Starstone National Insurance Company

What they litigate

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

• AOE/COE2
• Permanent disability rating2
• QME/AME process1
• Medical treatment / UR / IMR1

Where they appear

• Van Nuys 3
• Marina del Rey 2
• Oxnard 2
• Los Angeles 1
• Marina del Ray 1
• Oakland 1
• Pomona 1
• San Francisco 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.

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

Counted over 12 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.

• ADJ15972441 · 2026-04-06 · Pomona District OfficeMedical treatment / UR / IMRdefendant prevailed

  Determinative passage · p.11Next, applicant argues that the June 2, 2025 report by PTP Dr. Hannani "contained new and significant medical findings" requiring that defendant conduct a new UR despite the May 20, 2025 UR denial of the same surgery recommended in Dr. Hannani's May 9, 2025 report. However, based on a line-by-line comparison of Dr. Hannani's May 9, 2025 and June 2, 2025 reports, it is noted that the reports are identical except for 4 paragraphs at the bottom of page 3 of the June 2, 2025 report. In other words, the sections of the reports under the headings of Subjective Complaints, Objective Complaints, Motor Examination, Sensation, Reflexes, Lower Extremities Examination, Bilateral Hips, Vascular Examination, Diagnosis, Prescriptions Given and Disability Status are word for word the same.

  The June 2, 2025 report by PTP Dr. Hannani did not identify any material change in the applicant's medical condition subsequent to the May 20, 2025 utilization review denial. The reports were nearly identical except for clarifying paragraphs that did not constitute new evidence. Applicant's testimony of worsening symptoms did not specify a material change after the May 20, 2025 denial. Therefore, no new utilization review was required and the June 5, 2025 deferral was reasonable.

  Official decision · page 11 →
• ADJ16350553 · 2025-08-25 · Oakland District OfficeQME/AME processremanded

  Determinative passage · p.1Applicant seeks removal of the Findings and Order (F&O) issued by the workers' compensation administrative law judge (WCJ) on May 30, 2025, wherein the WCJ found in pertinent part that the reporting of QME Dr. Lorenzo Hughes violated Labor Code section 46281; that the reporting does not constitute substantial medical evidence; and, that it must be stricken from the record. The WCJ also granted defendant's petition for a replacement QME panel and ordered that a replacement panel in pain medicine be provided within 30 days.

  The WCJ found Dr. Hughes violated section 4628 by allowing a third party to summarize medical records, but the WCAB found due process was not afforded to Dr. Hughes before striking the reports, so the matter was remanded for further proceedings.

  Official decision · page 1 →
• ADJ13064691 · 2023-10-16 · Oxnard District OfficePermanent disability ratingapplicant prevailed

  Determinative passage · p.1Defendant seeks reconsideration of our Decision After Reconsideration of May 12, 2023, wherein we found that while employed on August 21, 2019 as a medical records director, applicant sustained industrial injury to her back causing permanent total (100%) disability. In so finding, we amended a workers' compensation administrative law judge's (WCJ) Findings, Award and Order of February 21, 2023, wherein it was found that applicant's injury caused permanent partial disability of 45%. At trial applicant introduced vocational expert evidence standing for the proposition that applicant was unable to work, and had thus rebutted the scheduled permanent disability, and should be found permanently totally (100% disabled). This evidence was rejected by the WCJ, but was the basis for our May 12, 2023 Opinion and Decision After Reconsideration.

  The Board found that applicant successfully rebutted the scheduled permanent partial disability rating of 45% by showing through vocational expert evidence that she was unable to work or be vocationally rehabilitated, thus warranting a finding of permanent total (100%) disability. The Board rejected the defendant's apportionment argument due to lack of detailed explanation in the medical opinion and the WCJ's prior rejection of apportionment.

  Official decision · page 1 →
• ADJ13210964 · 2023-06-13 · Los Angeles District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.1Defendant seeks reconsideration of a Findings & Award & Order (F&O) issued by a workers' compensation administrative law judge (WCJ) on March 20, 2023, wherein the WCJ found in pertinent part that applicant sustained industrial injury arising out of and in the course of her employment.

  The injury occurred while applicant was driving her own vehicle to a caregiver shift at a non-fixed location and time, and she was required to have reliable transportation, which benefited the employer. This fits the 'required vehicle' exception to the going and coming rule, making the injury compensable.

  Official decision · page 1 →
• ADJ13064691 · 2023-05-12 · Oxnard District OfficePermanent disability ratingapplicant prevailed

  Determinative passage · p.1Applicant seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings, Award and Order of February 21, 2023, wherein it was found that while employed on August 21, 2019 as a medical records director, applicant sustained industrial injury to her back causing permanent disability of 45% and the need for further medical treatment. At trial applicant introduced vocational expert evidence standing for the proposition that applicant was unable to work, and had thus rebutted the scheduled permanent disability, and should be found permanently totally (100% disabled). However, this evidence was rejected by the WCJ.

  Applicant's vocational expert evidence persuasively showed that applicant is not employable or amenable to vocational rehabilitation, rebutting the scheduled rating and supporting a finding of permanent total disability.

  Official decision · page 1 →
• ADJ11978261 · 2022-05-09 · Marina del Rey District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.1Applicant seeks reconsideration of the Findings and Order (F&O) issued by the workers' compensation administrative law judge (WCJ) on March 4, 2022, wherein the WCJ found in pertinent part that defendant's denial of applicant's injury claim was untimely under Labor Code section 5402, that defendant successfully rebutted the Labor Code section 5402(b) presumption of compensability, and that applicant did not sustain injury arising out of and occurring in the course of employment (AOE/COE) to his neck, bilateral shoulders, bilateral elbows, lumbar spine, and left leg, while employed by defendant; the WCJ ordered that applicant take nothing by way of his injury claim.

  The WCAB found that the QME Dr. Gowey's well-reasoned medical opinion constituted substantial evidence that applicant sustained cumulative injury AOE/COE to lumbar spine, left shoulder, and left elbow, rejecting the pre-employment medical exam as insufficient evidence.

  Official decision · page 1 →
• ADJ15400555 · 2025-10-10 · 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.,

  Removal granted because the WCJ's order to take the matter off calendar violated due process by not creating a record or explaining the need for further development, causing irreparable harm to the parties.

  Official decision · page 1 →
• ADJ13738581 · 2023-06-09 · Marina del Ray 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 petitioner's arguments in the WCJ's report, we will deny removal.

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

  Official decision · page 1 →
• ADJ13738581 · 2022-12-23 · Marina del Rey 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 petitioner's arguments in the WCJ's report, we will deny removal.

  Petitioner failed to show substantial prejudice or irreparable harm if removal was denied and failed to show reconsideration would be inadequate remedy if final decision adverse to petitioner issued.

  Official decision · page 1 →
• ADJ14228796 · 2022-09-07 · Van Nuys District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.2substantial 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 defendant'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 defendant.

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

  Official decision · page 2 →
• ADJ13354508 · 2021-09-09 · 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, former § 10843(a), now § 10955(a) (eff. Jan. 1, 2020); 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, former § 10843(a), now § 10955(a) (eff. Jan. 1, 2020).) 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 →
• ADJ10750446 · 2021-05-05 · San Francisco District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.2The petition in this matter was filed on March 8, 2021. This was more than 25 days after the service of the WCJ's February 5, 20211 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 and is therefore untimely under the applicable statutes and regulations.

  Official decision · page 2 →

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.

• STARSTONE NATIONAL INSURANCE COMPANY
• Starstone National Insurance Company
• STARSTONE NATIONAL INSURANCE CO.
• Starstone National Ins. Co.
• STARSTONE NATIONAL INS. CO.
• Starstone Torus

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.