administrative law judge's award to applicant Martin Vasquez. Defendant argued the judge improperly admitted medical reports not disclosed at the mandatory settlement conference. However, the Board found that a properly disclosed supplemental report effectively incorporated the unlisted permanent and stationary report, negating surprise or prejudice. Therefore, the Board concluded that admitting the incorporated report was consistent with substantial justice.

Petition for ReconsiderationWCJ Findings of FactAward and OrdersIndustrial InjuryLeft Knee InjuryTemporary DisabilityPermanent DisabilityPrimary Treating PhysicianMedical OpinionMandatory Settlement Conference
References
Case No. ADJ6535347, ADJ6534384
Regular
Nov 02, 2015

CHRISTINE KNAPP vs. COUNTY OF FRESNO

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration. The applicant sought to overturn findings of $53\%$ permanent disability and disputed the exclusion of vocational expert reports and a claim of $100\%$ disability. The Board found the petition contained numerous factual misrepresentations and violations of WCAB rules and professional conduct by the applicant's attorney. The Board adopted the WCJ's report, which recommended denial due to the petition's legal defects and factual inaccuracies.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardOccupational Group NumberIndustrial InjuryRight ShoulderMigraine HeadachesPermanent DisabilityAgreed Medical ExaminerQualified Medical Examiner
References
Case No. ADJ815944
Regular
Jan 14, 2010

LINDALAIVAREZ vs. BLUE DIAMOND GROWERS, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The Workers' Compensation Appeals Board denied a Petition for Removal, upholding the WCJ's decision to deny a new QME panel. The applicant's attempt to obtain a new panel was deemed impermissible "doctor-shopping" by delaying objection to a late supplemental QME report until after receiving and reviewing it, and finding it favorable. The Board applied the principle that parties cannot exploit delays in medical reports for strategic advantage. Therefore, removal was denied as the conduct did not justify a new panel appointment.

Petition for RemovalQME panelmedical-legal reportdoctor-shoppinguntimely reportsupplemental reportobjectionwrit deniedAppeals Board panel decisionadministrative law judge
References
Case No. ADJ10202437, ADJ10383918
Regular
Jul 26, 2018

JOACHIM SCHNEIDER vs. SALINAS VALLEY MEMORIAL HOSPITAL, ACCLAMATION INS. MGT. SERVICES

This case involves a Petition for Removal concerning an Order for Additional Qualified Medical Evaluator. The Workers' Compensation Appeals Board (WCAB) previously granted removal and issued a notice of intention to admit specific medical records and a supplemental report into evidence. As no objections were filed by the parties, the WCAB has admitted these exhibits. Consequently, the WCAB affirms the WCJ's original Order.

Workers' Compensation Appeals BoardRemovalQualified Medical EvaluatorMedical RecordsSupplemental ReportPetition for RemovalAnswerReport and RecommendationWCJ's ReportExhibit Admission
References
Case No. ADJ7944187
Regular
Oct 24, 2013

LISA MENDOZA vs. RITE AID CORPORATION, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The Workers' Compensation Appeals Board denied Lisa Mendoza's Petition for Removal, finding no irreparable harm or significant prejudice. The Board adopted the Administrative Law Judge's report, which determined that removal was not warranted despite disputes over discovery completion. The case remains off calendar pending deposition of applicant's vocational expert and receipt of a supplemental report from Dr. Isaac. The Board declined to rule on closing discovery regarding Dr. Charles's supplemental report, leaving that to the ALJ if the case is returned to the calendar.

Petition for RemovalIrreparable HarmSignificant PrejudiceWCJ ReportDiscovery ClosureSupplemental ReportVocational RehabilitationDiminished Future Earning CapacityOpen Labor MarketLeBoeuf Framework
References
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