California WCABInsurance carrier

WCF National Insurance Company

WCF National Insurance Company is named as an insurance carrier in 8 released California WCAB decisions from 2022–2026. The disputes run to AOE/COE (1), Jurisdiction / venue (1) and Permanent disability rating (1). Defense most often ran through Albert and Mackenzie (2). The employer appearing most often is Café Rio Mexican Grill, INC. (1). The office that heard the most of them is Bakersfield.

Decisions: 8
Years: 2022–2026
Issues disputed: 5
District offices: 8

What they litigate

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

Who defends them

6 more firms appear in the same decisions and are not listed: we could not read which side they were on.

Whose claims they run

Café Rio Mexican Grill, INC.1
Highlands Community Charter and Technical School1
Jpa Landscape Construction, INC1
Oxford Suites1
Paq Incorporated1
Table Bluff Brewery1
Torres Farm Labor Contractor, INC.1
Zions Bancorporation, N.a.1

Where they appear

Bakersfield 1
Eureka 1
Los Angeles 1
Sacramento 1
San Diego 1
San Luis Obispo 1
Santa Ana 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 insurance carrier does its work. It describes how a set of appealed disputes came out.

4 for the applicant
4 for the defense
2 returned for more record

Counted over 8 appealed decisions. Not this insurance carrier’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 insurance carrier is named in, each with the passage the panel turned on and a link to the official PDF.

ADJ19186265 · 2026-05-26 · Los Angeles District OfficeJurisdiction / venueapplicant prevailed
Determinative passage · p.6fax of the RFA indicated it was sent at 3:39 p.m. (Exhibit X.) Thus, it is deemed received on July 31, 2025. (Cal. Code Regs., tit. 8 § 9792.9.1(a)(1), amended effective 04/01/2026.) The determination indicates that the vendor did receive the RFA within the 72 hour timeframe, but there is no indication of when it was reviewed, but the decision date is August 6, 2025, well beyond 72 hours. Moreover, there is no notation in the determination as to the reasons the request did not qualify for expedited review, by the medical professional. While the request is for a program beginning after the typical five day timeframe for decisions pursuant to former AD Rule 9792.9.1 (c)(3), the request still had to be reviewed by a medical professional to determine whether the typical timeframe is not warranted. Moreover, the language in former AD Rule 9792.9.1(c) is disjunctive. Even if the analysis does not satisfy one condition, here the standard timeline component, the rule still requires determining whether there is an imminent threat to the health of the patient. The evidence in the record is not clear that the RFA was reviewed by a medical professional within 72 hours for either reason. If it is untimely, the WCAB is vested with jurisdiction over the underlying medical treatment dispute. (Dubon v. World Restoration (2014) 79 Cal.Comp.Cases 1298 [2014 Cal. Wrk. Comp. LEXIS 131].)
The Board found that the RFA was not reviewed by a medical professional within the 72-hour timeframe required for expedited review, thus the WCAB has jurisdiction to determine the medical necessity of the treatment.
Official decision · page 6 →
ADJ16533639 · 2024-07-22 · Eureka District OfficePermanent disability ratingremanded
Determinative passage · p.6All findings of the WCAB must be based on substantial evidence. (Le Vesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627, 637 [35 Cal.Comp.Cases 16]; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 620 [Appeals Bd. en banc].) As the Court of Appeal wrote in E.L. Yeager Construction v. Workers' Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, 928 [71 Cal.Comp.Cases 1687], "In order to constitute substantial evidence, a medical opinion must be predicated on reasonable medical probability. [Citation.] Also, a medical opinion is not substantial evidence if it is based on facts no longer germane, on inadequate medical histories or examinations, on incorrect legal theories, or on surmise, speculation, conjecture, or guess. [Citation.] Further, a medical report is not substantial evidence unless it sets forth the reasoning behind the physician's opinion, not merely his or her conclusions. [Citation.]"
The WCAB found Dr. Cox's permanent disability rating unclear regarding the proper gait derangement rating and whether the lifting capacity rating should be combined or used alternatively. The record was remanded for further development to clarify these issues consistent with AMA Guides and Almaraz/Guzman standards.
Official decision · page 6 →
ADJ15383875 · 2023-07-03 · San Luis Obispo District OfficeStatute of limitationsapplicant prevailed
Determinative passage · p.9In summary, we accord to the WCJ's credibility determination the great weight to which it is entitled. We further find that applicant's date of injury was September 1, 2021, the date applicant first received medical advice as to the existence and industrial etiology of a cumulative injury. Because the application for adjudication was filed within one year of the date of injury, compensation is not barred under section 5405(a). Finally, and irrespective of our determination with regard to section 5405(a), the employer's provision of healthcare used by applicant to cure or relieve the effects of the industrial injury tolled the running of the statute of limitations under section 5405(c). Accordingly, we affirm the F&O, except that we amend it to include the date of injury, as contemplated by section 5412 and placed in issue by the parties.
The WCJ's credibility determination was given great weight. The date of injury under Labor Code section 5412 was found to be September 1, 2021, the date of the QME's medical advice. The statute of limitations was tolled by employer-provided medical benefits under section 5405(c). Defendant failed to prove compensation was barred by the statute of limitations.
Official decision · page 9 →
ADJ15117833 · 2023-05-26 · Van Nuys District OfficeAOE/COEapplicant prevailed
Determinative passage · p.1Applicant seeks reconsideration of the Findings of Fact and Order (F&O) issued by a workers' compensation administrative law judge (WCJ) March 9, 2023, wherein the WCJ found that applicant failed to sustain his burden of proving industrial injury arising out of and in the course of his employment (AOE/COE) and ordered that applicant "take nothing further on this claim." Applicant contends that his injury was AOE/COE.
Applicant was injured on employer's premises while performing activities reasonably incidental to his employment, including picking up tools, which was not a substantial deviation from his duties, and even if he violated employer's rules, the injury still arose out of and in the course of employment.
Official decision · page 1 →
ADJ21537607 · 2026-06-29 · Sacramento District OfficeReconsideration / removaldefendant prevailed
Determinative passage · p.10In the absence of a record, we are unable to evaluate petitioner's contentions. Consequently, we dismiss the Petition for Reconsideration as premature and return the matter to the WCJ for further proceedings consistent with this opinion. We direct the parties and the WCJ to the en banc decision in Gaines for guidance with respect to approval of C&Rs that both WCJs and parties must follow. Upon return of this matter to the trial level, the WCJ may treat the Petition as a petition to set aside the OACR, conduct further proceedings, and create a record as to whether there are grounds for setting aside the OACR. After the WCJ issues a decision, any aggrieved party may timely seek reconsideration.
The petition for reconsideration was dismissed as premature because the WCJ had not yet conducted a hearing or rescinded the OACR within the 15-day period after the petition was filed, and the matter was returned to the trial level for further proceedings.
Official decision · page 10 →
ADJ17151530 · 2023-06-21 · Bakersfield 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 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 adverse decision.
Official decision · page 1 →
ADJ11150021 · 2022-07-06 · Santa Ana District OfficeReconsideration / removaldefendant prevailed
Determinative passage · p.2Although the decision contains a finding that is final, the petitioner is only challenging an interlocutory finding/order in the decision. The defendant disputes the interlocutory order that the applicant's choice of chiropractic PQME is not inappropriate. (F&O, p. 2.) Therefore, we will apply the removal standard to our review. (See Gaona, supra.)
The petition challenged an interlocutory order regarding the applicant's choice of chiropractic PQME, but the Board found no significant prejudice or irreparable harm to justify removal and held that reconsideration would be an adequate remedy.
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.

WCF NATIONAL INSURANCE COMPANY
WCF NATIONAL INSURANCE
WCF NATIONAL INS

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.

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WCF National Insurance Company

Decisions

Years

2022–2026

Issues disputed

District offices

How the appealed decisions came out

4 for the applicant

4 for the defense

2 returned for more record

Decisions

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

ADJ19186265 · 2026-05-26 · Los Angeles District OfficeJurisdiction / venueapplicant prevailed

Determinative passage · p.6fax of the RFA indicated it was sent at 3:39 p.m. (Exhibit X.) Thus, it is deemed received on July 31, 2025. (Cal. Code Regs., tit. 8 § 9792.9.1(a)(1), amended effective 04/01/2026.) The determination indicates that the vendor did receive the RFA within the 72 hour timeframe, but there is no indication of when it was reviewed, but the decision date is August 6, 2025, well beyond 72 hours. Moreover, there is no notation in the determination as to the reasons the request did not qualify for expedited review, by the medical professional. While the request is for a program beginning after the typical five day timeframe for decisions pursuant to former AD Rule 9792.9.1 (c)(3), the request still had to be reviewed by a medical professional to determine whether the typical timeframe is not warranted. Moreover, the language in former AD Rule 9792.9.1(c) is disjunctive. Even if the analysis does not satisfy one condition, here the standard timeline component, the rule still requires determining whether there is an imminent threat to the health of the patient. The evidence in the record is not clear that the RFA was reviewed by a medical professional within 72 hours for either reason. If it is untimely, the WCAB is vested with jurisdiction over the underlying medical treatment dispute. (Dubon v. World Restoration (2014) 79 Cal.Comp.Cases 1298 [2014 Cal. Wrk. Comp. LEXIS 131].)

The Board found that the RFA was not reviewed by a medical professional within the 72-hour timeframe required for expedited review, thus the WCAB has jurisdiction to determine the medical necessity of the treatment.

Official decision · page 6 →

ADJ16533639 · 2024-07-22 · Eureka District OfficePermanent disability ratingremanded

Determinative passage · p.6All findings of the WCAB must be based on substantial evidence. (Le Vesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627, 637 [35 Cal.Comp.Cases 16]; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 620 [Appeals Bd. en banc].) As the Court of Appeal wrote in E.L. Yeager Construction v. Workers' Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, 928 [71 Cal.Comp.Cases 1687], "In order to constitute substantial evidence, a medical opinion must be predicated on reasonable medical probability. [Citation.] Also, a medical opinion is not substantial evidence if it is based on facts no longer germane, on inadequate medical histories or examinations, on incorrect legal theories, or on surmise, speculation, conjecture, or guess. [Citation.] Further, a medical report is not substantial evidence unless it sets forth the reasoning behind the physician's opinion, not merely his or her conclusions. [Citation.]"

The WCAB found Dr. Cox's permanent disability rating unclear regarding the proper gait derangement rating and whether the lifting capacity rating should be combined or used alternatively. The record was remanded for further development to clarify these issues consistent with AMA Guides and Almaraz/Guzman standards.

Official decision · page 6 →

ADJ15383875 · 2023-07-03 · San Luis Obispo District OfficeStatute of limitationsapplicant prevailed

Determinative passage · p.9In summary, we accord to the WCJ's credibility determination the great weight to which it is entitled. We further find that applicant's date of injury was September 1, 2021, the date applicant first received medical advice as to the existence and industrial etiology of a cumulative injury. Because the application for adjudication was filed within one year of the date of injury, compensation is not barred under section 5405(a). Finally, and irrespective of our determination with regard to section 5405(a), the employer's provision of healthcare used by applicant to cure or relieve the effects of the industrial injury tolled the running of the statute of limitations under section 5405(c). Accordingly, we affirm the F&O, except that we amend it to include the date of injury, as contemplated by section 5412 and placed in issue by the parties.

The WCJ's credibility determination was given great weight. The date of injury under Labor Code section 5412 was found to be September 1, 2021, the date of the QME's medical advice. The statute of limitations was tolled by employer-provided medical benefits under section 5405(c). Defendant failed to prove compensation was barred by the statute of limitations.

Official decision · page 9 →

ADJ15117833 · 2023-05-26 · Van Nuys District OfficeAOE/COEapplicant prevailed

Determinative passage · p.1Applicant seeks reconsideration of the Findings of Fact and Order (F&O) issued by a workers' compensation administrative law judge (WCJ) March 9, 2023, wherein the WCJ found that applicant failed to sustain his burden of proving industrial injury arising out of and in the course of his employment (AOE/COE) and ordered that applicant "take nothing further on this claim." Applicant contends that his injury was AOE/COE.

Applicant was injured on employer's premises while performing activities reasonably incidental to his employment, including picking up tools, which was not a substantial deviation from his duties, and even if he violated employer's rules, the injury still arose out of and in the course of employment.

Official decision · page 1 →

ADJ21537607 · 2026-06-29 · Sacramento District OfficeReconsideration / removaldefendant prevailed

Determinative passage · p.10In the absence of a record, we are unable to evaluate petitioner's contentions. Consequently, we dismiss the Petition for Reconsideration as premature and return the matter to the WCJ for further proceedings consistent with this opinion. We direct the parties and the WCJ to the en banc decision in Gaines for guidance with respect to approval of C&Rs that both WCJs and parties must follow. Upon return of this matter to the trial level, the WCJ may treat the Petition as a petition to set aside the OACR, conduct further proceedings, and create a record as to whether there are grounds for setting aside the OACR. After the WCJ issues a decision, any aggrieved party may timely seek reconsideration.

The petition for reconsideration was dismissed as premature because the WCJ had not yet conducted a hearing or rescinded the OACR within the 15-day period after the petition was filed, and the matter was returned to the trial level for further proceedings.

Official decision · page 10 →

ADJ17151530 · 2023-06-21 · Bakersfield 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 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 adverse decision.

Official decision · page 1 →

ADJ11150021 · 2022-07-06 · Santa Ana District OfficeReconsideration / removaldefendant prevailed

Determinative passage · p.2Although the decision contains a finding that is final, the petitioner is only challenging an interlocutory finding/order in the decision. The defendant disputes the interlocutory order that the applicant's choice of chiropractic PQME is not inappropriate. (F&O, p. 2.) Therefore, we will apply the removal standard to our review. (See Gaona, supra.)

The petition challenged an interlocutory order regarding the applicant's choice of chiropractic PQME, but the Board found no significant prejudice or irreparable harm to justify removal and held that reconsideration would be an adequate remedy.

Official decision · page 2 →