California Restaurant Mutual Benefit Corporation

What they litigate

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

• AOE/COE2
• Jurisdiction / venue1
• Medical treatment / UR / IMR1

Where they appear

• Riverside 2
• Los Angeles 1
• San Diego 1
• Stockton 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.

• 3 for the applicant
• 2 returned for more record
• 1 for the defense

Counted over 5 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.

• 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 →
• 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 →
• ADJ11187899 · 2021-05-21 · Stockton District OfficeAOE/COEremanded

  Determinative passage · p.4Review of the record indicates that defendant does not dispute applicant's claim that while at work on February 28, 2017, her right elbow was hit by a freezer door that was pushed open by a co-worker. It appears the actual issue is whether the February 28, 2017 incident constitutes an industrial injury. A specific injury is an incident that causes disability or need for medical treatment. (Lab. Code, § 3208.1(a).)

  The record lacked substantial medical evidence addressing whether the February 28, 2017 incident constituted an industrial injury. The QME's opinions were not substantial evidence on injury AOE/COE, and the applicant's testimony was inconsistent with medical reports. The Appeals Board exercised its discretion to develop the record further by ordering a new evaluation by an agreed medical examiner or WCJ-appointed physician.

  Official decision · page 4 →
• ADJ11114421 · 2025-06-05 · San Diego District OfficeOther disputed issueapplicant prevailed

  Determinative passage · p.6[i]n the case of cancellation or termination of coverage of a group member, whether voluntary or involuntary, the group self-insurer shall remain liable for all compensation liabilities of the group member resulting from any claim with a date of injury during the period of membership in the group self-insurer up to the effective date of the termination and revocation of the group member's Affiliate Certificate of Consent to Self-Insure, including the 45 day notice period in the event of involuntary termination. (Ibid.) Assuming that CRMBC's cancellation letter dated December 27, 2017 served as proper notice of cancellation or termination from group membership, we agree with the WCA that January 27, 2018 is the earliest possible date CRMBC could have cancelled its policy, and since the January 27, 2018 cancellation date occurs after the November 22, 2017 alleged injury, CRMBC remains liable for coverage of the subject injury.

  The panel found that CRMBC's cancellation letter dated December 27, 2017, served as notice of cancellation, making January 27, 2018 the earliest cancellation date, which is after the injury date of November 22, 2017, thus CRMBC remains liable for coverage.

  Official decision · page 6 →
• ADJ8494732 · 2021-07-06 · Los Angeles District OfficeOther disputed issueapplicant prevailed

  Determinative passage · p.2After considering the compromise and release in light of the entire record, we conclude that the settlement amount is adequate and that the agreement is in the best interest of applicant.

  The Appeals Board found the settlement amount adequate and in the best interest of the applicant, and the attorneys' fee reasonable.

  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.

• California Restaurant Mutual Benefit Corporation
• CALIFORNIA RESTAURANT MUTUAL BENEFIT CORPORATION
• CALIFORNIA RESTAURANT MUTUAL BENEFIT CORP.

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.