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

Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ3304426
Regular
Apr 14, 2017

JIMMIE WISE vs. EASTSIDE RESERVOIR PORJECT/AWZ, ITT HARTFORD, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a defendant's petition for reconsideration of a Workers' Compensation Arbitrator's (WCA) award for further medical treatment, specifically surgery. The defendant did not dispute the need for surgery but challenged a mediator's prior order as exceeding authority. The Workers' Compensation Appeals Board (WCAB) dismissed the petition primarily because the defendant failed to serve it on the WCA, which is a procedural defect. The Board noted that the WCA's subsequent order was also untimely and without jurisdiction due to the lack of proper service.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardWorkers' Compensation ArbitratorFurther Medical TreatmentSurgerySecond Medical OpinionAlternative Dispute ResolutionMediationMediator's Authority
References
Case No. ADJ7531724, ADJ7531690
Regular
Dec 01, 2017

AURORA LEMUS vs. FREEBIRDS WORLD BURRITO, GRANITE STATE INSURANCE COMPANY, MARK ORFALIA, REDWOOD FIRE AND CASUALTY COMPANY

This case involves a dispute between Granite State Insurance Company and Redwood Fire and Casualty Company regarding contribution for workers' compensation benefits paid to applicant Aurora Lemus. Granite, initially denied contribution by the WCJ, petitioned for reconsideration. The parties subsequently settled the contribution claim for $22,500.00 through mediation, which has been approved by the Board. This stipulation fully resolves Granite's claims against Redwood.

Workers' Compensation Appeals BoardReconsiderationContributionReimbursementJoint Findings of FactCompromise and ReleaseStipulationVoluntary MediationCommissioners' Settlement ConferenceInsurer
References
Case No. ADJ8480026
Regular
Jan 14, 2019

Patricia Tapia vs. International Laser, Twin City Fire Insurance

This case involves a workers' compensation applicant, Patricia Tapia, who sustained spinal and upper extremity injuries. The defendant, Twin City Fire Insurance, sought reconsideration of a prior order finding that lien claimant Scripte Corporation had timely filed a required declaration. The parties subsequently engaged in mediation and reached a settlement resolving Scripte's lien for $2,850.00. The Board rescinded the original Findings and Order and approved the lien settlement agreement.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderAdministrative Law JudgeCumulative InjuryCervical SpineLumbar SpineRight Upper ExtremityLien ClaimantLabor Code Section 4903.05(c)
References
Case No. ADJ1518346 (MON 0297186)
Regular
Nov 20, 2017

THOMAS MARTINEZ vs. RALPHS GROCERY COMPANY, Permissibly Self-Insured; Administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a WCJ's decision allowing a lien claim of $51,400.37 for medical treatment. During reconsideration, the defendant, Ralphs Grocery Company, and the lien claimant, Motion Picture Health Fund (MPHF), resolved the lien dispute through mediation. They agreed to a settlement payment of $29,950.00. Consequently, the WCAB rescinded the original WCJ order, approved the settlement agreement, and dismissed the defendant's petition for reconsideration as moot.

Workers' Compensation Appeals BoardRalphs Grocery CompanySedgwick Claims Management ServicesMotion Picture Health Fundlien claimmedical treatment expensepenaltiesinterestreconsiderationvoluntary mediation
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. ADJ5806281
Regular
Jul 03, 2012

DEBBIE SCHLATER vs. NORTH COAST DRIVERS, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's petition to reopen for new and further disability after an initial award became final. The Workers' Compensation Appeals Board (WCAB) granted removal to review an administrative law judge's denial of a voluntary arbitration request. The WCAB clarified that while arbitration is generally prohibited after testimony is taken, it is permissible for issues not decided in a final award. Therefore, the WCAB rescinded the denial, allowing the parties to arbitrate the new and further disability claim.

Petition for RemovalVoluntary ArbitrationWCAB Rule 10997Labor Code section 5275(b)Court Administrator Rule 10296(a)Findings and AwardNew and Further DisabilityReopen CaseDisability Evaluator TestimonyFinal Award
References
Case No. ADJ2653693
Regular
Jul 12, 2012

TIMETHY PORTEOUS vs. REAL ROCK INDUSTRIES, LUMBERMENS MUTUAL INSURANCE COMPANY

This case involves a dispute over voluntary arbitration after a prior Workers' Compensation Appeals Board (WCAB) award. The WCJ initially denied arbitration based on WCAB Rule 10997, which generally prohibits arbitration after testimony has been taken. However, the Appeals Board granted removal, reversing the WCJ's decision. They clarified that Rule 10997 only bars arbitration for issues previously decided in a final award after testimony, allowing parties to voluntarily arbitrate any *remaining, undecided* issues. Therefore, the parties were permitted to proceed with arbitration for outstanding matters.

Petition for RemovalVoluntary ArbitrationWCAB Rule 10997Labor Code section 5275(b)Court Administrator Rule 10296(a)Order Denying Request for Submittal to Voluntary ArbitrationFindings and Awardcumulative traumaindustrial injurytemporary disability indemnity
References
Case No. ADJ10423250
Regular
Jul 21, 2025

MARC LAFLEUR vs. MILHOUSE CHILDREN'S SERVICES, NON-PROFITS UNITED, SEDGWICK CLAIMS MANAGEMENT SERVICES, INCORPORATED

Applicant Marc Lafleur sought reconsideration of an April 18, 2025 Findings and Award, which denied his Petition to Reopen for new and further disability. The initial award found no evidence of new and further disability within five years of his June 11, 2015 injury. Lafleur argued that the workers' compensation administrative law judge (WCJ) should have relied on the opinion of Agreed Medical Evaluator (AME) Thomas Pattison, M.D., and correctly identified his occupation. The Appeals Board granted the petition for reconsideration, stating that this is not a final order on the merits but defers a final decision for further review of factual and legal issues, encouraging the parties to consider mediation.

Petition for ReconsiderationNew and Further DisabilityStipulated AwardAgreed Medical EvaluatorPermanent DisabilityFive-Year RuleLabor Code Section 5909Substantial EvidenceContinuing JurisdictionFinal Order
References
Case No. ADJ10405221
Regular
Feb 03, 2023

CARMEN MARTINEZ vs. SAMBRAILO PACKAGING, ZENITH INSURANCE COMPANY

In this workers' compensation case, the defendant insurer sought reconsideration of an order requiring them to pay $540.00 for interpreter services. Following mediation, the defendant and the interpreter, Victor Fridman, reached a settlement for $250.00. The Workers' Compensation Appeals Board rescinded the original order and approved the agreed-upon settlement. The Board commended the parties for resolving the dispute through mediation.

ReconsiderationFindings and OrderWorkers' Compensation Appeals BoardWCJInterpreter servicesMediation conferenceSettlement agreementRescindApproveDefendant's counsel
References
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