Pacific Claims Management

What they litigate

Disputed issues across the decisions this insurance carrier is named in. Every row opens the decisions it counts.

Where they appear

• Fresno 4
• Van Nuys 3
• San Francisco 2
• Anaheim 1
• Los Angeles 1
• Marina del Rey 1
• San Diego 1
• Santa Ana 1
• Santa Barbara 1

How the appealed decisions came out

These are decisions that were appealed and published — the tail of a system that mostly settles. Most claims end in a compromise and release or a stipulation and never reach a panel, so nothing below describes how this insurance carrier does its work. It describes how a set of appealed disputes came out.

• 9 for the defense
• 4 for the applicant
• 1 returned for more record

Counted over 14 appealed decisions. Not this insurance carrier’s book of work.

Decisions

Newest decisions this insurance carrier is named in, each with the passage the panel turned on and a link to the official PDF.

• ADJ11080934 · 2025-10-28 · Fresno District OfficePenalties under Labor Code §5814defendant prevailed

  Determinative passage · p.9Labor Code 5813 states, in pertinent part, "The workers' compensation referee or appeals board may order a party, the party's attorney, or both, to pay any reasonable expenses, including attorney's fees and costs, incurred by another party as a result of bad-faith actions or tactics that are frivolous or solely intended to cause unnecessary delay." WCAB Rule 10421(b), for its part, states, "Bad faith actions or tactics that are frivolous or solely intended to cause unnecessary delay include actions or tactics that result from a willful failure to comply with a statutory or regulatory obligation, that result from a willful intent to disrupt or delay the proceedings of the Workers' Compensation Appeals Board, or that are done for an improper motive or are indisputably without merit."

  The WCAB found insufficient evidence that defendant engaged in bad-faith actions or tactics that were frivolous or solely intended to cause unnecessary delay, and thus rescinded the WCJ's sanctions order.

  Official decision · page 9 →
• ADJ17308688 · 2025-10-17 · Van Nuys District OfficeQME/AME processmixed

  Determinative passage · p.6In this case only the initial exam with a medical report is medical-legal. The remaining reports from Dr. Mirzaians were mere progress reports of the treating physician. They were not requested by anyone, nor do they identify any contested issue. The provision of progress reports is one of the duties of the primary treatment physician. Cal. Code of Regs. sec. 9785. But unless someone specifically requests a medical-legal opinion which shall be used to determine a dispute, those progress reports are medical treatment costs.

  Only the initial report was specifically requested as a medical-legal report to address a disputed issue; subsequent reports were routine progress reports not requested to resolve a dispute and thus are medical treatment costs.

  Official decision · page 6 →
• ADJ19297551 · 2025-08-11 · San Francisco District OfficeMedical treatment / UR / IMRapplicant prevailed

  Determinative passage · p.12Lastly, section 4605 provides: Nothing contained in this chapter shall limit the right of the employee to provide, at his or her own expense, a consulting physician or any attending physicians whom he or she desires. Any report prepared by consulting or attending physicians pursuant to this section shall not be the sole basis of an award of compensation. A qualified medical evaluator or authorized treating physician shall address any report procured pursuant to this section and shall indicate whether he or she agrees or disagrees with the findings or opinions stated in the report, and shall identify the bases for this opinion. (Lab. Code, § 4605.) Here, we have concluded that Dr. Tarin's medical report is relevant to the issue and must be provided to Dr. Bressler under section 4062.3(a)(2). We note that the application of section 4605 is more significant in the context of whether reporting by a consulting physician may be the basis for an award. Here the issue is causation, not permanent disability, but we observe that the language of section 4605 also supports a conclusion that the QME should review the reporting. Accordingly, we grant applicant's Petition, rescind the WCJ's May 9, 2025 F&O, and issue a new decision ordering that Dr. Tarin's report be provided to QME Dr. Bressler.

  The Appeals Board found that Dr. Tarin's pathology report is relevant and must be provided to the QME under Labor Code section 4062.3(a)(2), rejecting the WCJ's exclusion based on AD Rule 35(e) and WCAB Rule 10682(b).

  Official decision · page 12 →
• ADJ11080934 · 2025-08-04 · Fresno District OfficePenalties under Labor Code §5814defendant prevailed

  Determinative passage · p.7We find insufficient evidence in this case of bad-faith actions or tactics that are frivolous or that result from a willful failure to comply with a statutory or regulatory obligation. Although the WCJ is correct that the parties should have sought a neuropsychological evaluation when it was recommended by Dr. Bhatia, we see no evidence this was a willful failure by the defendant. We do not believe that the onus for seeking such discovery fell solely on the defendant's shoulders. Indeed, applicant was represented and has the burden of proving industrial injury. Given that there is no evidence at all of applicant mentioning the need for a neuropsychological evaluation for nearly six years after Dr. Bhatia's report, it is unclear how defendant's actions could be found "willful" and or that a finding could be made that defendant did not deal fairly and in good faith. During this time, applicant could have engaged defendant in discussions regarding the need for further discovery or setting forth good cause for further panels before the WCAB and obtaining an order for further discovery. We find nothing in the record that defendant obstructed any such efforts.

  The WCAB found insufficient evidence that defendant's actions were willful or in bad faith, noting the applicant's delay in seeking neuropsychological evaluation and defendant's reasonable position requiring good cause for additional panels.

  Official decision · page 7 →
• ADJ13368607 · 2025-02-24 · San Diego District OfficeQME/AME processremanded

  Determinative passage · p.1Defendant seeks reconsideration of the November 27, 2024 Findings and Award issued by the workers' compensation administrative law judge (WCJ). Therein and as relevant here, the WCJ found that applicant sustained industrial injury to his left ring and left middle finger, neck, right upper extremity including shoulder, forearm, hand, in the form of a diagnosis of CRPS, and psyche in the form of PTSD while employed as a lube technician on May 16, 2020. The WCJ further found that the Petition to Replace Panel QME Reiss is denied and that applicant is permanently totally disabled.

  The WCJ found no good cause to delay trial for QME Reiss to review sub rosa video; the Appeals Board granted reconsideration to further review the issue.

  Official decision · page 1 →
• ADJ21267547 · 2026-06-15 · Van Nuys District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.1On March 23, 2026, defendant timely filed a Petition for Reconsideration. On April 15, 2026, the WCJ issued a Report and Recommendation (Report), recommending that we deny the Petition for Reconsideration. The WCJ did not set a hearing to address whether the Compromise & Release (C&R) should be set aside. On April 29, 2026, the parties submitted an amended C&R. On May 4, 2026, the WCJ issued an amended OACR. Turning first to the merits of the Petition for Reconsideration, we note that as observed by the WCJ, there was no evidentiary record with respect to the allegations in the Petition for Reconsideration. Decisions of the Appeals Board "must be based on admitted evidence in the record." (Hamilton v. Lockheed Corporation (Hamilton) (2001) 66 Cal.Comp.Cases 473, 476 (Appeals Board en banc).) Furthermore, decisions of the Appeals Board must be supported by substantial evidence. (Lab. Code, § 5903, 5952(d); Lamb v. Workmen's Comp. Appeals Bd. (1974) 11 Cal.3d 274 [39 Cal.Comp.Cases 310]; Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312 [35 Cal.Comp.Cases 500]; LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) An adequate and complete record is necessary to understand the basis for the WCJ's decision. (Lab. Code, § 5313; see also Cal. Code Regs., tit. 8, § 10787.)

  The Appeals Board dismissed the Petition for Reconsideration because the WCJ erred by recommending denial without creating an evidentiary record and by issuing an amended order while the matter was pending before the Appeals Board, violating procedural rules.

  Official decision · page 1 →
• ADJ20340059 · 2026-03-26 · Marina Del Rey District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.1Applicant contends that the matter is ready to proceed to trial. We have not received an Answer from defendants. The WCJ filed a Report and Recommendation on Petition for Removal (Report) recommending that we deny removal. We have considered the allegations of the Petition for Removal and the contents of the WCJ's Report. Based on our review of the record and based upon the WCJ's analysis of the merits of petitioner's arguments in the WCJ's Report, we will deny removal. Removal is an extraordinary remedy rarely exercised by the Appeals Board. (Cortez v. Workers' Comp. Appeals Bd. (2006) 136 Cal.App.4th 596, 599, fn. 5 [71 Cal.Comp.Cases 155]; Kleemann v. Workers' Comp. Appeals Bd. (2005) 127 Cal.App.4th 274, 280, fn. 2 [70 Cal.Comp.Cases 133].) The Appeals Board will grant removal only if the petitioner shows that substantial prejudice or irreparable harm will result if removal is not granted. (Cal. Code Regs., tit. 8, 10955(a); see also Cortez, supra; Kleemann, supra.) Also, the petitioner must demonstrate that reconsideration will not be an adequate remedy if a final decision adverse to the petitioner ultimately issues. (Cal. Code Regs., tit. 8, § 10955(a).) Here, based upon the WCJ's analysis of the merits of petitioner's arguments, we are not persuaded that substantial prejudice or irreparable

  The Appeals Board denied removal because the petitioner did not show substantial prejudice or irreparable harm if removal was denied, and reconsideration would be an adequate remedy if the matter proceeds to a final adverse decision.

  Official decision · page 1 →
• ADJ19674146 · 2026-01-08 · Anaheim District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.1Applicant has filed a petition for removal from the order setting the matter for trial issued on October 8, 2025, by the workers' compensation administrative law judge (WCJ).

  The petitioner did not demonstrate substantial prejudice or irreparable harm if removal was denied, nor that reconsideration would be inadequate, based on the WCJ's analysis and the Appeals Board's review.

  Official decision · page 1 →
• ADJ19297551 · 2025-10-28 · San Francisco District OfficeReconsideration / removalapplicant prevailed

  Determinative passage · p.1Defendants filed a Joint Petition for Removal or Reconsideration (Petition) of the Opinion and Order Granting Petition for Reconsideration and Decision After Reconsideration, issued on August 11, 2025 (Prior Opinion). In the Prior Opinion, the Appeals Board granted applicant's petition for reconsideration; rescinded the May 9, 2025 Findings and Order issued by the workers' compensation administrative law judge (WCJ); and substituted new Findings and Order wherein the Appeals Board found, in relevant part, that the April 19, 2024 report of David Tarin, M.D., may be submitted to the Qualified Medical Evaluator (QME) Daniel Bressler, M.D., pursuant to Labor Code section 4062.3(a)(2) 1, and ordered that Dr. Tarin's report shall be sent to the QME.

  The Appeals Board found no merit to defendants' petition for removal or reconsideration, concluding that there was no irreparable harm or significant prejudice to applicant and that reconsideration was an adequate remedy. The Board upheld its prior decision allowing Dr. Tarin's report to be submitted to the QME Dr. Bressler.

  Official decision · page 1 →
• ADJ19549540 · 2025-10-22 · Van Nuys District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.1Removal is an extraordinary remedy rarely exercised by the Appeals Board. (Cortez v. Workers' Comp. Appeals Bd. (2006) 136 Cal.App.4th 596, 599, fn. 5 [71 Cal.Comp.Cases 155]; Kleemann v. Workers' Comp. Appeals Bd. (2005) 127 Cal.App.4th 274, 280, fn. 2 [70 Cal.Comp.Cases 133].) The Appeals Board will grant removal only if the petitioner shows that substantial prejudice or irreparable harm will result if removal is not granted. (Cal. Code Regs., tit. 8, 10955(a); see also Cortez, supra; Kleemann, supra.) Also, the petitioner must demonstrate that reconsideration will not be an adequate remedy if a final decision adverse to the petitioner ultimately issues. (Cal. Code Regs., tit. 8, § 10955(a).) Here, based upon the WCJ's analysis of the merits of petitioner's arguments, we are not persuaded that substantial prejudice or irreparable

  The Appeals Board found no substantial prejudice or irreparable harm if removal was denied and that reconsideration would be an adequate remedy if a final adverse decision is issued.

  Official decision · page 1 →
• ADJ11080934 · 2025-02-21 · Fresno District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.1We have considered the allegations of the Petition for Removal and the contents of the report of the workers' compensation administrative law judge (WCJ) with respect thereto. Based on our review of the record, and based upon the WCJ's analysis of the merits of the petitioner's arguments in the WCJ's report and for the reasons stated below, we will deny the Petition as one seeking reconsideration.

  The Appeals Board acted timely on the petition within the 60-day period from case transmission, so the petition was denied on the merits of removal standards.

  Official decision · page 1 →
• ADJ15923475 · 2024-05-17 · Santa Ana District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.5Here, there is currently no evidence admitted into the record regarding applicant's allegation that she was out of the country and has recently returned, and in order to ensure that applicant is provided with due process, we will return this matter to the trial level for further proceedings to develop the record. Upon return of this matter to the trial level, we recommend the WCJ treat applicant's Petition as a petition to set aside, including the setting of a hearing so that applicant can provide evidence in support of her arguments and create a record upon which a decision can be made by the WCJ.

  Applicant's petition for reconsideration was dismissed because the Board found no evidence admitted to the record supporting applicant's claim of being out of the country and not receiving notice, and returned the matter to the trial level for further proceedings to develop the record and treat the petition as a petition to set aside and/or reopen.

  Official decision · page 5 →

Also recorded as

The same insurance carrier is printed several ways across the decisions, and all of them were counted as one. This is every spelling behind the figures above.

• PACIFIC COMPENSATION INSURANCE COMPANY
• PACIFIC CLAIMS MANAGEMENT
• Pacific Claims Management
• PACIFIC INDEMNITY CO.
• Pacific Compensation Insurance Company
• PACIFIC COMPENSATION INSURANCE
• PACIFIC COMPENSATION

Is this your company and something here is wrong? Tell us and we will fix it. Every figure on this page is a count of released decisions this insurance carrier is named in, and the decisions themselves are listed above with the passage each turned on.