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

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. ADJ2904305 (GOL 0095697) ADJ1827151 (GOL 0095698)
Regular
Aug 02, 2010

GUADALUPE CARRILLO vs. SAN ANTONIO VILLAGE HOA, STATE FARM INSURANCE COMPANIES

The Workers' Compensation Appeals Board denied a lien claimant's petition for reconsideration regarding a disallowed lien balance of $9,349.46. The claimant, a doctor, failed to obtain required written authorization for work hardening services billed under CPT Code 97545. Despite a claim of verbal authorization and a general request for multiple modalities, the Board found the lack of specific written authorization for the disputed services to be determinative. Therefore, the administrative law judge's disallowance of the lien balance was upheld.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationCompromise and ReleaseWork hardeningWork conditioningCPT Code 97545Prior authorizationVerbal authorizationWritten authorization
References
Case No. ADJ4718149 (GRO 0034104) ADJ708995 (GRO 0034105)
Regular
Jul 03, 2012

ART QUIROS vs. SUPERIOR TANK COMPANY, INC., SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded an earlier order awarding reimbursement to the Employment Development Department (EDD). The Board found that EDD's claim for reimbursement was invalid because EDD failed to provide the defendant with proper written notice of the lien claim and its extent, as required by Labor Code section 4904(a). Although EDD argued oral notice was given at hearings, the Board held that statutory law mandates written notification for a lien to be valid. Therefore, EDD's claim for reimbursement was disallowed.

Workers' Compensation Appeals BoardSuperior Tank CompanySeabright Insurance CompanyEmployment Development Departmentlien claimCompromise and Releasewritten noticeLabor Code section 4904(a)actual or constructive noticetemporary disability benefits
References
Case No. ADJ11369357, ADJ11369329
Regular
May 21, 2025

GLORIA DAVIS vs. KAISER FOUNDATION HOSPITAL, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

Gloria Davis, the applicant, sought reconsideration of Findings and Orders issued on February 7, 2025. The original orders found she sustained a lumbar spine injury but denied her Labor Code section 132a claim for discrimination. Davis contended that the F&O was a result of fraud and WCJ bias, specifically regarding her termination from Kaiser Foundation Hospital for alleged HIPAA violations. The Workers' Compensation Appeals Board reviewed the petition, the defendant's answer, and the WCJ's report. The Board denied reconsideration, upholding the WCJ's credibility determination and finding no evidence that Davis was discriminated against due to her industrial injuries.

WORKERS' COMPENSATION APPEALS BOARDGLORIA DAVISKAISER FOUNDATION HOSPITALSEDGWICK CLAIMS MANAGEMENT SERVICESINC.ADJ11369357ADJ11369329Oakland District OfficeOPINION AND ORDER DENYING PETITION FOR RECONSIDERATIONpatient care technician
References
Case No. ADJ9531454 MF ADJ9531455
Regular
Dec 03, 2018

MOHAMMAD MORADI vs. NORTHWEST COLORADO TRANSPORT, LLC

The Workers' Compensation Appeals Board (WCAB) rescinded the finding of subject matter jurisdiction, determining that the applicant's contract of hire was concluded in North Dakota, not California, as per the written employment agreement signed there. Consequently, the WCAB lacks jurisdiction under Labor Code sections 3600.5(a) and 5305, which require the contract of hire to be made in California for out-of-state injuries. The WCAB's decision was influenced by the appellate court's ruling in *Tripplett*, which emphasized that a written employment contract signed out-of-state supersedes earlier oral agreements for jurisdictional purposes. As a result, the applicant will take nothing on his claims.

Workers' Compensation Appeals BoardSubject Matter JurisdictionPersonal JurisdictionContract of HireConditions SubsequentGeneral AppearanceWaiverLabor Code Section 5305Industrial InjuryNorth Dakota
References
Case No. SFO 0484956
Regular
Dec 10, 2007

LEANNE TAM vs. FAIRMONT HOTEL, ATHENS ADMINISTRATORS

This case concerns a lien claimant's attempt to testify at trial regarding the reasonableness of medical treatment. The Workers' Compensation Appeals Board denied the claimant's petition for removal, upholding the administrative law judge's decision to strike the witness. The Board reasoned that workers' compensation proceedings favor written medical reports over live testimony to ensure efficiency and substantial justice.

Petition for RemovalLien ClaimantTestimonyMandatory Settlement ConferenceWCAB Rule 10606Medical ReportsDirect ExaminationGood CauseSubstantial JusticeDue Process
References
Case No. ADJ1856849
Regular
Aug 21, 2014

ROGELIO MERLOS vs. AJ SLENDERS DAIRY, ZENITH INSURANCE COMPANY

This Workers' Compensation Appeals Board (WCAB) notice indicates they are reconsidering a prior ruling that excluded defendant's exhibits A through M as irrelevant. The WCAB believes these exhibits may be relevant to the issues presented at trial. Absent timely written objection demonstrating good cause, these exhibits will be admitted into evidence. This decision will inform the final determination on the defendant's petition for reconsideration.

Petition for ReconsiderationExhibits A through MWCJNotice of Intention to Admit EvidenceWorkers' Compensation Appeals BoardWorkers' Compensation Administrative Law JudgeGood CauseWritten ObjectionDemonstration of Good CauseService of Notice
References
Case No. ADJ7405264
Regular
Jun 19, 2012

IVORY PHILLIPS vs. IRWIN INDUSTRIES, INC., ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board sanctioned claims adjuster Richard Bailey $250 for failing to appear at an arbitration hearing. Despite Bailey's contentions about lack of written notice and fear of the arbitrator, the Board found he had actual notice of the verbal order. While the underlying issue was resolved, Bailey should have sought permission for his non-appearance, and his disregard for the arbitrator's order undermined the system's integrity.

Workers' Compensation Appeals BoardSanctionsClaims AdjusterArbitrationWritten ObjectionGood CauseArbitratorVerbal OrderLabor Code Section 5701Independent Medical Examination
References
Case No. ADJ9071017
Regular
May 12, 2017

ELISABETH PERRY, LISA MARIE SOUSA (Deceased) vs. MILLARD GROUP, YORK RISK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for removal. Removal is an extraordinary remedy granted only upon a showing of substantial prejudice or irreparable harm. The defendant sought to present live medical expert testimony despite having written reports, which the Administrative Law Judge (ALJ) initially disallowed. The WCAB found the defendant did not demonstrate the required prejudice and that reconsideration would be an adequate remedy if necessary.

Petition for RemovalAppeals BoardWorkers' Compensation Administrative Law JudgeSubstantial PrejudiceIrreparable HarmReconsiderationDue ProcessExpert TestimonyMedical DoctorsLive Testimony
References
Case No. ADJ4668407 (RIV 0055963)
Regular
Feb 19, 2015

JOSE MARTINEZ vs. 2K FABRICATION, INCORPORATED, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed a prior decision finding that State Compensation Insurance Fund (SCIF) did not provide coverage for 2K Fabrication, Inc. on July 8, 2003. The Board ruled that SCIF's cancellation of the employer's policy effective March 18, 2003, was valid. Arguments for coverage based on alleged lack of notice, estoppel due to premium acceptance, audits, and defense of the claim were rejected. The Board found no evidence of a written reinstatement of the canceled policy.

Workers' Compensation Appeals BoardReconsiderationPolicy CancellationCoverage DisputeEstoppelWaiverWritten NoticeInsurance ContractPremium PaymentPost-Cancellation Audit
References
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