Constitution State Services

What they litigate

Disputed issues across the decisions this claims administrator is named in. Every row opens the decisions it counts.

• Medical treatment / UR / IMR3
• Apportionment2
• AOE/COE1
• Psyche AOE/COE1
• Liens1

Where they appear

• Santa Ana 3
• Anaheim 2
• Long Beach 1
• Los Angeles 1
• Sacramento 1
• Santa Rosa 1
• Van Nuys 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 claims administrator does its work. It describes how a set of appealed disputes came out.

• 10 for the defense
• 3 for the applicant

Counted over 11 appealed decisions. Not this claims administrator’s book of work. A decision that went one way on one issue and the other way on another is counted in both columns, so the figures add up to more than the total.

Decisions

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

• ADJ18058034 · 2025-09-23 · Sacramento District OfficeApportionmentdefendant prevailed

  Determinative passage · p.3Defendant has the burden of proof on the issue of apportionment. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Board en banc).) Apportionment of permanent disability must be based on causation (Lab. Code, § 4663) and may be attributed to pathology, asymptomatic prior conditions, and retroactive prophylactic work preclusions, provided there is substantial medical evidence establishing that these other factors have caused permanent disability. (Yeager Construction v. Workers' Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, 928 [71 Cal.Comp.Cases 1687] citing Escobedo v. Marshalls, supra, at 612.) Permanent disability must be apportioned in accordance with substantial medical evidence. (Acme Steel v. Workers' Comp. Appeals Bd. (Borman) (2013) 218 Cal.App.4th 1137 [78 Cal.Comp.Cases 751])

  The Panel Qualified Medical Evaluator, Dr. Sean Robinson, provided substantial medical evidence supporting a 60% industrial apportionment and 40% non-industrial apportionment based on detailed examination, history, and medical records, which the Appeals Board found legally valid and supported the denial of reconsideration.

  Official decision · page 3 →
• ADJ17872943 · 2025-05-12 · Santa Ana District OfficeAOE/COEdefendant prevailed

  Determinative passage · p.7The applicant reported that his pain began on 01/06/2021 when he was involved in a motor vehicle accident while he was en route to make his delivery. He reported the injury but received no medical treatment.

  The WCJ found the applicant did not sustain injury arising out of and in the course of employment based on credible testimony of defendant's witness and lack of substantial medical evidence from Dr. Amin Nia due to inaccurate job history.

  Official decision · page 7 →
• ADJ16996210 · 2024-11-12 · Van Nuys District OfficeApportionmentapplicant prevailed

  Determinative passage · p.1Defendant seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings and Award of August 13, 2024, wherein it was found that while employed as a truck driver during a cumulative period ending November 9, 2022, applicant sustained industrial injury to his knees, thoracic spine and lumbar spine causing permanent disability of 29% after Labor Code section 4664 apportionment to a prior award of permanent disability. It appears uncontested that applicant sustained a previous industrial injury to the thoracic spine and knees during a cumulative period ending June 16, 2015 which resulted in a stipulated Award of 24% permanent disability in case ADJ10089577. In finding compensable permanent disability of 29% in the instant case, the WCJ found that the award of thoracic spine permanent disability in the previous case completely overlapped the permanent disability in the current case, and thus no new thoracic permanent disability was awarded. It was found that applicant's prior award of right knee permanent disability partially overlapped the disability caused in the current case, and the WCJ thus subtracted 3% right knee permanent disability from applicant's overall permanent disability pursuant to Labor Code section 4664.

  Defendant failed to prove overlap of prior permanent disability with current disability beyond what the WCJ found, so no additional apportionment was warranted.

  Official decision · page 1 →
• ADJ13245796 · 2024-06-03 · Long Beach District OfficePsyche AOE/COEdefendant prevailed

  Determinative passage · p.6Lien claimant also failed to demonstrate that applicant sustained a psychiatric injury as a compensable consequence of an industrial orthopedic industry. In concluding otherwise, Dr. Michaels found, without the assistance of medical reporting by an Agreed Medical Evaluator (AME) or Qualified Medical Evaluator (QME) in the field of orthopedics, or similar medical evidence, that applicant did, in fact, sustain the physical injuries that she described to Dr. Michaels during their discussions. In his report, Dr. Michaels admitted that he was not capable of diagnosing physical injuries, stating: "Assessment of the applicant's physical functioning is beyond the scope of my expertise...." (Lien Claimant Exh. 104, p. 22.) In other words, Dr. Michaels assumed that applicant sustained one or more industrial physical injuries and opined that she also sustained a psychological injury as a compensable consequence. Without additional evidence to support Dr. Michel's underlying assumption, the report is not capable of proving or disproving a disputed medical fact. Thus, the WCJ's decision to reject Dr. Michaels's report as substantial medical evidence of a compensable consequence psyche injury is affirmed.

  Dr. Michaels assumed physical injuries without medical evidence from an AME or QME; thus, his opinion on compensable consequence psyche injury was not substantial evidence.

  Official decision · page 6 →
• ADJ12190515 · 2022-08-09 · Anaheim District OfficeMedical treatment / UR / IMRdefendant prevailed

  Determinative passage · p.3There was no evidence offered that this report [the driving evaluation] was ever served on Defendants or reviewed by Dr. Patterson. As noted in the non- certification, along with the driving evaluation psychological issues, treatment plan and medical necessity were also required to complete the UR. It was not just a matter of the Applicant passing a driving evaluation. The request for additional information was valid. The driving evaluation on its own without medical review was not complete to support medical necessity and the other information requested was not provided. In light of that, the utilization review was timely. (Report, p. 3.)

  The utilization review was timely because the required supporting documentation, including the driving evaluation and other medical necessity information, was not provided; applicant is not entitled to a modified vehicle at this time but may request again with proper documentation.

  Official decision · page 3 →
• 1998-spd6 · 1998-10-26Liensdefendant prevailed

  Determinative passage · p.89 decision finding that II's recovery is barred by its failure to obtain

  The lien claim for physical therapy was denied because the referring physician did not obtain the required preauthorization under Labor Code section 139.31(e).

  Official decision · page 8 →
• ADJ19897089 · 2026-02-03 · Santa Rosa District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.4Here, the WCJ's decision includes findings that applicant sustained an admitted injury and regarding employment, which are threshold issues. Accordingly, the WCJ's decision is a final order subject to reconsideration rather than removal.

  The WCJ's decision included findings on threshold issues (injury and employment), making it a final order subject to reconsideration. The applicant's challenge to the QME's timely report and continued appointment was interlocutory and subject to removal standards, but no significant prejudice or irreparable harm was shown.

  Official decision · page 4 →
• ADJ12190515 · 2023-12-29 · Anaheim District OfficeOther disputed issueapplicant prevailed

  Determinative passage · p.4As to the issue if there is good cause for the Applicant to conduct the deposition of the person most knowledgeable (PMK) for Ericsson as to earnings and earnings capacity, it is found that there is good cause and that Applicant is entitled to conduct the deposition. The Applicant's earnings potential/capacity may be relevant to the issue of the applicant's disability rate.

  The WCJ found good cause to allow the deposition of the PMK regarding earnings and earning capacity as relevant to the applicant's disability rate, and the WCAB found no substantial prejudice or irreparable harm to defendant from allowing the deposition.

  Official decision · page 4 →
• ADJ8209954 · 2023-11-13 · Santa Ana District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.1Applicant seeks reconsideration1 of the September 7, 2023 Opinion and Order Denying Petition for Disqualification (O&O), wherein we determined that applicant's petition did not establish the facts necessary to support disqualification of the workers' compensation administrative law judge (WCJ) pursuant to Labor Code section 5311, Workers' Compensation Appeals Board (WCAB) Rule 10960, and Code of Civil Procedure section 641(f) and (g).

  The petition was dismissed because the September 7, 2023 decision was not a final order and the petition lacked evidence to support bias or disqualification.

  Official decision · page 1 →
• ADJ8209954 · 2023-09-07 · Santa Ana District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.1We have considered the allegations of the Petition for Disqualification filed on May 2, 2023, 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 for the reasons discussed below, we will deny the Petition for Disqualification.

  The petition did not establish sufficient grounds for disqualification under the applicable legal standards and procedural rules.

  Official decision · page 1 →
• ADJ15120447 · 2023-02-13 · Los Angeles 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 harm will result if removal is denied and/or that reconsideration will not be an adequate remedy if the matter ultimately proceeds to a final decision adverse to petitioner.

  The Appeals Board denied the petition because the petitioner did not demonstrate substantial prejudice or irreparable harm if removal was denied, nor that reconsideration would be inadequate if the matter proceeded to a final adverse decision.

  Official decision · page 1 →

Also recorded as

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

• CONSTITUTION STATE SERVICES
• Constitution State Services
• CONSTITUTION STATE SERVICES For INDEMNITY INSURANCE COMPANY OF THE NORTH
• Constitution State Services Company
• CONSTITUTION STATE SERVICE COMPANY

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 claims administrator is named in, and the decisions themselves are listed above with the passage each turned on.