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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. LAO 838220
Regular
May 14, 2007

MARIA SERAFIN vs. LANSCO DIE CASTING, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the previous award, and remanded the case to determine permanent disability using the 1997 Schedule. This decision stems from the Board's finding that the applicant's treating physician's December 20, 2004, report indicated the existence of permanent disability, triggering an exception under Labor Code section 4660(d). Consequently, the outdated 1997 Schedule, not the 2005 Schedule, must be applied to calculate the applicant's permanent disability benefits.

Workers' Compensation Appeals BoardMaria SerafinLansco Die CastingState Compensation Insurance FundLAO 838220ReconsiderationFindings and AwardWCJIndustrial InjuryRight Shoulder
References
Case No. ADJ383777
Regular
Apr 04, 2011

Roxanna Ortiz vs. ONE SOURCE, ESIS

The Workers' Compensation Appeals Board denied Roxanna Ortiz's petition for reconsideration of a prior findings and order. The initial ruling determined she sustained industrial injury only to her cervical spine as a janitor, not to other body parts or any resulting temporary/permanent disability or need for further medical treatment. Ortiz argued the judge erred by favoring defense medical reports and discrediting her testimony due to minor inconsistencies in her injury description. The Board adopted the WCJ's report, emphasizing deference to credibility determinations and that admissibility of medical reports should have been challenged at trial, not on reconsideration. A dissenting opinion argued the judge overemphasized minor variations in Ortiz's account and that medical evidence did not sufficiently support denial of other injuries or further treatment.

OrtizOne SourceESISWCABFindings and OrderPetition for ReconsiderationWorkers' Compensation Administrative Law Judgeindustrial injurycervical spineright arm
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. ADJ18027061
Regular
Sep 10, 2025

HEATHER TILLER KELLEY vs. SACRAMENTO CITY UNIFIED SCHOOL DISTRICT

Defendant Sacramento City Unified School District sought reconsideration of a WCAB decision that found applicant Heather Tiller Kelley sustained industrial injuries and that reports from her treating physicians (Mark Zuber, D.C., Adrienne Pasek, Psy.D., and Kasra Maasumi, M.D.) were admissible. Defendant argued these physicians lacked a proper treatment relationship and that the reports were improperly obtained. The Workers' Compensation Appeals Board denied the petition for reconsideration, affirming that defendant relinquished medical control by denying liability, allowing applicant to self-procure treatment, and thus the treating physician reports were admissible in proceedings.

WCABPetition for ReconsiderationOpinion and Order Granting PetitionAdmissible EvidenceTreating PhysiciansMedical-Legal ReportsLabor Code Section 4062.2Self-Procured TreatmentRemoval StandardPermanent and Stationary Status
References
Case No. ADJ3103905
Regular
Oct 28, 2011

JOSE PENALOZA VALDEZ vs. MANUEL AVILA, TRANSGUARD INSURANCE, Administered By FRYE CLAIMS CONSULTATION

This case concerns an applicant awarded 68% permanent disability, including a significant portion for psyche injury, based on a psychologist's report. The defendant appeals, arguing the psychologist's report was improperly admitted and they were denied the opportunity for rebuttal. The Appeals Board rescinded the award, finding that while the report was admissible, the defendant should have been allowed to obtain a rebuttal report, especially since the psychologist was not the primary treating physician. The case is returned for further proceedings to develop the record regarding the psyche injury and disability claims.

Workers' Compensation Appeals BoardPetition for ReconsiderationIndustrial InjuryPsyche InjuryPermanent DisabilityMedical Report AdmissibilityQualified Medical EvaluatorAgreed Medical EvaluatorDeclaration of Readiness to ProceedMandatory Settlement Conference
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. 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. ADJ6581429
Regular
Feb 28, 2010

ELLIS PARK vs. SCHOOL FIRST FEDERAL CREDIT UNION, TRAVELERS WALNUT CREEK

Here's a summary of the case for a lawyer, in a maximum of four sentences: This Workers' Compensation Appeals Board case concerns an applicant alleging a cervical and upper extremity injury on November 19, 2008, while retrieving an item under a desk. The Administrative Law Judge denied reconsideration, finding the applicant's medical reporting inconsistent with their trial testimony regarding the incident and its reporting to treating physicians. The applicant's failure to mention the specific injury mechanism to doctors shortly after the alleged event was a key factor in the denial. The Board adopted the WCJ's report, denying the petition for reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationIndustrial InjuryCourse of EmploymentCervical SpineUpper ExtremitiesMedical EvidenceTrier of FactTerminationKaiser Report
References
Case No. ADJ6948621 ADJ7946738
Regular
Apr 22, 2013

STEFANO MUSETTI vs. GOLDEN GATE DISPOSAL & RECYCLING dba RECOLOGY, permissibly self-insured, administered by CORVEL CORP.

In this workers' compensation case, the employer sought reconsideration of an award ordering a total knee replacement. The applicant's treating physician recommended the surgery, but the employer argued the award was premature as a panel qualified medical evaluator's report was pending and the treating physician's report lacked proper authorization markings. The Appeals Board denied reconsideration, finding the employer had sufficient time to obtain the PQME report and that the treating physician's report constituted substantial medical evidence supporting the surgery. The Board also noted that the employer failed to initiate utilization review despite being aware of the treatment request.

Workers' Compensation Appeals Boardindustrial injuryright kneegarbage collectortotal knee replacementsupplemental reportpanel qualified medical evaluator (PQME)treating physiciansubstantial medical evidencePetition for Reconsideration
References
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