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

Case No. 534917
Regular Panel Decision
Feb 09, 2023

Matter of Galdon v. Robert Basil Inc.

Claimant John Galdon, an autobody technician, filed a workers' compensation claim for a work-related back injury sustained on February 29, 2020. The employer and carrier disputed the claim, primarily citing a lack of timely notice. A Workers' Compensation Law Judge (WCLJ) found sufficient evidence for accident, notice, and causal relationship, awarding benefits, which the Workers' Compensation Board subsequently affirmed. On appeal, the Appellate Division, Third Department, upheld the Board's decision, determining that there was substantial evidence to support the finding that claimant provided adequate verbal notice to his employer shortly after the accident. The court also found substantial evidence for the causal relationship between Galdon's employment and his injury, based on his testimony and the consistent medical opinions of both his treating neurosurgeon, Michael Stoffman, and the carrier's examining neurosurgeon, Richard Kanoff.

Workers' CompensationBack InjuryTimely NoticeCausal RelationshipSubstantial EvidenceAppellate ReviewCredibility DeterminationDisc HerniationMedical OpinionEmployer Knowledge
References
9
Case No. VNO 0462079
Regular
Jul 11, 2007

JONAS MORENO vs. FILTERCOR, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's untimely petition for reconsideration of an approved compromise and release settlement. Despite the untimeliness, the WCAB remanded the matter to the administrative law judge to treat the petition as a request to reopen the case. This allows for further proceedings on the merits of the lien claimant's claim.

Petition for ReconsiderationPetition to ReopenUntimely FilingService by MailDefective ServiceLabor Code Sections 5803Labor Code Sections 5804Compromise and ReleaseLien ClaimantWorkers' Compensation Appeals Board
References
1
Case No. ADJ1377755 (FRE 0242857) ADJ1891281 (FRE 0242858)
Regular
Oct 11, 2010

RUDOLPH GUTIERREZ vs. DERREL'S MINI STORAGE, BERKSHIRE HATHAWAY HOMESTATE, CO.

The Workers' Compensation Appeals Board dismissed Applicant Gutierrez's petition for reconsideration of a January 19, 2010 stipulation and order. Applicant contended the settlement was not secured with his consent. The Board treated his petition as a motion to set aside the award. The case is returned to the trial level for the judge to consider the set-aside petition and conduct further proceedings.

Workers' Compensation Appeals BoardReconsiderationPetition to Set AsideStipulation and OrderPro SeAdministrative Law JudgeDismissedReturned to Trial LevelAwardConsent
References
0
Case No. ADJ9834159 (MF) ADJ9834161
Regular
Jul 30, 2018

ESAU HERNANDEZ vs. D.L. BONE AND SONS PAINTING, ICW GROUP/EXPLORER INSURANCE COMPANY, STATE COMPENSATION INSURANCE FUND

This case concerns a defendant's attempt to obtain a replacement Qualified Medical Evaluator (QME) panel after the applicant initially objected to the timeliness of the original QME's report. The Appeals Board treated the defendant's petition as one for removal and denied it. The Board found that the defendant, having failed to timely object to the QME's report itself, could not rely on the applicant's subsequent objection to request a new panel. The Board concluded that the defendant's failure to act promptly meant they were not entitled to a replacement QME panel, and no substantial prejudice or irreparable harm warranting removal was demonstrated.

Workers' Compensation Appeals BoardReconsiderationRemovalQualified Medical EvaluatorQME panelAdministrative Director RuleTimeliness objectionReplacement QME panelLabor CodeFindings of Fact
References
1
Case No. ADJ8829857 ADJ8829856
Regular
Apr 18, 2016

DULCE ESPINOZA vs. JENCO PRODUCTIONS, INC., FIRST NATIONAL INSURANCE COMPANY OF AMERICA

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration because the appealed finding, deferring development of the record on psychiatric injury, was not a final order. The Board then treated the petition as one for removal, granted it, and rescinded the deferral. Ultimately, the Board found that the applicant failed to prove industrial injury to her psyche, citing a lack of objective evidence and inconsistencies in her reporting, as well as a conflicted medical opinion.

WORKERS' COMPENSATION APPEALS BOARDDULCE ESPINOZAJENCO PRODUCTIONSINC.FIRST NATIONAL INSURANCE COMPANY OF AMERICAADJ8829857ADJ8829856Petition for ReconsiderationPetition for RemovalDecision After Removal
References
10
Case No. ADJ8717299
Regular
Mar 14, 2017

JOSEPH LOBB vs. JEFFREY D. HADDEN, JEFFREY D. HADDEN AND DOROTHY M. HADDEN DBA NAT PEST CONTROL AND FIREWOOK AKA NPC, DOROTHY M. HADDEN, NATURAL PEST CONTROLS FIREWOOD

This case involves an employer's objection, treated as a petition for reconsideration, to a Workers' Compensation Appeals Board (WCAB) decision that awarded benefits to an employee. The employers claim they never received notice of the original WCJ's decision or subsequent Board actions, including the September 2, 2016 decision. The WCAB found that the employers were indeed deprived of due process due to improper service. Consequently, the WCAB granted reconsideration to allow the employers to file an answer and ensure a just decision.

Petition for ReconsiderationDue ProcessImproper NoticeOfficial Address RecordProof of ServiceDeclaration of ServiceToll StatuteActual NoticeWCJ DecisionAppeals Board
References
0
Case No. ADJ3699477 (OAK 0345390)
Regular
Jul 05, 2011

GARY TOMEI vs. BAY ALARM COMPANY, TRAVELERS PROPERTY AND CASUALTY INSURANCE COMPANY

This case involves an applicant seeking authorization for cervical surgery, which was denied based on the treating physician's request not being properly formatted per AD Rule 9792.6(o). The Appeals Board granted reconsideration, finding the initial denial was due to the applicant's attorney adding a notation to the physician's report instead of the physician clearly marking it as a spinal surgery authorization request. The Board rescinded the original award, deferring the cervical surgery issue and ordering an expedited second opinion from a designated orthopedic surgeon or neurosurgeon.

Workers' Compensation Appeals BoardGary TomeiBay Alarm CompanyTravelers Property and Casualty Insurance CompanyADJ3699477Opinion and Order Granting Reconsiderationcervical surgerylumbar spineAdministrative Director Rule 9792.6(o)treating physician
References
1
Case No. MISSING
Regular Panel Decision

Hastrich v. Comm'r of Soc. Sec.

Plaintiff Robert A. Hastrich challenged the Commissioner of Social Security's denial of his disability insurance benefits. The District Court reviewed the Administrative Law Judge's five-step evaluation, which concluded Plaintiff was not disabled, despite his various medical conditions. Plaintiff specifically alleged errors in the ALJ's weighing of his treating neurosurgeon's opinion, the severity assessment of his carpal tunnel syndrome, the consideration of his daily activities, and the failure to address his learning disability. The Court ultimately upheld the Commissioner's decision, finding it supported by substantial evidence and free from legal error, and addressed each of Plaintiff's claims. Consequently, the Commissioner's motion for judgment on the pleadings was granted, and Plaintiff's motion was denied.

Social Security ActDisability Insurance BenefitsALJ DecisionTreating Physician RuleResidual Functional CapacityCarpal Tunnel SyndromeDaily ActivitiesLearning DisabilitySubstantial EvidenceMedical Opinion
References
25
Case No. ADJ18001417
Regular
Sep 05, 2025

CHRISTOPHER CANDIA vs. CITY AND COUNTY OF SAN FRANCISCO

The Workers' Compensation Appeals Board (WCAB) denied the defendant's Petition for Reconsideration in the case of Christopher Candia v. City and County of San Francisco. The Board adopted the Arbitrator's Report and Recommendation, which found applicant Christopher Candia's meningioma to be a compensable industrial injury. The decision was based on the cancer presumption under Labor Code section 3212.1 for firefighters, as the medical opinion of treating neurosurgeon Dr. Bruce McCormack classified the tumor as Grade II, indicating malignant features, and evidence showed Candia's exposure to carcinogens during his employment. The Board upheld the arbitrator's determination, giving greater weight to Dr. McCormack's opinion over the IME Dr. Raye Bellinger's.

Workers' Compensation Appeals BoardPetition for ReconsiderationArbitrator's ReportLabor Code Section 5909Electronic Adjudication Management Systemsubstantial evidenceneurosurgeontreating physicianIMEmeningioma
References
2
Case No. MISSING
Regular Panel Decision

DE MATTIES v. Astrue

Plaintiff Michael DeMatties initiated this action under 42 U.S.C. § 405(g) to appeal the Commissioner of Social Security's denial of his disability benefits claim. DeMatties alleged disability since 2001 due to severe left arm and hand impairments stemming from cervical degenerative disc disease and polyradiculopathy. After an Administrative Law Judge (ALJ) denied benefits, the case progressed to the District Court. Judge David G. Larimer found that the ALJ erred by not affording controlling weight to the treating neurosurgeon's opinion and by incorrectly determining the plaintiff's residual functional capacity. The court concluded the Commissioner's decision lacked substantial evidence, reversed the finding, and remanded the case for the calculation and payment of benefits.

Social Security DisabilityMedical ImpairmentResidual Functional CapacityTreating Physician RuleSubstantial Evidence ReviewCervical Degenerative Disc DiseasePolyradiculopathyVocational ExpertRemand for BenefitsSummary Judgment
References
18
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