LWP Claims Solutions, INC.

What they litigate

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

Where they appear

• Van Nuys 11
• Oxnard 5
• Los Angeles 4
• San Francisco 4
• Oakland 3
• Santa Ana 3
• Anaheim 2
• Fresno 2
• Riverside 2
• Santa Barbara 2
• Santa Rosa 2
• Bakersfield 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.

• 23 for the defense
• 16 for the applicant
• 7 returned for more record

Counted over 45 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.

• ADJ21161039 · 2026-09-04 · Santa Ana District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.4The medical opinions of Dr. Nikakhtar constitutes substantial medical evidence of injury AOE/COE and were unrefuted. The WCJ provided the following analysis in the Opinion on Decision (OOD): A defendant will not be liable for medical treatment where there is no industrial injury. (Kunz v. Patterson Floor Coverings (2002) 67 Cal.Comp.Cases 1588, 1593 (Appeals Board en banc).) Where a lien claimant litigates the issue of entitlement to payment for industrially related medical treatment, the lien claimant stands in the shoes of the injured worker and the lien claimant must establish industrial injury by a preponderance of evidence. (Kaiser Foundation Hospitals v. Workers' Comp. Appeals Bd. (Martin) (1985) Cal.3d 57, 67 [50 Cal.Comp.Cases 411]; Kunz, supra, 67 Cal.Comp.Cases at p. 1592.)”

  The WCJ found substantial medical evidence of injury AOE/COE based on Dr. Nikakhtar's medical opinion, which was unrefuted and based on reasonable medical probability after an adequate examination and evaluation. Defendant failed to provide evidence to refute the medical history or opinion. The WCAB affirmed the WCJ's findings and admitted lien claimants' exhibits into evidence.

  Official decision · page 4 →
• ADJ16313390 · 2026-07-30 · Santa Ana District OfficeQME/AME processdefendant prevailed

  Determinative passage · p.3It appears that the actual issue in these matters is whether defendant may replace Dr. Krishnareddy due to his alleged unavailability. Rather than try that issue on the merits, the WCJ bifurcated the sub-issue of whether applicant may take the QME’s deposition on the issue of his availability.

  The WCJ bifurcated the issue of QME availability and denied applicant's request to depose the QME. The Appeals Board found no substantial prejudice or irreparable harm to applicant to warrant replacement of the QME and dismissed the petition for reconsideration as the order was non-final and removal was not warranted.

  Official decision · page 3 →
• ADJ19688721 · 2026-07-15 · Fresno District OfficeQME/AME processapplicant prevailed

  Determinative passage · p.6Turning now to the merits of the Petition, applicant contends that the WCJ did not adequately weigh the prejudice caused to applicant by restarting the QME process and that substantial justice requires that Dr. Saadat remain as the PQME in this matter. Applicant further contends that the WCJ did not properly analyze the elements set forth in Vazquez. In Vazquez, we held that for represented cases, “the determination of whether a QME should be replaced due to unavailability to set an evaluation is within the discretionary power of the Appeals Board, and a PQME may be replaced where a party demonstrates good cause for the replacement.” (Id. at p. 523.) Under Vazquez, good cause is determined based upon a balancing of multiple factors, which include: a. The length of delay caused by the QME's unavailability.

  The Appeals Board found that the defendant did not establish good cause for replacement of Dr. Saadat as PQME, considering the length of delay, prejudice to applicant, efforts to remedy availability, and constitutional mandate for substantial justice.

  Official decision · page 6 →
• ADJ20009316 · 2026-07-07 · Los Angeles District OfficeQME/AME processapplicant prevailed

  Determinative passage · p.8Here, as acknowledged in the Petition, defendant stipulated to receipt of the October 22, 2025 email from applicant’s counsel striking Dr. Polushkin. Defendant was thus apprised of applicant’s valid and timely strike. Accordingly, to the extent that defendant seeks reconsideration, the Petition is dismissed, and to the extent that defendant seeks removal of the April 23, 2026 F&O, the Petition is denied.

  The Board found the strike valid despite defendant's procedural objections, emphasizing the informality allowed in workers' compensation proceedings and that the defendant was aware of the strike.

  Official decision · page 8 →
• ADJ13057169 · 2026-03-12 · San Francisco District OfficePermanent disability ratingapplicant prevailed

  Determinative passage · p.8Defendant contends that the WCJ's adoption of Dr. Burt's Almaraz-Guzman rating was an "improper deviation from the permanent disability rating schedule." (Petition, p. 10.)

  The WCJ's adoption of Dr. Burt's Almaraz-Guzman rating was supported by substantial medical evidence, including a thorough explanation of the alternative rating method and the synergistic effect of multiple injuries, consistent with Almaraz-Guzman II and Vigil standards.

  Official decision · page 8 →
• ADJ16040226 · 2026-01-06 · Oakland District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.7Here, based upon our review of the evidentiary record, including the QME reports of Dr. McBride, we agree with the WCJ that Dr. McBride obtained a thorough history of the injury, and completed a comprehensive examination of applicant and review of applicable medical records. (Report, p. 7.) Further, his opinions are well-reasoned and not based upon surmise, speculation, conjecture, or guess. We remind defendant that although the onus is on applicant to provide substantial evidence of injury AOE/COE, the "burden manifestly does not require the applicant to prove causation by scientific certainty." (Rosas v. Workers' Comp. Appeals Bd. (1993) 16 Cal.App.4th 1692, 1700-1701 [58 Cal.Comp.Cases 313].) Further, once this burden has been met, the burden shifts to defendant to provide evidence in rebuttal. Although defendant references reporting by Dr. Candell, no real contradictory evidence has been presented herein. The record overwhelmingly supports a finding of industrial causation. Accordingly, we agree with the PWCJ that applicant has met her burden in establishing substantial medical evidence of injury AOE/COE to the lumbar spine with a continuing need for future medical treatment.

  The Appeals Board found that applicant met her burden of proving injury AOE/COE based on substantial medical evidence from QME Dr. McBride, who provided well-reasoned opinions supported by medical history, examination, and records, and that defendant failed to present contradictory evidence sufficient to rebut this.

  Official decision · page 7 →
• ADJ11381920 · 2025-06-13 · Van Nuys District OfficeTemporary disabilityremanded

  Determinative passage · p.5Here, it appears that defendant reasonably relied on the pre-trial conference statement and the discussions at the time of trial to determine what issues it would need to defend at trial. Consequently, we cannot interpose our own findings on the specific issue of accrued and owing temporary disability, which was not identified as an issue pending at the time of the pre-trial conference statement or as an issue for adjudication at the time of trial. Under these circumstances, we cannot "do justice" as applicant argues, by interposing our own findings on the issue of accrued and unpaid temporary disability without violating the parties' rights to due process. (Gangwish v. Workers' Comp. Appeals Bd. (2001) 89 Cal.App.4th 1284, 1295 [66 Cal.Comp.Cases 584] citing Rucker, supra, 82 Cal.App.4th at pp. 157-158).

  The WCAB found that the issue of accrued temporary disability benefits and attorney fees was not identified for trial, and adjudicating it without notice would violate due process. Therefore, the issue was deferred to avoid due process violation.

  Official decision · page 5 →
• ADJ17068636 · 2025-05-19 · Riverside District OfficeAOE/COEdefendant prevailed

  Determinative passage · p.6To receive treatment charges this WCJ determined that Medland is faced with an initial burden of proving that the injured worker sustained injury arising out of and in the course of employment. As noted above, injury arising out of and in the course of employment has been denied. Medland did not provide a witness or applicant to testify at trial, and to establish industrial injury. Whereas Medland's examining physician Omid Haghighinia D.C. does report an injury in report of April 26, 2023, this WCJ takes note of further history of applicant denying prior or subsequent injuries or accidents off the job. Records/exhibits offered by defendant suggest otherwise. Records of Intercare Holdings (Defendant's Exhibit F) reflect injury to the back requiring treatment at US Healthworks dating back to 7/30/2012. Records of ACE Property and Casualty (Defendant's Exhibit G) reflect injury to back, arms and knees requiring treatment at Arrowhead Orthopedics back in May of 2017, and with diagnosis to include disc protrusion, fibromyalgia, and radiculopathy.

  The WCJ and WCAB found lien claimant failed to meet burden of proof for injury AOE/COE due to inconsistent medical history and prior injuries not disclosed to PTP.

  Official decision · page 6 →
• ADJ1829851 · 2025-04-29 · Oakland District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.9Accordingly, applicant was acting within the course of his employment by attempting to retrieve the employer's vehicle for his employer's benefit. Therefore, applicant's resulting injury arose out of and in the course of his employment and is compensable. (Williams, supra, 41 Cal.App.3d at pp. 940-941; Westbrooks, supra, 203 Cal.App.3d at pp. 253-254.) We therefore affirm the WCJ's decision and deny reconsideration.

  The WCJ and WCAB found that applicant was acting within the course of employment by attempting to retrieve the employer's stolen vehicle for the employer's benefit, and that the injury arose out of and in the course of employment despite defendant's argument that the applicant's final actions were an unauthorized departure from employment.

  Official decision · page 9 →
• ADJ15406201 · 2024-04-22 · Van Nuys District OfficeAOE/COEremanded

  Determinative passage · p.1Defendants Enki Medical Services and Service American Indemnity Company, administered by LWP Claims Solutions, seek reconsideration of the February 5, 2024 Findings of Fact, wherein the workers' compensation administrative law judge (WCJ) found that applicant sustained injury arising out of and in the course of employment to her circulatory system and other body systems resulting in her death.

  The WCAB granted reconsideration to further study whether the death inference applies and whether the record supports Dr. Markowitz's opinion on causation, deferring final decision.

  Official decision · page 1 →
• ADJ16542754 · 2024-01-23 · Santa Rosa District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.1Defendant seeks reconsideration of the Findings and Award and Order (F&A) issued by the workers' compensation administrative law judge (WCJ) on November 3, 2023, wherein the WCJ found in pertinent part that applicant sustained injury arising out of and occurring in the course of employment (AOE/COE) to her cervical spine, right shoulder, and low back; and that the reporting from treating physician Brendan P. Morely, M.D., is more persuasive than the reporting from orthopedic qualified medical examiner (QME) Jeffrey O. McGillicuddy, M.D. The WCJ also found that, "The record is not fully developed on the issue of the applicant's periods of partial temporally disability or total temporary disability" and ordered the parties "to develop the record with respect to the applicant's periods of temporary disability..." (F&A, pp. 1 § 2.)

  The WCJ found applicant's testimony credible and consistent with Dr. Morley's opinions, which were detailed and based on medical evidence, and rejected Dr. McGillicuddy's contrary opinion as less persuasive.

  Official decision · page 1 →
• ADJ16904999 · 2023-11-06 · Riverside District OfficeJurisdiction / venueremanded

  Determinative passage · p.3We begin by noting that, as we read the Findings of Fact, it appears that the WCJ believed that a determination that applicant was not employed for six months meant that: 1) applicant's claim was barred by section 3208.3(d), and 2) applicant did not sustain injury AOE/COE. However, the latter is an incorrect reading of section 3208.3(d); that portion of the statute has nothing to do with whether an injury was industrial, i.e., AOE/COE. Additionally, injury AOE/COE was not an issue identified for determination at trial. Thus, the WCJ's finding that applicant did not sustain injury AOE/COE was unnecessary and lacked any legal basis.

  The Board found the WCJ erred in applying the six-month employment rule and in concluding the claim was barred without sufficient evidence of employment length and injury causation. The Board rescinded the F&O and remanded for further proceedings to develop the record.

  Official decision · page 3 →

Also recorded as

The same claims administrator is printed several ways across the decisions, and all of them were counted as one. These are the twelve commonest of 14.

• LWP CLAIMS SOLUTIONS, INC.
• LWP CLAIMS SOLUTIONS
• LWP CLAIMS
• LWP Claims Solutions, Inc.
• LWP Claims Solutions
• LWP Claims
• LWP CLAIMS SOLUTIONS, INC
• LWP CLAIMS SOLUTIONS INC.
• LWP Claims Solutions Inc.
• LWP CLAIMS SOLUTIONS INC
• LWP CLAIMS SACRAMENTO
• LWP CLAIM SOLUTIONS

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.