Helmsman Management Services

What they litigate

Disputed issues across the decisions this claims administrator is named in. Every row opens the decisions it counts.

Where they appear

• Oakland 4
• Long Beach 3
• Riverside 3
• Van Nuys 3
• Anaheim 2
• Lodi 2
• Marina del Rey 2
• Sacramento 2
• San Francisco 2
• Goleta 1
• Oxnard 1
• Pomona 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 claims administrator does its work. It describes how a set of appealed disputes came out.

• 15 for the defense
• 11 for the applicant
• 4 returned for more record

Counted over 29 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.

• ADJ19233122 · 2025-10-06 · San Francisco District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.1Defendant seeks reconsideration of the July 3, 2025 Findings and Award (F&A) wherein the workers' compensation administrative law judge (WCJ) found, in relevant part, that applicant, while employed by defendant as a cashier during the period from September 21, 2022 through September 21, 2023, sustained injury arising out of and in the course of employment (AOE/COE) to the cervical, thoracic, and lumbar spine, bilateral shoulders, and right upper extremity with a need for continuing medical treatment to cure or relieve from the effects of the injury.

  The Appeals Board found substantial medical evidence from Dr. Hughes supporting injury AOE/COE to multiple body parts and need for continuing medical treatment, rejecting defendant's argument that no compensable disability existed on the date of injury.

  Official decision · page 1 →
• ADJ11204383 · 2025-09-29 · Long Beach District OfficeAOE/COEdefendant prevailed

  Determinative passage · p.12As noted above, two PQMEs with relevant expertise, Internist Dr. Ross and Neurologist Dr. Gorinstein, found after evaluating the applicant and reviewing his extensive treatment record that his strokes were caused by a non-industrial condition, Antiphospholipid Syndrome, and that his employment did not contribute to them. They both supported their findings appropriately, and their reports and findings meet the standards for substantial medical evidence set forth in Escobedo v. Marshalls (2005), 70 Cal.Comp.Cases 604, 621. There is no medical evidence in the record that counters their findings, and no reports from other doctors in their respective areas of expertise. The applicant's neurological injury is therefore found non-industrial.

  Two PQMEs with relevant expertise found the applicant's strokes were caused by a non-industrial condition, Antiphospholipid Syndrome, and employment did not contribute to them. No medical evidence contradicted their findings.

  Official decision · page 12 →
• ADJ18936354 · 2024-11-26 · Anaheim District OfficeJurisdiction / venueapplicant prevailed

  Determinative passage · p.1Applicant seeks removal of the Findings and Order ("F&O") issued on September 17, 2024, wherein the workers' compensation administrative law judge ("WCJ") concluded that defendant need not produce a video recording of applicant's injury prior to applicant's deposition. Applicant asserts that the WCJ erred because the video is a video of the alleged incident itself, not sub rosa surveillance, and is therefore properly discoverable prior to her deposition.

  The Appeals Board found that the video footage was not sub rosa surveillance but footage of the incident itself, which must be produced prior to deposition to avoid prejudice to the applicant.

  Official decision · page 1 →
• ADJ11431030 · 2024-10-22 · Sacramento District OfficeApportionmentapplicant prevailed

  Determinative passage · p.2We now turn to the merits. The defendant has the burden of proof on apportionment. (Lab. Code, § 5705; Pullman Kellogg v. Workers Comp. Appeals Bd. (Normand) (1980) 26 Cal.3d 450, 456 [45 Cal.Comp.Cases 170]; Kopping v. Workers' Comp. Appeals Bd. (Kopping) (2006) 142 Cal.App.4th 1099, 1115 [71 Cal.Comp.Cases 1229]; Escobedo v. Marshalls (Escobedo) (2005) 70 Cal.Comp.Cases 604, 613 (Appeals Board en banc).) To meet this burden, the defendant "must demonstrate that, based upon reasonable medical probability, there is a legal basis for apportionment." (Gay v. Workers' Comp. Appeals Bd. (Gay) (1979) 96 Cal.App.3d 555, 564 [44 Cal.Comp.Cases 817]; see also Escobedo, supra, at p. 620.)

  The WCJ and WCAB found that the medical opinion of Dr. Renbaum on apportionment was not substantial medical evidence because it lacked detailed reasoning and explanation required by law, thus denying apportionment and awarding permanent disability without apportionment.

  Official decision · page 2 →
• ADJ12205629 · 2024-04-23 · Oakland District OfficeMedical treatment / UR / IMRapplicant prevailed

  Determinative passage · p.2In this case, we disagree with the WCJ's conclusion that they "[do] not have the power to award a future medical" based on the panel qualified medical evaluator (QME)'s present reporting. (Report and Recommendation p. 3.) Specifically, we note that applicant need not establish that he will certainly need future medical care for an award of future medical care to issue and the appropriate way for a defendant to dispute whether treatment is reasonable and necessary is through the UR process. (See Lab. Code, § 4610.)2

  The Appeals Board found that the applicant is entitled to future medical care despite the WCJ's initial conclusion, noting that the appropriate dispute mechanism for treatment necessity is the utilization review process.

  Official decision · page 2 →
• ADJ10919652 · 2024-01-23 · Marina del Rey District OfficeJurisdiction / venueapplicant prevailed

  Determinative passage · p.3We agree with the WCJ that the applicant in this matter was not temporarily within this state doing work for his employer as a minimum of 23.6% or 35% of his deliveries were made in California. Additionally, it is undisputed that the incident causing applicant's injury occurred at a California truck stop and applicant received medical attention in California. (Cf. Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson) (2013) 221 Cal.App.4th 1116, 1126 [78 Cal.Comp.Cases 1257] [location of injury and medical treatment are factors to consider in deciding if California workers' compensation applies].) Therefore, California has a strong interest in covering applicant under California's workers' compensation system.

  California has a legitimate and substantial interest in protecting injured workers and the applicant was regularly in California doing business for the employer, making California jurisdiction appropriate.

  Official decision · page 3 →
• ADJ9387304 · 2023-01-20 · Oakland District OfficeDiscrimination under Labor Code §132aremanded

  Determinative passage · p.1applicant, petitions for reconsideration of the Findings, Award and Orders issued by the workers' compensation administrative law judge (WCJ) in this matter on June 16, 2022. In that decision, the WCJ found that applicant's injury to his lumbar spine, head and psyche arising out of and in the course of his employment as a granite edge fabricator on September 23, 2013, by defendant, ADP Total Source, Inc./Duracite caused permanent partial disability of 45%.

  The WCJ found permanent partial disability of 45%, but the applicant contended for permanent total disability; the panel did not rule on the merits but remanded for consideration of the Compromise and Release.

  Official decision · page 1 →
• ADJ10711761 · 2022-12-14 · San Jose District OfficeMedical treatment / UR / IMRapplicant prevailed

  Determinative passage · p.3On December 9, 2020, the matter proceeded to an expedited hearing. The issues for adjudication were the need for future medical treatment in the form of medical transportation to medical appointments, whether the WCAB has jurisdiction over the transportation dispute in light of the November 5, 2020 UR denial, and whether there was good cause to terminate wheelchair transportation services in October 2020.

  The WCAB found that defendant improperly terminated medical transportation services without medical evidence of changed condition and without proper utilization review, requiring continuation of services until a proper UR determination is made.

  Official decision · page 3 →
• ADJ11738998 · 2022-04-22 · Van Nuys District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.1Defendant ADP Total Source FLXVI, Inc., dba Three D Plastics, insured by American Home Assurance Company, administered by Helmsman Management Services, Inc. (Three D Plastics) seeks reconsideration of the May 11, 2021 Amended Findings and Award (F&A), wherein the workers' compensation administrative law judge (WCJ) found that applicant, while employed as a machinist from May 1, 2016 to January 13, 2019, sustained industrial injury to the wrists, back and neck, with all other body parts deferred. Applicant had concurrent employment during the alleged cumulative trauma with Vallarta Supermarkets (Vallarta) and with Three D Plastics. The WCJ found that the reporting of Agreed Medical Evaluator (AME) Yuri Falkinstein, M.D. constituted substantial medical evidence, and relying thereon, determined that applicant sustained injury arising out of and in the course of employment (AOE/COE), attributable solely to her employment with Three D Plastics.

  The WCAB found substantial medical evidence in the AME Dr. Falkinstein's reports and deposition supporting that the applicant sustained cumulative trauma injury arising out of and in the course of employment with Three D Plastics, rejecting the alternative causation scenario and the QME Dr. Guellich's report as not substantial evidence.

  Official decision · page 1 →
• ADJ10557068 · 2021-11-23 · Oxnard District OfficeJurisdiction / venuedefendant prevailed

  Determinative passage · p.5The Appeals Board has jurisdiction to determine whether a UR decision is timely. (Dubon v. World Restoration, Inc. (2014) 79 Cal.Comp.Cases 1298, 1299 (Appeals Board en banc) (Dubon II).) If a UR decision is untimely, the determination of medical necessity for the requested treatment may be made by the Appeals Board. (Id. at p. 1300.) However, "where a UR decision is timely, IMR is the sole vehicle for reviewing the UR physician's expert opinion regarding the medical necessity of a proposed treatment." (Id. at pp. 1310-1311; see also Lab. Code, § 4062(b), 4610.5; King v. CompPartners, Inc. (2018) 5 Cal.5th 1039, 1048 [83 Cal.Comp.Cases 1523] [IMR "is the exclusive mechanism for review of a utilization review decision"].) "All other disputes regarding a UR decision must be resolved by IMR." (Dubon II, supra, 79 Cal.Comp.Cases at p. 1299.)

  The Appeals Board has jurisdiction only to determine whether a UR decision is timely. Since the UR decision was timely, the Appeals Board has no jurisdiction to address other disputes regarding the UR decision, which must be resolved through IMR.

  Official decision · page 5 →
• ADJ12915738 · 2021-04-26 · Anaheim District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.5The Findings and Award and Opinion on Decision were based upon a review of the entire record which included that applicant's credible and unrebutted testimony along with the medical reporting.... The Applicant's unrebutted testimony was that he was not aware of what a continuous trauma was until he saw his attorney.... The Applicant also credibly testified that while he did have prior specific injuries including injury to his back, that he never fully recovered from his injuries and that his ongoing work duties aggravated his back and right wrist. His testimony regarding his ongoing heavy work duties and repetitive hand use was credible and not rebutted. (Report, pp. 2 § 3.)

  The WCJ's findings were based on applicant's credible and unrebutted testimony and the substantial medical evidence from treating physician Dr. Offenberger, whose opinions were found to be substantial evidence despite conflicting QME reports. The WCAB gave great weight to the WCJ's credibility determinations and found no reason to disturb the findings.

  Official decision · page 5 →
• ADJ10772269 · 2021-02-05 · Marina Del Rey District OfficeMedical treatment / UR / IMRremanded

  Determinative passage · p.2Here, the WCJ's decision solely resolves an intermediate procedural or evidentiary issue or issues. The decision does not determine any substantive right or liability and does not determine a threshold issue. Accordingly, it is not a "final" decision and the petition will be dismissed to the extent it seeks reconsideration.

  The WCAB found the WCJ's decision was interlocutory and not final, dismissing reconsideration but granting removal to allow further proceedings on the timeliness and reasonableness of the UR denial.

  Official decision · page 2 →

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.

• HELMSMAN MANAGEMENT
• HELMSMAN MANAGEMENT SERVICES, LLC
• HELMSMAN MANAGEMENT SERVICES
• Helmsman Management Services
• HELMSMAN MANAGEMENT SERVICES, INC.
• Helmsman Management
• HELMSMAN FOR NATIONAL UNION FIRE INSURANCE COMPANY
• HELMSMAN MANAGEMENT SERVICES, LLC.
• Helmsman Management Services, LLC
• HELMSMAN MANGEMENT SERVICES
• Helmsman Management Service

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.