Gallagher Bassett

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 36
• Santa Ana 33
• Oakland 29
• Los Angeles 28
• Oxnard 15
• Anaheim 14
• San Francisco 13
• Marina del Rey 12
• Sacramento 12
• Pomona 11
• San Diego 10
• Bakersfield 8

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.

• 139 for the defense
• 99 for the applicant
• 42 returned for more record

Counted over 261 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.

• ADJ21943588 · 2026-09-01 · Pomona District OfficeAOE/COEdefendant prevailed

  Determinative passage · p.4section 5402(b), which states, “If liability is not rejected within 90 days after the date the claim form is filed under Section 5401, the injury shall be presumed compensable under this division. The presumption of this subdivision is rebuttable only by evidence discovered subsequent to the 90-day period.” Preliminarily, we note that applicant seeks relief from the Board by petitioning for reconsideration and in the alternative for removal. Pursuant to section 5900, the Board only has jurisdiction to grant reconsideration from a “final order, decision, or award.” In Maranian v. Workers’ Compensation Appeals Bd. (2000) 81 Cal.App.4th 1068 [65 Cal.Comp.Cases 650], it was held that a ruling regarding the applicability of the section 5402(b) presumption is “final” for purposes of section 5900, and thus properly raised by way of a petition for reconsideration. We therefore consider the merits of applicant’s contentions as a petition for reconsideration. Turning to the merits, we do not find the fact that two numbers were transposed in an apparent typographical error to invalidate the denial. We note that Administrative Rule 9812 does not require the date of injury to be listed in a Notice of Denial. (Cal. Code Regs., tit. 8, § 9812, subd.

  The WCJ correctly determined that the applicant was not entitled to the presumption because the claim was timely denied within the statutory period despite a typographical error in the denial notice.

  Official decision · page 4 →
• ADJ19338918 · 2026-09-01 · Oxnard District OfficeSubstantial evidence / credibilityapplicant prevailed

  Determinative passage · p.6In the current case, Dr. McClintock-Greenberg utilized Table 5-12 of the AMA Guides to capture Applicant's impairment, placing Applicant in Class 4 (51% - 100% WPI). (see Ex. 6, QME November 20, 2025 Report, pg. 2). Individuals with a Vo2max of less than 15 mL/(kgmin) or a METS score of less than 4.3 meet the criteria to be placed in Class 4. Applicant's Vo2max reading from the CPET was 10.5 ml/min/kg and his METS score was 2.3 which qualifies him for Class 4. (see Ex. 6, QME November 20, 2025 Report, pg. 2.; Ex. 5, QME Vol. III Deposition pg. 25, line 7). Dr. McClintock-Greenberg explained that the CPET results showed significant loss of lung function, suggesting that Applicant “has rapidly progressive lung disease, and not merely end-stage lung disease.” (see Ex. 6, QME November 20, 2025 Report, pg. 2). He provided 100% WPI, based on Applicant’s “end-stage lung disease due to pulmonary fibrosis with rapid deterioration of [Applicant’s] lung function.” (see Ex. 6, QME November 20, 2025 Report, pg. 3). Dr. McClintock-Greenberg warned that with Applicant’s “rapid decline in lung function, [Applicant] will not be alive in one year if he does not receive a bilateral lung transplant.” (see Ex. 6, QME November 20, 2025 Report, pg. 3).

  The Appeals Board found that PQME Dr. Greenberg's reports and deposition testimony constitute substantial medical evidence supporting 100% permanent disability and no apportionment to non-industrial factors, based on objective test data and clinical foundation.

  Official decision · page 6 →
• ADJ10837798 · 2026-08-31 · Oakland District OfficePermanent disability ratingremanded

  Determinative passage · p.1Applicant and defendant each seek reconsideration of a workers’ compensation administrative law judge’s (WCJ) Findings and Award of May 28, 2026, wherein it was found that while employed as a housekeeper during a cumulative period ending April 24, 2017, applicant sustained industrial injury to her cervical and lumbar spine causing permanent disability of 38%. In finding permanent disability of 38%, it was found that apportionment of permanent disability was indicated to previous injuries, but not to applicant’s diabetes condition (Opinion on Decision at p. 13). Additionally, despite agreed medical evaluator orthopedist Peter Mandell’s opinion that applicant’s lumbar permanent disability and cervical permanent disability be added rather than combined utilizing the combined values chart (CVC) of the 2005 Schedule for Rating Permanent Disabilities, the WCJ utilized the CVC to rate the applicant’s permanent disability (Opinion on Decision at p. 12).

  The WCJ's permanent disability rating and apportionment were challenged by both parties; the medical evidence was found to be stale and incomplete, requiring further development of the record and decision on all outstanding issues.

  Official decision · page 1 →
• ADJ13520237 · 2026-07-28 · Los Angeles District OfficePsyche AOE/COEremanded

  Determinative passage · p.1133, emphasis added.) The WCJ, by contrast, only discusses two skeletal medical leave of absence forms from 2019 before concluding “there is no medical evidence to establish applicant sustained a psych/stress claim.” (Opinion on Decision, pp. 1-2.) The WCJ does not discuss the 2020 and 2021 medical records which mention psychiatric/stress. A claimed cumulative psychiatric injury is the exemplar of “a scientific question, requiring a judgment based upon scientific knowledge and inaccessible to the unguided rudimentary capacities of lay arbiters.” (McLaughlin, supra, p. 839.) Here, there is medical evidence of a psychiatric injury in the form of limited reporting from chiropractor Torres and Dr. Green. What is missing is a substantial medical opinion addressing psychiatric injury. Until that opinion is obtained it is not possible to determine if there is an injury, the date of injury, nor what defenses, if any, may be applicable. The WCJ and the Appeals Board have a duty to further develop the record where there is insufficient evidence on an issue. (McClune v. Workers’ Comp. Appeals Bd. (1998) 62 Cal.App.4th 1117, 1121-1122 [63 Cal.Comp.Cases 261].) The Appeals Board has a constitutional mandate to

  There is medical evidence of psychiatric injury but no substantial medical opinion; issue deferred to WCJ for further development and obtaining psychiatric AME or PQME.

  Official decision · page 11 →
• ADJ10111444 · 2026-07-24 · Bakersfield District OfficeTemporary disabilityremanded

  Determinative passage · p.1Applicant seeks reconsideration of the “Findings and Award” (F&A) issued on September 2, 2025, by the workers’ compensation administrative law judge (WCJ). The WCJ found, in pertinent part, that applicant was not entitled to an award of temporary disability because he was capable of working modified duty, but did not work. Applicant contends that defendant failed to offer modified work within applicant’s work restrictions. We have received an answer from defendant. The WCJ filed a Report and Recommendation on Petition for Reconsideration (Report) recommending that we deny reconsideration or grant reconsideration to amend the findings of fact to find that defendant offered appropriate work to applicant. Thereafter, we issued an order granting the petition, pending further review of the entire record. Subsequently, the parties successfully participated in a voluntary mediation at the Appeals Board. On July 16, 2026, the parties advised that a proposed settlement by stipulation and order had been reached, and requested return of the matter to the trial level for review of the proposed settlement.

  The WCJ originally found the applicant was not entitled to temporary disability because he was capable of working modified duty but did not work; the applicant contended the defendant failed to offer modified work within restrictions; the Appeals Board rescinded the WCJ decision and returned the matter for settlement consideration without ruling on the merits.

  Official decision · page 1 →
• ADJ18890787 · 2026-06-15 · San Diego District OfficeJurisdiction / venuedefendant prevailed

  Determinative passage · p.7We agree with the WCJ that the second case against Asset Protection is an attempt by applicant to relitigate the issues decided against him with finality in case number ADJ10622598 and as such, the case is precluded by the doctrine of res judicata. Furthermore, we agree that this case should be dismissed with prejudice as there is no new evidence in the record to support the contention that applicant should be allowed to proceed against defendants.

  The Appeals Board agreed with the WCJ that the second case ADJ18890787 is an attempt to relitigate issues decided with finality in ADJ10622598 and is precluded by res judicata, warranting dismissal with prejudice due to no new evidence supporting the claim.

  Official decision · page 7 →
• ADJ number not stated · 2026-06-10 · Santa Ana District OfficeStatute of limitationsapplicant prevailed

  Determinative passage · p.3On March 23, 2026, we issued our Decision determining in relevant part that the filing of a workers' compensation claim on applicant's behalf in 2004 did not impart the knowledge required to establish a date of injury under section 5412 and commence the running of the statute of limitations under section 5405. We observed that per applicant's testimony, he had not initiated the 2004 claim and had never spoken to the filing attorney. We also observed that none of the claim filing documents and supporting documentation were signed by applicant and that evidence established that applicant's only involvement with the claim had been to instruct that it be withdrawn after learning of the filing. (Decision, at pp. 9-10.) We noted the first evidence establishing compensable disability arising out of industrial exposures was the May 4, 2021 medical reporting of orthopedic physician Dr. Einbund. We thus identified May 4, 2021 as the section 5412 date of injury, and concluded that because the instant claim was not filed more than one year from the date of injury, compensation was not barred under section 5405. (Id. at p. 11.)

  The WCAB found that the applicant's date of injury was May 4, 2021, based on medical evidence, and that the 2004 claim filing did not establish knowledge of compensable disability to trigger the statute of limitations under section 5405.

• ADJ16112682 · 2026-05-19 · Oakland District OfficeApportionmentapplicant prevailed

  Determinative passage · p.3The WCJ's opinion found that apportionment was not appropriately addressed per the standards outlined in Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 611 (en banc) because the physician did not clearly outline the pre-existing conditions nor did he adequately address with particularity how those conditions caused the current impairment. He accepted the QME's opinion that the impairment to the right and left shoulder should be added instead of combined. The WCJ also found that the correct occupational code is 330 based on the job description provided (Defendant's Exhibit A.)

  The WCJ found that the QME Dr. Hughes did not adequately explain the apportionment of pre-existing conditions to the current impairment as required by Escobedo, and thus rejected the apportionment and rated permanent disability at 76% without apportionment based on Dr. Reiter's opinion.

  Official decision · page 3 →
• ADJ20106865 · 2026-05-18 · Pomona District OfficeQME/AME processapplicant prevailed

  Determinative passage · p.7Not only does the letter not explicitly refer to objection, it does not contain any objection whatsoever. Applicant is entitled to retain the control of the QME process and did nothing to lose that control. Thus, defendant waived its right to an objection.

  Defendant's strike letter did not contain any objection to the QME panel specialty, so defendant waived its right to object; applicant was entitled to choose the specialty and chiropractic was appropriate.

  Official decision · page 7 →
• ADJ10642765 · 2026-05-18 · Marina Del Rey District OfficeReopening / new and further disabilitydeferred

  Determinative passage · p.9Accordingly, we will grant reconsideration, rescind the Findings of Fact that relate to the issue of new and further disability, and substitute a new Order that the issue of whether applicant has sustained new and further disability as alleged in her Petition to Reopen dated April 13, 2021, is deferred.

  The Appeals Board found the evidentiary record insufficient to adjudicate new and further disability and compensable consequence injuries, and thus deferred the issue for further development of the medical record.

  Official decision · page 9 →
• ADJ11351201 · 2026-05-07 · Los Angeles District OfficeAOE/COEremanded

  Determinative passage · p.1Applicant seeks reconsideration of the Findings and Order (F&O) issued on February 27, 2023, by the workers' compensation administrative law judge (WCJ). The WCJ found in pertinent part that applicant did not sustain industrial injury to his eyes, neck, shoulders, arms, hands, fingers, legs, ankles, circulatory and excretory system, and psyche and ordered that applicant take nothing on his claims.

  The WCAB found the record insufficient to resolve conflicting medical opinions on industrial causation, including orthopedic, neurological, and psychiatric claims, requiring further development of the medical record.

  Official decision · page 1 →
• ADJ18206391 · 2026-05-04 · Santa Rosa District OfficeAOE/COEremanded

  Determinative passage · p.15Here, PQME Dr. McGahan's expert medical opinions are based on inadequate medical history and an incorrect legal theory and therefore are not substantial.

  PQME Dr. McGahan's opinions were not substantial evidence due to inadequate medical history and incorrect legal theory; record requires further development.

  Official decision · page 15 →

Also recorded as

The same claims administrator is printed several ways across the decisions, and all of them were counted as one. These are the twelve commonest of 30.

• GALLAGHER BASSETT
• GALLAGHER BASSETT SERVICES, INC.
• GALLAGHER BASSETT SERVICES
• Gallagher Bassett
• Gallagher Bassett Services, Inc.
• Gallagher Bassett Services
• Gallagher Bassett Insurance Services
• GALLAGHER BASSETT SACRAMENTO
• GALLAGHER BASSETT SERVICES, INCORPORATED
• Gallagher Bassett Services, Incorporated
• GALLAGHER BASSETT SERVICES, INC
• GALLAGHER BASSETT SERVICES INC.

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.