Tristar Risk Management

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 12
• Oakland 11
• Pomona 8
• Fresno 7
• Los Angeles 7
• San Francisco 7
• Stockton 5
• San Jose 3
• Bakersfield 2
• Marina del Rey 2
• Oxnard 2
• Salinas 2

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.

• 33 for the defense
• 31 for the applicant
• 17 returned for more record

Counted over 79 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.

• ADJ21245209 · 2026-08-14 · Fresno District OfficeQME/AME processapplicant prevailed

  Determinative passage · p.4The WCJ found that the QME process was not correctly initiated apparently because the QME process is triggered by an objection to a “primary treating physician” and that neither Nurse Uichanco, nor Dr. Roach was a “primary treating physician.” However, Labor Code section 3209.10(a) plainly states:

  The WCAB found that Nurse Uichanco was acting under Dr. Roach's supervision, making Dr. Roach the primary treating physician under Labor Code section 3209.10, and that the QME process was properly initiated. The WCAB granted reconsideration and reversed the WCJ's removal of Dr. Bolling as QME, allowing Dr. Bolling to remain as QME.

  Official decision · page 4 →
• ADJ19265320 · 2026-07-30 · San Jose District OfficeMedical treatment / UR / IMRremanded

  Determinative passage · p.2On June 22, 2026, the parties agreed to, and filed a signed “Stipulation to Remand Matter to Trial Level for Further Proceedings.” In pertinent part, the Stipulation states that: The parties agree to remand this matter to trial level for further proceedings without withdrawing their positions or arguments. Based on the record, the parties present the following issue: whether defendant was obligated to file a Petition for Determination of Medical-Legal Expense Dispute and concurrent Declaration of Readiness within 60 days of the provider’s objection as set forth by Labor Code § 4622. In addition, the WCJ shall address any other issue he deems appropriate.

  The matter was remanded to the WCJ for further proceedings to create a more complete record on this issue.

  Official decision · page 2 →
• ADJ11055389 · 2026-07-27 · San Bernardino District OfficeApportionmentremanded

  Determinative passage · p.5However, providing two separate awards for the exact same disability is not supported by the law and would result in an impermissible double recovery for the applicant. If apportionment assigned by Dr. Hasday for the two injuries is not deemed substantial medical evidence, the appropriate remedy would be to rate the injuries together and issue one award for both injuries. Pursuant to Benson, “[…] there may be limited circumstances when the evaluating physician cannot parcel out, with reasonable medical probability, the approximate percentages to which each distinct industrial injury causally contributed to an employee’s overall permanent disability. In such limited circumstances, when the employer has failed to meet its burden of proof, a combined award of permanent disability may still be justified.” (Benson v. Workers’ Comp. Appeals Bd., 170 Cal. App. 4th 1535, 1536.)

  The Appeals Board found that the record may be incomplete regarding apportionment and that the WCJ's reliance on Dr. Hasday's apportionment opinion was persuasive but could be improved. The Board granted reconsideration to further study the factual and legal issues, deferring final decision.

  Official decision · page 5 →
• ADJ11167605 · 2026-07-20 · San Francisco District OfficePermanent disability ratingapplicant prevailed

  Determinative passage · p.14In this case I found Dr. Feinberg’s reporting to be substantial medical evidence on impairments and adopted his finding of 60 percent WPI for the right upper extremity, and 20 percent WPI for the left upper extremity. Dr. Feinberg’s opinion was based on Table 13-22 on page 343 of the AMA Guides[.]… In this case I find that there was sufficient support in the reporting of Dr. Feinberg to justify his opinions on WPI. The applicant has consistently reported that she cannot use her dominant right upper extremity for self-care or daily activities. Therefore, she meets the stated criteria of a Class 4 impairment for the right upper extremity, which was what Dr. Feinberg assigned. The applicant also has consistently reported that she has difficulty with self-care activities with her non-dominant left upper extremity, thus meeting the criteria for a Class 3 impairment of the left upper extremity per Table 13-22. Dr. Feinberg’s physical examination of the applicant supported the applicant’s complaints in his observation of her bilateral upper extremities. He found reduced range of motions, positive tests, and obvious deformity.

  The WCJ found substantial medical evidence supporting the permanent disability rating based on the QME Dr. Feinberg's reports, including the justification for adding impairments rather than combining them, consistent with the en banc Vigil decision. The defendant's challenges to the impairment ratings and vocational evidence were rejected due to lack of substantial evidence.

  Official decision · page 14 →
• ADJ13384253 · 2026-02-09 · Los Angeles District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.2In the Opinion on Decision, the WCJ states: AOE/COE:... The Court accepts Dr. Yuri Falkinstein's medical reports as substantial medical evidence and accepts his medical finding that applicant sustained an industrially related cumulative trauma injury arising out of and occurring in the course of employment during the period May 29, 2019 through May 29, 2020.

  The WCJ accepted medical reports and testimony as substantial evidence that applicant sustained an industrial cumulative trauma injury during employment period; defendant failed to disprove injury claim.

  Official decision · page 2 →
• ADJ2755694 · 2025-10-15 · Los Angeles District OfficeMedical treatment / UR / IMRapplicant prevailed

  Determinative passage · p.5The WCJ's Report initially addresses the issue of the admissibility of the reporting of Dr. Miller, which was excluded from evidence because there was no evidence that a party first objected to a treating physician report as required under section 4061 and 4062. The Report observes, however, that the record contains a notice of denial of applicant's claimed injury of October 12, 2003, and that the report of Dr. Miller should have been admitted into evidence on the basis that it was obtained to address a compensability dispute under section 4060. (Report, at p. 3.) The WCJ thus concludes the reporting of Dr. Miller should have been received in evidence. Regarding applicant's claim of industrial sleep impairment, the WCJ observes that the reporting of AME Dr. Hirsch did not find industrial injury, and that the WCJ found the AME reporting to be the more persuasive and well-reasoned. (Id. at p.

  The WCJ initially excluded Dr. Miller's report for lack of objection to a treating physician report under sections 4061 and 4062, but the WCJ's Report found a notice of denial of claim before the report date, making the report admissible under section 4060 for compensability disputes. The WCAB agreed and ordered reconsideration.

  Official decision · page 5 →
• ADJ15251480 · 2025-06-03 · San Francisco District OfficeJurisdiction / venueapplicant prevailed

  Determinative passage · p.1Applicant seeks reconsideration of the "Findings of Fact and Order" (F&O) issued on March 12, 2025, by the workers' compensation administrative law judge (WCJ). The WCJ found, in pertinent part, that the Appeals Board does not have jurisdiction to determine an applicant's entitlement to advance disability pension payments ("ADPP") under Labor Code1 section 4850.4.

  The Appeals Board has jurisdiction to award ADPP as it constitutes compensation under Division 4 of the Labor Code, consistent with Gage. The issue of entitlement to ADPP must be decided at the trial level.

  Official decision · page 1 →
• ADJ11110973 · 2025-05-23 · Los Angeles District OfficeSJDB voucherdefendant prevailed

  Determinative passage · p.1Applicant seeks reconsideration of the August 15, 2023 Findings and Order, wherein the workers' compensation administrative law judge (WCJ) found that applicant is not entitled to an additional payment from the Return-to-Work Supplement Program (RTWSP) because applicant received an earlier RTWSP in connection with a prior injury after the date of the instant injury from which applicant is claiming RTWSP benefits. Rule 17302(b) prohibits a second or subsequent RTWSP payment "except where the individual receives a [Supplemental Job Displacement Benefit (SJDB)] Voucher for an injury which occurs subsequent to receipt of every previous Return to Work Supplement." (Cal. Code Regs., tit. 8, § 17302(b).)

  The Board found that Rule 17302(b) prohibits a second RTWSP payment unless the individual receives a subsequent SJDB Voucher for a later injury, and the applicant did not meet this requirement. The Board also held that the applicant's remedy to challenge the regulation's validity lies in Superior Court, not the Appeals Board.

  Official decision · page 1 →
• ADJ19245370 · 2025-03-11 · Van Nuys District OfficeJurisdiction / venueremanded

  Determinative passage · p.4Here, the WCJ summarily issued an order denying the petition for joinder without issuing a notice of intent and without conducting a hearing on the petition. (Cal. Code Regs., tit. 8, § 10832.) No record supports the order denying joinder; accordingly, due process requires that we grant removal, rescind the order denying joinder, and return this matter to the trial level for further proceedings.

  The WCJ denied SISF's petition for joinder, reasoning that SISF steps into the shoes of the insolvent self-insured employer and does not require formal joinder. The WCAB found that due process was not provided because no hearing or notice of intent was issued, and no record supported the denial. The WCAB rescinded the order and remanded for further proceedings.

  Official decision · page 4 →
• ADJ19199519 · 2025-02-18 · Van Nuys District OfficeJurisdiction / venueremanded

  Determinative passage · p.2While a WCJ is empowered to join additional parties necessary for the full adjudication of the case at any time, [Labor Code § 5307.5(b); Cal. Code Regs., tit. 8, § 10380] the California Self-Insurers' Security Fund, much like the California Insurance Guarantee Association, rather than functioning as a party defendant separate and distinct from the exiting insolvent self-insured employer, steps in the shoes of that employer and assumes its liability, thereby negating the judicial requirement of a formal joinder as a party defendant. In addition, to require its joinder in every case involving a liquidated self-insured employer places an exceptional burden on already overwhelmed limited judicial resources and frustrates its essentially constitutional purpose of providing expeditious delivery and resolution of litigated workers' compensation cases.

  SISF steps into the shoes of the insolvent self-insured employer and need not be formally joined as a separate party defendant; denial of joinder was a non-final order and due process required a hearing or notice before denial.

  Official decision · page 2 →
• ADJ9017829 · 2025-01-06 · Van Nuys District OfficeJurisdiction / venueremanded

  Determinative passage · p.1Defendant California Insurance Guarantee Association (CIGA) seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings and Order of September 30, 2024, wherein it was found that "the applicant... while employed on June 16, 2013 as a fo[r]k lift operator... by DIAMOND STAFFING SERVICES, whose workers' compensation insurance carrier was CALIFORNIA INSURANCE GUARANTEE ASSOCIATION FOR LUMBERMAN'S UNDERWRITING ALLIANCE IN LIQUIDATION, sustained injury arising out of and occurring in the course of employment to the lumbar spine, cervical spine, and bilateral knees." (Finding of Fact No. 1.) Finding of Fact Number 2 then contradicts the first finding, (incorrectly) stating, "Pursuant to the Directive of the Workers['] Compensation Appeals Board, the Applicant was an employee of National Retail Transportation, and not an employee of Diamond Staffing Services." Finding of Fact Number 3 cryptically states, "No further issues will be addressed by the Court per Hartford's request." In this matter, Hartford is the carrier for National Retail Transportation (NRT).

  The WCJ failed to rule on CIGA's Petition for change of administration and instead re-litigated a previously settled issue; the Appeals Board granted reconsideration and remanded for proper ruling on the outstanding issues.

  Official decision · page 1 →
• ADJ285288 · 2025-01-03 · Anaheim District OfficeAOE/COEdefendant prevailed

  Determinative passage · p.11JOINT FINDINGS OF FACT 1. the applicant, age 49, while employed on 2/29/2000, and during the period 4/15/1995 to 2/29/2000, sustained injury arising out of and in the course of his employment as a soil technician in California with his general employer being GTG, Inc. dba Leighton & Associates, whose workers' compensation insurance carrier was American Motorists Insurance, now identified as California Insurance Guarantee Association by its servicing facility, Tristar Risk Management, for Lumbermens Mutual Casualty Company in liquidation. 2. The applicant did not have dual or special employment with Koll Construction Company on February 29, 2000 nor during the period October 1999 to February 29, 2000.

  The evidence showed Koll did not exercise control over applicant's work, applicant was paid and supervised by GTG, Inc., and Koll's role was limited to scheduling and oversight without direct control, thus no dual or special employment existed.

  Official decision · page 11 →

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.

• TRISTAR RISK MANAGEMENT
• TRISTAR
• Tristar Risk Management
• Tristar
• TRISTAR INSURANCE GROUP
• TRISTAR RISK MANAGEMENT, INC.
• TRISTAR ROSEVILLE
• Tristar Risk Management, Inc.
• Tristar Insurance Group
• TRISTAR RISKMANAGEMENT
• TRISTAR RISK MANAGMENT

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.