CNA Insurance/sedgwick CMS

What they litigate

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

• Jurisdiction / venue3
• Psyche AOE/COE2
• Medical treatment / UR / IMR1
• Permanent total disability1

Where they appear

• Santa Ana 4
• Van Nuys 3
• Fresno 2
• Anaheim 1
• Los Angeles 1
• Marina del Rey 1
• Sacramento 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.

• 6 for the defense
• 5 for the applicant
• 2 returned for more record

Counted over 13 appealed decisions. Not this claims administrator’s book of work.

Decisions

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

• ADJ8015380 · 2026-06-17 · Santa Ana District OfficeJurisdiction / venueremanded

  Determinative passage · p.18For the foregoing reasons, IT IS ORDERED, as the Decision After Reconsideration of the Workers' Compensation Appeals Board, that the July 2, 2019 Findings and Order is AMENDED as follows:

  The Appeals Board deferred the rollback issue pending resolution of the section 3600.5(b) application at the trial level.

  Official decision · page 18 →
• ADJ3317169 · 2025-05-21 · Fresno District OfficePermanent total disabilityapplicant prevailed

  Determinative passage · p.1The WCJ found, in pertinent part, that due to the combined effect of multiple injuries, applicant was not amenable to participate in vocational rehabilitation and was unable to compete in the open labor market and issued a joint and several award of 100% permanent total disability without apportionment.

  Applicant proved permanent total disability through medical and vocational evidence showing complete loss of earning capacity due to industrial injuries; defendant failed to prove apportionment of disability to non-industrial causes.

  Official decision · page 1 →
• ADJ13474651 · 2024-11-25 · Santa Ana District OfficeJurisdiction / venueapplicant prevailed

  Determinative passage · p.1Applicant seeks reconsideration of the Findings and Order (F&O), issued by the workers' compensation administrative law judge (WCJ) on August 14, 2024, wherein the WCJ found in pertinent part that applicant's claims are barred by the doctrine of res judicata because applicant previously settled a case involving the same employers, similar injuries, and the same body parts.

  The Appeals Board found the WCJ erred in barring the claim by res judicata because the prior settlement did not clearly include the brain, nervous system related to psych or stress, or neurological problems aside from Parkinson's disease, and the applicant did not intend to settle those injuries.

  Official decision · page 1 →
• ADJ14327332 · 2023-11-06 · Van Nuys District OfficePsyche AOE/COEremanded

  Determinative passage · p.1Applicant seeks reconsideration of the Findings of Fact and Order (F&O) of August 14, 2023, wherein the workers' compensation administrative law judge (WCJ) found that applicant did not sustain injury arising out of and during the course of employment (AOE/COE) in the form of injury to his psyche and ordered that he take nothing.

  The WCAB found the WCJ's reliance on the PQME report inadequate due to incomplete medical history and recommended further development of the record to clarify causation and apportionment issues.

  Official decision · page 1 →
• ADJ8068969 · 2023-08-29 · Santa Ana District OfficePsyche AOE/COEapplicant prevailed

  Determinative passage · p.1Defendant Mitsui Sumitomo Insurance Company of America (Petitioner) seeks reconsideration of the June 14, 2023 Findings of Fact, wherein the workers' compensation administrative law judge (WCJ) found that applicant, while employed as a server from June 19, 2002 to May 1, 2011, sustained industrial injury to cervical and lumbar spine, psyche, right shoulder, bilateral wrists, left shoulder, mid back, headache and "multiple." The WCJ found that applicant sustained but one cumulative injury, and that the date of injury pursuant to Labor Code1 section 5412 was 2011. Accordingly, the WCJ determined that section 5405 did not bar compensation, and that the period of liability under section 5500.5 commenced in 2010.

  The WCJ and the Board found that the applicant did not sustain compensable disability or acquire requisite knowledge of work-related cumulative injury until 2011, despite earlier medical treatment in 2008. The application was timely filed within one year of the 2011 date of injury, so compensation is not barred.

  Official decision · page 1 →
• ADJ808475 · 2023-08-25 · Van Nuys District OfficeMedical treatment / UR / IMRdefendant prevailed

  Determinative passage · p.11Petitioner argues that due process requires a full development of the record in all worker's compensation cases. The Court agrees. However, the question of whether the requirements of 8 C.C.R. 9767.9 have been met required neither additional discovery nor further development of the record. The evidence submitted at trial justified the granting of defendant's Petition; applicant admitted to receiving the transfer of care notices, Dr. Holmes objected to the transfer, and defendant delayed the transfer in accordance with Dr. Holmes' objection well beyond the time that it was required to do so. Defendant's transfer of care notices complied with both 8 C.C.R. 9767.9 and 8 C.C.R. 9767.12. The record contained no obvious deficiencies warranting supplementation.

  Defendant complied with the regulatory requirements for transfer to MPN, provided proper notice, and applicant received additional time for treatment outside the MPN due to a serious chronic condition. No evidence showed defendant lost medical control or failed to comply with notice requirements.

  Official decision · page 11 →
• 1997-spd4 · 1997-07-21Jurisdiction / venueapplicant prevailed

  Determinative passage · p.110 Lien claimants Beverly Radiology Medical Group, Internal

  The lien claimants were denied discovery, cross-examination, and notice of hearings, which denied them due process and caused substantial prejudice.

  Official decision · page 1 →
• ADJ8015380 · 2026-03-30 · Santa Ana District OfficeReconsideration / removaldeferred

  Determinative passage · p.1We granted reconsideration1 to further study the factual and legal issues in this case. Applicant sought reconsideration of the July 2, 2019 Findings & Order, wherein the workers' compensation administrative law judge (WCJ) concluded that applicant could not recover compensation for his cumulative injury because recovery against the terminal employer, the Cleveland Browns ("Browns"),2 was barred by Labor Code section 3600.5, subdivision (b),3 and because there was no basis under section 5500.5, subdivision (a) to roll back liability to the Minnesota Vikings ("Vikings"), applicant's prior employer. Applicant contends that the WCJ erred because either (1) section 3600.5, subdivision (b) does not apply to this claim because applicant was hired in California during the period of injurious exposure, and/or (2) liability under section 5500.5, subdivision (a) should roll back if the terminal employer is exempt according to the former section.

  The Appeals Board granted reconsideration to further study the factual and legal issues regarding the applicability of Labor Code sections 3600.5 and 5500.5 to the applicant's cumulative injury claim, and allowed further briefing to consider recent case law.

  Official decision · page 1 →
• ADJ7742588 · 2025-06-04 · Van Nuys District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.1We have considered the allegations of the Petition for Reconsideration and Removal (Petition), defendant CNA Insurance's answer (Answer), and the contents of the Report and Recommendation (Report) of the workers' compensation administrative law judge (WCJ) with respect thereto. Based on our review of the record, we will dismiss the Petition to the extent it seeks reconsideration and deny it to the extent it seeks removal.

  The WCJ's order quashing the subpoena is an interlocutory procedural order, not a final order, so the petition for reconsideration is dismissed. The petition for removal is denied because the petitioner failed to show substantial prejudice or irreparable harm and reconsideration will be an adequate remedy.

  Official decision · page 1 →
• ADJ1120351 · 2023-11-27 · Los Angeles District OfficeReconsideration / removalapplicant prevailed

  Determinative passage · p.2On August 3, 2023, without holding a hearing, the WCJ issued an Order of Dismissal of applicant's cases. The Order states as follows:

  The Board found the dismissal order was issued without a hearing or evidentiary record, violating due process and requiring rescission and further proceedings.

  Official decision · page 2 →
• ADJ11827202 · 2023-02-13 · Marina del Rey 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 for Removal 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 →
• ADJ6852132 · 2022-12-22 · Fresno District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.2The petition in this matter was filed on October 24, 2022. This was more than 25 days after the service of the WCJ's September 22, 2022 decision and beyond whatever extension of time, if any, the petitioner might have been entitled to under WCAB Rule 10600.

  The petition for reconsideration was filed more than 25 days after service of the WCJ's decision, making it untimely and depriving the Appeals Board of jurisdiction to consider it.

  Official decision · page 2 →

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.

• CNA CLAIMS PLUS
• CNA
• CNA CLAIMS PLUS, INC.
• CNA Insurance/Sedgwick CMS
• CNA CLAIMPLUS, INC.
• CNA INSURANCE CO.

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.