Michael D. Drobot Pacific Hospital of Long Beach Additional Case Information Case number
Injured Worker
Employer
Claims administrator
ADJ2259171
DOLORES MORENO
7UP BOTTLING COMPANY
7UP/RC BOTTLING CO
ADJ1719616
LIRA LEBRON
99 CENT STORES
99" ONLY STORE
ADJ1719616
LIRA LEBRON
99 CENTS ONLY STORE
99" ONLY STORE
ADJ496698
JERONIMO GALLARDO
SOUTHWEST MARINE
ACCLAIM IRVINE
ADJ7190535
BETTY MYLES
COUNTY OF LOS ANGELES
ACCLAMATION 802108 SANTA CLARITA
ADJ8071516
ZHENIK AKOPYAN
COUNTY OF L A DEPT OF CHILDREN
ACCLAMATION 802108 SANTA CLARITA
ADJ846180
MICHAEL NESREEN
L A COUNTY PROBATION DEPT
ACCLAMATION 802108 SANTA CLARITA
ADJ4284751
LADONNA ROBINSON
GRANADA HILLS HOSP
ACCLAMATION FRESNO
ADJ4284751
LADONNA ROBINSON
GRANADA HILLS HOSPITAL
ACCLAMATION FRESNO
ADJ4308441
DENISE RODRIGUEZ
DANIEL FREEMAN MEMORIAL
ACCLAMATION FRESNO
FAM
HOSPITAL ADJ6451880
CHARITO NUNEZ
CITY OF DELANO
ACCLAMATION FRESNO
ADJ1242640 ADJ6748230
L KENYA SMITH WIGGS
COUNTY OF LOS ANGELES
ACCLAMATION SANTA CLARITA
RUSSELL REED
COUNTY OF LOS ANGELES
ACCLAMATION SANTA CLARITA
ADJ6748230
RUSSELL REED
OFFICE OF THE COUNTY COUNSEL
ACCLAMATION SANTA CLARITA
ADJ7904002
JO ANN WILLIAMS
COUNTY OF LOS ANGELES DEPT OF
ACCLAMATION SANTA CLARITA
CHILD SERVICES ADJ1103380
BARBARA MCGOWAN
INLAND PAPERBOARD & PACKAGING
ACE
INC ADJ1472382
ORA DICKSON
LOCKHEED MARTIN
ACE
ADJ1548254
LAWRENCE GONZALEZ
TIMEC
ACE
ADJ1548254
LAWRENCE GONZALEZ
TIMEC INC
ACE ACE
ADJ203871
JELKA SKORIC
AMPCO PARKING
ADJ2349516
ARMANDO SANCHEZ
RELIANCE STEEL
ACE
ADJ2411123
KEVIN NICHOLS
FOLEY ELECTRIC
ACE
ADJ2429736
JOSE CARRILLO
ACE
ADJ3650236
EVELYN ALDANA
SELECT STAFFING
ACE
ADJ598884
ROBERTO ATONAL
SELECT PERSONNEL
ACE
ADJ7804777
JUAN TORRES
PIERRE SPRINKLER AND LANDSCAPE
ACE
ADJ4212052
VICTOR MORENO
ASPEN DISTRIBUTION
ACE AMERICAN INSURANCE COMPANY
ADJ4212052
VICTOR MORENO
PACIFIC EXTERIORS INC
ACE AMERICAN INSURANCE COMPANY
ADJ1788202
IRENE NAVARRO
CITY OF EL MONTE
ADMINSURE DIAMOND BAR
ADJ1941549
JOSE MACIEL
WHITTIER UNION HIGH SCHOOL
ADMINSURE DIAMOND BAR
ADJ290765
JANICE ASHFORD
CITY OF INGLEWOOD
ADMINSURE DIAMOND BAR
ADJ290765
JANICE ASHFORD
CITY OF INGLEWOOD POLICE DEPT
ADMINSURE DIAMOND BAR
ADJ3365600
HUGO ESPARZA
COUNTY SANITATION DIST L A
ADMINSURE DIAMOND BAR
COUNTY ADJ6780464
KATHY ROBINSON
CITY OF HOPE
ADMINSURE DIAMOND BAR
ADJ7512141
SHELLEY BENJAMIN
CITY OF INGLEWOOD
ADMINSURE DIAMOND BAR
ADJ7767004
RAMONA LAFRANCE
CITY OF INGLEWOOD
ADMINSURE DIAMOND BAR
ADJ8045665
JOSE LUIS ARCOS
LOS ANGELES COMMUNITY COLLEGES
ADMINSURE DIAMOND BAR
ADJ8396668
JAMES MARSH
CITY OF DOWNEY FIRE DEPT
ADMINSURE DIAMOND BAR
ADJ3792880
MIGUEL FLORES
BBSI/SABROSO
ADVANTAGE ROCKLIN
Page 1
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ1129988
GENEVIEVE CLAVREUL
GLENDALE ADVENTIST MEDICAL
ADVENTIST HEALTH ROSEVILLE
CNTR ADJ7139227
JOSE ARAGON
GLENDALE ADVENTIST MEDICAL
ADVENTIST HEALTH ROSEVILLE
CENTER ADJ1357308
RUTH CHARLES
GELSON'S MARKET
AIG AMERICAN INTL CLAIMS SERVICES
ADJ1357308
RUTH CHARLES
GELSON'S MARKET #6
AIG AMERICAN INTL CLAIMS SERVICES
ADJ1921048
STEVE CORDRAY
ENTERTAINMENT PARTNERS
AIG AMERICAN INTL CLAIMS SERVICES
ADJ1921048
STEVE CORDRAY
WARNER BROTHERS
AIG AMERICAN INTL CLAIMS SERVICES
ADJ3263529
LISA PRICE
HAPI MANAGEMENT INC
AIG AMERICAN INTL CLAIMS SERVICES
ADJ3363262
FRANCES SAUNDERS TIPPIN
BOEING COMPANY
AIG AMERICAN INTL CLAIMS SERVICES
ADJ3363262
FRANCES SAUNDERS TIPPIN
THE BOEING COMPANY
AIG AMERICAN INTL CLAIMS SERVICES
ADJ3887877
NELIA SARDIDO
G.T.E. VERIZON
AIG AMERICAN INTL CLAIMS SERVICES
ADJ3073005
JOAQUIN RIVERA
BENS ASPHALT SEAL AND COATING
AIG CLAIM SERVICES
ADJ1062268
ROBERT SOWMA
RAINBOW ENGINEERING
AIG CLAIMS CONCORD
ADJ1139914
MATEO SILVA
ADJ1357308
RUTH CHARLES
GELSON'S MARKET
AIG CLAIMS CONCORD AIG CLAIMS CONCORD
ADJ1357308
RUTH CHARLES
GELSON'S MARKET #6
AIG CLAIMS CONCORD
ADJ2180310
MARTHA VIRGEN
ROYAL COURT
AIG CLAIMS CONCORD
ADJ2536003
ROBIN CRADER
BECKMAN COULTER INC
AIG CLAIMS CONCORD
ADJ2643505
ANNIE COVIN
NORTHROP GRUMMAN
AIG CLAIMS CONCORD
ADJ3902747
CHRISTOPHER COLLINS
WAREHOUSE EQUIPMENT
AIG CLAIMS CONCORD
ADJ3902747
CHRISTOPHER COLLINS
WAREHOUSE EQUIPMENT, INC.
AIG CLAIMS CONCORD
ADJ4183519
CYNTHIA THOMPSON
DRAKE CERTIVO
AIG CLAIMS CONCORD
ADJ4183519
CYNTHIA THOMPSON
DRAKE CERTIVO INC
AIG CLAIMS CONCORD
ADJ926199
MICHELLE EVANS
BANK OF AMERICA
AIG CLAIMS CONCORD AIG CLAIMS COSTA MESA
ADJ1030031
JOSE AREVALO
TOBIN, LUCKS & GOLDMAN
ADJ1046462
TAMMY TROGLIN
ENTERTAINMENT PARTNERS
AIG CLAIMS COSTA MESA
ADJ1386722
EDDIE VALDIVIA
NORTHROP GRUMMAN
AIG CLAIMS COSTA MESA
ADJ1432513
DAVID RIDDING
KEDREN COMMUNITY HEALTH
AIG CLAIMS COSTA MESA
CENTER ADJ1480265
MARIA CEBALLOS
ADJ1593443
ANTONIO REYES
J.C. PENNY LOGISTICS
AIG CLAIMS COSTA MESA AIG CLAIMS COSTA MESA
ADJ1861342
DAWN WALKER
SKYWEST AIRLINES
AIG CLAIMS COSTA MESA
ADJ1863051
KELSEY MADDOX
TRADER JOE'E
AIG CLAIMS COSTA MESA
ADJ1921048
STEVE CORDRAY
ENTERTAINMENT PARTNERS
AIG CLAIMS COSTA MESA
ADJ1921048
STEVE CORDRAY
WARNER BROTHERS
AIG CLAIMS COSTA MESA
ADJ2127502
JOSE ORTEGA MARQUEZ
HARBOR RAIL SERVICES OF
AIG CLAIMS COSTA MESA
CALIFORNIA ADJ2176209
MIGUEL DELGADILLO
LANE FRAMING SYSTEMS INC
AIG CLAIMS COSTA MESA
ADJ2364181
JOSE ANGEL TAPIA IXTA
POTENTIAL INDUSTRIES
AIG CLAIMS COSTA MESA
ADJ2443167
FRANK MARISCAL
CTR PRINTING
AIG CLAIMS COSTA MESA
ADJ2501329
JOSHUA PINA
AUTO CHLOR SYSTEMS
AIG CLAIMS COSTA MESA
ADJ251786
LINDA SMITH ARNOLD
ENTERTAINMENT PARTNERS
AIG CLAIMS COSTA MESA
Page 2
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ2630657
SANDRA MORTON
LEHMAN BROTHERS HOLDING INC
AIG CLAIMS COSTA MESA
ADJ2677684
ROSSLYN ELMORE MORRIS
MCDONNELL DOUGLAS CORP.
AIG CLAIMS COSTA MESA
ADJ2705470
DALE ERVIN
STAFF MARK
AIG CLAIMS COSTA MESA
ADJ273194
JAMES GOODMAN
MGE UPS SYSTEMS
AIG CLAIMS COSTA MESA
ADJ3036684
RUTH STILL
VERIZON
AIG CLAIMS COSTA MESA
ADJ3073005
JOAQUIN RIVERA
BENS ASPHALT SEAL AND COATING
AIG CLAIMS COSTA MESA
ADJ3136111
DAVID T DURBORAW
AXIUM INTERNATIONAL
AIG CLAIMS COSTA MESA
ADJ3136111
DAVID T DURBORAW
CAST & CREW PRODUCTION
AIG CLAIMS COSTA MESA
PAYROLL INC ADJ3136111
DAVID T DURBORAW
ENTERTAINMENT PARTNERS
AIG CLAIMS COSTA MESA
ADJ3154751
AMY MARTIN
MONTAGE RESORT
AIG CLAIMS COSTA MESA
ADJ3222155
CARMEN GIL
J.C. PENNEY
AIG CLAIMS COSTA MESA
ADJ3231061
STEPHEN TREVINO
BRIAN KORINER
AIG CLAIMS COSTA MESA
ADJ3477816
GIL CRENSHAW
NORTHROP GRUMMAN
AIG CLAIMS COSTA MESA
ADJ3640706
RICHARD TEALOR
CROWN DISPOSAL COMPANY INC
AIG CLAIMS COSTA MESA
ADJ3672183
ALFONSO CORRAL
AIG CLAIMS COSTA MESA
ADJ3854079
JOSE GARCIA
WING LEE FARMS
AIG CLAIMS COSTA MESA
ADJ3977675
KEITH SIMIEN
CRST INTERNATIONAL
AIG CLAIMS COSTA MESA
ADJ3988151
ROSE CALDERON
LASERLYTE
ADJ4305002
LOUISE COLEMAN
TTCC, INC.
AIG CLAIMS COSTA MESA
ADJ4367196
ENRIQUE CUEVAS
SIMMONS
AIG CLAIMS COSTA MESA
ADJ4417255
RONNIE HURST
ALLIAD WASTE
AIG CLAIMS COSTA MESA
ADJ4700809
RAY RAMIREZ
NATIONAL OAK DISTRIBUTORS
AIG CLAIMS COSTA MESA
INCORPORATED AIG CLAIMS COSTA MESA
ADJ6506806
PERLA SOSA
CPR STAFFING
AIG CLAIMS COSTA MESA
ADJ666229
CANDIDA SILVA
PEERLESS BUILDING
AIG CLAIMS COSTA MESA
ADJ6699463
CLEMENCIA SUAREZ LOPEZ
WAL MART
AIG CLAIMS COSTA MESA
ADJ6711322
ANTONIO OLIVO
CITI STAFF SOLUTIONS INC
AIG CLAIMS COSTA MESA
JAM INDUSTRIES INC DBA JAM
AIG CLAIMS COSTA MESA
DECEASED ADJ6724087
MAYRA ROQUEZ
WAREHOUSE ADJ6737703
MARIA TOVAR
ADJ6852886
CHRISTOPHER MOORE
G-2 SECURE STAFF
AIG CLAIMS COSTA MESA
AIG CLAIMS COSTA MESA
ADJ6946204
LORETTA DARDEN
SHELLDS FOR FAMILIES
AIG CLAIMS COSTA MESA
ADJ6961509
KAREN MAZON
PORTS AMERICA
AIG CLAIMS COSTA MESA
ADJ6963945
CHRISTOPHER PASCUZZO
ENTERTAINMENT PARTNERS
AIG CLAIMS COSTA MESA
ADJ7002068
SUSAN MILLER
SONUS HEARING CARE
AIG CLAIMS COSTA MESA
ADJ7176344
JORGE GARCIA LEMUS
SMART PARTY RENTALS INC
AIG CLAIMS COSTA MESA
ADJ7232700
LEE SHEPARD
BURRTEC WASTE GROUP INC
AIG CLAIMS COSTA MESA
ADJ7305003
DAVID CAST
NORTHROP GRUMMAN
AIG CLAIMS COSTA MESA
ADJ7305247
LUIZ IRIAS LI
SOUTHERN CALIFORNIA PIZZA
AIG CLAIMS COSTA MESA
COMPANY PIZZA HUT
Page 3
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7410042
DONALD KENNEY
BRITISH TELECOM
AIG CLAIMS COSTA MESA
ADJ7447861
LAURA DE GALVEZ
UNIFIED CARE SERVICES INC DBA
AIG CLAIMS COSTA MESA
ADJ750791
ARTURO CONTRERAS
NOVESTAFF RESOURCE GROUP, LLC.
AIG CLAIMS COSTA MESA
ADJ750791
ARTURO CONTRERAS
UEBTF LOS ANGELES
AIG CLAIMS COSTA MESA
ADJ7578897
EDWARD ORTIZ
CRAFT RESOURCES
AIG CLAIMS COSTA MESA
ADJ7608132
HARVEY AMEZCUA
PENHALL
AIG CLAIMS COSTA MESA
ADJ7638366
JOSE MARTINEZ
CPS EXPRESS
AIG CLAIMS COSTA MESA
ADJ7686424
GUADALUPE RODELO
SOURCE INTERLINK RETAIL SERVICES
AIG CLAIMS COSTA MESA
PACIFIC PALM HEALTHCARE
ADJ7789932
MARLON BLANDON
BIZJET SERVICES
AIG CLAIMS COSTA MESA
ADJ7880142
GERARDO CONTRERAS
PACIFIC TANK LINES
AIG CLAIMS COSTA MESA
ADJ8113244
MARTHA GOMEZ
TECTRANS INC
AIG CLAIMS COSTA MESA
ADJ8131001
FERNANDO ALVAREZ JR
HOLLYWOOD PARK RACING
AIG CLAIMS COSTA MESA
ADJ817041
ALEJANDRO MORENO
ADJ8240130 ADJ860176 ADJ2127502
ASSOCIATION J.C. PENNEY
AIG CLAIMS COSTA MESA
FRANCISCO GONZALEZ
ROCK TENN
AIG CLAIMS COSTA MESA
MERCY GEE
ALVARADO PARKWAY INSTITUTE
AIG CLAIMS COSTA MESA
JOSE ORTEGA MARQUEZ
HARBOR RAIL SERVICES OF
AIG CLAIMS PHOENIX
CALIFORNIA ADJ6605588
DAVID SANTISTEVAN
ADJ6737703
MARIA TOVAR
ADJ7056112
JULIO PEREZ
GEVITY PEOPLE 1ST
AIG CLAIMS PHOENIX AIG CLAIMS SAN DIEGO
PERSONNEL PLUS AGENCY INC
AIG CLAIMS SAN DIEGO
ADJ7136263
ROSA GUEVARRA
FRESH FOOD CONCEPTS
AIG CLAIMS SAN DIEGO
ADJ7329727
KRISSY KORN
ENTERTAINMENT PARTNERS
AIG CLAIMS SAN DIEGO
ADJ7346458
MAURICIO MORALES
AMERICAN GUNITE INCORP
AIG CLAIMS SAN DIEGO
ADJ7346458
MAURICIO MORALES
UNINSURED EMPLOYERS FUND
AIG CLAIMS SAN DIEGO
ADJ7514118
MICHAEL PHILLIPS
CRST INTERNATIONAL
AIG CLAIMS SAN DIEGO
ADJ7589739
RANULFO GARCIA
CROWN DISPOSAL CO INC
AIG CLAIMS SAN DIEGO
ADJ7637915
JUAN SORIANO
PERSONNEL PLUS
AIG CLAIMS SAN DIEGO
ADJ7673467
ANTONIO ZENDEJAS
DEERE & COMPANY
AIG CLAIMS SAN DIEGO
ADJ7842128
EDWIN RODRIGUEZ
SOUTHERN CALIFORNIA PIZZA
AIG CLAIMS SAN DIEGO
COMPANY ADJ8039543
MARTHA CASAS
PERSONNEL PLUS
AIG CLAIMS SAN DIEGO
ADJ8321209 ADJ3426267
JAHANA SOTO
PERSONNEL PLUS
AIG CLAIMS SAN DIEGO
THOMAS DAY
COUNTY OF LA/PROBATION DEPT
AIMS
ADJ5827299
SHEILA LABOMME
COUNTY OF LOS ANGELES
AIMS INC.
ADJ1211630
JOSE LUA DIAZ
UNIVERSAL SODEXHO
ALASKA NATIONAL SEATTLE
ADJ4372048
JOSE LUA DIAZ
UNIVERSAL SODEXHO
ALASKA NATIONAL SEATTLE
ADJ6544953
CALIXTO DILLON
CONNECT TELEVISON
ALASKA NATIONAL WALNUT CREEK
ADJ6759057
ALFREDO LEYVA
JADE INC
ALASKA NATIONAL WALNUT CREEK
ADJ7363129
JOSEFINA ETRATA
VILLA MESA CARE CENTER
ALASKA NATIONAL WALNUT CREEK
ADJ2854178
BELITA RIGOLI
VONS WAREHOUSE
ALBERTSONS HOLDINGS FULLERTON
BETANCOURT ADJ3318078
GLORIA ROJAS
VONS MARKET
ALBERTSONS HOLDINGS FULLERTON
ADJ601181
MARIA ANDERSON
PAVILION #233
ALBERTSONS HOLDINGS FULLERTON
Page 4
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ6569802
JOE ORIGEL
VONS COMPANIES, INC.
ALBERTSONS HOLDINGS FULLERTON
ADJ8667338
FRANCIS APONTE
ALBERTSONS INC
ALBERTSONS INC
ADJ4230430
LINDA SMITH
UNITED AIRLINES
ALEXIS RISK MGT
ADJ896033
MICHAEL WRIGHT
HANFORD GLASS COMPANY
ALISTAR INS CO IN LIQUIDATION
ADJ3876482
ANTONIO MELGAREJO
MCSTARLITE CO
ALLIANZ BURBANK
ADJ3876482
ANTONIO MELGAREJO
MCSTARLITE CO
ALLIANZ INSURANCE COMPANY
ADJ746480
ROSA GARCIA
L.A. SMOKING AND CURING
ALLIANZ INSURANCE COMPANY
ADJ162927
MARIA VIANA
THE GRAFTON ON SUNSET
ALLIANZ RESOLUTION PETALUMA
ADJ3520155
MARISELA URIBE
DR. MORRIS AKHAMZADEH/FAMILY
ALLIANZ RESOLUTION RANCHO CORDOVA
DENT. ADJ7647732
BRAY PANFILO
CHARTER FURNITURE
ALLIANZ RESOLUTION RANCHO CORDOVA
ADJ7702149
DEBORAH HAASE
SAFEWORK INC
ALLIANZ RESOLUTION RANCHO CORDOVA
ADJ8175645
MARTHA ROCHA
MC1 FOODS
ALLIANZ RESOLUTION RANCHO CORDOVA
ADJ8188419
JULIO MUNOZ
INDUSTRIAL METAL SUPPLY
ALLIANZ RESOLUTION RANCHO CORDOVA
ADJ830119
DESTINY MORGAN
DESERT DUNES ANIMAL HOSPITAL
ALLIANZ RESOLUTION RANCHO CORDOVA
ADJ1254664
LETICIA SANDOVAL
CENTRAL PARKING SYSTEM
ALTERNATIVE SERVICE CITRUS HEIGHTS
ADJ1341056
GUADALUPE SANCHEZ
INTERCOMMUNITY NURSING CENTER
AMERICAN CASUALTY
ADJ1563144
GARY CUSUMANO
TREND OFF SET PRINTERS
AMERICAN CASUALTY
ADJ1649554
MARIA MEZA
ANZA APT
AMERICAN CASUALTY
ADJ1819572
RONALD WARD
ASCENT MEDIA GROUP
AMERICAN CASUALTY
ADJ1921048
STEVE CORDRAY
ENTERTAINMENT PARTNERS
AMERICAN CASUALTY
ADJ1921048
STEVE CORDRAY
WARNER BROTHERS
AMERICAN CASUALTY
ADJ212263
DONNA MILLER
HOLY CROSS MEDICAL CENTER
AMERICAN CASUALTY
ADJ3275386
MARIA GARCIA DE JESUS
MGH GOURMET INC
AMERICAN CASUALTY
ADJ3669642
LUISA O CONNOR
UNIVERSAL PROTECTION SERVICES
AMERICAN CASUALTY
ADJ1801513
SOFIA DEL CARMEN
AMERICAN CLAIMS SAN DIEGO
ZELAYA ADJ3163359
LISSETTE AGUILAR
MCDONALDS
AMERICAN CLAIMS SAN DIEGO
ADJ7146789
DANNY PHILLIPS
CONTINENTAL MARBLE AND TILE
AMERICAN CLAIMS SAN DIEGO
ADJ7146789
DANNY PHILLIPS
ESIS FREMONT
AMERICAN CLAIMS SAN DIEGO
ADJ7523496
HELGA RAMIREZ
TRIAS LLC
AMERICAN CLAIMS SAN DIEGO
ADJ7904218
MARTHA DURAN
CHECK CASHIERS
AMERICAN CLAIMS SAN DIEGO
ADJ8330151
SANTIAGO CORONADO
R T FRAMING CORPORATION
AMERICAN CLAIMS SAN DIEGO
ADJ8411444
BEVERLY ORANGE
AVALON VILLA CARE CENTER
AMERICAN CLAIMS SAN DIEGO
ADJ3538802
GUADALUPE BUENO
ALAHAMBRA BUILDING
AMERICAN COMMERCIAL AMERICAN COMMERCIAL
ADJ3649101
EDWARD DAVIS
PERSONNEL PLOS ANAHEIM
ADJ4201565
MELECIO GONZALEZ
TEMPLE ISRAEL OF HOLLYWOOD
AMERICAN COMMERCIAL
ADJ1460361
MARIA BAFILE
DEBILIO FOOD DISTRIB.
AMERICAN COMMERCIAL SAN DIEGO
ADJ1545119
TROY FUCONE
PACIFIC WEST LITHO INC
AMERICAN COMMERCIAL SAN DIEGO
Page 5
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ1749683
ALFREDO ZATARIAN
JAYAR MANUFACTURING COMPANY
AMERICAN COMMERCIAL SAN DIEGO
ADJ3076419
JOANNE OSBY
DRC
AMERICAN COMMERCIAL SAN DIEGO
ADJ3076419
JOANNE OSBY
UEF
AMERICAN COMMERCIAL SAN DIEGO
ADJ4264155
LISA WARNER
MERCEDES BENZ OF LAGUNA NIGUEL
AMERICAN COMMERCIAL SAN DIEGO
ADJ4522208
ESPIRIDION CONTRERAS
ROYAL CABINETS
AMERICAN COMMERCIAL SAN DIEGO
ADJ6939275
AGUSTIN VELAZQUEZ
BROOKER ASSOCIATES INC
AMTRUST CONCORD
ACEVEDO ADJ3153732
DENEANE STEVENSON
CERTIFIED GROCERS OF CALIFORNIA
AMTRUST COVINA
ADJ1545119
TROY FUCONE
PACIFIC WEST LITHO INC
AMTRUST IRVINE
ADJ443823
RICHARD ZOSCHKE
REDWOOD FIRE & CASUALTY
AMTRUST IRVINE
INSURANCE C ADJ443823
RICHARD ZOSCHKE
SUREFIRE, LLC
AMTRUST IRVINE
ADJ7058838
RICHARD SUTTON
CERRITOS FORD
AMTRUST IRVINE
ADJ7129093
SANTIAGO HERRERA
RAINBOW
AMTRUST IRVINE
ADJ7346458
MAURICIO MORALES
AMERICAN GUNITE INCORP
AMTRUST IRVINE
ADJ7346458
MAURICIO MORALES
UNINSURED EMPLOYERS FUND
AMTRUST IRVINE
ADJ7431227
GUADALUPE AQUINO
PICASSO STYLE INC
AMTRUST IRVINE
ADJ7552608
ELIZABETH EISENFELD
SOUTHERN CALIFORNIA NESSAH
AMTRUST IRVINE
EDUCATIONAL CULTURAL CENTER ADJ7733498
MINOO DANESHRAD
NESSAH EDUCATIONAL AND
AMTRUST IRVINE
CULTURAL CENTER ADJ3185843
FERNANDO CAMPOS
CPE/DANMAR RETIREMENT VILLA
AMTRUST NORTH AMERICA/TECHNOLOGY INSURANCE
ADJ1679828
JUAN CARLOS DIAZ
JKP INC
APPLIED RISK OMAHA
ADJ2898367
SEAN QUINLIVAN
PETE'S PLUMBING
APPLIED RISK OMAHA
ADJ3331582
MICHAEL LOPEZ
SOLO TERMITE CONTROL
APPLIED RISK OMAHA
ADJ6784010
ALEJO RUBIO
CATALINA YACHTS
APPLIED RISK OMAHA
ADJ7437470
JOSE BECERRA
COAST CHEM EXTERMINATING
APPLIED RISK OMAHA
ADJ7937467
ROSARIO LARA
MY C INC DBA GOLDILOCKS CORP
APPLIED RISK OMAHA
ADJ817604
SHIRLEY BOESSNECK
SAMS CLUB
ARCMI
ADJ3465583
SIPRIANO HUITRON
CEMCO,INC
ARGONAUT FRESNO
ADJ4652794
ALICIA PENALVER
AGRI-CEL, INC.
ARGONAUT FRESNO
ADJ3345793
ROSENDO VELIZ
FAIRCHILD FASTENER GRP
ARROWOOD INDEMNITY COMPANY
ADJ3471970
ANDREA LOPEZ
KRAGEN AUTO PARTS
ARROWOOD INDEMNITY COMPANY
ADJ4113415
JHOANA MORALES
WESTSIDE PACKAGING, INC.
ASIC
ADJ4062533
JOSE REYES
ASSOC CONCRETE PRODUCTS
ASSOCIATED CONCRETE PRODUCTS/AUFAIT
CHARLOTTE CHARLOTTE
RISK MANAGEMENT SERVICE
Page 6
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ4062533
JOSE REYES
ASSOCIATED CONCRETE PRODUCTS
ASSOCIATED CONCRETE PRODUCTS/AUFAIT RISK MANAGEMENT SERVICE
ADJ6985332
FAKHRI TAHERI
IHASET
ASSURANCE CO OF AMERICA SACRAMENTO
ADJ1690845
MARY NASH
PACIFIC BELL
AT & T TECHNOLOGIES/HELMSMAN
ADJ2876773
VERONICA BAILEY
FALLBROOK UNION HIGH SCHOOL
ATHENS ADMINISTRATORS CONCORD
MANAGEMENT SERVICES INC DISTRIC ADJ3875469
MARIA PRECIADO
ADJ6625078
ARLENE NELSON
HOUSING AUTHORITY
ATHENS ADMINISTRATORS CONCORD
ADJ6744645
PASTOR ESTRADA
LA PARTY RENTS
ATHENS ADMINISTRATORS CONCORD
ADJ7988038
CHRISTEN VINCENT
ABF FREIGHT SYSTEMS
ATHENS ADMINISTRATORS CONCORD
ADJ7028491
ROSE LOPEZ
PRESBYTERIAN COMMUNITY
ATHENS ADMINISTRATORS ORANGE
ATHENS ADMINISTRATORS CONCORD
HOSPITAL ADJ3283627
JULIO MORALES
SAFE PLATING INC
ATHENS ADMINISTRATORS SACRAMENTO
ADJ2054212
SILVANO GUERRERO
THE QUIKRETE CO
ATLANTIC MUTUAL INSURANCE CO
ADJ6882755
JONATHAN HAMMER
P AND R PAPER SUPPLY COMPANY
AVIZENT 4740 EL DORADO HILLS
ADJ6684842
GABRIEL VILLA
CRS COMMERCIAL BBSI SANTA ANA
BARRETT BUSINESS SACRAMENTO
ADJ6694885
GABRIEL VILLA
CRS COMMERCIAL BBSI SANTA ANA
BARRETT BUSINESS SACRAMENTO
ADJ8246437
SALVADOR LARIOS
BRO PACK INC
BARRETT BUSINESS SACRAMENTO
ADJ6684842
GABRIEL VILLA
CRS COMMERCIAL BBSI SANTA ANA
BARRETT BUSINESS SACRAMENTO
ADJ6694885
GABRIEL VILLA
CRS COMMERCIAL BBSI SANTA ANA
BARRETT BUSINESS SACRAMENTO
ADJ6759338
COBI JONES
LOS ANGELES GALAXY
BERKLEY SPECIALTY IRVING
ADJ6759338
COBI JONES
MAJOR LEAGUE SOCCER
BERKLEY SPECIALTY IRVING
ADJ7269278
ANTE RAZOV
LOS ANGELES GALAXY
BERKLEY SPECIALTY IRVING
ADJ7380036
BOBBY YOUNG
UNITED PIMPING SERVICE INC
BERKLEY SPECIALTY IRVING
ADJ8199704
OLIVER ROSS
ARIZONA CARDINALS
BERKLEY SPECIALTY IRVING
ADJ1164224
ANTONIO PEREZ
AMERICAN LANDSCAPE
BERKSHIRE HATHAWAY PASADENA
MAINTENANCE ADJ1164224
ANTONIO PEREZ
AMERICAN LANDSCAPE
BERKSHIRE HATHAWAY PASADENA
MAINTENENCE ADJ2949920
MARINA SILVA
PLAZA DE LA RAZA HEAD START INC
BERKSHIRE HATHAWAY PASADENA
ADJ443823
RICHARD ZOSCHKE
REDWOOD FIRE & CASUALTY
BERKSHIRE HATHAWAY PASADENA
INSURANCE C ADJ443823
RICHARD ZOSCHKE
SUREFIRE, LLC
BERKSHIRE HATHAWAY PASADENA
ADJ6814391
LUCY JASSO
LEGAL AID FOUNDATION OF LOS
BERKSHIRE HATHAWAY PASADENA
ADJ6828953
PETE GARABITO
UNITY COURIER
BERKSHIRE HATHAWAY PASADENA
ADJ6828953
PETE GARABITO
UNITY COURIER
BERKSHIRE HATHAWAY SAN DIEGO
ADJ7487053
AGUSTINA CONTRERAS
RAYS WRAP INC.
BERKSHIRE HATHAWAY SAN DIEGO
ADJ1623288
KENNETH ECHAVARRIA
AIR GOURMET INC
BERKSHIRE HATHAWAY SAN FRANCISCO
ANGELES
Page 7
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ4384574
MARIA DUENAS
LB PROPERTY MANAGEMENT
BERKSHIRE HATHAWAY SAN FRANCISCO
ADJ6744645
PASTOR ESTRADA
LA PARTY RENTS
BERKSHIRE HATHAWAY SAN FRANCISCO
ADJ7244721
ALMA CASTILLO
DIANA'S MEXICAN FOOD
BERKSHIRE HATHAWAY SAN FRANCISCO
ADJ7447845
ERNESTO HERMOSILLO
EVYCA
BERKSHIRE HATHAWAY SAN FRANCISCO
ADJ7733498
MINOO DANESHRAD
NESSAH EDUCATIONAL AND
BERKSHIRE HATHAWAY SAN FRANCISCO
CULTURAL CENTER ADJ8068932
GREGORY POWELL
BLUE DAISY CEMENT PRODUCTS INC
BERKSHIRE HATHAWAY SAN FRANCISCO
ADJ8120012
MARCOS GONZALES
ROSS & BARROWS INC
BERKSHIRE HATHAWAY SAN FRANCISCO
ADJ7900772
CARMEN BARRANCO
BOEING
BOEING
ADJ3650313
JORGE DOMINGUEZ
AM PERSONNEL PARTNERS, INC.
BROADSPIRE
ADJ3650313
JORGE DOMINGUEZ
BARRATT AMERICAN INCORPORATED
BROADSPIRE
ADJ3650313
JORGE DOMINGUEZ
FORD PLASTERING
BROADSPIRE
ADJ7925389
LUIS QUINTERO
AMERICANOS USA
BROADSPIRE 12586 FRESNO CLOSED
ADJ1069951
LINDA CERDA
GLORY USA, INC.
BROADSPIRE 24016 FRESNO
ADJ1308857
ULUALO ASUEGA
STAFF MARK
BROADSPIRE 24016 FRESNO
ADJ1423647
DIANA MORALES
SO CAL AUTO AUCTION
BROADSPIRE 24016 FRESNO
ADJ1423647
DIANA MORALES
SOUTHERN CALIFORNIA AUTO
BROADSPIRE 24016 FRESNO
AUCTION ADJ1673870
SOFIA CERDA
99 CENTS ONLY STORE
BROADSPIRE 24016 FRESNO
ADJ2381097
JOHN RHODES
C.R. ENGLAND
BROADSPIRE 24016 FRESNO
ADJ2804761
RUBEN PEREZ ARAUJO
CENTIMARK CORPORATION
BROADSPIRE 24016 FRESNO
ADJ317660
LORENZO GARCIA
LINDBERG HEAT TREATING
BROADSPIRE 24016 FRESNO
ADJ4681462
BETTY CHAN
LOS ANGELES FIREMANS CREDIT
COMPANY BROADSPIRE 24016 FRESNO
UNION ADJ7859341
TUYET TATE
AMETEK
BROADSPIRE 24016 FRESNO
ADJ8207921
MIGUEL MEDINA
MV TRANSPORTATION
BROADSPIRE 24016 FRESNO
ADJ1044616
ALFRED SANCHEZ
THE BOEING CO
BROADSPIRE BREA
ADJ1116165
GILBERT AGUILAR
AJILON COMMUNICATIONS
BROADSPIRE BREA
ADJ1311205
GARY CLEVENGER
POOL WELL SERVICES
BROADSPIRE BREA
ADJ1781346
ROBERT AZALBARIAN
SAM'S SHELL #1
BROADSPIRE BREA
ADJ1921048
STEVE CORDRAY
ENTERTAINMENT PARTNERS
BROADSPIRE BREA
ADJ1921048
STEVE CORDRAY
WARNER BROTHERS
BROADSPIRE BREA
ADJ2656740
JOHN FANOUS
THE BOEING COMPANY
BROADSPIRE BREA
ADJ3088000
BRIAN ROJAS
DUNN-EDWARDS CORPORATION
BROADSPIRE BREA
ADJ3193103
MARIA STEVENS DIAKIS
UNIVERSITY OF SOUTHERN
BROADSPIRE BREA
ADJ3363262
FRANCES SAUNDERS TIPPIN
BOEING COMPANY
BROADSPIRE BREA
ADJ3363262
FRANCES SAUNDERS TIPPIN
THE BOEING COMPANY
BROADSPIRE BREA
CALIFORNIA
ADJ4032540
DONALD DOTY
BOEING CO.
BROADSPIRE BREA
ADJ4320776
JOHN MARTIN
TRW
BROADSPIRE BREA
ADJ4364675
SILVIA HUERTAS
JACK IN THE BOX
BROADSPIRE BREA
Page 8
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ4606617
ROBERT MOYA
BRAND SCAFFOLD RENTAL AND
BROADSPIRE BREA
ERECTION ADJ6567956
MATTY CAMPOS
USC
BROADSPIRE BREA
ADJ6778624
PAUL CALLOWAY
SECURITAS SECURITY SERVICE
BROADSPIRE BREA
ADJ6989046
OSCAR LARA
MAXUM PETROLIUM INC
BROADSPIRE BREA
ADJ7083510
THOMAS MELENDEZ
STRAUB DISTRIBURING COMPANY
BROADSPIRE BREA
ADJ7181841
LIDIA VELAZQUEZ
USC
BROADSPIRE BREA
ADJ7285453
MARIA VARGAS
SMURFIT STONE
BROADSPIRE BREA
ADJ7481451
RAMON PALAFOX
TEXTRON INC
BROADSPIRE BREA
ADJ8142625
ALEJANDRO RIEGER
HOBART
BROADSPIRE BREA
ADJ8383846
LONGMY HUYNH
GENERAL DYNAMICS
BROADSPIRE BREA
ADJ1023285
MARINA GONZALEZ
PROFESSIONAL STAFFING
BROADSPIRE CIGA GLENDALE CLOSED
ADJ1023285
MARINA GONZALEZ
PROFESSIONAL STAFFING SERVICES
BROADSPIRE CIGA GLENDALE CLOSED
ADJ1023285
MARINA GONZALEZ
SIMPLE TECHNOLOGY
BROADSPIRE CIGA GLENDALE CLOSED
ADJ105997
SAMUEL HYNES
TAMCO STEEL
BROADSPIRE CIGA GLENDALE CLOSED
ADJ1253139
BRENDA BECKER
BESTFORMS
BROADSPIRE CIGA GLENDALE CLOSED
ADJ1315320
SARA PEDRAZA
SOUTH COAST MEDICAL CENTER
BROADSPIRE CIGA GLENDALE CLOSED
ADJ1579947
ELAINE VASQUEZ
LA HABRA VILLA
BROADSPIRE CIGA GLENDALE CLOSED
ADJ2757596
SERGIO VALENZUELA
ELITE PERSONNEL SERVICE
BROADSPIRE CIGA GLENDALE CLOSED
ADJ2757596
SERGIO VALENZUELA
SOUTHLAND BOX CO.
BROADSPIRE CIGA GLENDALE CLOSED
ADJ2817792
DOROTHY GOULD
HARVEST FARMS
BROADSPIRE CIGA GLENDALE CLOSED
ADJ2859662
MARICELA PANTOJA
ROGER'S FOODS
BROADSPIRE CIGA GLENDALE CLOSED
ADJ2890022
SHEILA CIANCANELLI
HYDRA BATHS INC.
BROADSPIRE CIGA GLENDALE CLOSED
ADJ3162883
JOSE GARCIA
UNITED ALLOYS INC
BROADSPIRE CIGA GLENDALE CLOSED
ADJ4019325
ALLEN SHEPARD
SWIFT TRANSPORTATION
BROADSPIRE CIGA GLENDALE CLOSED
ADJ4113415
JHOANA MORALES
WESTSIDE PACKAGING, INC.
BROADSPIRE CIGA GLENDALE CLOSED
ADJ576480
ARSENIO GARCIA
TEMPSTAR SERVICES
BROADSPIRE CIGA GLENDALE CLOSED
ADJ576480
ARSENIO GARCIA
WET SEAL
BROADSPIRE CIGA GLENDALE CLOSED
ADJ746480
ROSA GARCIA
L.A. SMOKING AND CURING
BROADSPIRE CIGA GLENDALE CLOSED
ADJ896033
MICHAEL WRIGHT
HANFORD GLASS COMPANY
BROADSPIRE CIGA GLENDALE CLOSED
ADJ7875869
REINA ELIZABETH
OBERTHUR TECHNOLOGIES OF
BROADSPIRE CONCORD
ORELLANA
AMERICA CORP
ADJ8286541
MARIA TORRES
PENTAIR WATER POOL AND SPA
BROADSPIRE CONCORD
ADJ1286605
LAURO GUERRERO
UNIVERSAL ALLOY
BROADSPIRE INSURANCE COMPANIES
ADJ2646272
SUZAN GUBRUD
FRESH START BAKERY
BROADSPIRE INSURANCE COMPANIES
ADJ3756070
ANDRES CORTEZ
DUNHAM ROOFING, INC.
BROADSPIRE INSURANCE COMPANIES
ADJ4358198
KAREN BROWN POUNCY
PACIFIC CARE OF CALIFORNIA
BROADSPIRE INSURANCE COMPANIES
ADJ546036
MARIBEL GOMEZ
ANGELICA TEXTILES SERVICES
BROADSPIRE INSURANCE COMPANIES
ADJ1140089
SCOTT CANNELL
TIERNAY METALS
BROADSPIRE SACRAMENTO
ADJ1140089
SCOTT CANNELL
TIERNEY METALS
BROADSPIRE SACRAMENTO
ADJ1202959
GEORGE MARTINEZ
US FOOD SERVICE
BROADSPIRE SACRAMENTO
ADJ1305070
MARK MARGOLIS
ALBERTSONS
BROADSPIRE SACRAMENTO
ADJ1333680
REYNA CASTILLO
COURTESY EMPLOYMENT SERVICES
BROADSPIRE SACRAMENTO
ADJ2013835
JAMES MOORE
BOEING
BROADSPIRE SACRAMENTO
Page 9
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ2695773
JANINE PERDEW
ALBERTSONS
BROADSPIRE SACRAMENTO
ADJ2859662
MARICELA PANTOJA
ROGER'S FOODS
BROADSPIRE SACRAMENTO
ADJ3335294
BERT SASSENBERG
RENZENBERGER, INC.
BROADSPIRE SACRAMENTO
ADJ3590636
DONALD REICHENECKER
OWENS & MINOR
BROADSPIRE SACRAMENTO
ADJ3732140
GARY SIMS
BOYD COFFEE CO
BROADSPIRE SACRAMENTO
ADJ3934528
CECILIA LEDEZMA
STAPLES
BROADSPIRE SACRAMENTO
ADJ4038941
RONALD HIGHLEY
NEWPORT DIVERSIFIED
BROADSPIRE SACRAMENTO
ADJ406953
LARRY SPRATT
BRAND SCAFFOLD
BROADSPIRE SACRAMENTO
ADJ4238525
SHANNON HILL LEMIEUX
JOHNSON & JOHNSON
BROADSPIRE SACRAMENTO
ADJ4523497
ANTHONY BECKER
AMERICAN DRUG STORES
BROADSPIRE SACRAMENTO
ADJ6882300
CARLOS HUERTA
MCDPETERSONHERB GA ENTERPRISES
BROADSPIRE SACRAMENTO
ADJ6972089
DANA VAN AUKEN
CAST AND CREW PRODUCTION
BROADSPIRE SACRAMENTO
ADJ6972089
DANA VAN AUKEN
ENTERTAINMENT PARTNERS
BROADSPIRE SACRAMENTO
ADJ6972089
DANA VAN AUKEN
FILM PAYMENT SERVICES
BROADSPIRE SACRAMENTO
ADJ6972089
DANA VAN AUKEN
REEL PAYROLL INC
BROADSPIRE SACRAMENTO
ADJ7706751
MARIA AVILA
FRENCH CRAFT LEATHER GOODS INC
BROADSPIRE SACRAMENTO
ADJ791635
DONALD REICHENECKER
OWENS & MINOR
BROADSPIRE SACRAMENTO
ADJ2856536
JOSE NEVAREZ
SEE'S CANDY
BROADSPIRE SERVICES
ADJ2856536
JOSE NEVAREZ
SEES CANDY
BROADSPIRE SERVICES
ADJ1566681
ENRIQUE MACIAS
CHECK MATE
BUCKEYE CERRITOS CLOSED
ADJ200259
JOEL SANCHEZ
CHECK MATE STAFFING
BUCKEYE CERRITOS CLOSED
ADJ200259
JOEL SANCHEZ
MERRICK ENGINEERING INC
BUCKEYE CERRITOS CLOSED
ADJ272143
ALEJANDRO SOSA
NEW NUMATECH
BUCKEYE CERRITOS CLOSED
ADJ2948575
JOSE RAMIREZ
CHECK MATE AGENCY
BUCKEYE CERRITOS CLOSED
ADJ2948575
JOSE RAMIREZ
SUPERIOR ASSEMBLY DISTRIBUTION
BUCKEYE CERRITOS CLOSED
ADJ3650313
JORGE DOMINGUEZ
AM PERSONNEL PARTNERS, INC.
BUCKEYE CERRITOS CLOSED
ADJ3650313
JORGE DOMINGUEZ
BARRATT AMERICAN INCORPORATED
BUCKEYE CERRITOS CLOSED
ADJ3650313
JORGE DOMINGUEZ
FORD PLASTERING
BUCKEYE CERRITOS CLOSED BUCKEYE CERRITOS CLOSED
ADJ431885
MINOR CARDONA
CHECKMATE STAFFING
ADJ4382097
GEMMA MILLNER
DIVERSIFIED PARATRANSIT INC
BUCKEYE CERRITOS CLOSED
ADJ4622151
CYNTHIA AGUILAR
DIVERSIFIED PARIT TRANSIT
BUCKEYE CERRITOS CLOSED
ADJ676071
JAIME REYES
CHECKMATE STAFFING
BUCKEYE CERRITOS CLOSED
ADJ2855238
JOSE VASQUEZ
IDEAL STAFFING INC
CA SELF INSURED SECURITY FUND ESTATE
ADJ1364894
FLETCHER RAYNOR
CITY OF RIDGECREST
CALIF COMPENSATION & FIRE CO/BROADSPIRE
ADJ1364894
FLETCHER RAYNOR
SASS
CALIF COMPENSATION & FIRE CO/BROADSPIRE
ADJ1924892
ROBERTO JIMENEZ
BURGER KING - GE ENTERPRIESE
CALIF COMPENSATION & FIRE CO/BROADSPIRE
MAINSTAY
Page 10
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ3345965
JENNIFER GUERRERO
RUIZ FOODS PRODUCTS INC
CALIF COMPENSATION & FIRE CO/BROADSPIRE
ADJ367455
VICTORIA SARGENT
DENNY'S/QLC MANAGEMENT
CALIF COMPENSATION & FIRE CO/BROADSPIRE
ADJ367455
VICTORIA SARGENT
DONAHUE ENTERPRISES
CALIF COMPENSATION & FIRE CO/BROADSPIRE
ADJ4184795
MARIA ELENA CALDERON
AF GILMORE COMPANY
CALIF COMPENSATION & FIRE CO/BROADSPIRE
ADJ1299994
DANIEL SANDOVAL
CARLTON FORGE WEST
CALIFORNIA CASUALTY INSURANCE CO/GAB ROBINS NORTH AMERICA INC
ADJ1299994
DANIEL SANDOVAL
CARLTON FORGE WORKS
CALIFORNIA CASUALTY INSURANCE CO/GAB
ADJ1156697
OFELIA SARINO
CITY OF LOS ANGELES
CAMBRIDGE
ADJ3434414
CHRISTOPHER BERNAL
LOS ANGELES COUNTY PROBATION
CAMBRIDGE INTEGRATED
ROBINS NORTH AMERICA INC
DEPT ADJ3663324
ESTEBANA GONZALES
SPOTLESS PLASTIC USA
CAMBRIDGE INTEGRATED SERVICE
ADJ2222094
SYLVIA TORRES
MERLE NORMAN COSMETICS
CAMBRIDGE INTEGRATED SERVICE
ADJ127237
PAUL SCHWARTZ
GREGG ELECTRIC
CAMBRIDGE INTEGRATED SERVICES
ADJ2381097
JOHN RHODES
C.R. ENGLAND
CAMBRIDGE INTEGRATED SERVICES GROUP
ADJ1350011
VALERIE SHUMAKE
AIS INSURANCE
CAMBRIDGE PASADENA CLOSED
ADJ1354849
ALMA HOLGUIN
HACIENDA-LA PUENTE SCHOOL DIST
CAMBRIDGE PASADENA CLOSED
ADJ1448844
ENRIQUE MANCILLA
PUCHE DENTAL LAB
CAMBRIDGE PASADENA CLOSED
ADJ174140
SANDRA BROWN
COUNTY OF LA DCFS
CAMBRIDGE PASADENA CLOSED
ADJ2285295
JEANETTE SMITH
ANADITE INC WESTERN DIV
CAMBRIDGE PASADENA CLOSED
ADJ3245361
CHERYL NAKISO
L.A. COUNTY/DPSS
CAMBRIDGE PASADENA CLOSED
ADJ3306755
MICHELLE FRITZ
LOS ANGELES COUNTY DPSS
CAMBRIDGE PASADENA CLOSED
ADJ3434817
ANA FRANCO
CITY OF LA HOUSING AUTHORITY
CAMBRIDGE PASADENA CLOSED
ADJ3434817
ANA FRANCO
CITY OF LA/HOUSING AUTHORITY
CAMBRIDGE PASADENA CLOSED
ADJ3460127
FLOYD LUCAS DECEASED
THE BOEING CO
CAMBRIDGE PASADENA CLOSED
ADJ3833368
IRENE DELGADILLO
MEMORIAL MEDICAL GROUP
CAMBRIDGE PASADENA CLOSED
ADJ3914162
SIDNEY PEARSON
LAC-USC MEDICAL CNTR
CAMBRIDGE PASADENA CLOSED
ADJ4347928
SALVADOR SANCHEZ
ANAHEIM TERRACE CARE CENTER
CAMBRIDGE PASADENA CLOSED
ADJ4645734
MICHAEL CROUGH
MCDONNELL DOUGLAG AIRCRAFT
CAMBRIDGE PASADENA CLOSED CAMBRIDGE PASADENA CLOSED
ADJ4676910
PATRICIA SABIJON
OLIVE VIEW MEDICAL CNTR
ADJ846180
MICHAEL NESREEN
L A COUNTY PROBATION DEPT
CAMBRIDGE PASADENA CLOSED
ADJ1252993
JOANNE BARNES
CITY NATIONAL BANK
CAMBRIDGE SAN DIEGO CLOSED
ADJ1286605
LAURO GUERRERO
UNIVERSAL ALLOY
CAMBRIDGE SAN DIEGO CLOSED
ADJ132852
FRANCES VACA
AQUARIUM OF THE PACIFIC
CAMBRIDGE SAN DIEGO CLOSED
ADJ1621412
CARLOS ORREGO
RESEDA AUTO & ELECTRIC
CAMBRIDGE SAN DIEGO CLOSED
ADJ2185675
ANGEL SHOFNER
AHMED SYED NORTH AMERICAN
CAMBRIDGE SAN DIEGO CLOSED
GROUP
Page 11
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ2185675
ANGEL SHOFNER
FANTASTIC SAMS
CAMBRIDGE SAN DIEGO CLOSED
ADJ313717
RAMON MARQUEZ
WESTLAND GRAPHICS
CAMBRIDGE SAN DIEGO CLOSED
ADJ3259223
CHRISTOPHER LOPEZ
SOUTH TITLE CORPORATION
CAMBRIDGE SAN DIEGO CLOSED
ADJ3259223
CHRISTOPHER LOPEZ
SOUTHLAND TITLE CORP
CAMBRIDGE SAN DIEGO CLOSED
ADJ3990441
SHARON ROWELL
ANAHEIM UNIFIED SCHOOL DISTRICT
CAMBRIDGE SAN DIEGO CLOSED
ADJ3990441
SHARON ROWELL
ANAHEIM UNION HIGH SCH DIST
CAMBRIDGE SAN DIEGO CLOSED
ADJ3995603
HERMINEGILDA CHAVEZ
AUTO ZONE
CAMBRIDGE SAN DIEGO CLOSED
ADJ3995603
HERMINEGILDA CHAVEZ
CHIEF AUTO PARTS
CAMBRIDGE SAN DIEGO CLOSED
ADJ406518
JAVIER RIOS
HARRISON-NICHOLS COMPANY
CAMBRIDGE SAN DIEGO CLOSED
ADJ4231027
MIKE DEHOYOS
SYSTEMS SOURCE INC.
CAMBRIDGE SAN DIEGO CLOSED
ADJ7482272
JULIO ESCALANTE
BILTMORE HOTEL
CANNON COCHRAN CONCORD
ADJ1781346
ROBERT AZALBARIAN
SAM'S SHELL #1
CANNON COCHRAN IRVINE
ADJ7939474
JOHN MCCRATIC
UNITED ROAD TOWING
CANNON COCHRAN IRVINE
ADJ7500629
RAMON SALAZAR
REPUBLIC SERVICES
CANNON COCHRAN SCOTTSDALE
ADJ7768399
ESTHER DEL CAMPO
ROSE VILLA HEALTHCARE CENTER
CARL WARREN TUSTIN
ADJ7346458
MAURICIO MORALES
AMERICAN GUNITE INCORP
CASTLEPOINT NATIONAL INS IRVINE
ADJ7346458
MAURICIO MORALES
UNINSURED EMPLOYERS FUND
CASTLEPOINT NATIONAL INS IRVINE
ADJ1535502
CLEOTIDE CRUZ
TRANS BOX SYSTEMS
CHUBB GROUP LOS ANGELES
ADJ2940195
EDWARD REYES
LIQUI-BOX
CHUBB GROUP LOS ANGELES
ADJ4233069
MARIA MONTESINOS
SUPERBRA
CHUBB GROUP LOS ANGELES
ADJ4357182
DANIEL MARTINEZ
PRIMARY STEEL
CHUBB GROUP LOS ANGELES
ADJ6459504
LINDA MYERS
SULLIVAN AND CROMWELL
CHUBB GROUP LOS ANGELES
ADJ6827065
GLEN MURRAY
BOSTON BRUINS
CHUBB GROUP LOS ANGELES
ADJ6827065
GLEN MURRAY
PITTSBURGH PENGUINS
CHUBB GROUP LOS ANGELES
ADJ6831999
ANITA LOPEZ DE LOPEZ
SANTA MONICA BEACH HOTEL
CHUBB GROUP LOS ANGELES
CORPORATION ADJ7051002
SUSAN MCKINNEY
PHNS INC
CHUBB GROUP LOS ANGELES
ADJ7079221
HELEN BATES
TICKET MASTER
CHUBB GROUP LOS ANGELES
ADJ7361488
LOUIS RITTENHOUSE
TIFFANY AND COMPANY
CHUBB GROUP LOS ANGELES
ADJ7410042
DONALD KENNEY
BRITISH TELECOM
CHUBB GROUP LOS ANGELES
ADJ7457407
KAYELLE MORGAN
PURPLE COMMUNICATIONS INC
CHUBB GROUP LOS ANGELES
ADJ7561994
NOE PAZ
PRIMARY COLOR PRINTING
CHUBB GROUP LOS ANGELES
ADJ7624479
MARIA REYES
ADAM NUTRITION
CHUBB GROUP LOS ANGELES
ADJ7822727
ANA NARKORN
MCCULLOCH TRUST
CHUBB GROUP LOS ANGELES
ADJ804550
VENUS REDE DURAN
TONAWANDA PICTURES
CHUBB GROUP LOS ANGELES
ADJ8048910
RICARDO CHILLON
HYATT REGENCY
CHUBB GROUP LOS ANGELES
ADJ3709853
MARIA THOMPSON
COMMUNITY BAPTIST CHURCH OF
CHURCH MUTUAL MERRILL
MANHATT ADJ8384175
GILBERT CANTY
VISTA DEL MAR SENIOR LIVING
CHURCH MUTUAL MERRILL
ADJ2673188
NONITO ZAMORA
I WAS FRAMED INC
CIGA
ADJ1074010
ESAM NADROUS
PARADISE THEATER
CIGA GLENDALE
ADJ117564
CATRINA WILLIAMS
DIVERSIFIED PHOTO GRAPHICS
CIGA GLENDALE
SUPPLY ADJ1308857
ULUALO ASUEGA
STAFF MARK
Page 12
CIGA GLENDALE
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ1680667
JANET MLADY FLETCHER
VERDUGO HILLS HOSPITAL
CIGA GLENDALE
ADJ2673188
NONITO ZAMORA
I WAS FRAMED INC
CIGA GLENDALE
ADJ3455123
CARMELO PEREYRA
FOSTER PRINTING CO
CIGA GLENDALE
ADJ3460127
FLOYD LUCAS DECEASED
THE BOEING CO
CIGA GLENDALE
ADJ3650313
JORGE DOMINGUEZ
AM PERSONNEL PARTNERS, INC.
CIGA GLENDALE
ADJ3650313
JORGE DOMINGUEZ
BARRATT AMERICAN INCORPORATED
CIGA GLENDALE
ADJ3650313
JORGE DOMINGUEZ
FORD PLASTERING
CIGA GLENDALE
ADJ3672183
ALFONSO CORRAL
ADJ7476261
DANNY LEE TOLER
ADJ7484505
FRANCISCO VILCHIS
ADJ750791
CIGA GLENDALE CIGA GLENDALE PACIFIC FLOOR COVERING
CIGA GLENDALE
ARTURO CONTRERAS
NOVESTAFF RESOURCE GROUP, LLC.
CIGA GLENDALE
ADJ750791
ARTURO CONTRERAS
UEBTF LOS ANGELES
CIGA GLENDALE CIGA GLENDALE
MONDRAGON
ADJ8250681
MARIA SHARGAY
TOP PRIORITY COURIER
ADJ8469449
FRANK RICE
TAMPA BAY BUCCANEERS
CIGA GLENDALE
ADJ1581308
CAROL DEL REAL
PINAACLE TECHNOLOGY SERVICES
CIGA TRISTAR RANCHO CORDOVA
ADJ576480
ARSENIO GARCIA
TEMPSTAR SERVICES
CIGA TRISTAR RANCHO CORDOVA
ADJ576480
ARSENIO GARCIA
WET SEAL
CIGA TRISTAR RANCHO CORDOVA
ADJ684643
PAUL JACKSON
CLEGG INDUSTRIES INC
CIGA TRISTAR RANCHO CORDOVA
ADJ3663324
ESTEBANA GONZALES
SPOTLESS PLASTIC USA
CIGNA
ADJ1167904
APRIL PAYNE
COUNTY OF LOS ANGELES
CIS/PRESIDIUM
ADJ1513760
LESLIE GORDON
MOULTON PLAZA PHARMACY
CITATION/FREMONT INSURANCE CO
ADJ894396
RUBEN RICO
HARVEST PRODUCE
CITATION/FREMONT INSURANCE CO/CAMBRIDGE INTEGRATED SERVICES GROUP
ADJ689855
THOMAS BROOKS
CITY OF LOS ANGELES/DEPT WATER
CITY ATTORNEY'S OFFICE
POWE ADJ7767004
RAMONA LAFRANCE
CITY OF INGLEWOOD
CITY OF INGLEWOOD
ADJ7143227
PAULINO CABRAL
CITY OF LA PUBLIC WORK
CITY OF LA PUBLIC WORK SANATATION
SANATATION ADJ1354925
ROSA BRIONES
CITY OF LONG BEACH
CITY OF LONG BEACH
ADJ1291176
SHERRY TOWNSEND
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ152197
YOLANDA NESBY
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ1547810
BELEN CASTRO
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ1775760
MAURY BULLARD
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ1942560
ROGER MARKEL
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ2086386
IAN SALAVARIA
CITY OF LA/OFFICE OF THE CITY
CITY OF LOS ANGELES
ATTY/ ADJ2086386
IAN SALAVARIA
LOS ANGELES WORLD AIRPORTS
CITY OF LOS ANGELES
ADJ2548467
MICHAEL PUGA
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ2605713
ANGELIA COYNE
MTA
CITY OF LOS ANGELES
ADJ2913933
SHERRI GONZALEZ
CITY OF LOS ANGELES
CITY OF LOS ANGELES
Page 13
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ3026190
ANNIE AUZENNE
CITY OF LOS ANGELES POLICE DEPT
CITY OF LOS ANGELES
ADJ3053419
ROBERTO CORONA
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ3131361
ANN MEDINA
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ3318388
MATILDA VALLES
ADJ3385689
SABRINA WILLIAMS
CITY OF LOS ANGELES/LAPD
CITY OF LOS ANGELES CITY OF LOS ANGELES
ADJ342227
ROLAND DARNELL
CITY OF LOS ANGELES-DEPT OF AI
CITY OF LOS ANGELES CITY OF LOS ANGELES
GARLAND ADJ3637682
ROSEMARY ARROYO
L.A.P.D.
ADJ3657796
BRIDGETTE BARNES
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ3932432
JANIS ROACH
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ4095783
LANE WELLS
LOS ANGELES DEPT OF PUBLIC
CITY OF LOS ANGELES
WORKS ADJ4271541
DANILO YAP
LOS ANGELES DEPARTMENT OF
CITY OF LOS ANGELES
WATER & ADJ616136
LINDA WALKER
LOS ANGELES POLICE DEPT
CITY OF LOS ANGELES
ADJ6672457
ESTELA SANCHEZ
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ6672457
ESTELA SANCHEZ
CITY OF LOS ANGELES DEPT OF
CITY OF LOS ANGELES
GENERAL SERVICES ADJ6759075
SANDRA RODRIGUEZ
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ6945132
VASDEV SINGH
CITY OF LOS ANGELES OFFICE OF
CITY OF LOS ANGELES
FINANCE ADJ7083355
SHARLENE SUTHERLAND
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ7143227
PAULINO CABRAL
CITY OF LA PUBLIC WORK
CITY OF LOS ANGELES
SANATATION ADJ717684
LYDIA GARCIA
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ7371318
JULIE WALTERS
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ7427851
RODNEY BEVERLY
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ779674
CAESAR RIVAS
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ7825078
REGINA DONALDSON
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ7842154
MIKA NEAL
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ7870087
PATRICIA WOOD
CITY OF LOS ANGELES PUBLIC WORKS
CITY OF LOS ANGELES
ADJ788955
CYNTHIA HILL
CITY OF LOS ANGELES
CITY OF LOS ANGELES
STREET LIGHTING ADJ8013900
BRENDA CASTRO
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ807086
JULIE ALEXIS TUEGEL
CITY OF L.A./DEPT.OF RECREATION
CITY OF LOS ANGELES
ADJ8071453
DOUG BELL
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ8605369
EILEEN STUART
CITY OF LOS ANGELES LAPD
CITY OF LOS ANGELES
ADJ905973
TERRY THOMAS
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ6672457
ESTELA SANCHEZ
CITY OF LOS ANGELES
CITY OF LOS ANGELES DEPT OF GENERAL SERVICES
ADJ6672457
ESTELA SANCHEZ
CITY OF LOS ANGELES DEPT OF
CITY OF LOS ANGELES DEPT OF GENERAL
GENERAL SERVICES
SERVICES
EILEEN STUART
CITY OF LOS ANGELES LAPD
CITY OF LOS ANGELES LAPD
ADJ8486513
CLAY STOWERS
CITY OF SAN BERNARDINO
CITY OF SAN BERNARDINO
ADJ6760885
ROBERT YAMANE
CITY OF SANTA MONICA
CITY OF SANTA MONICA
ADJ8605369
Page 14
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ8243929
MICHAEL WILEY
CITY OF SANTA MONICA
CITY OF SANTA MONICA
ADJ8314466
JOHN BAYLISS
CITY OF SANTA MONICA
CITY OF SANTA MONICA
ADJ7064604
JOSEPH YOUNG
CITY OF VENTURA FIRE DEPARTMENT
CITY OF VENTURA FIRE DEPARTMENT
ADJ1351571
JAVIER LARIOS
G & M MATTRESS & FOAM CORP
CLAIMQUEST INC
ADJ1351571
JAVIER LARIOS
POWER P.E.O. (FOR G&M MATTRESS)
CLAIMQUEST INC
ADJ1719616
LIRA LEBRON
99 CENT STORES
CLAIMQUEST INC
ADJ1719616
LIRA LEBRON
99 CENTS ONLY STORE
CLAIMQUEST INC
ADJ2154585
JUAN CADENAS
ST HART CONTAINER CORPORATION
CLAIMQUEST INC
ADJ2842446
DAVID LANDIN
PACIFIC SECURITY SYSTEMS
CLAIMQUEST WALNUT
ADJ3650313
JORGE DOMINGUEZ
AM PERSONNEL PARTNERS, INC.
CLAIMQUEST WALNUT
ADJ3650313
JORGE DOMINGUEZ
BARRATT AMERICAN INCORPORATED
CLAIMQUEST WALNUT
ADJ3650313
JORGE DOMINGUEZ
FORD PLASTERING
CLAIMQUEST WALNUT
ADJ7480247
VIDAL ORDONEZ
MERCHANTS BUILDING
CLAIMQUEST WALNUT
ADJ7484505
FRANCISCO VILCHIS
PACIFIC FLOOR COVERING
CLAIMQUEST WALNUT
MAINTENANCE LLC MONDRAGON ADJ1923391
MIGUEL GOMEZ
ROYAL ROOFING COMPANY
CLAIMS ADMINISTRATION (INDEPENDING
ADJ1923391
MIGUEL GOMEZ
UEBTF LOS ANGELES
CLAIMS ADMINISTRATION (INDEPENDING
ADJ3504138
LADONNE GREEN
PROJECT INDEPENDENT
CLARENDON NATIONAL INSURANCE CO
ADJ3504138
LADONNE GREEN
SU CASA FAMILY SUPPORT
CLARENDON NATIONAL INSURANCE CO
ADJ2270033
DONNA HORNAK
SHERMAN OAKS HOSP
CLARENDON NATIONAL INSURANCE
ADJ2270033
DONNA HORNAK
SHERMAN OAKS HOSPITAL
CLARENDON NATIONAL INSURANCE
CO/BROADSPIRE CO/BROADSPIRE ADJ4498874
LUIS ROBLES
CLOUGHERTY PACKING
CLOUGHERTY PACKING CO
ADJ4000411
FLIP NIMMANANT
FARMER JOHN/HORMEL FOODS
CLOUGHERTY PACKING LOS ANGELES
ADJ2459616
MICHELE PALMER
ANTELOPE VALLEY UNION HIGH
CNA CASUALTY OF CALIFORNIA
SCHOOL ADJ4624427
MARY ROCCO
LANCASTER SCHOOL DIST
CNA CASUALTY OF CALIFORNIA
ADJ1921048
STEVE CORDRAY
ENTERTAINMENT PARTNERS
CNA CLAIMS PLUS BREA
ADJ1921048
STEVE CORDRAY
WARNER BROTHERS
CNA CLAIMS PLUS BREA
ADJ2173767
MARIA FERNANDEZ
PARADISE BUILDING SERVICE
CNA CLAIMS PLUS BREA
ADJ3275386
MARIA GARCIA DE JESUS
MGH GOURMET INC
CNA CLAIMS PLUS BREA
ADJ3669642
LUISA O CONNOR
UNIVERSAL PROTECTION SERVICES
CNA CLAIMS PLUS BREA
ADJ7236976
TOMMY LUONG
HAWAIIAN GARDENS CASINO
CNA CLAIMS PLUS BREA
ADJ7370852
JUAN DAVILA
FOASBERG LAUNDRY
CNA CLAIMS PLUS BREA
ADJ7444114
JOSE LAZARIT
AJAY BERI CORPORATION SUBWAY
CNA CLAIMS PLUS BREA
NO 28347 ADJ7491185
SENAIDA BENITEZ
INFINITY INSURANCE
CNA CLAIMS PLUS BREA
ADJ7586982
OCTAVIO CASTELLANOS
WARE DISPOSAL INC
CNA CLAIMS PLUS BREA
ADJ7640342
MARIO TAPIA
V5 CAR WASH
CNA CLAIMS PLUS BREA
Page 15
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ8172255
TOMMIE AMOS
UNIVERSAL PROTECTION SERVICE LP
CNA CLAIMS PLUS BREA
ADJ8645585
OSCAR GONZALEZ
ELECTRIZE
CNA CLAIMS PLUS BREA
ADJ1341056
GUADALUPE SANCHEZ
INTERCOMMUNITY NURSING CENTER
CNA CLAIMS PLUS PORTLAND
ADJ1942382
MARGARET SIMMS
STATE FARM INSURANCE
CNA CLAIMS PLUS PORTLAND
ADJ2001914
ELVIA GONZALEZ
HAAS AUTOMATION
CNA CLAIMS PLUS PORTLAND
ADJ212263
DONNA MILLER
HOLY CROSS MEDICAL CENTER
CNA CLAIMS PLUS PORTLAND
ADJ3923996
BRENDA PHILLIPS
STIRI-OSS INC
CNA CLAIMS PLUS PORTLAND
ADJ7959519
MARIA ESTRADA
ANZA APARTMENTS
CNA CLAIMS PLUS PORTLAND
ADJ3198657
PETE VASQUEZ
PEPSI COLA SAN JOAQUIN BOTTLING
CNA CLAIMS PLUS SAN FRANCISCO
ADJ807100
RICHARD TURGEON
ABM ENGINEERING SERVICES
CNA CLAIMS PLUS SAN FRANCISCO
ADJ2377517
MICHAEL GOEKEN
RIVERSIDE COUNTY SHERIFF'S DEPT
CNTY OF RIVERSIDE WORK COMP DIV
ADJ4301180
BELINDA WINFIELD
DEPT OF PUBLIC HEALTH / RIVERSIDE
CNTY OF RIVERSIDE WORK COMP DIV
ADJ7175248
KARAPET TOROSYAN
COACH AMERICA
COACH AMERICA
ADJ2666892
SCOTT CORWIN
US FOOD SERVICE
COMCO MANAGEMENT SIERRA MADRE
ADJ3090987
DONNA ARGENT TOLLE
INLAND VALLEY REGIONAL MED CTR
COMCO MANAGEMENT SIERRA MADRE COMMERCIAL INSURANCE CO.
ADJ1891702
JESUS LICEA
MAERSK LINES
ADJ1242705
RALEIGH ALCARAZ
SUNWEST ELECTRIC, INC.
COMP LINK INC
ADJ1242705
RALEIGH ALCARAZ
SUNWEST ELECTRIC, INC.
COMPLINK IRVINE
ADJ1665131
JEANNETTE CAJIGAL
STORM INDUSTRIES INC
COMPWEST NEWPORT BEACH
ADJ4200229
RUFINO RODRIGUEZ
BAY CITIES CONTAINER CORP
COMPWEST NEWPORT BEACH
ADJ6691870
HUGO AMADOR
STRINGERS GIFT BASKETS
COMPWEST NEWPORT BEACH
HERNANDEZ ADJ7691042
FRANKLIN GUARDADO
HUXTABLES KITCHEN INC
COMPWEST NEWPORT BEACH
ADJ7715435
MERCED GONZALEZ
GAR LABORATORIES
COMPWEST NEWPORT BEACH
ADJ1856376
DONNETTE LOUD
LACMTA
CONSTITUTION STATE SERVICE CO CONTINENTAL RISK MANAGEMENT
ADJ212263
DONNA MILLER
HOLY CROSS MEDICAL CENTER
ADJ1364894
FLETCHER RAYNOR
CITY OF RIDGECREST
CORVEL CHINO
ADJ1364894
FLETCHER RAYNOR
SASS
CORVEL CHINO
ADJ2143562
DANNY BRADFIELD
LYNWOOD USD
CORVEL CHINO
ADJ2471312
ROSEMARY VAUGHN
COUNTY OF ORANGE
CORVEL CHINO
ADJ2471312
ROSEMARY VAUGHN
SUPERIOR COURT OF CA
CORVEL CHINO
ADJ2962943
SAMUEL COLE
COMPTON UNIFIED SCHOOL DIST
CORVEL CHINO
ADJ3536913
ANDREW PILCHER
CITY OF RIALTO
CORVEL CHINO
ADJ4087514
ERMELINDA HARWOOD
DURHAM SCHOOL SERVICE
CORVEL CHINO
OCHOA ADJ4600692
NINFA MENDEZ
POMONA UNIFIED SCHOOL DISTRICT
CORVEL CHINO
ADJ6915527
DANIEL SOLIS
PASADENA UNIFIED SCHOOL
CORVEL CHINO
DISTRICT ADJ7011336
BLANCA SERRANO
PRIME HEALTH CARE SERVICES
CORVEL CHINO
ADJ7193990
JESUS JIM
CLOUGHERTY PARKING LLC
CORVEL CHINO
Page 16
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7503779
JULIA BERO
CENTINELA HOSPITAL
CORVEL CHINO
ADJ7706875
DAMITA SMITH
COMPTON UNIFIED SCHOOL
CORVEL CHINO
ADJ7755542
JULIO CASASOLA
BOERNER TRUCK CENTER
CORVEL CHINO
ADJ7852902
ELESHA AGUIRRE
VENTURA SUPERIOR COURTS
CORVEL CHINO
ADJ8159898
NORMA GARCIA
COUNTY OF LOS ANGELES
CORVEL CHINO
ADJ8205923
MATTHEW HICKMAN
COACHELLA VALLEY WATER
CORVEL CHINO
DISTRICT
DISTRICT ADJ1039793
DANIELA TAMAYO
COUNTY OF VENTURA
CORVEL CORPORATION
ADJ1039793
DANIELA TAMAYO
COUNTY OF VENTURA
CORVEL OXNARD
ADJ4076124
EFREN BALBUENA
AJAX BOILER, INC.
CORVEL SACRAMENTO
ADJ6430823
STEVEN GUERRERO
BANK OF AMERICA
CORVEL SACRAMENTO
ADJ7500183
RAMON MARTIN
T D COMMUNICATION
CORVEL SACRAMENTO
ADJ8902662
PATRICK HEDRICK
WHITES STEEL INC
CORVEL SACRAMENTO
ADJ6596192
ANA CAMPOS
HDSI MANAGEMENT INC
CORVEL SAN DIEGO
ADJ7663575
KIMBERLY WILKERSON
COUNTY OF LA DEPT OF CHILDREN
COUNTY OF LA DEPT OF CHILDREN AND
AND FAMILY SERVICES
FAMILY SERVICES
ADJ7479678
CARLA OWENS
COUNTY OF LOS ANGELES
COUNTY OF LOS ANGELES
ADJ7582924
LISA COLEMAN
COUNTY OF LOS ANGELES
COUNTY OF LOS ANGELES
ADJ7690343
GLORIA CORTEZ
COUNTY OF LOS ANGELES
COUNTY OF LOS ANGELES
ADJ7709574
DAVID GALINDO
COUNTY OF LOS ANGELES
COUNTY OF LOS ANGELES
ADJ7710943
CHARLES DOREMUS
COUNTY OF LOS ANGELES
COUNTY OF LOS ANGELES
ADJ7939631
VAL CHACON
COUNTY OF LOS ANGELES
COUNTY OF LOS ANGELES
ADJ8113583
ANITRA CHATMAN
COUNTY OF LOS ANGELES
COUNTY OF LOS ANGELES
ADJ8382059
EDWARD GANDARA
COUNTY OF LOS ANGELES
COUNTY OF LOS ANGELES
ADJ913365
GLORIA WILLIAMS
LOS ANGELES COUNTY/DPSS
COUNTY OF LOS ANGELES
ADJ6657844
RICHARD ENGERSBACH
COUNTY OF LOS ANGELES SHERIFFS
COUNTY OF LOS ANGELES SHERIFFS DEPT
DEPT ADJ1168353
FRANCISCO BLANCO
COUNTY OF LOS ANGELES
COUNTY OF LOS ANGELES/CAMBRIDGE
ADJ6729300
PRISCILLA BAEZA
COUNTY OF LOS ANGELES/DPSS
COUNTY OF LOS ANGELES/DPSS
ADJ2231855
LUIS BUSTOS
COUNTY OF LOS ANGELES SHERIFF
COUNTY OF LOS ANGELES/TRISTAR CLAIMS
INTEGRATED SERVICES GROUP
ADJ2231855
LUIS BUSTOS
DEPT
MGMT #2
COUNTY OF LOS ANGELES SHERIFFS
COUNTY OF LOS ANGELES/TRISTAR CLAIMS
DEPT
MGMT #2
ADJ7099636
GALE GUERRA
COUNTY OF SAN BERNARDINO
COUNTY OF SAN BERNARDINO
ADJ1456596
MAGGIE WHITEHAIR
COUNTY OF SAN BERNARDINO
COUNTY OF SAN BERNARDINO/SAN
ADJ3172634
MICHAEL HUSE
SAN BERNARDINO COUNTY MEDICAL
COUNTY OF SAN BERNARDINO/SAN
CTR
BERNARDINO COUNTY RISK MGMT DIV
ADJ3128769
ALNEDIUS BURTON
RALLY STAFFING
CRAWFORD & CO.
ADJ625356
CHAUNCEE HICKS
RALLY STAFFING
CRAWFORD & CO.
ADJ2216746
ANITA SCHAEFFER
MEDI RIDE
CRAWFORD & COMPANY
ADJ3128769
ALNEDIUS BURTON
RALLY STAFFING
CRAWFORD & COMPANY
ADJ2171718
FRED FARLEY
LOS ANGELES COUNTY FIRE
CRAWFORD AND CO
ADJ2735904
LARRY SPEARS
SHERIFF'S DEPARTMENT
CRAWFORD AND CO
ADJ2831300
JOHN CASTANEDA
COUNTY OF LOS ANGELES
CRAWFORD AND CO
ADJ4013338
IRMA OLAQUE
LAIDLAW TRANSIT
CRAWFORD AND CO
BERNARDINO COUNTY RISK MGMT DIV
Page 17
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ494644
HELEN ARIIZUMI
COUNTY OF LA SUPERIOR COURT
CRAWFORD AND CO
ADJ6684842
GABRIEL VILLA
CRS COMMERCIAL BBSI SANTA ANA
CRS COMMERCIAL BBSI SANTA ANA
ADJ6684842
GABRIEL VILLA
CRS COMMERCIAL BBSI SANTA ANA
CRS COMMERCIAL BBSI SANTA ANA CRUM FORSTER ORANGE
ADJ398278
MARIA SALAZAR
SUN GLASS PRODUCTS
ADJ4266982
HARRY CHICAS
J. ROBERT SCOTT, INC.
CRUM FORSTER ORANGE
ADJ6668417
JUAN CHAVEZ
SWEETNER PRODUCTS
CRUM FORSTER ORANGE
ADJ6757965
GEOVANNY MONTANO
EL SUPER Z BODEGA LATINA
CRUM FORSTER ORANGE
ADJ6784010
ALEJO RUBIO
CATALINA YACHTS
CRUM FORSTER ORANGE
ADJ6898941
SOLEDAD MORENO
O C HEADSTART
CRUM FORSTER ORANGE
ADJ6973286
AMPARO OROS
ORANGE COUNTY HEAD START INC
CRUM FORSTER ORANGE
ADJ7037184
MARIA BOTELLO
TROJAN BATTERY COMPANY
CRUM FORSTER ORANGE
ADJ7231505
MARIA PERDOMO
ACME AUTO HEADLING CO
CRUM FORSTER ORANGE
ADJ7498536
EFRAIN BARCO
IPS CORPORATION
CRUM FORSTER ORANGE
ADJ8235740
STEVEN STORM
THIBIANT INTERNATIONAL INC
CRUM FORSTER ORANGE
ADJ977341
OSARO AKHIONBARE
LIVE HOME INC
CRUM FORSTER ORANGE
ADJ7103397
JOSE PERALTA
PARKING CONCEPTS INC
CRUM FORSTER RICHARDSON
ADJ7678850
TINA COTY
IPC THE HOSPITALIST COMPANY
CRUM FORSTER RICHARDSON
ADJ7818550
FRANK BIELAWA
DEPARTMENT OF CORRECTIONS AND
DEPARTMENT OF CORRECTIONS AND
REHABILITATION
REHABILITATION
ADJ8567568
GARY CURRIER
DEPARTMENT OF CORRECTIONS AND
DEPARTMENT OF CORRECTIONS AND
REHABILITATION
REHABILITATION
DEPARTMENT OF WATER AND
DEPARTMENT OF WATER AND POWER
ADJ8062137
ROBERT TOCCO
POWER ADJ6756982
LEAH GARVER
DEPT OF CORRECTIONS AND REHAB
DEPT OF CORRECTIONS AND REHAB
ADJ3907604
AIDA DELGADILLO
LOS ANGELES COUNTY TAX
DEPT OF SOCIAL SERVICES
COLLECTOR ADJ4031234
CAROLYN MCLAURIN
LOS ANGELES DEPART OF WATER &
DEPT WATER & POWER OF CITY OF L A
POWER ADJ1321576
GUSTAVO BARRIOS
DISNEYLAND
DISNEY ANAHEIM
ADJ4271541
DANILO YAP
LOS ANGELES DEPARTMENT OF
DWP LOS ANGELES
WATER & ADJ8062137
ROBERT TOCCO
DEPARTMENT OF WATER AND
DWP LOS ANGELES
POWER ADJ3345793
ROSENDO VELIZ
FAIRCHILD FASTENER GRP
DYNAMIC CLAIMS IRVINE
ADJ7119442
ROBERT GUY
ADJ4452453
ANTHONY BRISENO
BATH MASTERS, INC
EMPLOYERS COMP GLENDALE
DYNAMIC CLAIMS IRVINE
ADJ6871785
SHAROL JOHNSON
LAKESIDE MEDICAL GROUP
EMPLOYERS COMP GLENDALE
ADJ6929435
JIMMY FLORES
SOICHER MARIN
EMPLOYERS COMP GLENDALE
ADJ7074277
FELIX RODRIGUEZ
LE PARC HOMEOWNERS
EMPLOYERS COMP GLENDALE
ASSOCIATION ADJ7194044
SUSANA LOPEZ
CLINICA MEDICA BERNALES
EMPLOYERS COMP GLENDALE
ADJ7476702
QUINTILA CRUZ
CROWN PLAZA VENTURA BEACH
EMPLOYERS COMP GLENDALE
ADJ7530211
REYNER ABREU
JUICE IT UP
EMPLOYERS COMP GLENDALE
Page 18
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7636364
ALEJANDRO RAMIREZ
ARION INTERNATIONAL
EMPLOYERS COMP GLENDALE
ADJ8055050
KENNETH MORALES
AEOLUS DOWN INC
EMPLOYERS COMP GLENDALE
ADJ8418094
ARMANDO GOMEZ
PERFORMANCE PAINT AND BODY
EMPLOYERS COMP GLENDALE
ADJ8427382
SUSANA GUAJARDO
ALL STAR HR
EMPLOYERS COMP GLENDALE
ADJ8427382
SUSANA GUAJARDO
MCKENNA LABS
EMPLOYERS COMP GLENDALE
ADJ6871785
SHAROL JOHNSON
LAKESIDE MEDICAL GROUP
EMPLOYERS COMP NEWBURY PARK
ADJ7146789
DANNY PHILLIPS
CONTINENTAL MARBLE AND TILE
EMPLOYERS COMPENSATION EMPLOYERS COMPENSATION
ADJ7146789
DANNY PHILLIPS
ESIS FREMONT
ADJ7822747
YOLANDA HUERTA
AMERICAN MOVING PARTS
EMPLOYERS COMPENSATION
ADJ4338093
MARLENE QUINTERO
PARK PLACE MEDICAL CENTER
EMPLOYERS COMPENSATION INSURANCE
ADJ3995603
HERMINEGILDA CHAVEZ
AUTO ZONE
EMPLOYERS INSURANCE OF WAUSAU
ADJ3995603
HERMINEGILDA CHAVEZ
CHIEF AUTO PARTS
EMPLOYERS INSURANCE OF WAUSAU
ADJ7795086
WEI QU
RADNET MANAGEMENT INC
EMPLOYERS PREFERRED GLENDALE
ADJ115424
PONCIANO FUENTES
AAA PACKING AND SHIPPING INC
ENSTAR US ORANGE
ADJ2630604
ADOLFO MENDOZA
RIALTO CONCRETE PRODUCTS
ENSTAR US ORANGE ENSTAR US ORANGE
ADJ4010082
CESAR CORTES
GOMEZ CONSTRUCTION
ADJ4212052
VICTOR MORENO
ASPEN DISTRIBUTION
ENSTAR US ORANGE
ADJ4212052
VICTOR MORENO
PACIFIC EXTERIORS INC
ENSTAR US ORANGE
ADJ6577293
CEVIN LACK
FINAL PHASE INC
ENSTAR US ORANGE
ADJ6720440
TONY PHAM
BETTS EXPRESS
ENSTAR US ORANGE
ADJ7494006
RAUL TOVAR
SANA FE BUILDING EQUIPMENT
ENSTAR US ORANGE
ADJ7795086
WEI QU
RADNET MANAGEMENT INC
ENSTAR US ORANGE
ADJ8158631
TODD SCOTT
WINDOR
ENSTAR US ORANGE
ADJ1023285
MARINA GONZALEZ
PROFESSIONAL STAFFING
ESIS CHATSWORTH
ADJ1023285
MARINA GONZALEZ
PROFESSIONAL STAFFING SERVICES
ESIS CHATSWORTH
ADJ1023285
MARINA GONZALEZ
SIMPLE TECHNOLOGY
ESIS CHATSWORTH
ADJ1967544
JENNIFER STRONG
LOCKHEED MARTIN
ESIS CHATSWORTH
ADJ2320713
JOSE TIRADO
ABM INDUSTRIES INC
ESIS CHATSWORTH
ADJ2349516
ARMANDO SANCHEZ
RELIANCE STEEL
ESIS CHATSWORTH
ADJ2384732
ARTURO JR RODRIGUEZ
LOCKHEED MARTIN SKUNK WORKS
ESIS CHATSWORTH
ADJ2429736
JOSE CARRILLO
ADJ305396
JOSE CARRASCO
KING MEAT, INC.
ESIS CHATSWORTH
ESIS CHATSWORTH ESIS CHATSWORTH
ADJ354979
JOE MARTINEZ
AUTHENTIC FITNESS
ADJ3650236
EVELYN ALDANA
SELECT STAFFING
ESIS CHATSWORTH
ADJ598884
ROBERTO ATONAL
SELECT PERSONNEL
ESIS CHATSWORTH
ADJ6759338
COBI JONES
LOS ANGELES GALAXY
ESIS CHATSWORTH
ADJ6759338
COBI JONES
MAJOR LEAGUE SOCCER
ESIS CHATSWORTH
ADJ6933559
CHRISTINE BOYD
WIS INTERNATIONAL
ESIS CHATSWORTH
ADJ7010898
CYNTHIA EVANS
WDS WAREHOUSE DEMO SERVICES
ESIS CHATSWORTH
ADJ7140230
ANABELLA SANCHEZ
CHIPOTLE MEXICAN GRILL
ESIS CHATSWORTH
Page 19
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
ADJ745634
MARIA TORRES
ONE SOURCE
Claims administrator ESIS CHATSWORTH
ADJ7777352
MARGARET BROOKS
WERNER ENTERPRISES
ESIS CHATSWORTH
ADJ7849800
SUGEY ESTRADA
KOOSHAREM CORPORATION DBA
ESIS CHATSWORTH
SELECT STAFFING ADJ7879981
EARL BUELER
CLP RESOURCES
ESIS CHATSWORTH
ADJ7921257
MELISSA PRIETO
TIME WARNER CABLE INC
ESIS CHATSWORTH
ADJ7985342
YAIRO SIERRA
PARSEC INC
ESIS CHATSWORTH
ADJ8063998
LAQUINTA HOSEIN
KELLY SERVICES
ESIS CHATSWORTH
ADJ807100
RICHARD TURGEON
ABM ENGINEERING SERVICES
ESIS CHATSWORTH
ADJ8176174
MARIBEL REYES
SELECT STAFFING
ESIS CHATSWORTH
ADJ8198298
JACK JEWETT
ADJ8233740
ILIANA BARRIOS
BLOOMFIELD BAKERS
ESIS CHATSWORTH
ADJ8424503
DANNY WAFER
HOSTESS BRANDS
ESIS CHATSWORTH
ADJ3663571
CECILIA LEDEZMA
STAPLES
ESIS CHATSWORTH
ADJ7010898
CYNTHIA EVANS
WDS WAREHOUSE DEMO SERVICES
ESIS FREMONT
ADJ7146789
DANNY PHILLIPS
CONTINENTAL MARBLE AND TILE
ESIS FREMONT
ADJ7146789
DANNY PHILLIPS
ESIS FREMONT
ESIS FREMONT
ADJ7269278
ANTE RAZOV
LOS ANGELES GALAXY
ESIS FREMONT
ADJ7295407
GERARDO GUILLEN
IRVINE VALENCIA GROWERS
ESIS FREMONT
ADJ7578481
MANUEL GIL
AMERIPRIDE SERVICES INC
ESIS FREMONT
ADJ8315020
CLEMMIE GRAVES
RON SAIDARA DDS
ESIS FREMONT
ADJ2320713
JOSE TIRADO
ABM INDUSTRIES INC
ESIS PORTLAND
ESIS CHATSWORTH
ADJ6823602
VALERIA CAPOZZI
SONY PICTURES
ESIS PORTLAND
ADJ1103380
BARBARA MCGOWAN
INLAND PAPERBOARD & PACKAGING
ESIS TAMPA
INC ADJ6759338
COBI JONES
LOS ANGELES GALAXY
ESIS TAMPA
ADJ6759338
COBI JONES
MAJOR LEAGUE SOCCER
ESIS TAMPA
ADJ7269278
ANTE RAZOV
LOS ANGELES GALAXY
ESIS TAMPA
ADJ8277789
LYNN WILCHER
DELTA AIRLINES
ESIS TAMPA
ADJ794548
DANIEL NAVARRETE
LA PRINCESITA TORTILLERIA
EVEREST NATIONAL INSURANCE CO
ADJ2216629
JORGE SANCHEZ
GELSONS MARKETS
EVEREST NATIONAL INSURANCE OAKLAND
ADJ3974204
MARIA CORTINA
EDGEWATER CONV HOSPITAL
EVEREST NATIONAL INSURANCE OAKLAND
ADJ2948575
JOSE RAMIREZ
CHECK MATE AGENCY
EVEREST NATIONAL ORANGE INVALID
ADJ2948575
JOSE RAMIREZ
SUPERIOR ASSEMBLY DISTRIBUTION
EVEREST NATIONAL ORANGE INVALID
ADJ4042638
RAMONA LOZANO
A RUDIN DESIGNS
EVEREST NATIONAL ORANGE INVALID
ADJ6578710
RUBEN GARZA
CALSTRIP INDUSTRIES
EVEREST NATIONAL ORANGE INVALID
ADJ1167159
PANFILO SALDANA
COLOR SPOT NURSERIES
EXPLORER INSURANCE/ICW
ADJ6616863
LORI BATES
EXPRESS EMPLOYMENT
EXPRESS EMPLOYMENT PROFESSIONALS
ADJ1164224
ANTONIO PEREZ
AMERICAN LANDSCAPE
PROFESSIONALS FARA ORANGE
MAINTENANCE ADJ1164224
ANTONIO PEREZ
AMERICAN LANDSCAPE MAINTENENCE
Page 20
FARA ORANGE
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ1772324
MERCEDES SANDOVAL
CIMMS INC.
FARA ORANGE
ADJ4000411
FLIP NIMMANANT
FARMER JOHN/HORMEL FOODS
FARMER JOHN
ADJ3348853
ENRIQUE SANCHEZ
AMBER ALVAREZ GARCIA
FARMERS PLEASANTON
ADJ3348853
ENRIQUE SANCHEZ
FRANK GARCIA
FARMERS PLEASANTON
ADJ3348853
ENRIQUE SANCHEZ
TROPICAL ROCK
FARMERS PLEASANTON
ADJ3348853
ENRIQUE SANCHEZ
UEBTF LOS ANGELES
FARMERS PLEASANTON
ADJ7671902
LIET BUI
SOUTH BAY FABRICATION
FARMERS PLEASANTON
ADJ2203324
KRISTA DILLON
HOT DIGGITY DOG
FARMERS SANTA ANA
ADJ3799621
SCOTT BREZNOCK
OCEAN BREWING CO INC
FARMERS SANTA ANA FARMERS SANTA ANA
ADJ4038021
JOSE VILICANA
AUTO CRAFT
ADJ4648342
PEDRO FUENTES
ALBERT J. BAN LUND
FARMERS SANTA ANA
ADJ6934397
ISRAEL SIERRA
OSTIONERIA PLAYAS DE SINALOA
FARMERS SANTA ANA
ADJ7638558
SALOMON VALENTE
CAPITAL SEAFOOD GROUP
FARMERS SANTA ANA
ADJ7930943
JORGE PEREZ
JOHN & ETHEL SUN
FARMERS SANTA ANA
ADJ8000258
MARIA DE ROSARIO
FACILITY MASTERS INC
FARMERS SANTA ANA FARMERS WESTLAKE VILLAGE
CHAVARIN ADJ123892
ADOLFO GOMEZ
ROBERT PALMER DBA TITAN
ADJ1621412
CARLOS ORREGO
RESEDA AUTO & ELECTRIC
FARMERS WESTLAKE VILLAGE
ADJ1661603
SANTOS TOVAR
CALIFORNIA BUYERS
FARMERS WESTLAKE VILLAGE
ADJ3024787
EVELYN ZAPANTA
RAYMOND TODD
FARMERS WESTLAKE VILLAGE
ADJ3312998
OSCAR NAVA
ISLAND FLOOR COVERING/CARPET
FARMERS WESTLAKE VILLAGE
ADJ3799621
SCOTT BREZNOCK
OCEAN BREWING CO INC
FARMERS WESTLAKE VILLAGE
ADJ3965600
MARTA SANTIZO
ELITE PERSONNEL SERVICES, INC.
FARMERS WESTLAKE VILLAGE
ADJ4523825
FRANCISCO DIAZ -
KING PLUSH
FARMERS WESTLAKE VILLAGE
ALI GACHAIN AND DIANA GACHAIN
FARMERS WESTLAKE VILLAGE
AUTOMOBILE
MIRANDA ADJ6611254
MARIA SALTO
ADJ8038699
ALBERT RUBIO
PARK PLAZA AUTOMOTIVE
FARMERS WESTLAKE VILLAGE
ADJ8136599
BERNARDO ORTIZ
SIGNATURE MAINTENANCE
FARMERS WESTLAKE VILLAGE
MARTINEZ ADJ3875469
MARIA PRECIADO
HOUSING AUTHORITY
FEDERAL EXPRESS CORP/ATHENS
ADJ2003630
ANNIE COLES
MACY'S
FEDERATED CLAIMS SERVICE GROUP
ADMINISTRATORS ADJ2003630
ANNIE COLES
MACYS WEST
FEDERATED CLAIMS SERVICE GROUP
ADJ1299994
DANIEL SANDOVAL
CARLTON FORGE WEST
FIREMANS FUND INSURANCE COMPANY/CALCO MEDICAL MANAGEMENT CORP
ADJ1299994
DANIEL SANDOVAL
CARLTON FORGE WORKS
FIREMANS FUND INSURANCE COMPANY/CALCO MEDICAL MANAGEMENT CORP
ADJ3174868
ABRAHAM CAPERS
FLEETWOOD ENTERPRISES
FLEETWOOD ENTERPRISES INC
ADJ3174868
ABRAHAM CAPERS
SELF INSURED SECURITIES FUND
FLEETWOOD ENTERPRISES INC
ADJ4024637
ZENAIDA GONZALEZ
FLEETWOOD ENTERPRISES INC
FLEETWOOD ENTERPRISES INC
FLEETWOOD HOMES
FLEETWOOD ENTERPRISES INC
ARROYO ADJ4024637
ZENAIDA GONZALEZ ARROYO
Page 21
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ4621751
KAREN ANDERSON
LONG BEACH UNIFIED SCHOOL
FLEMING & ASSOCIATES
DISTRICT ADJ7545331
ESTEBAN CRUZ
FAR EAST LANDSCAPE MAINTENANCE
FLORISTS MUTUAL INS EDWARDSVILLE
INC ADJ7992256
IGNACIO LUNA
O` CONNELL LANDSCAPING
FLORISTS MUTUAL INS EDWARDSVILLE
MAINTNANCE ADJ751718
JULIE HERNANDEZ
COUNTRY INN OF PORT HUENEME
FREMONT COMP (29069)
ADJ117564
CATRINA WILLIAMS
DIVERSIFIED PHOTO GRAPHICS
FREMONT COMPENSATION INSURANCE CO
SUPPLY ADJ3259223
CHRISTOPHER LOPEZ
SOUTH TITLE CORPORATION
FREMONT COMPENSATION INSURANCE CO
ADJ3259223
CHRISTOPHER LOPEZ
SOUTHLAND TITLE CORP
FREMONT COMPENSATION INSURANCE CO
ADJ3548804
VICTOR ESQUIVEL
NATIONAL GENETICS INSTITUTE
FREMONT COMPENSATION INSURANCE CO
ADJ751718
JULIE HERNANDEZ
COUNTRY INN OF PORT HUENEME
FREMONT INDEMNITY INSURANCE CO
ADJ3502707
RICARDO TORRES
ESCAMILLA & SONS INC
FRONTIER IN REHAB NEW YORK
ADJ7545762
EDGAR NAVA
JBL MOVING AND STORAGE
FRYE CLAIMS HAYWARD
ADJ4230430
LINDA SMITH
UNITED AIRLINES
GALLAGHER BASSETT 255397 SACRAMENTO
ADJ6807404
PAULINE NGUYEN
YOSHINOYA AMERICA INC
GALLAGHER BASSETT 255397 SACRAMENTO
ADJ6980403
DENESE DAVIDSON
AMERICAN CORPORATE SECURITY
GALLAGHER BASSETT 255397 SACRAMENTO
ADJ7162235
DELIA CASTILLO
LA QUINTA INN AND SUITES
GALLAGHER BASSETT 255397 SACRAMENTO
ADJ7798560
JANE WOHLFEIL
SWIFT TRANSPORTATION
GALLAGHER BASSETT 255397 SACRAMENTO
ADJ8516710
WILLIAM MARTAK
SWIFT TRANPORTATION CO INC
GALLAGHER BASSETT 255397 SACRAMENTO
ADJ6599290
MARTIN MELCHOR
MK CONSTRUCTION
GALLAGHER BASSETT 4040 SACRAMENTO
ADJ6966307
LUIS PINONES
ALLSCAPE ARCHITECTURAL
GALLAGHER BASSETT 4040 SACRAMENTO
LANDSCAPE LIGHTING ADJ6966307
LUIS PINONES
PHILIPS ELECTRONICS NORTH
GALLAGHER BASSETT 4040 SACRAMENTO
AMERICA CORPORATION ADJ7879973
MARYANN CAZAREZ
VEOLIA TRANSPORTATION
GALLAGHER BASSETT 4040 SACRAMENTO
ADJ8072856
ELIZABETH TAFOYA
HOSPITALITY STAFFING SOLUTIONS
GALLAGHER BASSETT 4040 SACRAMENTO
ADJ8143281
ROBERT GRIFFITH
MINNESOTA VIKINGS
GALLAGHER BASSETT 4040 SACRAMENTO
ADJ8173896
NORIA VALIENTE
AUTONATION POWER FOOD
GALLAGHER BASSETT 4040 SACRAMENTO
ADJ1074010
ESAM NADROUS
PARADISE THEATER
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ1443430
ART MONTOYA
CSX LINES
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ2113629
JEFF BAILEY
FIRST CLASS GLASS INC
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
Page 22
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ2172344
MEREGILDO RAMIREZ
SME ERECTORS
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ2172344
MEREGILDO RAMIREZ
SME STEEL CONTRACTORS
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ2405930
ENRIQUE MANCILLA
PIZZA HUT
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ2536003
ROBIN CRADER
BECKMAN COULTER INC
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ2551935
MARIA ROMERO
MCDONALDS RESTAURANT
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ3046200
HECTOR MARTINEZ
SYSCO FOODS
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ3046604
ANGELICA GUTIERREZ
MCDONALDS CORPORATION
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ3896516
ALEX RAMIREZ
BRIDGESTONE AMERICAS HOLDING
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ4166687
GINA NEVARES
MCMASTER-CARR SUPPLY CO
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ4356152
MARIA ROMERO
MCDONALDS RESTAURANT
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ6581434
GRISELDA RUBALCAVA
DART CONTAINER CORP
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ6755786
AN TONY YOUNG
LOS ANGELES TIMES
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ7176475
OSCAR ALVARADO
BROTHERS TOWING OF NORCO INC
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ873638
ANA OSORIO
TRIBUNE COMPANY
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ891833
MARIO MARQUEZ
VOPAK/WILMINGTON LIQUID
GALLAGHER BASSETT 70003 ANAHEIM CLOSED
ADJ2151581
LILIAN ESPINOZA TINTLE
CHARMING STORES
GALLAGHER BASSETT BURBANK
ADJ4249228
LOURDES DUARTE
CLEGG INDUSTRIES INC
GALLAGHER BASSETT BURBANK
ADJ4445031
SANDINA SIDMORE
OPTION ONE MORTGAGE CORP
GALLAGHER BASSETT BURBANK
ADJ6759338
COBI JONES
LOS ANGELES GALAXY
GALLAGHER BASSETT BURBANK
ADJ6759338
COBI JONES
MAJOR LEAGUE SOCCER
GALLAGHER BASSETT BURBANK
ADJ7261396
JEFFARIE OWENS
VIEW PARK COVALESSANT HOSPITAL
GALLAGHER BASSETT BURBANK
ADJ1557067
PAULINE MARK
GALLAGHER BASSETT CALABASAS
ADJ1817438
ANDRES DEHARO
FOAMEX
GALLAGHER BASSETT CALABASAS
ADJ3328246
ELISA ZUNIGA
G&K SERVICES
GALLAGHER BASSETT CALABASAS
ADJ377301
WITOLD FRANCZAK
WESSLEN CONSTRUCTION
GALLAGHER BASSETT CALABASAS
ADJ6533912
GERARD BEST
20TH CENTURY
GALLAGHER BASSETT CALABASAS
ADJ6694770
DULJO AVDIBASIC
JOURNEY ELECTRICAL
GALLAGHER BASSETT CALABASAS
TECHNOLOGIES INC ADJ6861535
MARIA ROMERO
SODEXHO
GALLAGHER BASSETT CALABASAS
ADJ7010597
MARINA GALAVIZ
SODEXO INC
GALLAGHER BASSETT CALABASAS
Page 23
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7176475
OSCAR ALVARADO
BROTHERS TOWING OF NORCO INC
GALLAGHER BASSETT CALABASAS
ADJ7255564
ELISSA SELVO
FOX CABLE NETWORKS
GALLAGHER BASSETT CALABASAS
ADJ7306766
HARRISON SUMMERISE
SODEXHO
GALLAGHER BASSETT CALABASAS
ADJ7310705
ZENAIDO PARRA
LIVE NATION HOUSE OF BLUES
GALLAGHER BASSETT CALABASAS
ADJ7967236
MARGARITA NICOLAS
SODEXO INC
GALLAGHER BASSETT CALABASAS
ADJ1689231
ARTURO PLANCARTE
FAMILY TREE PRODUCE
GALLAGHER BASSETT CORONA
ADJ179617
MICHAEL RICCOBONO
PCT/KENAN ADVANTAGE GROUP INC
GALLAGHER BASSETT CORONA
ADJ1891702
JESUS LICEA
MAERSK LINES
GALLAGHER BASSETT CORONA
ADJ2112764
RUBEN TAPIA
AMERICAN GOLF CORP
GALLAGHER BASSETT CORONA
ADJ277029
JOSE DUARTE
US GYPSUM
GALLAGHER BASSETT CORONA
ADJ3211317
MARIA ROSAS
TACO BELL
GALLAGHER BASSETT CORONA
ADJ3211317
MARIA ROSAS
UNITRANS INC
GALLAGHER BASSETT CORONA
ADJ3211317
MARIA ROSAS
YUM BRANDS,INC.
GALLAGHER BASSETT CORONA
ADJ6537827
KEVIN BEDINGFIELD
THEODORE ROBINS FORD
GALLAGHER BASSETT CORONA
ADJ6568102
UZZIEL AMBRIZ
BFS RETAIL AND COMMERCIAL
GALLAGHER BASSETT CORONA
ADJ6702985
MARIANO MELCHOR
PIZZA HUT/ SAN FERNANDO
GALLAGHER BASSETT CORONA
ADJ7013140
SOFIA RIVERA
LAKE FORST NURSING CENTER
GALLAGHER BASSETT CORONA
ADJ7024443
RANDAL VANDERTUIG
K HOVANANIAN HOMES
GALLAGHER BASSETT CORONA
ADJ7028159
WAYNE KITRELL
M AND M ACTION TOWING
GALLAGHER BASSETT CORONA
ADJ7129858
NORMA GUERRERO
PIZZA HUT
GALLAGHER BASSETT CORONA
ADJ7503235
RICARDO HERNANDEZ
SIMONIZ JANSS MALL
GALLAGHER BASSETT CORONA
ADJ8321962
CHERYL JENKINS
TUTOR TIME LEARNING CARE GROUP
GALLAGHER BASSETT CORONA
ADJ8398567
LINDA SMITH
BROOKDALE SENIOR LIVING
GALLAGHER BASSETT CORONA
ADJ8467309
ALFONSO LEON
AUTONATION INC
GALLAGHER BASSETT CORONA
ADJ6939282
MARIA ELENA IBARRA
PRICEWATERHOUSECOOPERS LLP
GALLAGHER BASSETT GLENDALE
ADJ8048910
RICARDO CHILLON
HYATT REGENCY
GALLAGHER BASSETT GLENDALE
ADJ6430823
STEVEN GUERRERO
BANK OF AMERICA
GALLAGHER BASSETT GOLD RIVER
ADJ7147964
THERESA STONE
BANK OF AMERICA
GALLAGHER BASSETT GOLD RIVER
ADJ7282201
RUFINO SANCHEZ
WASTE MANAGEMENT
GALLAGHER BASSETT GOLD RIVER
ADJ7635173
JUAN RODRIGUEZ
SEALY MATTRESS CO
GALLAGHER BASSETT GOLD RIVER
ADJ2216746
ANITA SCHAEFFER
MEDI RIDE
GALLAGHER BASSETT LAGUNA HILLS GALLAGHER BASSETT LAGUNA HILLS
ADJ3732140
GARY SIMS
BOYD COFFEE CO
ADJ4013338
IRMA OLAQUE
LAIDLAW TRANSIT
GALLAGHER BASSETT LAGUNA HILLS
ADJ6586492
JOSE MENJIVAR
MASSIVE PRINTS
GALLAGHER BASSETT LAGUNA HILLS
ADJ6852886
CHRISTOPHER MOORE
G-2 SECURE STAFF
GALLAGHER BASSETT LAGUNA HILLS
ADJ933594
JOSE MENJIVAR
MASSIVE PRINTS
GALLAGHER BASSETT LAGUNA HILLS
ADJ1891702
JESUS LICEA
MAERSK LINES
GALLAGHER BASSETT LAS VEGAS
ADJ7998498
JEANETTE ALVAREZ
GALLAGHER BASSETT
GALLAGHER BASSETT LAS VEGAS
ADJ112728
EDWARD ROSS
SAVE ON / CVS PHARMACY
GALLAGHER BASSETT ONTARIO
ADJ6759338
COBI JONES
LOS ANGELES GALAXY
GALLAGHER BASSETT ONTARIO
ADJ6759338
COBI JONES
MAJOR LEAGUE SOCCER
GALLAGHER BASSETT ONTARIO
ADJ8430296
LYDIA PENA
SAVA SENIORCARE ADMINISTRATIVE
GALLAGHER BASSETT ONTARIO
SERVICES ADJ8486309
ARTEMIO LUNA
DUNN EDWARDS
Page 24
GALLAGHER BASSETT ONTARIO
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ3043881
EDMUNDO SUAREZ
UNITED AIRLINES
GALLAGHER BASSETT ORANGE
ADJ3880736
MICHAEL STEWART
CALIFORNIA COMMUNITY NEWS
GALLAGHER BASSETT ORANGE
ADJ3920506
ABRAHAM CHRISTIAN
RING SECURITY AGENCY INC
GALLAGHER BASSETT ORANGE
ADJ4026089
RICHARD PERRY
COMPTON UNIFIED SCHOOL DIST
GALLAGHER BASSETT ORANGE
ADJ4026089
RICHARD PERRY
COMPTON UNIFIED SCHOOL
GALLAGHER BASSETT ORANGE
ADJ4062533
JOSE REYES
ASSOC CONCRETE PRODUCTS
GALLAGHER BASSETT ORANGE
ADJ4062533
JOSE REYES
ASSOCIATED CONCRETE PRODUCTS
GALLAGHER BASSETT ORANGE
DISTRICT
ADJ6430823
STEVEN GUERRERO
BANK OF AMERICA
GALLAGHER BASSETT ORANGE
ADJ6581434
GRISELDA RUBALCAVA
DART CONTAINER CORP
GALLAGHER BASSETT ORANGE
ADJ6941579
MICHAEL SMITH
U HAUL
GALLAGHER BASSETT ORANGE
ADJ7037231
THERESA TOPPS
VEOLIA TRANSPORTATION
GALLAGHER BASSETT ORANGE
ADJ7392923
MANUEL ALONZO
REAL MEX DBA EL TORITO
GALLAGHER BASSETT ORANGE
ADJ7526359
HARVEY MUNOZ
ARCHER DANIELS MIDLAND CO
GALLAGHER BASSETT ORANGE
ADJ7902802
TRESE CORDOZA
ACAPULCO MEXICAN RESTAURANT
GALLAGHER BASSETT ORANGE
ADJ7998498
JEANETTE ALVAREZ
GALLAGHER BASSETT
GALLAGHER BASSETT ORANGE
ADJ8045665
JOSE LUIS ARCOS
LOS ANGELES COMMUNITY COLLEGES
GALLAGHER BASSETT ORANGE
ADJ8108987
JACK STRICKLER
LOS ANGELES TIMES
GALLAGHER BASSETT ORANGE
ADJ8142182
IVONNE SANCHEZ
PANDA RESTAURANT GROUP INC
GALLAGHER BASSETT ORANGE
ADJ1863051
KELSEY MADDOX
TRADER JOE'E
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ2112764
RUBEN TAPIA
AMERICAN GOLF CORP
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ3211351
CLIFFORD THOMPSON
USF REDDAWAY
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ3243253
MINH NGUYEN
USF BESTWAY
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ3575268
CARMEN AGUIRRE MEDINA
AMERICAN RACING
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ3575268
CARMEN AGUIRRE MEDINA
AMERICAN RACING EQUIPMENT
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ4713038
MARCOS LOPEZ
PEACH PERSONNEL
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ4713038
MARCOS LOPEZ
SUNDANCE SPAS INC
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ6712153
MARIA TRUJILLO
MONTEREY PARK CONVALESCENT
GALLAGHER BASSETT RANCHO CUCAMONGA
HOSPITAL ADJ6814387
LETICIA IBARRA
OCEAN BEAUTY SEAFOODS INC
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ6876253
ALMA PEREZ VILLAREAL
MEMORIAL PARK & MORTUARY
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ7024443
RANDAL VANDERTUIG
K HOVANANIAN HOMES
GALLAGHER BASSETT RANCHO CUCAMONGA
Page 25
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7203790
BELEN SANCHEZ
PARK REGENCY RETIREMENT
GALLAGHER BASSETT RANCHO CUCAMONGA
RESIDENCE ADJ7774238
MIRIAM PANTOJA
PAYLESS SHOE SOURCE
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ7942828
ANTHONY BELL
FEDEX
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ8450363
YVONNE TADROS
YMCA OF GREATER LONG BEACH
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ8486309
ARTEMIO LUNA
DUNN EDWARDS
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ8795651
ANDRES ESPINOZA
MRS REDD'S PIE
GALLAGHER BASSETT RANCHO CUCAMONGA
ADJ6966307
LUIS PINONES
ALLSCAPE ARCHITECTURAL
GALLAGHER BASSETT ROSEVILLE
ADJ6966307
LUIS PINONES
PHILIPS ELECTRONICS NORTH
LANDSCAPE LIGHTING GALLAGHER BASSETT ROSEVILLE
AMERICA CORPORATION ADJ6980403
DENESE DAVIDSON
AMERICAN CORPORATE SECURITY
GALLAGHER BASSETT ROSEVILLE
ADJ7003401
ART JARAMILLO
WALDEN HOUSE
GALLAGHER BASSETT ROSEVILLE
ADJ7167269
JANINA COX
RAND CORPOKAT10N
GALLAGHER BASSETT ROSEVILLE
ADJ7174699
ROSA ALDRETE
STRATEGIC STAFFING ALLIANCE INC
GALLAGHER BASSETT ROSEVILLE
ADJ7786647
REYNALDO SIERRA
COVENANT TRANSPORT
GALLAGHER BASSETT ROSEVILLE
ADJ6523117
GILBERTO RUVALCABA
KEER
GALLAGHER BASSETT SACRAMENTO
ADJ6759338
COBI JONES
LOS ANGELES GALAXY
GALLAGHER BASSETT SACRAMENTO
ADJ6759338
COBI JONES
MAJOR LEAGUE SOCCER
GALLAGHER BASSETT SACRAMENTO
ADJ7798560
JANE WOHLFEIL
SWIFT TRANSPORTATION
GALLAGHER BASSETT SACRAMENTO
ADJ7957628
SANDRA NELSON
ICEF PUBLIC SCHOOLS
GALLAGHER BASSETT SACRAMENTO
ADJ3226110
CELIA MENDEZ
JACK IN THE BOX
GALLAGHER BASSETT SAN DIEGO
ADJ4589871
MAIDA ORELLANA
7-UP/RC BOTTLING COMPANIES OF
GALLAGHER BASSETT SAN DIEGO
SO CA ADJ6692329
DARLEY SHORT
TRANS PACIFIC CONTAINER SERVICES
GALLAGHER BASSETT SAN DIEGO
CORP ADJ7562162
TIMOTHY SMITH
U S FOOD SERVICE
GALLAGHER BASSETT SAN DIEGO
ADJ8205620
JUAN MARTINEZ
SOKEN TRADE CORP
GALLAGHER BASSETT SAN DIEGO
ADJ8415535
DIANE BRENNAN
FRONTIER AIRLINE
GALLAGHER BASSETT SAN DIEGO
ADJ1891702
JESUS LICEA
MAERSK LINES
GALLAGHER BASSETT SCOTTSDALE
ADJ7392923
MANUEL ALONZO
REAL MEX DBA EL TORITO
GALLAGHER BASSETT SCOTTSDALE
ADJ1557067
PAULINE MARK
GALLAGHER BASSETT SERVICES
ADJ458935
LETICIA DE LEON
MAXINE SWIM GROUP INC
GALLAGHER BASSETT SERVICES
ADJ1817438
ANDRES DEHARO
FOAMEX
GALLAGHER BASSETT SERVICES INC
ADJ1970035
BERTHA GUZMAN
SALIB ENTERPRISES
GALLAGHER BASSETT SERVICES INC
ADJ2277275
ROSIE GONZAGA
20TH CENTURY FOX
GALLAGHER BASSETT SERVICES INC
ADJ7578368
MICHAEL VASQUEZ
UPS
GALLAGHER BASSETT UPS5141 LAKE FOREST
ADJ2471312
ROSEMARY VAUGHN
COUNTY OF ORANGE
GATES MCDONALD & CO
ADJ2471312
ROSEMARY VAUGHN
SUPERIOR COURT OF CA
GATES MCDONALD & CO
ADJ4083116
THELMA CANDELARIO
KAREN & MARTIN MOHAN
GOLDEN EAGLE ALISO VIEJO
Page 26
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ3040624
JOSE HERNANDEZ
MAGNET SALES & MANUFACTURING
GOLDEN EAGLE INSURANCE CO
ADJ4014122
BECKEY RILEY
HOOSE NEWS
GOLDEN EAGLE INSURANCE CO
ADJ458935
LETICIA DE LEON
MAXINE SWIM GROUP INC
GOLDEN EAGLE INSURANCE CO
ADJ852762
JOE SMITH
ADJ1491843
GONZALO SANDOVAL
PHOENIX PAVING
GOLDEN EAGLE ORANGE
ADJ4038941
RONALD HIGHLEY
NEWPORT DIVERSIFIED
GOLDEN EAGLE ORANGE
ADJ4096616
SOFIA ORTIZ
RALPHS GROCERY
GOLDEN EAGLE ORANGE
ADJ2063594
PRESCILIANO LAGUNA
NORTH AMERICAN TEXTILE CO
GRANITE STATE INSURANCE COMPANY
ADJ4053010
LAURIE BROWN
BRUNSWICK SANDS BOWL
HARTFORD ACCIDENT & INDEMNITY
ADJ4212052
VICTOR MORENO
ASPEN DISTRIBUTION
HARTFORD ACCIDENT AND INDEMNITY
GOLDEN EAGLE INSURANCE CO
CO/SPECIALTY RISK SERVICES INC COMPANY ADJ4212052
VICTOR MORENO
PACIFIC EXTERIORS INC
HARTFORD ACCIDENT AND INDEMNITY
ADJ3497846
JORGE MARTINEZ
TRAFFIC CONTROL SERVICES
HARTFORD SACRAMENTO
ADJ3497846
JORGE MARTINEZ
TRAFFIC CONTROL SYSTEMS
HARTFORD SACRAMENTO
ADJ447304
CYNTHIA MILLER
COLORADO RIVER MEDICAL CENTER
HARTFORD SACRAMENTO
ADJ460944
LILIA AGUILAR
PILLOWTEX CORP.
HARTFORD SACRAMENTO
ADJ6502174
LINDA RHODES
STEPHEN F LINDSAY MD INC & JOHN
HARTFORD SACRAMENTO
COMPANY
W PUCKETT MD INC ADJ6890655
ROMAN BUTLER
STS EXCEL FOODS
HARTFORD SACRAMENTO
ADJ6985332
FAKHRI TAHERI
IHASET
HARTFORD SACRAMENTO
ADJ7293368
ROSENDA SANDOVAL
CASTEC INC
HARTFORD SACRAMENTO
ADJ7487053
AGUSTINA CONTRERAS
RAYS WRAP INC.
HARTFORD SACRAMENTO
ADJ7520941
FIDEL RAMIREZ
ADEL WIGGIN DIV
HARTFORD SACRAMENTO
ADJ7568577
CHARLES DIXON
MA FOLKES
HARTFORD SACRAMENTO
ADJ7576206
MAI VU
ATRON INC
HARTFORD SACRAMENTO
ADJ7594309
ANA DURAND ACOSTA
WESTERN DENTAL SERVICE
HARTFORD SACRAMENTO
ADJ7600103
VINH QUANG TRAN
QSC AUDIO
HARTFORD SACRAMENTO
ADJ7652196
JOSE MARTINEZ
PREMIER MOUNTS
HARTFORD SACRAMENTO
ADJ7699267
CHRIS LUNTSFORD
SMART SOURCE
HARTFORD SACRAMENTO
ADJ8062100
BLAINE COTTON
CENTRAL ASTISTS
HARTFORD SACRAMENTO
ADJ8062382
DEBORA BATRES
ROBERT L GORDON MARK EDELSTEIN
HARTFORD SACRAMENTO
HOWARD ADJ8188660
ANITA HERNANDEZ
FUSION LINENS
HARTFORD SACRAMENTO
ADJ8218751
SHAWN JEWELL
PRECISION OMB
HARTFORD SACRAMENTO
ADJ8264158
ANGELICA ARVIZU
CONTRACT SERVICE GROUP INC
HARTFORD SACRAMENTO
ADJ4446499
JANET RILEY
COUNTY OF LOS ANGELES
HCM/HERTZ CLAIM MANAGEMENT
ADJ3071975
DEIDRA HARPER
SBC
HELMSMAN MANAGEMENT
ADJ3739661
JANNIE BLAKE
MANUAL ARTS HIGH SCHOOL
HELMSMAN MANAGEMENT
ADJ3071975
DEIDRA HARPER
SBC
HELMSMAN MANAGEMENT GLENDALE
ADJ7748926
ARTURO MAGALLANES JR
UPS FREIGHT
HELMSMAN MANAGEMENT GLENDALE
ADJ8290929
LILY RAINS
VIVENDI UNIVERSAL ENTERTAINMENT
HELMSMAN MANAGEMENT GLENDALE
LLP ADJ8344472
KATHLEEN ROBINSON
ALLSTATE INSURANCE COMPANY
Page 27
HELMSMAN MANAGEMENT GLENDALE
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ1491843
GONZALO SANDOVAL
PHOENIX PAVING
HELMSMAN MANAGEMENT ROCKLIN
ADJ8340709
TRINA CONGER
COSTCO
HELMSMAN MANAGEMENT ROCKLIN
ADJ8472627
EFREN CABRERA
USED GYM EQUIPMENT
HELMSMAN MANAGEMENT ROCKLIN
ADJ1160976
DERICK TAYLOR
LAUSD
HELMSMAN MANAGEMENT SERVICE INC
ADJ1168353
FRANCISCO BLANCO
COUNTY OF LOS ANGELES
HELMSMAN MANAGEMENT SERVICE INC
ADJ2032286
DAVID MASON
COUNTY OF LOS ANGELES
HELMSMAN MANAGEMENT SERVICE INC
ADJ2598466
CLAYTON CHAMBERS
BECKMAN INSTRUMENTS
HELMSMAN MANAGEMENT SERVICE INC
ADJ3549419
ZETTA BROWN
COUNTY OF LOS ANGELES/TREASURE
HELMSMAN MANAGEMENT SERVICE INC
ADJ3269930
ARON THOMPSON
LOS ANGELES COUNTY PROBATION
HELMSMAN MANAGEMENT SERVICES
ADJ4039160
ELEANOR CHAGOLLA
COUNTY OF L A /D P S S
HELMSMAN MANAGEMENT SERVICES
ADJ1420328
VIRGINIA MORALES
EL TAPATIO
HIGHLANDS INSURANCE CO
ADJ1521253
JULIE MESA
NORM REEVES HONDA OF CERRITOS
HIGHLANDS INSURANCE COMPANY
ADJ4079093
DIANNE MILTMORE
JIMBOS NATURALLY
HIGHLANDS INSURANCE COMPANY
ADJ4249228
LOURDES DUARTE
CLEGG INDUSTRIES INC
HIGHLANDS INSURANCE COMPANY
ADJ1621412
CARLOS ORREGO
RESEDA AUTO & ELECTRIC
HIH AMERICA INS
ADJ2515216
MARK WILLIAMS
STEVEDORING SERVICES OF AMERICA
HOMEPORT INSURANCE
ADJ2331910
BRIAN CODD
STEVEDORING SERVICES OF AMERICA
HOMEPORT INSURANCE COMPANY
ADJ4714463
MANUEL JIMENEZ ZAVALA
MIKE CAMPBELL & ASSOCIATES
HUMAN DYNAMICS CORP
ADJ2148573
RODGER NAPIER
WALT'S DIESEL
ILLINOIS MIDWEST SPRINGFIELD
ADJ3366924
RICHARD MARQUEZ
CO OPPORTUNITY
ILLINOIS MIDWEST SPRINGFIELD
ADJ6613623
GERARDO PEREZ
PARTY PRONTO
ILLINOIS MIDWEST SPRINGFIELD
ADJ6930945
SOO JANG
EDWARD SKY INC DBA SURASANG
ILLINOIS MIDWEST SPRINGFIELD
ADJ7224109
FRANCISCO ZAZUETA
REXHALL INDUSTRIES
ILLINOIS MIDWEST SPRINGFIELD
ADJ7304477
CARMEN RUIZ
CREATIVE CARE INC
ILLINOIS MIDWEST SPRINGFIELD
ADJ7333719
FRANCISCO MARTINEZ
TORRAHOP DBA IHOP
ILLINOIS MIDWEST SPRINGFIELD
RESTAURANT
SOTO ADJ7589739
RANULFO GARCIA
CROWN DISPOSAL CO INC
ILLINOIS MIDWEST SPRINGFIELD
ADJ7606360
LUCIA AYALA ZURITA
KNOWL WOOD ENTERPRISES
ILLINOIS MIDWEST SPRINGFIELD
ADJ8028993
JORGE CHAVEZ
MI PIACE RESTAURANTS
ILLINOIS MIDWEST SPRINGFIELD
ADJ6730204
ALLEN HORNSBY
BOB AND DAVES TOWING INC
IMPERIUM INSURANCE NEW YORK
ADJ6730204
ALLEN HORNSBY
CALIFORNIA COACH AUTO BODY
IMPERIUM INSURANCE NEW YORK
AND TOWING ADJ6730204
ALLEN HORNSBY
KENNY'S AUTO SERVICE
IMPERIUM INSURANCE NEW YORK
ADJ3663324
ESTEBANA GONZALES
SPOTLESS PLASTIC USA
INDEMNITY INSURANCE OF NO AMERICA
ADJ1366769
DOROTEO MONTERO
GIBBEL BROTHERS INC
INS CO OF NORTH AMERICA
ADJ2172344
MEREGILDO RAMIREZ
SME ERECTORS
INSURANCE CO OF STATE OF PA/GALLAGHER
ADJ2172344
MEREGILDO RAMIREZ
SME STEEL CONTRACTORS
INSURANCE CO OF STATE OF PA/GALLAGHER
BASSETT SERVICES INC BASSETT SERVICES INC ADJ2569041
HUMBERTO GONZALEZ
SUN & SUN INDUSTRIES
INSURANCE CO OF THE WEST SAN DIEGO
ADJ2569041
HUMBERTO GONZALEZ
SUN INDUSTRIES
INSURANCE CO OF THE WEST SAN DIEGO
Page 28
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ4415129
TIMOTHY REMBAC
KEN SMITH MASONRY INC
INSURANCE CO OF THE WEST SAN DIEGO
ADJ6738724
DANIEL DEJOHN
MOUNTA1N VLEW LAND COMPANY
INSURANCE CO OF THE WEST SAN DIEGO
ADJ7074277
FELIX RODRIGUEZ
LE PARC HOMEOWNERS
INSURANCE CO OF THE WEST SAN DIEGO
ASSOCIATION ADJ7804777
JUAN TORRES
PIERRE SPRINKLER AND LANDSCAPE
INSURANCE CO OF THE WEST SAN DIEGO
ADJ7830089
HILARIO PEREZ
ALMAC FELT CO
INSURANCE CO OF THE WEST SAN DIEGO
ADJ8100697
JOSE DE JESUS MORALES
UGMC
INSURANCE CO OF THE WEST SAN DIEGO
ADJ290765
JANICE ASHFORD
CITY OF INGLEWOOD
INTEGRATED CLAIMS TORRANCE
ADJ290765
JANICE ASHFORD
CITY OF INGLEWOOD POLICE DEPT
INTEGRATED CLAIMS TORRANCE
ADJ7512141
SHELLEY BENJAMIN
CITY OF INGLEWOOD
INTEGRATED CLAIMS TORRANCE
ADJ7767004
RAMONA LAFRANCE
CITY OF INGLEWOOD
INTEGRATED CLAIMS TORRANCE
ADJ1112224
HECTOR TOPETE
COUNTY OF LOS ANGELES
INTERCARE 14243 ORANGE
ADJ1230843
CORINA CASTRO
LA COUNTY PARKS & RECREATIONS
INTERCARE 14243 ORANGE
ADJ1783472
BARBARA BARTICK
COUNTY OF LOS ANGELES
INTERCARE 14243 ORANGE
ADJ1924617
JANICE PAYNE
SUPERIOR COURT/COUNTY OF LA
INTERCARE 14243 ORANGE
ADJ2841612
ALICE ALONSO
L.A. COUNTY-DISTRICT ATTORNEY
INTERCARE 14243 ORANGE
ADJ3208118
BRIDGET JOHNSON SIMS
COUNTY OF LOS ANGELES
INTERCARE 14243 ORANGE
ADJ3452514
ELISA MORENO
LA COUNTY SUPERIOR COURT
INTERCARE 14243 ORANGE
ADJ3477656
EZELL GIPSON
COUNTY OF LOS ANGELES/CORONER
INTERCARE 14243 ORANGE
ADJ3606965
RODNEY PREYER
LA COUNTY PARKS & RECREATION
INTERCARE 14243 ORANGE
ADJ4025175
BLANCA ARREOLA
LA COUNTY SUPERIOR
INTERCARE 14243 ORANGE
COURT/BELLFLOWER ADJ408531
CHARLENE PADLO
LOS ANGELES SUPERIOR COURT
INTERCARE 14243 ORANGE
ADJ6523265
ROSEMARY BASKOM
COUNTY OF LOS ANGELES LA
INTERCARE 14243 ORANGE
SUPERIOR COURT ADJ6599441
ALICE ALONSO
COUNTY OF LOS ANGELES
INTERCARE 14243 ORANGE
ADJ6599441
ALICE ALONSO
OFFICE OF THE COUNTY COUNSEL
INTERCARE 14243 ORANGE
ADJ6641654
STELLA APARICIO
COUNTY OF LOS ANGELES SUPERIOR
INTERCARE 14243 ORANGE
COURT ADJ6674530
SUSAN WATERMAN
LOS ANGELES COUNTY SUPERIOR
INTERCARE 14243 ORANGE
COURT ADJ6735051
KIMBERLEE ALVAREZ
LA COUNTY DEPT OF PARK AND REC
INTERCARE 14243 ORANGE
ADJ6743883
CYNTHIA BARBEE
LOS ANGELES COUNTY FIRE
INTERCARE 14243 ORANGE
DEPARTMENT ADJ7333405
BRINDA CHAVEZ
LOS ANGELES SUPERIOR COURT
Page 29
INTERCARE 14243 ORANGE
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7502603
NATOSHA SANDERS
LOS ANGELES COUNTY SUPERIOR
INTERCARE 14243 ORANGE
BOWEN
COURT DEPT OF TRAFFIC
CHERRYL BUTTS
COUNTY OF LOS ANGELES CHILD
ADJ7588195
INTERCARE 14243 ORANGE
SUPPORT SERVICES ADJ7690343
GLORIA CORTEZ
COUNTY OF LOS ANGELES
INTERCARE 14243 ORANGE
ADJ7709574
DAVID GALINDO
COUNTY OF LOS ANGELES
INTERCARE 14243 ORANGE
ADJ7710943
CHARLES DOREMUS
COUNTY OF LOS ANGELES
INTERCARE 14243 ORANGE
ADJ7752545
DILVA ROSAS
LOS ANGELES SUPERIOR COURT
INTERCARE 14243 ORANGE
ADJ7939631
VAL CHACON
COUNTY OF LOS ANGELES
INTERCARE 14243 ORANGE
ADJ8000301
YOLANDA CABADA
LOS ANGELES COUNTY SHERIFFS DEPT
INTERCARE 14243 ORANGE
ADJ8130638
BEATRIZ PABLO
MAR PIZZA
INTERCARE 14243 ORANGE
ADJ8382059
EDWARD GANDARA
COUNTY OF LOS ANGELES
INTERCARE 14243 ORANGE
ADJ872513
BARBARA SALAZAR
LOS ANGELES COUNTY SUPERIOR
INTERCARE 14243 ORANGE
VILLAJIN
COURT
ADJ7641636
ESTER ANDERSON
COUNTY OF LOS ANGELES CHILD
ADJ1110485
KURT GALLARDO
DYZNEE TOWING SERVICE
INTERCARE CIGA GLENDALE
ADJ3108458
GLEN CUNNINGHAM
VINEYARD CHIRSTIAN FELLOWSHIP
INTERCARE CIGA GLENDALE
INTERCARE 5915 ORANGE
SUPPORT SERVICES
OF AN ADJ4245584
BARBARA SEOANE
FURNITURE TRADING CO
INTERCARE CIGA GLENDALE
ADJ4442446
GAVINO VASQUEZ
WEST STAR DAIRY
INTERCARE CIGA GLENDALE
ADJ7720401
JOSE MANUEL SALAS
CV WINDOWS AND DOORS MV
INTERCARE CIGA GLENDALE
ADJ1311205
GARY CLEVENGER
POOL WELL SERVICES
INTERCARE FRESNO
ADJ4557777
DENISE CRUZ WOODS
REDLANDS COMMUNITY HOSPITAL
INTERCARE INSURANCE SERVICES
ADJ2678985
NICOLE GOODEN
ST ERNE HEALTHCARE
INTERCARE IRVINE CLOSED
ADJ2678985
NICOLE GOODEN
ST. ERNE HEALTHCARE
INTERCARE IRVINE CLOSED
ADJ3185843
FERNANDO CAMPOS
CPE/DANMAR RETIREMENT VILLA
INTERCARE IRVINE CLOSED
ADJ3995603
HERMINEGILDA CHAVEZ
AUTO ZONE
INTERCARE IRVINE CLOSED
ADJ3995603
HERMINEGILDA CHAVEZ
CHIEF AUTO PARTS
INTERCARE IRVINE CLOSED
ADJ4557777
DENISE CRUZ WOODS
REDLANDS COMMUNITY HOSPITAL
INTERCARE IRVINE CLOSED
ADJ533246
JORGE PRIETO
COAST CONVERTER
INTERCARE IRVINE CLOSED
ADJ533246
JORGE PRIETO
COAST CONVERTERS
INTERCARE IRVINE CLOSED
ADJ586036
ANITA MEDINA CAMPOS
ACTION EMBROIDERY CORP
INTERCARE IRVINE CLOSED
ADJ1074010
ESAM NADROUS
PARADISE THEATER
INTERCARE PASADENA
ADJ1354849
ALMA HOLGUIN
HACIENDA-LA PUENTE SCHOOL DIST
INTERCARE PASADENA
ADJ1521253
JULIE MESA
NORM REEVES HONDA OF CERRITOS
INTERCARE PASADENA
TORRES
ADJ2203053
ELSA AGUIRRE
SELECT PERSONNEL
INTERCARE PASADENA
ADJ4179389
CYNTHIA GLASIER
BODY WORKS EMPORIUM
INTERCARE PASADENA
Page 30
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ4179389
CYNTHIA GLASIER
BODYWORK EMPORIUM, INC.
INTERCARE PASADENA
ADJ4557777
DENISE CRUZ WOODS
REDLANDS COMMUNITY HOSPITAL
INTERCARE PASADENA
ADJ7064604
JOSEPH YOUNG
CITY OF VENTURA FIRE DEPARTMENT
INTERCARE PASADENA
ADJ709641
LINDA LANGLEY
MARINERS CHURCH
INTERCARE PASADENA
ADJ7114084
KAREN MATICICH
BRASWELL`S CHATEAU VILLA LTD
INTERCARE PASADENA
ADJ7910754
MARIA ELENA PANIAGUA
OLYMPIA CONVALESCENT HOSPITAL
INTERCARE PASADENA
ADJ8330151
SANTIAGO CORONADO
R T FRAMING CORPORATION
INTERCARE PASADENA
ADJ1074010
ESAM NADROUS
PARADISE THEATER
INTERCARE ROSEVILLE
ADJ1115074
MICHAEL BARON
MOON BEAN PRODUCTION
INTERCARE ROSEVILLE
ADJ2640752
CARLOS MACIAS
N-U ENTERPRISES
INTERCARE ROSEVILLE
ADJ2678985
NICOLE GOODEN
ST ERNE HEALTHCARE
INTERCARE ROSEVILLE
ADJ2678985
NICOLE GOODEN
ST. ERNE HEALTHCARE
INTERCARE ROSEVILLE
ADJ4296342
VALERI BRANNON
COUNTY OF LOS ANGELES
INTERCARE ROSEVILLE
ADJ548133
MARIA NAVARETE
FOAM ROGER MN CORPORATION
INTERCARE ROSEVILLE
ADJ6608581
ANTONIA VILLALBA
DENNYS NO 6715
INTERCARE ROSEVILLE
ADJ7523496
HELGA RAMIREZ
TRIAS LLC
INTERCARE ROSEVILLE
ADJ2375030
MARTIN BERNAL
WESTERN TEAR OFF DISPOSAL INC
INTERCARE SACRAMENTO CLOSED
ADJ2855238
JOSE VASQUEZ
IDEAL STAFFING INC
INTERCARE SACRAMENTO CLOSED
ADJ3108458
GLEN CUNNINGHAM
VINEYARD CHIRSTIAN FELLOWSHIP
INTERCARE SACRAMENTO CLOSED
ADJ3365680
ALONDRA BROWNER
METHODIST HOSPITAL OF SO
OF AN INTERCARE SACRAMENTO CLOSED
CALIFORNIA ADJ881498
JAMES SHAW
SOUTH BAY FORD
INTERCARE SACRAMENTO CLOSED
ADJ3760450
MATTEO BUSCAINO
INTERSTATE BRANDS
INTERSTATE BRANDS SAN DIEGO
ADJ4074598
LYDIA CASTILLO
INTERSTATE BRANDS
INTERSTATE BRANDS SAN DIEGO
ADJ4518347
LYDIA RIOS CHAVEZ
POMONA UNIFIED SCHOOL DIST
JT2 INTEGRATED ONTARIO
ADJ6848365
OSCAR BURGOS
VALLEY PRESBYTERIAN HOSPITAL
JT2 INTEGRATED ONTARIO
ADJ7101859
FRANCES AIRADA
KAISER
KAISER
ADJ6802971
MARIA BARRIERE
KAISER FOUNDATION HOSPITAL
KAISER FOUNDATION HOSPITAL
ADJ7256873
RYAN CLEGG
KAISER HOSPITAL
KAISER HOSPITAL KAISER OAKLAND
ADJ1011528
BRENDA LEAKE
KAISER PERMANETE
ADJ142151
THOMAS MORENO
KAISER PERMANENTE
KAISER OAKLAND
ADJ2441835
ANNETTE NAJERA
KAISER PERMANENTE
KAISER OAKLAND
ADJ4540979
VICKY MARINO
KAISER PERMANENTE
KAISER OAKLAND
ADJ6802971
MARIA BARRIERE
KAISER FOUNDATION HOSPITAL
KAISER OAKLAND
ADJ6808327
RENEE WEDGEWORTH
KAISER PERMANENTE
KAISER OAKLAND KAISER OAKLAND
GLASS ADJ6894500
ISABEL VASQUEZ
KAISER PERMANENTE
ADJ6997376
GWENDOLYN SPENCER
KAISER PERMANENTE
KAISER OAKLAND
ADJ7101859
FRANCES AIRADA
KAISER
KAISER OAKLAND
ADJ7233713
TANYA WASHINGTON
KAISER PERMANENTE MEDICAL
KAISER OAKLAND
GROUP ADJ7256873
RYAN CLEGG
KAISER HOSPITAL
Page 31
KAISER OAKLAND
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7355162
MANUELA RAMIREZ
KAISER PERMANENTE
KAISER OAKLAND
ADJ8017049
JURY ROCHA
KAISER PERMANENTE
KAISER OAKLAND
ADJ8377391
ELIZABETH CORONA
KAISER PERMANENTE
KAISER OAKLAND
ADJ6894500
ISABEL VASQUEZ
KAISER PERMANENTE
KAISER PERMANENTE
ADJ6997376
GWENDOLYN SPENCER
KAISER PERMANENTE
KAISER PERMANENTE
ADJ7355162
MANUELA RAMIREZ
KAISER PERMANENTE
KAISER PERMANENTE KAISER PERMANENTE
ADJ8017049
JURY ROCHA
KAISER PERMANENTE
ADJ2664599
EDWARD VULJAK
MT SAN ANTONIO COLLEGE
KEENAN & ASSOC
ADJ8043410
JO RAY
RIVERSIDE COUNTY OFFICE OF
KEENAN ASSOCIATES RIVERSIDE
EDUCATION ADJ2664599
EDWARD VULJAK
MT SAN ANTONIO COLLEGE
KEENAN ASSOCIATES TORRANCE
ADJ3990441
SHARON ROWELL
ANAHEIM UNIFIED SCHOOL DISTRICT
KEENAN ASSOCIATES TORRANCE
ADJ3990441
SHARON ROWELL
ANAHEIM UNION HIGH SCH DIST
KEENAN ASSOCIATES TORRANCE
ADJ4198803
TRAVIS MARTIN
COMPTON COMMUNITY COLLEGE
KEENAN ASSOCIATES TORRANCE
ADJ4609707
ROBERT RODRIGUEZ
CULVER CITY UNIFIED SCHOOL
KEENAN ASSOCIATES TORRANCE
ADJ6954786
VICTORIA ASTURI
ANAHEIM UNION HIGH SCHOOL
DISTRICT KEENAN ASSOCIATES TORRANCE
DISTRICT ADJ7019771
EDDIE WALKER
HOAG MEMORIAL HOSPITAL
KEENAN ASSOCIATES TORRANCE
ADJ7028491
ROSE LOPEZ
PRESBYTERIAN COMMUNITY
KEENAN ASSOCIATES TORRANCE
HOSPITAL ADJ7412806
LORETTA PADRON
HOAG HOSPITAL
KEENAN ASSOCIATES TORRANCE
ADJ8004073
EVELEEN IBRAHIM
TORRANCE UNIFIED SCHOOL
KEENAN ASSOCIATES TORRANCE
DISTRICT ADJ3590636
DONALD REICHENECKER
OWENS & MINOR
KEMPER INSURANCE COMPANIES
ADJ8402781
CHUCK TIFFANY
CANTERBURY BASEBALL LLC AKA
KENTUCKY EMPLOYERS MUTUAL INS
FLORENCE FREEDOM ADJ8402781
CHUCK TIFFANY
GRAND PRAIRIE PROFESSIONAL
KENTUCKY EMPLOYERS MUTUAL INS
BASEBALL LP ADJ8402781
CHUCK TIFFANY
HAWAII BASEBALL LLC
KENTUCKY EMPLOYERS MUTUAL INS
ADJ8402781
CHUCK TIFFANY
LOS ANGELES DODGERS
KENTUCKY EMPLOYERS MUTUAL INS
ADJ8402781
CHUCK TIFFANY
ST GEORGE ROADRUNNERS ET AL
KENTUCKY EMPLOYERS MUTUAL INS
ADJ6777137
MARY CHAVEZ
LA COUNTY SHERIFFS DEPT
LA COUNTY SHERIFFS DEPT
ADJ6450006
ROCHELLE OKEKE
LACMTA
LACMTA
ADJ7427348
ERNESTO PADILLA
LACNY LOGISTICS
LACNY LOGISTICS
ADJ4062533
JOSE REYES
ASSOC CONCRETE PRODUCTS
LEGION INSURANCE COMPANY/SCOTT WETZEL
ADJ4062533
JOSE REYES
SERVICES ASSOCIATED CONCRETE PRODUCTS LEGION INSURANCE COMPANY/SCOTT WETZEL SERVICES ADJ1545119
TROY FUCONE
PACIFIC WEST LITHO INC
ADJ3096584
ALBERTO MOLINA
ROYAL ELECTRIC COMPANY
LIBERTY MUTUAL
ADJ1252993
JOANNE BARNES
CITY NATIONAL BANK
LIBERTY MUTUAL 29073 GLENDALE
ADJ1305625
ANGEL MARCUCCI
COUNTY OF LOS ANGELES
LIBERTY MUTUAL 29073 GLENDALE
Page 32
LIBERTY MUTUAL
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ1484619
MARLENE WELTERS
COUNTY OF LOS
LIBERTY MUTUAL 29073 GLENDALE
ANGELES,MED.CENTER ADJ1661203
JUDY HUGHES
PACIFIC BELL
LIBERTY MUTUAL 29073 GLENDALE
ADJ1690845
MARY NASH
PACIFIC BELL
LIBERTY MUTUAL 29073 GLENDALE
ADJ1876116
JOANNE BARNES
CITY NATIONAL BANK
LIBERTY MUTUAL 29073 GLENDALE
ADJ2467170
LISA DRUCKER
SBC
LIBERTY MUTUAL 29073 GLENDALE
ADJ250567
BRENDETTA BHONES
LA COUNTY/MCLARENS CHILDREN
LIBERTY MUTUAL 29073 GLENDALE
CENTER ADJ3360359
DEBBIE MUNCIE
UPS
LIBERTY MUTUAL 29073 GLENDALE
ADJ3614205
PAUL MUNOZ
UPS
LIBERTY MUTUAL 29073 GLENDALE
ADJ3838622
JODY DUNBAR
SBC
LIBERTY MUTUAL 29073 GLENDALE
ADJ3933377
MARIA PARRA
CITY OF LOS ANGELES/LAPD
LIBERTY MUTUAL 29073 GLENDALE
ADJ3933377
MARIA PARRA
LORETO STREET ELEMENTARY
LIBERTY MUTUAL 29073 GLENDALE
ADJ4087635
JANICE ALVAREZ
HERITAGE POINTE
LIBERTY MUTUAL 29073 GLENDALE
ADJ4144521
SHIRLEY WARD
DEPT OF SOCIAL SERVICES
LIBERTY MUTUAL 29073 GLENDALE
ADJ4289444
SYLVIA TORRES
MERLE NORMAN COSMETICS
LIBERTY MUTUAL 29073 GLENDALE
ADJ433160
JUAN MORENO
FARA
LIBERTY MUTUAL 29073 GLENDALE
ADJ433160
JUAN MORENO
HOLLYWOOD PARK
LIBERTY MUTUAL 29073 GLENDALE
ADJ433160
JUAN MORENO
HOLLYWOOD PARK OPERATIN
LIBERTY MUTUAL 29073 GLENDALE
COMPANY ADJ6707057
REFUGIO GUTIERREZ
J L S CONCRETE PUMPING INC
LIBERTY MUTUAL 29073 GLENDALE
ADJ6882605
ALFRED JACKSON
ARS RESCUE ROOTER
LIBERTY MUTUAL 29073 GLENDALE
ADJ7210547
PATRICIA MUNOZ
SAPUTO CHEESE USA INC
LIBERTY MUTUAL 29073 GLENDALE
ADJ7589739
RANULFO GARCIA
CROWN DISPOSAL CO INC
LIBERTY MUTUAL 29073 GLENDALE
ADJ771228
BRENDETTA BHONES
LA COUNTY / MCLARENS CHILD
LIBERTY MUTUAL 29073 GLENDALE
CENTER ADJ7804777
JUAN TORRES
PIERRE SPRINKLER AND LANDSCAPE
ADJ7912831
ANDRES RODRIGUEZ
FIRST FIRE SYSTEMS
LIBERTY MUTUAL 29073 GLENDALE
ADJ7946485
SHAWNTEL ROBERTO
JANI KING
LIBERTY MUTUAL 29073 GLENDALE
EDUARDO ANTONIO
CERADYNE INC
LIBERTY MUTUAL 29073 GLENDALE
ADJ8129097
LIBERTY MUTUAL 29073 GLENDALE
AVALOS HERNANDEZ DIAZ ADJ8233740
ILIANA BARRIOS
BLOOMFIELD BAKERS
LIBERTY MUTUAL 29073 GLENDALE
ADJ1861342
DAWN WALKER
SKYWEST AIRLINES
LIBERTY MUTUAL BEAVERTON
ADJ4087635
JANICE ALVAREZ
HERITAGE POINTE
LIBERTY MUTUAL BEAVERTON
ADJ7481303
ANTONIA GONZALEZ
THE TERRACES AT PARK MARINO
LIBERTY MUTUAL BEAVERTON
USED GYM EQUIPMENT
LIBERTY MUTUAL BEAVERTON
MENDOZA ADJ8472627
EFREN CABRERA
ADJ2598466
CLAYTON CHAMBERS
BECKMAN INSTRUMENTS
LIBERTY MUTUAL INS
ADJ1315320
SARA PEDRAZA
SOUTH COAST MEDICAL CENTER
LIBERTY MUTUAL ORANGE
ADJ1687929
OSCAR ROSALES
BOSTON BRICK AND STONE
LIBERTY MUTUAL ORANGE
ADJ1687929
OSCAR ROSALES
PERSONNEL LEASING INC.
LIBERTY MUTUAL ORANGE
ADJ2001914
ELVIA GONZALEZ
HAAS AUTOMATION
LIBERTY MUTUAL ORANGE
ADJ2142589
JOHN JAMES
COAST IRON & STEEL
LIBERTY MUTUAL ORANGE
ADJ2423265
JESUS GARCIA
CLEAN STEEL
LIBERTY MUTUAL ORANGE
ADJ3436569
TERRY SALGUERO
UCI MEDICAL CENTER
LIBERTY MUTUAL ORANGE
ADJ3724502
CARLOS AREVALOS
UNITED PARCEL SERVICE
LIBERTY MUTUAL ORANGE
Page 33
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ6807404
PAULINE NGUYEN
YOSHINOYA AMERICA INC
LIBERTY MUTUAL ORANGE
ADJ6905799
ANDRE BERRU LICON
DOMTAR PAPER COMPANY, LLC
LIBERTY MUTUAL ORANGE
ADJ7037187
CLEOTILDE HERNANDEZ
SABRITEC
LIBERTY MUTUAL ORANGE
ADJ7485767
ALFREDO LIMON
KENS BEVERAGE INC
LIBERTY MUTUAL ORANGE
ADJ7647732
BRAY PANFILO
CHARTER FURNITURE
LIBERTY MUTUAL ORANGE
ADJ894848
MARIA TORREZ
MOLLY MAID OF CALIFORNIA
LIBERTY MUTUAL ORANGE
ADJ3732140
GARY SIMS
BOYD COFFEE CO
LIBERTY MUTUAL RCG PORTLAND
ADJ1463748
JOSE PINEDA
MAGGIANO'S LITTLE ITALY
LIBERTY MUTUAL ROCKLIN
ADJ1471922
FRANCISCO MANZO
PROFESSIONAL COMMUNITY
LIBERTY MUTUAL ROCKLIN
MANAGEMENT ADJ1471922
FRANCISCO MANZO
PROFESSIONAL COMMUNITY MGMT
LIBERTY MUTUAL ROCKLIN
ADJ1884198 ADJ3734442
ANNABEL TAJANLANGIT
BORDERS BOOKS AND MUSIC
LIBERTY MUTUAL ROCKLIN
LAURA WERNER
LIBERTY MUTUAL INSURANCE GROUP
LIBERTY MUTUAL ROCKLIN
ADJ6724834
JESUS CHAFFINO
JLS CONCRETE PUMPING
LIBERTY MUTUAL ROCKLIN
ADJ6772667
WEBBER KNIGHT
WORLD WIDE FACILITIES
LIBERTY MUTUAL ROCKLIN
ADJ6822233
ROSA RIVERA
GATE GOURMET INC
LIBERTY MUTUAL ROCKLIN
ADJ7586053
GLENDY VALDEZ
CARL`S JR
LIBERTY MUTUAL ROCKLIN
ADJ7597721
TAREK ABDO
NEIMAN MARCUS GROUP INC
LIBERTY MUTUAL ROCKLIN
ADJ7759920
JOSE PINEDA
MAGGIANOS LITTLE ITALY
LIBERTY MUTUAL ROCKLIN
ADJ7946485
SHAWNTEL ROBERTO
JANI KING
LIBERTY MUTUAL ROCKLIN
ADJ8134710
RUTH CASTILLO
LOS ANGELES COUNTY MTA
LOS ANGELES COUNTY MTA
ADJ4095783
LANE WELLS
LOS ANGELES DEPT OF PUBLIC
LOS ANGELES DEPT OF PUBLIC WORKS
WORKS ADJ231465
ROBERT WILLIAMS
LACMTA
LOS ANGELES METROPOLITAN AUTHORITY
ADJ2605713
ANGELIA COYNE
MTA
LOS ANGELES METROPOLITAN AUTHORITY
ADJ2917702
ZINA KELLEY
MTA
LOS ANGELES METROPOLITAN AUTHORITY
ADJ569546
GERALD NOLEN
LACMTA
LOS ANGELES METROPOLITAN AUTHORITY
ADJ634231
ELIHUE BROOMFIELD
MTA
LOS ANGELES METROPOLITAN AUTHORITY
ADJ7320644
LYDIA MAZARIEGOS
METRO SAN GABRIEL VALLEY SECTOR
LOS ANGELES METROPOLITAN AUTHORITY
DIVISION ADJ7441121
PEDRO PENA
LOS ANGELES PROBATION DEPT
LOS ANGELES PROBATION DEPT LOS ANGELES PROBATION DEPTI
ADJ7441121
PEDRO PENA
LOS ANGELES PROBATION DEPT
ADJ3447105
JOSEFINA GARCIA
L.A.U.S.D.,(52ND ST. ELEM. SCHOOL)
LOS ANGELES UNIFIED SCHOOL DIST/HELMSMAN MANAGEMENT SERVICES INC
ADJ3447105
JOSEFINA GARCIA
LOS ANGELES UNIFIED SCHOOL DIST
LOS ANGELES UNIFIED SCHOOL DIST/HELMSMAN MANAGEMENT SERVICES INC
ADJ6772864
PHILLIS NEWBORN
LOS ANGELES UNIFIED SCHOOL DISTRICT
Page 34
LOS ANGELES UNIFIED SCHOOL DISTRICT
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ8333198
JAMES WRIGHT
LOS ANGELES UNIFIED SCHOOL
LOS ANGELES UNIFIED SCHOOL DISTRICT
DISTRICT ADJ7744200
RYAN BOBLETER
TRI DIAMOND STAFFING
LUMBERMENS UNDERWRITING BOCA RATON
ADJ7888192
SALVADOR SANCHEZ
FOOTE AXLE FORGELLC
LUMBERMENS UNDERWRITING BOCA RATON
ADJ7923715
BLANCA REBOLLAR
ACCOUNTABILITY INC
LUMBERMENS UNDERWRITING BOCA RATON
ADJ7930519
ANA JIFKINS DE DIOS
DIAMOND STAFFING
LUMBERMENS UNDERWRITING BOCA RATON
ADJ8250681
MARIA SHARGAY
TOP PRIORITY COURIER
LUMBERMENS UNDERWRITING BOCA RATON
ADJ1763727
MARTIN ERICKSON
MOUNTAIN HIGH SKI RESORT
LWP CLAIMS GLENDALE
ADJ6620429
ANTONIO ACEVES
ORTIZ TRANSPORTATION
LWP CLAIMS SACRAMENTO
ADJ6620429
ANTONIO ACEVES
UEBTF LOS ANGELES
LWP CLAIMS SACRAMENTO
ADJ6620429
ANTONIO ACEVES
UEBTF SACRAMENTO
LWP CLAIMS SACRAMENTO
ADJ6759057
ALFREDO LEYVA
JADE INC
LWP CLAIMS SACRAMENTO
ADJ6882300
CARLOS HUERTA
MCDPETERSONHERB GA ENTERPRISES
LWP CLAIMS SACRAMENTO
ADJ7300143
MARIA SALAZAR
PELICAN PRODUCTS INC
LWP CLAIMS SACRAMENTO
ADJ7853984
JULIETTE JARRETTE
ANDREW INTLS
LWP CLAIMS SACRAMENTO
ADJ8005455
OSCAR VASQUEZ
ADJ8562736
JOSE FRAUSTO
ADJ4179389
CYNTHIA GLASIER
BODY WORKS EMPORIUM
LWP CLAIMS SOLUTIONS
ADJ4179389
CYNTHIA GLASIER
BODYWORK EMPORIUM, INC.
LWP CLAIMS SOLUTIONS
LWP CLAIMS SACRAMENTO NORTHSTAR MOVING CORPORATION
LWP CLAIMS SACRAMENTO
ADJ4179389
CYNTHIA GLASIER
BODY WORKS EMPORIUM
LWP CLAIMS SOLUTIONS, INC.
ADJ4179389
CYNTHIA GLASIER
BODYWORK EMPORIUM, INC.
LWP CLAIMS SOLUTIONS, INC.
ADJ3854111
ALICIA GARIBAY
FEDERATED LOGISTICS
MACYS REDONDO BEACH
ADJ4045308
TIFFANY RICHER
BLOOMINGDALE'S
MACYS REDONDO BEACH
ADJ532561
JANET SOUZA
MACY'S
MACYS REDONDO BEACH
ADJ7611196
PAUL SOBHANI
MACY`S WEST STORES, INC.
MACYS REDONDO BEACH
ADJ7827727
MIRALBA CASTRO ROSAS
MACYS REDONDO BEACH
MACYS REDONDO BEACH
ADJ2003630
ANNIE COLES
MACY'S
MACYS WEST/BROADWAY STORES MACYS WEST/BROADWAY STORES
ADJ2003630
ANNIE COLES
MACYS WEST
ADJ7809907
HIPOLITO FIGUEROA
MAINSTAY BUSINESS SOLUTIONS
MAINSTAY BUSINESS SOLUTIONS
ADJ7655083
BRIAN PRIDEMORE
MCCORMACK ROOFING
MAINSTAY BUSINESS SOLUTIONS FOLSOM
ADJ3497846
JORGE MARTINEZ
TRAFFIC CONTROL SERVICES
MARKEL SERVICES OMAHA
ADJ3497846
JORGE MARTINEZ
TRAFFIC CONTROL SYSTEMS
MARKEL SERVICES OMAHA
ADJ577350
KWANG YEO
RANCHO CAR WASH & DETAIL
MARKEL SERVICES OMAHA
CENTER ADJ6671812
GERALDINE GUIMONT
PAGE LEARNING ACADEMY INC
MARKEL SERVICES OMAHA MARKEL SERVICES OMAHA
ADJ6687936
JORGE ORTEGA
PLAHN LANDSCAPING
ADJ6910889
MARIA CHAVEZ
FORTUNE AVENUE FOODS
MARKEL SERVICES OMAHA
ADJ6998509
OSBALDO ORTIZ
CAR BODY REPAIR
MARKEL SERVICES OMAHA
ADJ7451395
GUILLERMO REYES
JOEL ESCOBEDO
MARKEL SERVICES OMAHA
ADJ7480134
SUNG PAK
BOBBY K CORP
MARKEL SERVICES OMAHA
Page 35
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7832176
MARIA ZARATE
CENTRAL COMMUNITY HEALTH CARE
MARKEL SERVICES OMAHA
CENTER ADJ8062810
RODRIGO CHAVEZ
AMERICAN GLASS COMPANY
ADJ1061680
SANDRA MORAN
MARINA BEACH MARRIOTT
MARKEL SERVICES OMAHA MARRIOTT HOT SPRINGS
ADJ4630024
JULIE SCHULTZ
MARRIOTT DESERT SPRINGS
MARRIOTT HOT SPRINGS
ADJ6516052
CARLOS PEREZ
LA AIRPORT MARRIOTT HOTEL
MARRIOTT HOT SPRINGS MARRIOTT HOT SPRINGS
ADJ6784681
ELSA ALVARADO
MARRIOTT HOTEL
ADJ6784681
ELSA ALVARADO
MARRIOTT HOTEL
MARRIOTT HOTEL
ADJ1435978
LORI BENSON
ABBOTT LABORATORIES
MATRIX RANCHO CUCAMONGA
ADJ4024637
ZENAIDA GONZALEZ
FLEETWOOD ENTERPRISES INC
MATRIX RANCHO CUCAMONGA
FLEETWOOD HOMES
MATRIX RANCHO CUCAMONGA
ARROYO ADJ4024637
ZENAIDA GONZALEZ ARROYO
ADJ7998417
MYISHA JACKSON
ECOLOGY AUTO PARTS
MATRIX ROCKLIN
ADJ6989046
OSCAR LARA
MAXUM PETROLIUM INC
MAXUM PETROLIUM INC
ADJ6989064
OSCAR LARA
MAXUM PETROLIUM INC
MAXUM PETROLIUM INC
ADJ7174699
ROSA ALDRETE
STRATEGIC STAFFING ALLIANCE INC
MEADOWBROOK INSURANCE LAS VEGAS
ADJ7518647
MARIA ELENA BARAJAS
VELORIA FARM LABOR
MEADOWBROOK INSURANCE LAS VEGAS
CONTRACTING ADJ8218751
SHAWN JEWELL
PRECISION OMB
MEADOWBROOK INSURANCE LAS VEGAS
ADJ2855238
JOSE VASQUEZ
IDEAL STAFFING INC
METRO RISK LONG BEACH
ADJ3174868
ABRAHAM CAPERS
FLEETWOOD ENTERPRISES
METRO RISK LONG BEACH
ADJ3174868
ABRAHAM CAPERS
SELF INSURED SECURITIES FUND
METRO RISK LONG BEACH
ADJ4024637
ZENAIDA GONZALEZ
FLEETWOOD ENTERPRISES INC
METRO RISK LONG BEACH
FLEETWOOD HOMES
METRO RISK LONG BEACH METRO RISK LONG BEACH
ARROYO ADJ4024637
ZENAIDA GONZALEZ ARROYO
ADJ6692246
MANUEL LEMUS
WALLDESIGN INC
ADJ7655083
BRIAN PRIDEMORE
MCCORMACK ROOFING
METRO RISK LONG BEACH
ADJ7809907
HIPOLITO FIGUEROA
MAINSTAY BUSINESS SOLUTIONS
METRO RISK LONG BEACH
ADJ1621412
CARLOS ORREGO
RESEDA AUTO & ELECTRIC
MID CENTURY INSURANCE ORANGE
ADJ3406521
JOSE LUCERO
TABC INC
MITSUI SUMITOMO INSURANCE GROUP
ADJ950588
MISAEL AVILA
TABC
MITSUI SUMITOMO MARINE MANAGEMENT MITSUI SUMITOMO UNIVERSAL CITY
ADJ256445
JOYCE TAYLOR
TABC TOYOTA
ADJ3406521
JOSE LUCERO
TABC INC
MITSUI SUMITOMO UNIVERSAL CITY
ADJ7024648
AMIR ARIF
JAPAN TELECOM, INC.
MITSUI SUMITOMO UNIVERSAL CITY
ADJ7149096
JAVIER CARO
NUMERO UNO ACQUISITIONS
MITSUI SUMITOMO UNIVERSAL CITY
ADJ7987961
MARIA BOYD
CHINA OCEAN SHIPPING
MITSUI SUMITOMO UNIVERSAL CITY
ADJ1772324
MERCEDES SANDOVAL
CIMMS INC.
MURPHY BEANE CULVER CITY
ADJ7302699
CERELA RUIZ
BROOKVALE INTERNATIONAL LLC
NATIONAL INTERSTATE RICHFIELD
ADJ7302699
CERELA RUIZ
CALIFORNIA CARTAGE CO
NATIONAL INTERSTATE RICHFIELD
ADJ7302699
CERELA RUIZ
RALLY MANAGEMENT STAFFING
NATIONAL INTERSTATE RICHFIELD
ADJ7861175
ERICK ANTON
GIESE TRUCKING
NATIONAL INTERSTATE RICHFIELD
ADJ3756070
ANDRES CORTEZ
DUNHAM ROOFING, INC.
NATIONAL UNION FIRE INSURANCE CO/BROADSPIRE
Page 36
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ2246754
ANI KARAMANUKYAN
THERMADOR WASTE KING
NI INDUSTRIES INC
ADJ2246754
ANI KARAMANUKYAN
WASTE KING
NI INDUSTRIES INC
ADJ2246754
ANI KARAMANUKYAN
THERMADOR WASTE KING
NI INDUSTRIES INC. ATTN: WORKERS'
ADJ2246754
ANI KARAMANUKYAN
WASTE KING
NI INDUSTRIES INC. ATTN: WORKERS'
COMPENSATION COMPENSATION ADJ3730664
ESTELA ZAMORA RIVERA
NORDSTROM
NORDSTROM SANTA ANA
ADJ645131
ROGER CZARN
NORDSTROM
NORDSTROMS
ADJ3212743
BRIAN SOLOWAY
LARRY MICHAEL EDWARDS
NORTH AMERICAN RISK ALTAMONTE SPRINGS
ADJ7804777
JUAN TORRES
PIERRE SPRINKLER AND LANDSCAPE
OLD REPUBLIC BROOKFIELD ONE BEACON ANAHEIM
ADJ6977377
TRACY THOMAS
SOREN MCADAM CHRISTENSEN
ADJ7766364
LUTASHA BRADLEY
LINGERIE FOOTBALL LEAGUE
ONE BEACON CANTON
ADJ7045716
YOLANDA GIBSON
FIRST COMMERCE BANK
ONE BEACON ENGLEWOOD
ADJ6620429
ANTONIO ACEVES
ORTIZ TRANSPORTATION
ORTIZ TRANSPORTATION ORTIZ TRANSPORTATION
ADJ6620429
ANTONIO ACEVES
UEBTF LOS ANGELES
ADJ6620429
ANTONIO ACEVES
UEBTF SACRAMENTO
ORTIZ TRANSPORTATION
ADJ7462108
DONALD AYALA
OXNARD SCHOOL DISTRICT
OXNARD SCHOOL DISTRICT
ADJ1376351
CESAR ROLDAN
PACIFIC COLLISION CENTER
PACIFIC COMP CLAIM THOU OAKS
ADJ2566258
GUADALUPE GOMEZ
GRAPHIC PRESS INC
PACIFIC COMP CLAIM THOU OAKS
ADJ2833273
JOSE LUIS LOPEZ
G L VENEER COMPANY, INC
PACIFIC COMP CLAIM THOU OAKS
ADJ3154751
AMY MARTIN
MONTAGE RESORT
PACIFIC COMP CLAIM THOU OAKS
ADJ345200
CHRIS PACK
MEDWAY PLASTICS CORPORATION
PACIFIC COMP CLAIM THOU OAKS
ADJ4200229
RUFINO RODRIGUEZ
BAY CITIES CONTAINER CORP
PACIFIC COMP CLAIM THOU OAKS
ADJ4522208
ESPIRIDION CONTRERAS
ROYAL CABINETS
PACIFIC COMP CLAIM THOU OAKS
ADJ4682968
BERTHA MENDOZA
BIG SAVER FOODS
PACIFIC COMP CLAIM THOU OAKS
ADJ6757965
GEOVANNY MONTANO
EL SUPER Z BODEGA LATINA
PACIFIC COMP CLAIM THOU OAKS
ADJ6948560
MARTIN PALACIOS
PACIFIC COAST WAREHOUSE
PACIFIC COMP CLAIM THOU OAKS
ADJ2819937
EDWARD LIZAMA
PACIFIC EMPLYERS INC CO.
PACIFIC EMPLOYERS INS
ADJ1513760
LESLIE GORDON
MOULTON PLAZA PHARMACY
PACIFIC NATIONAL INSURANCE COMPANY
ADJ1942794
SAMUEL RICHARDSON
CARDIS CORP
PACIFIC STATES CASUALTY COMPANY/CALIFORNIA INS GUARANTEE ASSOC
ADJ1942794
SAMUEL RICHARDSON
CARDIS CORPORATION
PACIFIC STATES CASUALTY COMPANY/CALIFORNIA INS GUARANTEE ASSOC
ADJ7302699
CERELA RUIZ
BROOKVALE INTERNATIONAL LLC
PATRIOT RISK CIGA RANCHO CORDOVA CLOSED
ADJ7302699
CERELA RUIZ
CALIFORNIA CARTAGE CO
PATRIOT RISK CIGA RANCHO CORDOVA
ADJ7302699
CERELA RUIZ
RALLY MANAGEMENT STAFFING
PATRIOT RISK CIGA RANCHO CORDOVA
CLOSED CLOSED
Page 37
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7720401
JOSE MANUEL SALAS
CV WINDOWS AND DOORS MV
PATRIOT RISK CIGA RANCHO CORDOVA
TORRES
CLOSED
ADJ7828329
KIMBERLY VARGAS
COLLEGE HEALTH ENTERPRISE
PATRIOT RISK CIGA RANCHO CORDOVA
ADJ7947716
JOSE HENRIQUEZ
SUPERIOR GROCERS
PATRIOT RISK CIGA RANCHO CORDOVA
CLOSED CLOSED ADJ8180280
FRANCISCO GIL
SUPERIOR GROCERIES BAKERSFIELD
PATRIOT RISK CIGA RANCHO CORDOVA
ADJ8563505
MANUEL ARDON
THE OLIVE BRANCH ASSISTED LIVING
PATRIOT RISK CIGA RANCHO CORDOVA
CLOSED CLOSED ADJ1333680
REYNA CASTILLO
COURTESY EMPLOYMENT SERVICES
PAULA INSURANCE COMPANY
ADJ8330151
SANTIAGO CORONADO
R T FRAMING CORPORATION
PENNSYLVANIA MANUFACTURERS
ADJ8002528
JOSE ENRIQUEZ
POTENTIAL INDUSTRIES INC
ADJ1054155
HIRITI OKUBAMICHAEL
POTENTIAL INDUSTRIES INC PREFERRED EMPLOYERS SAN DIEGO
ADJ2948274
KRISTEN DRAKE
DEREK LEE, M.D.
PREFERRED EMPLOYERS SAN DIEGO
ADJ815575
MARIA ARMENTA
DAYS INN MOTEL
PREFERRED EMPLOYERS SAN DIEGO
ADJ7028491
ROSE LOPEZ
PRESBYTERIAN COMMUNITY
PRESBYTERIAN COMMUNITY HOSPITAL
HOSPITAL ADJ4370525
JAMES CARTER
CITY OF LOS ANGELES
PRESIDIUM
ADJ7016252
JOSE LOPEZ
PACIFIC HOSPITAL OF LONG BEACH
PRIVATE ADJUSTING RANCHO CUCAMONGA
ADJ7346503
SANDRA BROWN
SANTA ANITA CONVALESCENT
PRIVATE ADJUSTING RANCHO CUCAMONGA
HOSPITAL ADJ7910754
MARIA ELENA PANIAGUA
OLYMPIA CONVALESCENT HOSPITAL
PRIVATE ADJUSTING RANCHO CUCAMONGA
ADJ7956233
MILUSKA WHEELER
PROVIDENCE LITTLE COMPANY OF
PROVIDENCE LITTLE COMPANY OF MARY
MARY ADJ6480318
ADALBERTO RUIZ
CAL BUMPER
QBE SPECIALTY INS SACRAMENTO
ADJ7795086
WEI QU
RADNET MANAGEMENT INC
RADNET MANAGEMENT INC
ADJ1325998
SHERLINE PRIEBE
RALPHS
RALPHS
ADJ2397613
SUSAN MALDONADO
RALPHS GROCERY COMPANY
RALPHS
ADJ632854
RICHARD PERKINS
RALPHS GROCERY CO
RALPHS
ADJ772195
LORETTA KABADIAN
RALPHS
RALPHS
ADJ4365919
VICTOR HYDE
RALPHS GROCERY
RALPHS GROCERY CO
ADJ4557777
DENISE CRUZ WOODS
REDLANDS COMMUNITY HOSPITAL
REDLANDS COMMUNITY HOSPITAL
ADJ1351571
JAVIER LARIOS
G & M MATTRESS & FOAM CORP
REINSURANCE COMPANY OF AMERICA
ADJ1351571
JAVIER LARIOS
POWER P.E.O. (FOR G&M MATTRESS)
REINSURANCE COMPANY OF AMERICA
ADJ2469368
ZOILA PINEDA
AMBROSIO GRANO, JR. AND JUAN
RELIANCE INSURANCE COMPANY/STERLING
GRANO
CLAIMS MANAGEMENT SERVICES
JUAN & AMBROSIO GRANO
RELIANCE INSURANCE COMPANY/STERLING
ADJ2469368
ZOILA PINEDA
CLAIMS MANAGEMENT SERVICES
Page 38
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ2469368
ZOILA PINEDA
LAS PALMAS CLUB
RELIANCE INSURANCE COMPANY/STERLING CLAIMS MANAGEMENT SERVICES
ADJ2469368
ZOILA PINEDA
UEBTF LOS ANGELES
RELIANCE INSURANCE COMPANY/STERLING CLAIMS MANAGEMENT SERVICES
ADJ1433352
DENNIS PETERMAN
MUFFIN PATCH
REPUBLIC INDEMNITY ENCINO
ADJ4140648
MARY BEATTY
CONEXANT SYSTEMS INC
RICOMP CLAIMS MANAGEMENT
ADJ3828682
RONA SARWARY
SHERMAN OAKS HOSPITAL
RISICO CLAIMS MANAGEMENT FRESNO
ADJ4010082
CESAR CORTES
GOMEZ CONSTRUCTION
RISICO CLAIMS MANAGEMENT FRESNO
ADJ6480318
ADALBERTO RUIZ
CAL BUMPER
RISICO CLAIMS MANAGEMENT FRESNO
ADJ7548256
DONNA COLEMAN
LANDMARK ASSET MANAGEMENT
RISICO CLAIMS MANAGEMENT FRESNO
GROUP ADJ7599563
RUBEN DEL REAL
KMK MANAGEMENT
RISICO CLAIMS MANAGEMENT FRESNO
ADJ2634490
TERESA ROGERS
KATELLA ANIMAL CLINIC/W. VICKERS
RISK ENTERPRISE 2314 BREA CLOSED
ADJ3034805
JESUS GARCIA
C & D AEROSPACE
RISK ENTERPRISE 2314 BREA CLOSED
ADJ433160
JUAN MORENO
FARA
RISK ENTERPRISE 2314 BREA CLOSED
ADJ433160
JUAN MORENO
HOLLYWOOD PARK
RISK ENTERPRISE 2314 BREA CLOSED
ADJ433160
JUAN MORENO
HOLLYWOOD PARK OPERATIN
RISK ENTERPRISE 2314 BREA CLOSED
COMPANY ADJ2948575
JOSE RAMIREZ
CHECK MATE AGENCY
RRPI INSURANCE SERVICES
ADJ2948575
JOSE RAMIREZ
SUPERIOR ASSEMBLY DISTRIBUTION
RRPI INSURANCE SERVICES
ADJ1321695
DAVID PARIS
SAVOLT, INC.
SAFECO LOS ANGELES CLOSED
ADJ3732140
GARY SIMS
BOYD COFFEE CO
SAFECO LOS ANGELES CLOSED
ADJ4083116
THELMA CANDELARIO
KAREN & MARTIN MOHAN
SAFECO LOS ANGELES CLOSED
ADJ6882755
JONATHAN HAMMER
P AND R PAPER SUPPLY COMPANY
SAFECO LOS ANGELES CLOSED
ADJ3071975
DEIDRA HARPER
SBC
SBC
ADJ4644157
ANTONIO SANTILLAN
CASTEC INC
SCIF
ADJ2423265
JESUS GARCIA
CLEAN STEEL
SCIF INSURED BAKERSFIELD
ADJ4029584
PAUL YBANEZ
CDC-NORTH KERN
SCIF INSURED BAKERSFIELD
ADJ4623414
DALE PAPPAS
J. NOBLE BINNS
SCIF INSURED BAKERSFIELD
ADJ552343
DENNIS ROGERS
CHEROKEE CABLE CONTRACTORS
SCIF INSURED BAKERSFIELD
ADJ7165561
JORGE OCHOA
COUNTERTOPS EXPRESS
SCIF INSURED BAKERSFIELD
ADJ1218269
JOSE GOMEZ
PAINTER & ROOFING/MISONG CORP
SCIF INSURED FRESNO
ADJ1383586
CARLOS VASQUEZ
BELTECH INC
SCIF INSURED FRESNO
ADJ233369
NICOLAS GUTIERREZ
CHOOLJIAN BROTHERS
SCIF INSURED FRESNO
ADJ2445845
ANDRES SALADO
VINCO CONSTRUCTION CORP
SCIF INSURED FRESNO
ADJ3040748
JACQUELYN LAWSON
SPIRES RESTAURANT
SCIF INSURED FRESNO
ADJ4415129
TIMOTHY REMBAC
KEN SMITH MASONRY INC
SCIF INSURED FRESNO
ADJ528659
KAREN GUERRERO
HEMET SURGERY CENTER
SCIF INSURED FRESNO
ADJ7170562
JEANETTE ALEXANDER
FAIRVIEW DEVELOPMENTAL CENTER
SCIF INSURED FRESNO
Page 39
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7348129
MEGAN STORY
ARTISM BEHAVIOR CONSULTANTS,
SCIF INSURED FRESNO
INC ADJ7361014
STEPHEN PAGE
STATE OF CALIFORNIA
ADJ7505155
JAY ALLEN STEINMAN
ECKLES CONSTRUCTION
SCIF INSURED FRESNO SCIF INSURED FRESNO
ADJ1296187
ELVA AURORA PLASCENCIA
PLASTIC DRESS UP COMPANY
SCIF INSURED GLENDALE
ADJ1330743
MARIA VIRAMONTES
AGOURA HILLS SENIOR RETREAT
SCIF INSURED GLENDALE
ADJ142824
ELSA CRUZ
AIRPORT CONCESSIONS, INC.
SCIF INSURED GLENDALE
ADJ1665131
JEANNETTE CAJIGAL
STORM INDUSTRIES INC
SCIF INSURED GLENDALE
ADJ1749683
ALFREDO ZATARIAN
JAYAR MANUFACTURING COMPANY
SCIF INSURED GLENDALE
ADJ1833650
DAVID FUENTES
IN MAINTENANCE
SCIF INSURED GLENDALE
ADJ1844115
GUSTAVO NUNEZ
HILLS RESTAURANT
SCIF INSURED GLENDALE
ADJ1925823
JAVIER SORIANO
ROSEMEAD MOTORS
SCIF INSURED GLENDALE
ADJ2055194
ERASMO GONZALEZ
BAY CITIES CONTAINER
SCIF INSURED GLENDALE
CORPORATION ADJ2063594
PRESCILIANO LAGUNA
NORTH AMERICAN TEXTILE CO
SCIF INSURED GLENDALE
ADJ2270033
DONNA HORNAK
SHERMAN OAKS HOSP
SCIF INSURED GLENDALE
ADJ2270033
DONNA HORNAK
SHERMAN OAKS HOSPITAL
SCIF INSURED GLENDALE
ADJ2287041
KATHLEEN BROWN
LEACH OIL
SCIF INSURED GLENDALE
ADJ2361959
ELOY TRUJILLO
S.O.S INC
SCIF INSURED GLENDALE
ADJ2415039
SAUNDRA BROWN
CONTINENTAL F C U
SCIF INSURED GLENDALE
ADJ2423265
JESUS GARCIA
CLEAN STEEL
SCIF INSURED GLENDALE
ADJ2497892
SONIA RIVERA
CONSOLIDATED FOUNDRIES
SCIF INSURED GLENDALE
ADJ2498393
ROCIO PAYAN
907 CLUB
SCIF INSURED GLENDALE
ADJ2503116
GUADALUPE VELASQUEZ
SOFTUB INC
SCIF INSURED GLENDALE
ADJ2605918
SILVIA VALDEZ
INTERNATIONAL ART
SCIF INSURED GLENDALE
ADJ2673188
NONITO ZAMORA
I WAS FRAMED INC
SCIF INSURED GLENDALE
ADJ2777755
ARSENIO AVALOS
LA POPULAR
SCIF INSURED GLENDALE
ADJ2777755
ARSENIO AVALOS
WEST VALLEY FURNITURE
SCIF INSURED GLENDALE
ADJ2792766
TIMOTHY SMITH
KKW TRUCKING
SCIF INSURED GLENDALE
ADJ2846845
REGINO GUTIERREZ
CLAUDES BODY & PAINT SHOP INC
SCIF INSURED GLENDALE
ADJ2960069
ROSA MENDOZA
AFFORDABLE SENIOR LIVING SINCE
SCIF INSURED GLENDALE
1968 ADJ2985835
MICHELLE TURNER
ADJ3053984
ARTURO REBOLLEDO
K. WATANABE CORP
SCIF INSURED GLENDALE
SCIF INSURED GLENDALE
ADJ3065398
SHARON BEALES
CAL-LIFT INC
SCIF INSURED GLENDALE SCIF INSURED GLENDALE
ADJ3111880
ROBERTO LARA
BUDDY BAR CASTING
ADJ3113030
GRISELDA DOMINGUEZ
TAMAYO RESTAURANT
SCIF INSURED GLENDALE
ADJ3215099
SOCORRO MUNOZ
FOUNDATION FOR EARLY
SCIF INSURED GLENDALE
CHILDHOOD ED ADJ3224593
GREGORY MAYER
LINDERO MASONRY
SCIF INSURED GLENDALE
ADJ3244236
STEPHEN ANDREW
NUWAY LINEN
SCIF INSURED GLENDALE
ADJ3288473
AURORA REALIVASQUEZ
TUR-BO JET PRODUCTS CO INC
SCIF INSURED GLENDALE
Page 40
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ3294428
LORENA VILLEGAS
PALOS VERDES HEALTH CARE CENTER
SCIF INSURED GLENDALE
ADJ336832
JOSE ARMANDO PEREZ
VALLEY COURIERS
SCIF INSURED GLENDALE
ADJ3373248
IVY IBAVEN
CIBA INSURANCE SERVICES
SCIF INSURED GLENDALE
ADJ3396927
MARIO FLORES
TORN & GLASSER
SCIF INSURED GLENDALE
ADJ3406993
THOMAS HALVORSON
R & R MASONRY
SCIF INSURED GLENDALE
ADJ3434230
ALEJANDRA COVARRUBIAS
RICO INTERNATIONAL
SCIF INSURED GLENDALE
ADJ3445678
LINDA SHAFFER
SUNLIT GARDENS
SCIF INSURED GLENDALE
ADJ3492835
LORENA VELAZQUEZ
PAIN NET, INC.
SCIF INSURED GLENDALE
ADJ3509131
COLLEEN HOWE
REVCARE
SCIF INSURED GLENDALE
ADJ3509131
COLLEEN HOWE
REVCARE INC
SCIF INSURED GLENDALE
ADJ3532448
ANTONIO SANTILLAN
CASTEC INC
SCIF INSURED GLENDALE
ADJ3603118
MANUEL APALATEQUI
L.A. YUMA FRIEGHTS LINES, INC.
SCIF INSURED GLENDALE
ADJ367320
CRISTINA UGARTE
FLINKMAN REALTY
SCIF INSURED GLENDALE
ADJ3677414
ROBERTO RIVAS
PACIFIC COURIERS INC
SCIF INSURED GLENDALE
ADJ3687513
FRANK ZEPEDA
CALIFORNIA MART
SCIF INSURED GLENDALE
ADJ371306
GILBERTO GONZALEZ
ORANGE COUNTY SCAFFOLD INC.
SCIF INSURED GLENDALE
ADJ3778585
JAVIER CORONEL
MALONEY MEAT CO.
SCIF INSURED GLENDALE SCIF INSURED GLENDALE
ADJ397223
MARIA ARREOLA
WILSON INDUSTRIES
ADJ398278
MARIA SALAZAR
SUN GLASS PRODUCTS
SCIF INSURED GLENDALE
ADJ4042638
RAMONA LOZANO
A RUDIN DESIGNS
SCIF INSURED GLENDALE
ADJ4075417
CARL GONZALES
STAFFORD'S QUALITY PAINTING
SCIF INSURED GLENDALE
ADJ4075736
FELIPE MEJIA MENA
FIRE SAFE SYSTEMS, INC.
SCIF INSURED GLENDALE
ADJ4148092
JOSE LUIS RAMIREZ
L.B. CONCEPTS
SCIF INSURED GLENDALE
ADJ4206936
YOKO DOMINGUEZ
DMS STORE CARE INC
SCIF INSURED GLENDALE
ADJ4221587
MIGUEL CAMACHO
CRC RIM INC
SCIF INSURED GLENDALE
ADJ433589
GLADYS GIRON
IDEAL CATERING
SCIF INSURED GLENDALE
ADJ433589
GLADYS GIRON
UEBTF LOS ANGELES
SCIF INSURED GLENDALE
ADJ4338093
MARLENE QUINTERO
PARK PLACE MEDICAL CENTER
SCIF INSURED GLENDALE
ADJ4347928
SALVADOR SANCHEZ
ANAHEIM TERRACE CARE CENTER
SCIF INSURED GLENDALE
ADJ4357182
DANIEL MARTINEZ
PRIMARY STEEL
SCIF INSURED GLENDALE
ADJ4398452
JEFF ROSS
JS GLASS & MIRROR INC
SCIF INSURED GLENDALE
ADJ4465831
TIMOTHY TIRRE
HOLIDAY PORCELAIN ENAMEL
SCIF INSURED GLENDALE
COMPANY ADJ4467720
JOSE AJA
CONSOLIDATED EQUIPMENT CORP
SCIF INSURED GLENDALE
ADJ4476995
OLIVIA MORFIN
STAFFING SERVICES
SCIF INSURED GLENDALE
ADJ4529657
JERRY BRISCOE
MEASURE COMP
SCIF INSURED GLENDALE
ADJ4644157
ANTONIO SANTILLAN
CASTEC INC
SCIF INSURED GLENDALE
ADJ533246
JORGE PRIETO
COAST CONVERTER
SCIF INSURED GLENDALE
ADJ533246
JORGE PRIETO
COAST CONVERTERS
SCIF INSURED GLENDALE
ADJ6429739
JOSE VALLES
ROYAL ROOT CO. #3
SCIF INSURED GLENDALE
ADJ648245
BENJAMIN ORTIZ
ADJ6634534
CYNTHIA GAMEZ
SILVERMAN AND GOLDSZER
SCIF INSURED GLENDALE
ADJ6730204
ALLEN HORNSBY
BOB AND DAVES TOWING INC
SCIF INSURED GLENDALE
SCIF INSURED GLENDALE
Page 41
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ6730204
ALLEN HORNSBY
CALIFORNIA COACH AUTO BODY
SCIF INSURED GLENDALE
AND TOWING ADJ6730204
ALLEN HORNSBY
KENNY'S AUTO SERVICE
SCIF INSURED GLENDALE
ADJ6744645
PASTOR ESTRADA
LA PARTY RENTS
SCIF INSURED GLENDALE
ADJ6784010
ALEJO RUBIO
CATALINA YACHTS
SCIF INSURED GLENDALE
ADJ6846161
JESUS SOTO
JOSEPH J BERTRAND
SCIF INSURED GLENDALE
ADJ6870638
ALBA ZUNIGA
ADJ6924960
GEORGE LABRECQUE
LABOR SYSTEMS
SCIF INSURED GLENDALE
SCIF INSURED GLENDALE
ADJ6930945
SOO JANG
EDWARD SKY INC DBA SURASANG
SCIF INSURED GLENDALE
RESTAURANT ADJ6939775
LUIS GONZALEZ
SOUTHERN CALIFORNIA ICE CO
SCIF INSURED GLENDALE
ADJ6971424
TERRY COVINGTON
AMERICAN COMPUTER SUPPLIES INC
SCIF INSURED GLENDALE
ADJ7014583
JOSE PEREZ
EVANS AND SON TOUR SERV INC AKA
SCIF INSURED GLENDALE
CALIF TOUCH OF CLASS ADJ7028159
WAYNE KITRELL
M AND M ACTION TOWING
SCIF INSURED GLENDALE
ADJ7203623
DOMINIC YANEZ
HEALTH DEVICES INC
SCIF INSURED GLENDALE
ADJ7215676
BLANCA MURILLO
CALIFORNIA FAIR PLAN
SCIF INSURED GLENDALE
ADJ7279312
BENJAMIN OCHOA
BROWNCO CONSTRUCTION
SCIF INSURED GLENDALE
ADJ7379766
JEFFREY WEAVER
URBAN BUILDERS, INC.
SCIF INSURED GLENDALE
ADJ7380036
BOBBY YOUNG
UNITED PIMPING SERVICE INC
SCIF INSURED GLENDALE
ADJ7437470
JOSE BECERRA
COAST CHEM EXTERMINATING
SCIF INSURED GLENDALE
ADJ7508664
DANIEL CERVANTES
STONE ETC INC
SCIF INSURED GLENDALE
ADJ7690667
ANTONIO YAX
BENALEX WINDOWS AND DOORS
SCIF INSURED GLENDALE
ADJ7816423
RONNIE ANGUIANO
DEL CAMPO TRUCKING
SCIF INSURED GLENDALE
ADJ7840950
SANDRA CARTER
BARBOUR FLOYD MEDICAL ASSOC
SCIF INSURED GLENDALE
ADJ8115142
DESTINY BIOSAH
PROJECT INDEPENDENCE
SCIF INSURED GLENDALE
ADJ819174
VICTOR HARO
C. LUJAN & COMPANY
SCIF INSURED GLENDALE
ADJ8402781
CHUCK TIFFANY
CANTERBURY BASEBALL LLC AKA
SCIF INSURED GLENDALE
CORP
FLORENCE FREEDOM ADJ8402781
CHUCK TIFFANY
GRAND PRAIRIE PROFESSIONAL
SCIF INSURED GLENDALE
BASEBALL LP ADJ8402781
CHUCK TIFFANY
HAWAII BASEBALL LLC
SCIF INSURED GLENDALE
ADJ8402781
CHUCK TIFFANY
LOS ANGELES DODGERS
SCIF INSURED GLENDALE
ADJ8402781
CHUCK TIFFANY
ST GEORGE ROADRUNNERS ET AL
SCIF INSURED GLENDALE
ADJ845436
GLENN MACDONALD
JON KERTES CONSTRUCTION CO
SCIF INSURED GLENDALE
ADJ912959
MELODY LARUE KREISS
LBS FINANCIAL CREDIT UNION
SCIF INSURED GLENDALE
ADJ1048691
SIXTO GUILLERMO
DESERT COASTAL TRANSPORT
SCIF INSURED INLAND EMPIRE
HUAPAYA ADJ1125444
KATHY SANCHEZ
INFONXX
SCIF INSURED INLAND EMPIRE
ADJ1125444
KATHY SANCHEZ
INFONXX INC
SCIF INSURED INLAND EMPIRE
ADJ1173510
ROSA GONZALEZ
UPLAND CONVALESCENT HOSPITAL
SCIF INSURED INLAND EMPIRE
ADJ1366096
ROY BEAMS
CTS
SCIF INSURED INLAND EMPIRE
Page 42
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ1764405
VICTOR FLORES
STK INTERNATIONAL, INC.
SCIF INSURED INLAND EMPIRE
ADJ1927566
ROBERT SMITH
SAUNDERS & MCMILLIN
SCIF INSURED INLAND EMPIRE
ADJ200259
JOEL SANCHEZ
CHECK MATE STAFFING
SCIF INSURED INLAND EMPIRE
ADJ200259
JOEL SANCHEZ
MERRICK ENGINEERING INC
SCIF INSURED INLAND EMPIRE
ADJ2009087
DOROTHY AUGUSTINE
PHS/MWA
SCIF INSURED INLAND EMPIRE
ADJ2039183
MICAELA CRUZ
DYNAMIC NURSING
SCIF INSURED INLAND EMPIRE
ADJ207268
DONALD FOWLER
BROOKSTONE EQUIPMENT SERVICES
SCIF INSURED INLAND EMPIRE
INC ADJ2107599
RAYMOND COTE
INTERNATIONAL E-Z UP
SCIF INSURED INLAND EMPIRE
ADJ2284440
CRAIG DANIELSON
EL & EL WOOD PRODUCTS CORP
SCIF INSURED INLAND EMPIRE
ADJ237230
ALFREDO LOPEZ
PREMIER HOMES
SCIF INSURED INLAND EMPIRE
ADJ2465041
TOMAS RAMOS
PERFORMANCE CONCRETE
SCIF INSURED INLAND EMPIRE
ADJ255494
JON RODEWALD
KOR BARNABEY'S LLC
SCIF INSURED INLAND EMPIRE
ADJ2753691
JERRY RODRIGUEZ
HANSEN CONSOLIDATORS
SCIF INSURED INLAND EMPIRE
ADJ2975177
JORGE VERASTEGUI
SCIF INSURED INLAND EMPIRE
ALVARADO ADJ325203
ANITA SCHAEFFER
ADMINISTAFF CO INC
SCIF INSURED INLAND EMPIRE
ADJ325203
ANITA SCHAEFFER
ARGUS PRO HEALTH
SCIF INSURED INLAND EMPIRE
ADJ3278964
ROBERTO SEPULVEDA
ABC WINDOW COMPANY
SCIF INSURED INLAND EMPIRE
ADJ3416812
JAMES BUSCH
NORTH COUNTY PUMP
SCIF INSURED INLAND EMPIRE
ADJ344371
MICHAEL GUILDING
J T AUTOMOTIVE
SCIF INSURED INLAND EMPIRE
ADJ3719710
ROSA GONZALEZ
UPLAND CONVALESCENT
SCIF INSURED INLAND EMPIRE
ADJ3747693
SALVADOR DURAN
ALHAMBRA FOUNDRY COMPANY
SCIF INSURED INLAND EMPIRE
ADJ3853229
ROBERT LUDWICK
DON'S AIRCONDITIONING SERVICE
SCIF INSURED INLAND EMPIRE
ADJ4290345
DIANA ZAMORA
J Z'S PARTY CHARM
SCIF INSURED INLAND EMPIRE
ADJ4361902
MARLENE GUADAMUZ
GUARANTY MANAGEMENT CORP
SCIF INSURED INLAND EMPIRE
ADJ4429497
LORENA VILLEGAS
PALOS VERDES HEALTH CARE CENTER
SCIF INSURED INLAND EMPIRE
ADJ603626
GERTRUDIS HERNANDEZ
BERTOLINI
SCIF INSURED INLAND EMPIRE
ADJ6790123
RONALD THRONSON
ALLAN FENCE
SCIF INSURED INLAND EMPIRE
ADJ7018828
DERRELL GARCIA
FREDS GLASS AND MIRROR
SCIF INSURED INLAND EMPIRE
ADJ7024442
CARLOS SERRANO
VEIRS KLUK ROOFING
SCIF INSURED INLAND EMPIRE
ADJ7176429
KIRK KING
KINGS POOL SERVICE
SCIF INSURED INLAND EMPIRE
ADJ7671874
YOLANDA DE LA TORRE
SATANAS MEXICAN FOOD
SCIF INSURED INLAND EMPIRE
ADJ7719317
CAROL VARGAS
SOUTH COAST CHILDRENS
SCIF INSURED INLAND EMPIRE
ADJ8047375
FRANCISCO RONQUILLO
TRAIL LINES
SCIF INSURED INLAND EMPIRE
ADJ1222132
BRENT MARTIN
G.E. CONSTRUCTION
SCIF INSURED OXNARD
ADJ2153519
WILLIAM LITMAN
ANACAPA HOSPITAL
SCIF INSURED OXNARD
ADJ2295179
ANNETTE FRANCO
TECHSTYLES
SCIF INSURED OXNARD
ADJ260724
ERNIE RASCON
ARCTURUS MFG
SCIF INSURED OXNARD
ADJ2809626
SALVADOR COVARRUBIAS
ROSSCO HOLDINGS
SCIF INSURED OXNARD
ADJ3373248
IVY IBAVEN
CIBA INSURANCE SERVICES
SCIF INSURED OXNARD
ADJ354887
SIKUKA PANAPA
SMITHSON FIRE PROTECTION
SCIF INSURED OXNARD
Page 43
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ3933871
CHARLES PAGE
REZAC MEYERS ATTORNEY S
SCIF INSURED OXNARD
ADJ642748
DELLA WALKER
HOME INSTEAD SENIOR CARE
SCIF INSURED OXNARD
ADJ8067163
ROBERT CAMACHO
AVENAL STATE PRISON
SCIF INSURED OXNARD
ADJ7741770
MARIA GARCIA
ROYAL CATERING CO
SCIF INSURED PLEASANTON
ADJ714637
MICHAEL MALO
CALIFORNIA HWY PATROL
SCIF INSURED SAN DIEGO
ADJ8869137
DOMINIC VELASQUEZ
CENTINELLA STATE PRISON
SCIF INSURED SAN DIEGO SCIF INSURED SAN JOSE
ADJ1723076
JESUS HERNANDEZ
J AND L FARMS
ADJ7979492
MICHAEL COSGROVE
GOLDEN BASEBALL LEAGUE
SCIF INSURED SAN JOSE
ADJ1110485
KURT GALLARDO
DYZNEE TOWING SERVICE
SCIF INSURED SANTA ANA
ADJ113049
BARBARA SEOANE
FURNITURE TRADING CO
SCIF INSURED SANTA ANA
ADJ1146069
ANTHONY VILLA
WESTMONT INDUSTRIES
SCIF INSURED SANTA ANA
ADJ125914
DONALD TOUPE
VAN ETTEN DRYWALL
SCIF INSURED SANTA ANA
ADJ1581910
LINDA BELSHE
CAL STATE UNIVERSITY LONG BEACH
SCIF INSURED SANTA ANA
ADJ1581910
LINDA BELSHE
CSULB FOUNDATION
SCIF INSURED SANTA ANA
ADJ1614898
FRANCISCO SANCHEZ
EAGLE RIDER
SCIF INSURED SANTA ANA
ADJ1709179
ED BYNG
CALVARY CHAPEL OF COSTA MESA
SCIF INSURED SANTA ANA
ADJ1764405
VICTOR FLORES
STK INTERNATIONAL, INC.
SCIF INSURED SANTA ANA
ADJ1826305
SALLY NGHIEM
VIETNAMESE LEAGUE OF ORANGE
SCIF INSURED SANTA ANA
COUNTY ADJ188754
MARIO RODRIGUEZ
QUAKER CITY PLATING
SCIF INSURED SANTA ANA
ADJ189448
YOLANDA DE GASPAR
JOB OPTIONS INC
SCIF INSURED SANTA ANA
ADJ2078909
EMILIO LOPEZ
VILORIA CONSTRUCTION INC
SCIF INSURED SANTA ANA
ADJ2214600
MICHAEL THOMPSON
TORREZ TRUCKING
SCIF INSURED SANTA ANA
ADJ2221138
DANIELL MORPHIS
SMART SYSTEMS TECH.
SCIF INSURED SANTA ANA
ADJ2268459
HERB PACHECO
SCOTT ROBINSON HONDA
SCIF INSURED SANTA ANA
ADJ2326468
MARIA GODINEZ
AIR INDUSTRIES
SCIF INSURED SANTA ANA
ADJ2497538
JOSE MENDEZ
U.S. GROWERS COLD STORAGE
SCIF INSURED SANTA ANA
ADJ2792766
TIMOTHY SMITH
KKW TRUCKING
SCIF INSURED SANTA ANA
ADJ2837957
SUSAN AHN
EASTWOOD INS
SCIF INSURED SANTA ANA
ADJ3040748
JACQUELYN LAWSON
SPIRES RESTAURANT
SCIF INSURED SANTA ANA
ADJ3253900
MARIA AQUINO
IMPERIAL TOY CORP
SCIF INSURED SANTA ANA
ADJ3253900
MARIA AQUINO
KHALID AHMED HACIENDA HEIGHTS
SCIF INSURED SANTA ANA
ADJ3394014
DONNA ABENT
MARINA MEDICAL BILLING SERVICES
SCIF INSURED SANTA ANA
ADJ3494021
CATHERINA YOUNG
EASTER SEALS
SCIF INSURED SANTA ANA
ADJ3504138
LADONNE GREEN
PROJECT INDEPENDENT
SCIF INSURED SANTA ANA
ADJ3504138
LADONNE GREEN
SU CASA FAMILY SUPPORT
SCIF INSURED SANTA ANA
ADJ3507140
FRANCISCO OBANDO
THOMPSON BUILDING MATERIALS
SCIF INSURED SANTA ANA
ADJ373202
DONALD PHILLIPS
AMERICAN CONTRACTING
SCIF INSURED SANTA ANA
ADJ3744523
MITCHELL MORENO
CAUSEY ELECTRIC INC
SCIF INSURED SANTA ANA
ADJ3828451
VICTOR MENDOZA
TOP INSTALLER
SCIF INSURED SANTA ANA
ADJ4027310
ALAN SPELL
M & N COASTLINE AUTO/GOODYEAR
SCIF INSURED SANTA ANA
Page 44
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ4033269
JESUS FRUTOS
ACADEMY MANUFACTURING CO.,
SCIF INSURED SANTA ANA
INC. ADJ4069490
DEAN FRANKLIN
HART BROS. ELECTRIC
SCIF INSURED SANTA ANA
ADJ4087635
JANICE ALVAREZ
HERITAGE POINTE
SCIF INSURED SANTA ANA
ADJ4237705
MARTHA DABOUB
NEWPORT HAND CENTER
SCIF INSURED SANTA ANA
ADJ4245584
BARBARA SEOANE
FURNITURE TRADING CO
SCIF INSURED SANTA ANA
ADJ4295994
MARIA ZALDANA
A.P. EXPRESS WORLDWIDE
SCIF INSURED SANTA ANA
ADJ4388525
ANITA FERNANDEZ
CUSTOMIZE SCREENPRINTING &
SCIF INSURED SANTA ANA
DISTRIBU ADJ4415129
TIMOTHY REMBAC
KEN SMITH MASONRY INC
SCIF INSURED SANTA ANA
ADJ4491590
CONCEPCION VELASQUEZ
ERUSTON CORP
SCIF INSURED SANTA ANA
ADJ4511565
JOSEPH CONTRERAS
ICC
SCIF INSURED SANTA ANA
ADJ458935
LETICIA DE LEON
MAXINE SWIM GROUP INC
SCIF INSURED SANTA ANA
ADJ6666743
BERNAVE SILVERIO
HOYT ROOFS INC
SCIF INSURED SANTA ANA
ADJ6742057
JOSE ESPINOZA
WILMINGTON WOODWORKING
SCIF INSURED SANTA ANA
ADJ6931866
DELFINO HERNANDEZ
L&R TRANSPORTES, INC., DBA
SCIF INSURED SANTA ANA
ADJ7458446
ELIZABETH MONTES
DIAMANTE BAR
SCIF INSURED SANTA ANA
ADJ7831833
ALBERTO VEGA
B L PRICE
SCIF INSURED SANTA ANA
ADJ7831938
CANDY TOURVILLE
FAIRVIEW DEVELOPMENTAL CENTER
SCIF INSURED SANTA ANA
FRONTERAS DEL NORTE
ADJ7834491
JUVENAL ALVAREZ
REXWAY ROOFING
SCIF INSURED SANTA ANA
ADJ809195
LUZ HERRERA BALBOA
MAXINE SWIM GROUP INC
SCIF INSURED SANTA ANA
ADJ8115142
DESTINY BIOSAH
PROJECT INDEPENDENCE
SCIF INSURED SANTA ANA
ADJ8411199
MARK BERGINE
RECAT INC
SCIF INSURED SANTA ANA
ADJ860891
JOHN WEBB
SHORE STEEL INC
SCIF INSURED SANTA ANA
ADJ912959
MELODY LARUE KREISS
LBS FINANCIAL CREDIT UNION
SCIF INSURED SANTA ANA SCIF INSURED SANTA ROSA
ADJ163167
MICHAEL VITALI
ULTIMATE JUICE COMPANY
ADJ7427348
ERNESTO PADILLA
LACNY LOGISTICS
SCIF INSURED SANTA ROSA
ADJ891833
MARIO MARQUEZ
VOPAK/WILMINGTON LIQUID
SCIF LONGSHORE PLEASANTON
ADJ3815656
LINDA SCOTT
STATE COMP. INSRUANCE FUND
SCIF SCIF EMPLOYEES ALL
ADJ3815656
LINDA SCOTT
STATE COMPENSATION INSURANCE
SCIF SCIF EMPLOYEES ALL
ADJ3128349
JORGE CORONA
PLAZA DEL SOL
SCIF SCO MONTEREY PARK SCIF SCO MONTEREY PARK
FUND ADJ3128349
JORGE CORONA
RICARDO NUNEZ
ADJ6624702
SUZANNE BOYLE
ME AND ED`S PIZZA PARLOR
SCIF SCO MONTEREY PARK
ADJ6624775
ABRAHAM JEON
YOUNG AGAIN ADULT DAY HEALTH
SCIF SCO MONTEREY PARK
CARE ADJ7014583
JOSE PEREZ
EVANS AND SON TOUR SERV INC AKA
SCIF SCO MONTEREY PARK
CALIF TOUCH OF CLASS ADJ7138683
RAMON PEREZ
LOS TAPATIOS
SCIF SCO MONTEREY PARK
ADJ7180930
SILVESTRE DIONISIO
ROYAL DINING
SCIF SCO MONTEREY PARK
ADJ7223042
JAMIE MANN
MILL CREEK EQUESTRAIN CENTER
SCIF SCO MONTEREY PARK
ADJ7330394
MARTIN GARCIA
LUPE TEOS PIANO
SCIF SCO MONTEREY PARK
ADJ7411005
KENNETH SCHUMACHER
JONES BROTHERS CONSTRUCTION
SCIF SCO MONTEREY PARK
Page 45
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
ADJ7007754
ADRIANA CENDEJAS
ADJ3128349
JORGE CORONA
Employer
Claims administrator SCIF SCO SAN BERNARDINO
PLAZA DEL SOL
SCIF STATE EMPLOYEES OXNARD
ADJ3128349
JORGE CORONA
RICARDO NUNEZ
SCIF STATE EMPLOYEES OXNARD
ADJ3304807
DEBRA COURTNEY
CAMARILLO STATE HOSPITAL
SCIF STATE EMPLOYEES OXNARD
ADJ727774
ISELA MENDOZA
PLEASANT VALLEY STATE PRISON
SCIF STATE EMPLOYEES OXNARD
ADJ1125444
KATHY SANCHEZ
INFONXX
SCIF STATE EMPLOYEES RIVERSIDE
ADJ1125444
KATHY SANCHEZ
INFONXX INC
SCIF STATE EMPLOYEES RIVERSIDE
ADJ1141411
WILLIAM HORTON
ALBERT V O'NEAL
SCIF STATE EMPLOYEES RIVERSIDE
ADJ1141411
WILLIAM HORTON
ALBERT'S TRUCKING
SCIF STATE EMPLOYEES RIVERSIDE
ADJ1141411
WILLIAM HORTON
UEBTF LOS ANGELES
SCIF STATE EMPLOYEES RIVERSIDE
ADJ1718463
ZERINA MESIHOVIC
COUNTY OF LOS ANGELES DPSS
SCIF STATE EMPLOYEES RIVERSIDE
ADJ6756982
LEAH GARVER
DEPT OF CORRECTIONS AND REHAB
SCIF STATE EMPLOYEES RIVERSIDE
ADJ710857
NICHOLAS ACORDI
DEPARTMENT OF CORRECTIONS
SCIF STATE EMPLOYEES RIVERSIDE
ADJ749699
BLANCA GUERRERO
IHSS
SCIF STATE EMPLOYEES RIVERSIDE
ADJ7818550
FRANK BIELAWA
DEPARTMENT OF CORRECTIONS AND
SCIF STATE EMPLOYEES RIVERSIDE
REHABILITATION ADJ8567568
GARY CURRIER
DEPARTMENT OF CORRECTIONS AND
SCIF STATE EMPLOYEES RIVERSIDE
REHABILITATION ADJ3323637
DARRYL BOSTON
CALIFORNIA DEPT OF CORRECTIONS
SCIF STATE EMPLOYEES SACRAMENTO
ADJ3957833
JOAN ROSS
CALIFORNIA HIGHWAY PATROL
SCIF STATE EMPLOYEES SACRAMENTO
ADJ6992217
DOROTHY LOPEZ
STATE OF CALIFORNIA CHP
SCIF STATE EMPLOYEES SACRAMENTO
ADJ714637
MICHAEL MALO
CALIFORNIA HWY PATROL
SCIF STATE EMPLOYEES SACRAMENTO
ADJ1008019
VICTORIA ISAAC
STATE OF CALIFORNIA DEPT. OF
SCIF STATE EMPLOYEES SANTA ANA
CORREC ADJ1334495
RAY RIVERA
CAL POLY UNIVERSITY
SCIF STATE EMPLOYEES SANTA ANA
ADJ1401899
EDWARD BEADLE
WASCO STATE PRISON
SCIF STATE EMPLOYEES SANTA ANA
ADJ2175401
CECILIA MARQUEZ
DEPT OF MOTOR VEHICLES
SCIF STATE EMPLOYEES SANTA ANA
ADJ2461296
ATI FUIAVA
CAL-TRANS
SCIF STATE EMPLOYEES SANTA ANA
ADJ2962063
CHARLENE SHEA
DEPARTMENT OF MENTAL HEALTH
SCIF STATE EMPLOYEES SANTA ANA
ADJ3505086
SIMONE BOULOS
EDD
SCIF STATE EMPLOYEES SANTA ANA
ADJ4141215
DOREEN LABOY
METROPOLITAN STATE HOSPITAL
SCIF STATE EMPLOYEES SANTA ANA
ADJ4703930
RICHARD ENRIQUEZ
DEPARTMENT OF MOTOR VEHICLES
SCIF STATE EMPLOYEES SANTA ANA
ADJ7932952
EUGENE WILLIAMS
CAL TRANS
SCIF STATE EMPLOYEES SANTA ANA
ADJ192640
ALAN LOONEY
TEMPLE-INLAND
SEDGWICK 14153 RIVERSIDE
ADJ7388184
MAURICIO RODRIGUEZ
CR AND R
SEDGWICK 14153 RIVERSIDE
ADJ8497086
JUDITH MALOOF
WEST ANAHEIM MEDICAL CENTER
SEDGWICK 14153 RIVERSIDE
ANAHEIM ADJ8667338
FRANCIS APONTE
ALBERTSONS INC
SEDGWICK 14153 RIVERSIDE
ADJ7646553
YOLANDA HERNANDEZ
BUD OF CALIFORNIA
SEDGWICK 14154 SACRAMENTO
ADJ7925389
LUIS QUINTERO
AMERICANOS USA
SEDGWICK 14154 SACRAMENTO
ADJ1928884
ROBERT TELLES
BED BATH & BEYOND
SEDGWICK 14442 ORANGE
ADJ3198657
PETE VASQUEZ
PEPSI COLA SAN JOAQUIN BOTTLING
SEDGWICK 14442 ORANGE
ADJ3413847
CONNIE JOHNSTON
COSTCO WHOLESALE
SEDGWICK 14442 ORANGE
Page 46
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ4087514
ERMELINDA HARWOOD
DURHAM SCHOOL SERVICE
SEDGWICK 14442 ORANGE
OCHOA ADJ4131269
DARCY ROBINSON
KINDRED HOSPITAL
SEDGWICK 14442 ORANGE
ADJ6523117
GILBERTO RUVALCABA
KEER
SEDGWICK 14442 ORANGE
ADJ6568102
UZZIEL AMBRIZ
BFS RETAIL AND COMMERCIAL
SEDGWICK 14442 ORANGE
ADJ6772972
DAVID TORRES
RIO TINTO MINERALS
SEDGWICK 14442 ORANGE
ADJ6788433
GAIL CAPLAN
ST JOSEPHS HOSPITAL
SEDGWICK 14442 ORANGE
ADJ6882163
NELY BARGOLA
ROSS STORES
SEDGWICK 14442 ORANGE
ADJ7165056
DAMEN WINSTON
PEPSI BOTTLING GROUP NEWBERN
SEDGWICK 14442 ORANGE
TRANSPORT ADJ7320812
ELIAS AGUILAR
BRIDGESTONE AMERICA TIRE
SEDGWICK 14442 ORANGE
OPERATIONS ADJ7562865
ROSA BATRES
TARGET CORPORATION
SEDGWICK 14442 ORANGE
ADJ7811686
JUAN ONTIVEROS
FIRESTONE TIRE & AUTO SERVICE
SEDGWICK 14442 ORANGE
ADJ7859337
CHARLES GRIMM
VERIZON GTE
SEDGWICK 14442 ORANGE
ADJ7956233
MILUSKA WHEELER
PROVIDENCE LITTLE COMPANY OF
SEDGWICK 14442 ORANGE
MARY ADJ8028767
DELINA GARCIA
PUBLIC STORAGE
SEDGWICK 14442 ORANGE
ADJ8231540
NANCY CARRILLO
ST MARYS MEDICAL CENTER
SEDGWICK 14442 ORANGE
ADJ8242062
SANDRA PALESTINO
COSTCO WHOLESALE
SEDGWICK 14442 ORANGE
ADJ8340709
TRINA CONGER
COSTCO
SEDGWICK 14442 ORANGE
ADJ3539520
JAMES DANIELS
TRANS WORLD AIRLINES
SEDGWICK 14450 LONG BEACH
ADJ4451760
DANIEL ALMOND
BOEING CO.
SEDGWICK 14450 LONG BEACH
ADJ6568102
UZZIEL AMBRIZ
BFS RETAIL AND COMMERCIAL
SEDGWICK 14450 LONG BEACH
ADJ6822100
LIZETTE GAMEZ
SMART & FINAL
SEDGWICK 14450 LONG BEACH
ADJ7103893
PATRICIA RAMIREZ
TARGET CORPORATION
SEDGWICK 14450 LONG BEACH
ADJ7572187
NORMA SALCEDO
RALPHS GROCERY COMPANY
SEDGWICK 14450 LONG BEACH
ADJ7591874
CHRISTIE KATHARY
KMART
SEDGWICK 14450 LONG BEACH
ADJ7775441
CYNTHIA BROWN
JENNY CRAIG
SEDGWICK 14450 LONG BEACH
ADJ7963695
RODNEY WILSON
THE BOEING COMPANY
SEDGWICK 14450 LONG BEACH
ADJ3363262
FRANCES SAUNDERS TIPPIN
BOEING COMPANY
SEDGWICK 14458 ONTARIO
ADJ3363262
FRANCES SAUNDERS TIPPIN
THE BOEING COMPANY
SEDGWICK 14458 ONTARIO
ADJ3626113
THERESA CONTINI
RALPH'S CORPORATION
SEDGWICK 14458 ONTARIO
ADJ2247649
KIM FOSTER
UNIVERSITY CORPORATION
SEDGWICK 14479 MCU IVOS VAN NUYS
ADJ8091644
SERINA JOHNSON
ST VINCENT MEDICAL CENTER
SEDGWICK 14479 MCU IVOS VAN NUYS
ADJ2125706
MODESTO CATALAN
COLOR SPOT
SEDGWICK 14522 VAN NUYS
EDWARDS
ADJ4591301
VICTOR GARCIA
ST FRANCIS MEDICAL CENTER
SEDGWICK 14522 VAN NUYS
ADJ6860128
AMANDA RUSSELL
THE UNIVERSITY CORPORATION
SEDGWICK 14522 VAN NUYS
ADJ7672005
SYLVIA APODACA
FIRST DATA REMITCO INC
SEDGWICK 14522 VAN NUYS
ADJ8377617
ISMAEL UDASCO
ST VINCENT MEDICAL CENTER
SEDGWICK 14522 VAN NUYS
ADJ8091644
SERINA JOHNSON
ST VINCENT MEDICAL CENTER
SEDGWICK 14535 OAKLAND
ADJ6633028
STELLA ANDRE
RALPHS GROCERY COMPANY
SEDGWICK 14563 LONG BEACH
ADJ6807474
DONUEL STALLWORTH
LOS ANGELES UNIFIED SCHOOL
SEDGWICK 14563 LONG BEACH
DISTRICT ADJ7045668
WALTER COLLINS
RALPHS GROCERY STORE
Page 47
SEDGWICK 14563 LONG BEACH
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7318795
ELIZABETH WILLIS
THE KROGER COMPANY
SEDGWICK 14563 LONG BEACH
ADJ7591874
CHRISTIE KATHARY
KMART
SEDGWICK 14563 LONG BEACH
ADJ7949084
LEONEL QUINTERO
RALPHS GROCERY
SEDGWICK 14563 LONG BEACH
EDWARDS ALMERAYA ADJ8059853
BELEN REZA
LOWES
SEDGWICK 14563 LONG BEACH
ADJ8079888
LAURIE TALSTAD KEIDSER
RALPHS GROCERY COMPANY
SEDGWICK 14563 LONG BEACH
ADJ8193929
MARTHA HART
RALPHS GROCERY STORE
SEDGWICK 14563 LONG BEACH
ADJ8255357
HOWARD CHAREST
LOS ANGELES UNIFIED SCHOOL
SEDGWICK 14563 LONG BEACH
DISTRICT ADJ8387593
JOSE AMEZQUITA
FOOD 4 LESS
SEDGWICK 14563 LONG BEACH
ADJ2423265
JESUS GARCIA
CLEAN STEEL
SEDGWICK 14573 SACRAMENTO
ADJ7329709
TIMOTHY HANNA
FEDERAL EXPRESS NATIONAL
SEDGWICK 14573 SACRAMENTO
ADJ7509958
ALDO CEPEDA
GORDON TRUCKING INC
SEDGWICK 14573 SACRAMENTO
ADJ7866586
ROBERTO MARQUEZ
CINTAS
SEDGWICK 14573 SACRAMENTO
ADJ1275544
TAUNA THOMPSON
PACIFIC BELL
SEDGWICK 14627 ONTARIO
ADJ1986731
PATRICIA JOHNSON
SBC/ATT
SEDGWICK 14627 ONTARIO
ADJ3071975
DEIDRA HARPER
SBC
SEDGWICK 14627 ONTARIO
ADJ6673120
ESTER SHRUM
AT AND T
SEDGWICK 14627 ONTARIO
ADJ6743384
ROBERT PEREZ
AT AND T
SEDGWICK 14627 ONTARIO
ADJ7155087
MELVIN SMITH
AT&T
SEDGWICK 14627 ONTARIO
ADJ8051546
LILLIAN GARCIA
AT T
SEDGWICK 14627 ONTARIO
ADJ3027124
MARIA GUZMAN
IRVINE MEDICAL CENTER
SEDGWICK 14667 ORANGE
ADJ3027124
MARIA GUZMAN
REGENTS - UNIVERSITY OF
SEDGWICK 14667 ORANGE
CALIFORNIA ADJ1215230
DOROTHY MOORE
CAL POLY POMONA UNIVERISTY
SEDGWICK 2078 OAKLAND
ADJ2247649
KIM FOSTER
UNIVERSITY CORPORATION
SEDGWICK 2078 OAKLAND
ADJ1215230
DOROTHY MOORE
CAL POLY POMONA UNIVERISTY
SEDGWICK 3170 RANCHO CORDOVA
ADJ6860128
AMANDA RUSSELL
THE UNIVERSITY CORPORATION
SEDGWICK 3170 RANCHO CORDOVA
ADJ7442060
JUSTIN HENDEE
CSU SAN BERNARDINO
SEDGWICK 3170 RANCHO CORDOVA
ADJ8431761
SAMUEL CASTRUITA
CSU DOMINQUEZ HILLS
SEDGWICK 3170 RANCHO CORDOVA
ADJ6819987
LUISA MESONES
ADJ2924625
CATHERINE TARBET
ALBERTSON'S
SEDGWICK ALBERTSONS BREA
ADJ4523497
ANTHONY BECKER
AMERICAN DRUG STORES
SEDGWICK ALBERTSONS BREA
SEDGWICK 51460 ONTARIO
ADJ1578859
EDILIA BLEDSOE
SAV-ON
SEDGWICK BREA
ADJ2216629
JORGE SANCHEZ
GELSONS MARKETS
SEDGWICK BREA
ADJ2307296
MARIA MOSQUEDA
ONE SOURCE
SEDGWICK BREA
ADJ2695773
JANINE PERDEW
ALBERTSONS
SEDGWICK BREA
ADJ2951264
O'KEEFE ANTEE
LOWE'S HOME IMPROVEMENT
SEDGWICK BREA
ADJ3426985
LISA BRUMFIELD
CENTURY CITY HOSPITAL
SEDGWICK BREA
ADJ355156
MARTHA DIAZ
ADECO EMPLOYMENT SERVICES
SEDGWICK BREA
ADJ355156
MARTHA DIAZ
VOLT SERVICES GROUP
SEDGWICK BREA
ADJ3866615
OLIVIA SALAZAR
TECHNICOLOR
SEDGWICK BREA
ADJ4023065
MARTHA MILLAN
USC UNIVERSITY HOSPITAL
SEDGWICK BREA
ADJ4053010
LAURIE BROWN
BRUNSWICK SANDS BOWL
SEDGWICK BREA
ADJ4571130
JESUS LUCERO
COMMUNITY & MISSION HOSPITAL OF
SEDGWICK BREA
Page 48
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
ADJ4596408
REYNALDA GONZALEZ
DOUBLE TREE HOTEL
Claims administrator SEDGWICK BREA
ADJ628072
CUI ZHEN FU
ZONG WEN JUN
SEDGWICK BREA
ADJ6772667
WEBBER KNIGHT
WORLD WIDE FACILITIES
SEDGWICK BREA
ADJ7281928
YVONNE ADAME
AUTOMBILE CLUB OF SOUTHERN
SEDGWICK BREA
ADJ7392610
SAYED SHAH
SOUTHERN CALIFORNIA
CALIFORNIA SEDGWICK BREA
AUTOMOBILE CLUB DBA AAA AUTO CLUB ADJ7472391
GLORIA BERMINGHAM
LOWES
SEDGWICK BREA
ADJ7476534
JAIME ADAME
CR&R INCORPORATED
SEDGWICK BREA
ADJ902591
MARIA DIAZ
RADISSON PLAZA HOTEL
SEDGWICK BREA
ADJ2192468
PAUL DRUSKY
INITIAL SECURITY
SEDGWICK BURBANK
ADJ3244236
STEPHEN ANDREW
NUWAY LINEN
SEDGWICK BURBANK
ADJ7309195
YOLANDA GARCIA
ARAMARK CLEANROOM SERVICES
SEDGWICK BURBANK
ADJ8234651
ZULEMA MIRANDA
ARAMARK
SEDGWICK BURBANK
ADJ8244599
ALEJANDRA VILLANUEVA
ARAMARK CLEANROOM SERVICES
SEDGWICK BURBANK
ADJ1023285
MARINA GONZALEZ
PROFESSIONAL STAFFING
SEDGWICK CIGA GLENDALE
ADJ1023285
MARINA GONZALEZ
PROFESSIONAL STAFFING SERVICES
SEDGWICK CIGA GLENDALE
ADJ1023285
MARINA GONZALEZ
SIMPLE TECHNOLOGY
SEDGWICK CIGA GLENDALE
ADJ1093811
HECTOR JIMENEZ
CRESCENT TRUCK LINES
SEDGWICK CIGA GLENDALE
ADJ1513760
LESLIE GORDON
MOULTON PLAZA PHARMACY
SEDGWICK CIGA GLENDALE
ADJ1630869
LEE TORRES
ANAHEIM DOOR CO
SEDGWICK CIGA GLENDALE
ADJ1630869
LEE TORRES
ANAHEIM DOOR COMPANY, INC
SEDGWICK CIGA GLENDALE
ADJ1763727
MARTIN ERICKSON
MOUNTAIN HIGH SKI RESORT
SEDGWICK CIGA GLENDALE
ADJ1942456
MARIA REBECCA
HRN SERVICES INC
SEDGWICK CIGA GLENDALE
ADJ1943091
STEVE FAIRLEY
MARTIN BROTHERS CO
SEDGWICK CIGA GLENDALE
ADJ1971926
EDY LEHRBASS
GRIFFITH CO
SEDGWICK CIGA GLENDALE
ADJ2090837
MARTIN GARCIA
TRIANGLE BRASS MFG
SEDGWICK CIGA GLENDALE
ADJ2535818
DANIEL WHITE
HEMET UNIFIED SCHOOL DIST
SEDGWICK CIGA GLENDALE
ADJ2535818
DANIEL WHITE
HEMET UNIFIED SCHOOL DISTRICT
SEDGWICK CIGA GLENDALE
ADJ2677684
ROSSLYN ELMORE MORRIS
MCDONNELL DOUGLAS CORP.
SEDGWICK CIGA GLENDALE
ADJ2848828
JEANETTE SMITH
ANADITE INC WESTERN DIV
SEDGWICK CIGA GLENDALE
ADJ2848828
JEANETTE SMITH
ANADITE METAL FINISHING DIVISION
SEDGWICK CIGA GLENDALE
DOMINGUEZ
ADJ2985835
MICHELLE TURNER
ADJ3299585
HERLINDA HERNANDEZ
S.K. TEXTILE, INC.
SEDGWICK CIGA GLENDALE SEDGWICK CIGA GLENDALE
ADJ3455123
CARMELO PEREYRA
FOSTER PRINTING CO
SEDGWICK CIGA GLENDALE
ADJ3548804
VICTOR ESQUIVEL
NATIONAL GENETICS INSTITUTE
SEDGWICK CIGA GLENDALE
ADJ365091
MARK JONES
INDUSTRY COLOR PRINTING
SEDGWICK CIGA GLENDALE
ADJ3710635
JIM CONTRERAS
PACIFIC MARINE MAINTENANCE
SEDGWICK CIGA GLENDALE
ADJ388925
ELIS MORENO
PRIME WHEEL
SEDGWICK CIGA GLENDALE
ADJ388925
ELIS MORENO
PRIME WHEEL CORPORATION
SEDGWICK CIGA GLENDALE
Page 49
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ4088091
ROSA PUJOL
BLUE CROSS OF CALIFORNIA
SEDGWICK CIGA GLENDALE
ADJ4179389
CYNTHIA GLASIER
BODY WORKS EMPORIUM
SEDGWICK CIGA GLENDALE
ADJ4179389
CYNTHIA GLASIER
BODYWORK EMPORIUM, INC.
SEDGWICK CIGA GLENDALE
ADJ4231027
MIKE DEHOYOS
SYSTEMS SOURCE INC.
SEDGWICK CIGA GLENDALE
ADJ4645734
MICHAEL CROUGH
MCDONNELL DOUGLAG AIRCRAFT
SEDGWICK CIGA GLENDALE
ADJ4681462
BETTY CHAN
LOS ANGELES FIREMANS CREDIT
SEDGWICK CIGA GLENDALE
UNION ADJ622630
LINDA CASTILLO
MOLINA MEDICAL CENTER
SEDGWICK CIGA GLENDALE
ADJ7176475
OSCAR ALVARADO
BROTHERS TOWING OF NORCO INC
SEDGWICK CIGA GLENDALE
ADJ894396
RUBEN RICO
HARVEST PRODUCE
SEDGWICK CIGA GLENDALE
ADJ896033
MICHAEL WRIGHT
HANFORD GLASS COMPANY
SEDGWICK CIGA GLENDALE
ADJ902591
MARIA DIAZ
RADISSON PLAZA HOTEL
SEDGWICK CIGA GLENDALE
ADJ7979454
CARMEN CORTAZAR
FULLERTON RESIDENTIAL MANOR
SEDGWICK CIGA ORANGE
ADJ3436569
TERRY SALGUERO
UCI MEDICAL CENTER
SEDGWICK CLAIMS MANAGEMENT
ADJ4131269
DARCY ROBINSON
KINDRED HOSPITAL
ADJ1292559
MARIA LOPEZ
ADJ1580080
BETTY STANCIEL
COACH USA
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ1580080
BETTY STANCIEL
COACH USA ANTELOPE DIV
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ1750932
RODNEY RICE
FRITO LAY INC.
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ1954265
MARY SMALL
AXIUM ENTERTAINMENT
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ1954265
MARY SMALL
CAST AND CREW PRODUCTION
SEDGWICK CLAIMS MANAGEMENT SERVICES
SEDGWICK CLAIMS MANAGEMENT SEDGWICK CLAIMS MANAGEMENT SERVICES
SERVICES INC ADJ1954265
MARY SMALL
ENTERTAINMENT PARTNERS
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ2084889
STACEY ROUX
COUNTY OF LOS ANGELES
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ2084889
STACEY ROUX
L.A.U.S.D.
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ220777
ESSIE ROBERSON
TARGET
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ2849194
KEITH PIERCE
PNS STORES (BIG LOTS)
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ2886819
JINOUS BAHRAMI
RALPHS
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ293247
MICHAEL GONZALES
RALPHS GROCERY CO
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ3193103
MARIA STEVENS DIAKIS
UNIVERSITY OF SOUTHERN
SEDGWICK CLAIMS MANAGEMENT SERVICES
CALIFORNIA ADJ3386967
PEGGY DRAPER
COMPTON UNIFIED SCHOOL DISTRICT
Page 50
SEDGWICK CLAIMS MANAGEMENT SERVICES
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ3572795
GARY DONNEL HARNAGE
SEARS AUTO CENTER
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ3832099
MARY PANINGSORO
U.S. AIRWAYS
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ3832099
MARY PANINGSORO
US AIRWAYS
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ4096616
SOFIA ORTIZ
RALPHS GROCERY
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ4234122
TINA MEDINA
RALPHS GROCERY
SEDGWICK CLAIMS MANAGEMENT SERVICES
ADJ3817160
JILL MAGUIRE
RALPHS GROCERY
SEDGWICK CLAIMS MANAGMENT SERVICES
ADJ1928884
ROBERT TELLES
BED BATH & BEYOND
SEDGWICK CMS
ADJ1112044
AMELIA GONZALEZ
COUNTY OF LOS ANGELES/DPSS
SEDGWICK COLA ONTARIO
ADJ1199269
TAMMY ELDRIDGE
LOS ANGELES COUNTY
SEDGWICK COLA ONTARIO
COUNTY OF LOS ANGELES/DPSS
SEDGWICK COLA ONTARIO
DECEASED ADJ1269315
TANISHA HAIRSTON
ADJ1305625
ANGEL MARCUCCI
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
ADJ1409388
BEVERLY WASHINGTON
LA COUNTY REGISTER RECORDER
SEDGWICK COLA ONTARIO
ADJ1464448
MARTHA GONZALEZ
COUNTY OF LA/REGOSTRAR
SEDGWICK COLA ONTARIO
RECORDS/ ADJ1490377
APO JONES
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
ADJ1528846
VALERIE CLEMENT
COUNTY OF LA/DPSS
SEDGWICK COLA ONTARIO
ADJ1701496
AISHA CHILDS
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
PROBATION ADJ2274703
JENNY AGUILAR
LOS ANGELES COUNTY/DPSS
SEDGWICK COLA ONTARIO
ADJ274195
LYDIA ARELLANO
LA COUNTY DEPT OF SOCIAL
SEDGWICK COLA ONTARIO
ADJ298139
PATRICIA COOKSIE
ADJ313551
CAMELIA LEE
ADJ3252376
OLGA ABGARYAN
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
ADJ339206
THOMAS REDE
MASONITE/DOOR FABRICATION
SEDGWICK COLA ONTARIO
ADJ3434414
CHRISTOPHER BERNAL
LOS ANGELES COUNTY PROBATION
SEDGWICK COLA ONTARIO
SERVICES SEDGWICK COLA ONTARIO COUNTY OF LOS ANGELES/DPSS
SEDGWICK COLA ONTARIO
DEPT ADJ3907604
AIDA DELGADILLO
LOS ANGELES COUNTY TAX
SEDGWICK COLA ONTARIO
COLLECTOR ADJ4068081
SHEILA LANGLEY
COUNTY OF LOS ANGELES/DPSS
SEDGWICK COLA ONTARIO
ADJ4132356
IRENE HERNANDEZ
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
ADJ4448585
ALBERT VALENZUELA
L.A. COUNTY DEPT. OF SOCIAL
SEDGWICK COLA ONTARIO
SERVICE ADJ5827299
SHEILA LABOMME
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
ADJ602112
PAULETTE MASON
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
ADJ6458077
MARY CONNER
LOS ANGELES COUNTY PROBATION
SEDGWICK COLA ONTARIO
MELENDREZ DEPT ADJ6500506
LILLIE THOMAS
COUNTY OF LA
SEDGWICK COLA ONTARIO
ADJ6617506
MARIA MUNOZ
COUNTY OF LOS ANGELES DPSS
SEDGWICK COLA ONTARIO
Page 51
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ6701052
MARLENA GRAVES
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
ADJ6729300
PRISCILLA BAEZA
COUNTY OF LOS ANGELES/DPSS
SEDGWICK COLA ONTARIO
ADJ6748230
RUSSELL REED
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
ADJ6748230
RUSSELL REED
OFFICE OF THE COUNTY COUNSEL
SEDGWICK COLA ONTARIO
ADJ6767727
ELLA BROWN
COUNTY OF LOS ANGELES REGISTRAR
SEDGWICK COLA ONTARIO
ADJ6792587
IVONNE ABBITT
COUNTY OF LOS ANGELES DPSS
SEDGWICK COLA ONTARIO
ADJ6875194
RAINI COLE
COUNTY OF LA DPSS WELFARE
SEDGWICK COLA ONTARIO
RECORDER
FRAUD INV ADJ7099485
BENJAMIN GAMBOA
COUNTY OF LOS ANGELES DEPT OF
SEDGWICK COLA ONTARIO
PUBLIC WORKS ADJ7169247
JOYCE SAMIA
SEDGWICK COLA ONTARIO
ADJ7190800
ALICE RIVADENEIRA
LOS ANGELES COUNTY
SEDGWICK COLA ONTARIO
ADJ7208671
JAIME BETANCOURT
LA COUNTY PROBATION
SEDGWICK COLA ONTARIO
ADJ7273546
SUSANA FRAGOSO
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
ADJ7321285
NANCY VILLICANA
LOS ANGELES COUNTY DEPT OF
SEDGWICK COLA ONTARIO
DEPARTMENT
PUBLIC AND SOCIAL SERVICES ADJ7341285
MIRIAM OHANIAN
LOS ANGELES COUNTY DPSS
SEDGWICK COLA ONTARIO
ADJ7430439
EVELYN HORTON
LA COUNTY DEPT OF CHILDREN AND
SEDGWICK COLA ONTARIO
CAMERON
FAMILY SERVICES
ADJ7441121
PEDRO PENA
LOS ANGELES PROBATION DEPT
SEDGWICK COLA ONTARIO
ADJ7478040
GLORIA YOUNG
COUNTY OF LOS ANGELES DPSS
SEDGWICK COLA ONTARIO
ADJ7479678
CARLA OWENS
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
ADJ7577206
ARGO HYMAN
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
ADJ7635030
TENAYA TRIPPLETT FIELDS
LA COUNTY PROBATION
SEDGWICK COLA ONTARIO
DEPARTMENT ADJ7647998
PAMELA HUNTER
LA COUNTY PROBATION
SEDGWICK COLA ONTARIO
DEPARTMENT ADJ7663575
KIMBERLY WILKERSON
COUNTY OF LA DEPT OF CHILDREN
SEDGWICK COLA ONTARIO
AND FAMILY SERVICES ADJ7678077
VALERY COLEMAN
COUNTY OF LOS ANGELES DCFS
SEDGWICK COLA ONTARIO
ADJ7737970
MARIA ROSALES
LOS ANGELES COUNTY
SEDGWICK COLA ONTARIO
ADJ7894189
EDDIE CHISM
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
ADJ7981874
JANEEN CAUDILLO
COUNTY OF LOS ANGELES DEPT OF
SEDGWICK COLA ONTARIO
CHILDREN FAMILY SERVICES ADJ8071516
ZHENIK AKOPYAN
COUNTY OF L A DEPT OF CHILDREN
SEDGWICK COLA ONTARIO
FAM ADJ8190096
OSCAR PLACENCIA
L A COUNTY DEPT OF SOCIAL
SEDGWICK COLA ONTARIO
SERVICES ADJ8319064
DAVID TRAN
COUNTY OF LOS ANGELES
SEDGWICK COLA ONTARIO
ADJ8376730
GLORIA ALVAREZ
COUNTY OF LOS ANGELES DEPT OF
SEDGWICK COLA ONTARIO
ADJ970109
JAMES WILBURN
HOUSING AUTHORITY OF L.A.
SEDGWICK COLA ONTARIO
ADJ1009051
FEDERICO MOSSIEU
AMERICAN RED CROSS
SEDGWICK CONCORD
ADJ1763727
MARTIN ERICKSON
MOUNTAIN HIGH SKI RESORT
SEDGWICK CONCORD
ADJ1931014
PATRICIA CALDERON
FEDERAL EXPRESS
SEDGWICK CONCORD
PUBLIC SOCIAL SERVICES
Page 52
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ433160
JUAN MORENO
FARA
SEDGWICK CONCORD
ADJ433160
JUAN MORENO
HOLLYWOOD PARK
SEDGWICK CONCORD
ADJ433160
JUAN MORENO
HOLLYWOOD PARK OPERATIN
SEDGWICK CONCORD
COMPANY ADJ2441835
ANNETTE NAJERA
KAISER PERMANENTE
SEDGWICK KAISER LEXINGTON
ADJ3536224
JOANNE BRETADO
KAISER PERMANENTE
SEDGWICK KAISER LEXINGTON
ADJ3566452
ROBERTO VELAZQUEZ
KAISER FOUNDATION HOSPITALS
SEDGWICK KAISER LEXINGTON
ADJ4540979
VICKY MARINO
KAISER PERMANENTE
SEDGWICK KAISER LEXINGTON
ADJ6675613
LEMUEL NAVARRETE
KAISER PERMANENTE REGIONAL LAB
SEDGWICK KAISER LEXINGTON
ADJ6675894
LEMUEL NAVARRETE
KAISER PERMANENTE REGIONAL LAB
SEDGWICK KAISER LEXINGTON
ADJ6788922
JOSEPH ROMERO
KAISER PERMANENTE
SEDGWICK KAISER LEXINGTON
ADJ6802971
MARIA BARRIERE
KAISER FOUNDATION HOSPITAL
SEDGWICK KAISER LEXINGTON
ADJ6808327
RENEE WEDGEWORTH
KAISER PERMANENTE
SEDGWICK KAISER LEXINGTON SEDGWICK KAISER LEXINGTON
GLASS ADJ7233713
TANYA WASHINGTON
KAISER PERMANENTE MEDICAL
ADJ7758348
CLAUDIA IBARRA
SOUTHERN CALIFORNIA
GROUP SEDGWICK KAISER LEXINGTON
PERMANENTE MEDICAL GROUP ADJ1556592
BETTE DAVIS
VAN NUYS HIGH SCHOOL
SEDGWICK PASADENA
ADJ2355924
MARIA FABRO
LAUSD
SEDGWICK PASADENA
ADJ2380797
RAMON DELEON
AMERICAN HONDA MOTOR CO
SEDGWICK PASADENA
ADJ2832636
HAROLD HAMILTON
LAUSD
SEDGWICK PASADENA
ADJ2889330
ALAN FRIEDMAN
LAUSD
SEDGWICK PASADENA
ADJ3447105
JOSEFINA GARCIA
L.A.U.S.D.,(52ND ST. ELEM. SCHOOL)
SEDGWICK PASADENA
ADJ3447105
JOSEFINA GARCIA
LOS ANGELES UNIFIED SCHOOL DIST
SEDGWICK PASADENA
ADJ3448289
ANGELA WIENCKOWSKI
LAUSD
SEDGWICK PASADENA
ADJ3671720
ESMERALDA MARISCAL
L.A.U.S.D.
SEDGWICK PASADENA
ADJ3750605
JOSE LEM
LAUSD
SEDGWICK PASADENA
ADJ3850642
MARIA DE LA LUZ FLORES
PACOIMA ELEMENTARY
SEDGWICK PASADENA
ADJ3933377
MARIA PARRA
CITY OF LOS ANGELES/LAPD
SEDGWICK PASADENA
ADJ3933377
MARIA PARRA
LORETO STREET ELEMENTARY
SEDGWICK PASADENA
ADJ3963872
MADELINE NAVA
LAUSD
SEDGWICK PASADENA
ADJ526914
HILDA PENA TEJEDA
LAUSD
SEDGWICK PASADENA
ADJ6697750
LINDA WALKER
WALGREENS
SEDGWICK PASADENA
ADJ6772864
PHILLIS NEWBORN
LOS ANGELES UNIFIED SCHOOL
SEDGWICK PASADENA
DISTRICT ADJ6856825
DELIA GOMEZ
LAUSD
SEDGWICK PASADENA
ADJ6868829
JUAN SOSA
LOS ANGELES UNIFIED SCHOOL
SEDGWICK PASADENA
ADJ705672
DORLENE PICAZZO
LOS ANGELES USD
SEDGWICK PASADENA
ADJ7457611
BRENDA INOUYE
LAUSD
SEDGWICK PASADENA
ADJ7639876
MIGUEL RODRIGUEZ
LAUSD EL CAMINO REAL HIGH
SEDGWICK PASADENA
DISTRICT
SCHOOL
Page 53
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ8013569
GARLAND GOFF
LAUSD MLK ELEMENTARY
SEDGWICK PASADENA
ADJ8079888
LAURIE TALSTAD KEIDSER
RALPHS GROCERY COMPANY
SEDGWICK PASADENA
ADJ8215051
NORBERT NAGY
SEARS HOLDINGS CORP
SEDGWICK PASADENA
ADJ8255357
HOWARD CHAREST
LOS ANGELES UNIFIED SCHOOL
SEDGWICK PASADENA
DISTRICT ADJ8301880
LINDA ESCOBAR
LOS ANGELES UNIFIED SCHOOL
SEDGWICK PASADENA
DISTRICT ADJ8333198
JAMES WRIGHT
LOS ANGELES UNIFIED SCHOOL
SEDGWICK PASADENA
DISTRICT ADJ1026795
MARIA YOLANDA
PACTIV CORPORATION
SEDGWICK PLEASANTON
LUNDGREN ADJ2857709
ROBERT WALL
AIRBORNE EXPRESS
SEDGWICK PLEASANTON
ADJ325203
ANITA SCHAEFFER
ADMINISTAFF CO INC
SEDGWICK PLEASANTON
ADJ325203
ANITA SCHAEFFER
ARGUS PRO HEALTH
SEDGWICK PLEASANTON
ADJ4023065
MARTHA MILLAN
USC UNIVERSITY HOSPITAL
SEDGWICK PLEASANTON
ADJ4274181
VICKI OBRIEN
SIERRA VISTA HOSPITAL
SEDGWICK PLEASANTON
ADJ4274181
VICKI OBRIEN
SIERRA VISTA REGIONAL MEDICAL
SEDGWICK PLEASANTON
CTR. ADJ6523020
JOSEPH EMMERSON
JOANN FABRICS
SEDGWICK PLEASANTON
ADJ654833
RACHAEL RODRIGUEZ
PIER 1 IMPORTS
SEDGWICK PLEASANTON
ADJ6852886
CHRISTOPHER MOORE
G-2 SECURE STAFF
SEDGWICK PLEASANTON
ADJ7330115
CLAUDIA CALDERA
RENT A WHEEL
SEDGWICK PLEASANTON
ADJ8173814
LUISA YANEZ
DOUBLETREE HOTEL
SEDGWICK PLEASANTON SEDGWICK PORTLAND
ADJ1364504
NARCISO GALENO
EUREST DINING SERVICES
ADJ3571910
MARIA TERESA AGUILAR
CROTHALL HEALTHCARE INC
SEDGWICK PORTLAND
ADJ3941567
RICHARD BURSON
PARKHOUSE TIRE INC
SEDGWICK PORTLAND
ADJ518971
ANGEL ESPINOZA
BON APPETIT MANAGEMENT
SEDGWICK PORTLAND
ADJ7231496
SOKHEOUN SUM
JAI BY WOLFGANG PUCK
ADJ989058
RICARDO CAMPOS
COMPANY SEDGWICK PORTLAND SEDGWICK PORTLAND
ADJ1673870
SOFIA CERDA
99 CENTS ONLY STORE
SEDGWICK RIVERSIDE
ADJ2192468
PAUL DRUSKY
INITIAL SECURITY
SEDGWICK RIVERSIDE
ADJ2903253
LINDA GARCIA
TYCO ELECTRONICS
SEDGWICK RIVERSIDE
ADJ3756945
DORIS AYALA
99 CENT ONLY STORE
SEDGWICK RIVERSIDE
ADJ7320812
ELIAS AGUILAR
BRIDGESTONE AMERICA TIRE
SEDGWICK RIVERSIDE
OPERATIONS ADJ7530594
MARIA BOZULICH
TXI RIVERSIDE CEMENTO
SEDGWICK RIVERSIDE
ADJ8100680
FINLEY LIDDELL
GENERAL MOTORS
SEDGWICK RIVERSIDE
ADJ8402781
CHUCK TIFFANY
CANTERBURY BASEBALL LLC AKA
SEDGWICK RIVERSIDE
FLORENCE FREEDOM ADJ8402781
CHUCK TIFFANY
GRAND PRAIRIE PROFESSIONAL
SEDGWICK RIVERSIDE
BASEBALL LP ADJ8402781
CHUCK TIFFANY
HAWAII BASEBALL LLC
SEDGWICK RIVERSIDE
ADJ8402781
CHUCK TIFFANY
LOS ANGELES DODGERS
SEDGWICK RIVERSIDE
ADJ8402781
CHUCK TIFFANY
ST GEORGE ROADRUNNERS ET AL
SEDGWICK RIVERSIDE
ADJ1861342
DAWN WALKER
SKYWEST AIRLINES
SEDGWICK ROSEVILLE
Page 54
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ6748556
ALBERT AGUILERA
WALGREENS PHARMACY
SEDGWICK ROSEVILLE
ADJ1196862
CECILIA ARMENTA
UCLA BILLING DEPT
SEDGWICK UC 14533 LOS ANGELES
ADJ1677424
JEANNE LAPORTE AKA
UCLA
SEDGWICK UC 14533 LOS ANGELES
MCCONNEL ADJ1751617
RITA WORTHEY
UCLA MEDICAL CENTER
SEDGWICK UC 14533 LOS ANGELES
ADJ262105
BRIAN SWINK
UCLA MEDICAL PLAZA
SEDGWICK UC 14533 LOS ANGELES SEDGWICK UC 14533 LOS ANGELES
ADJ262105
BRIAN SWINK
UCLA ORTHOPEDIC CLINIC
ADJ3287868
LILIANA CHALABI
UCLA MEDICAL CNTR
SEDGWICK UC 14533 LOS ANGELES
ADJ3555060
JEANNE LAPORTE AKA
UCLA
SEDGWICK UC 14533 LOS ANGELES
MCCONNEL ADJ4023065
MARTHA MILLAN
USC UNIVERSITY HOSPITAL
SEDGWICK UC 14533 LOS ANGELES
ADJ6567956
MATTY CAMPOS
USC
SEDGWICK UC 14533 LOS ANGELES
ADJ7467133
MITCHELL MCCONNELL
UCLA
SEDGWICK UC 14533 LOS ANGELES
ADJ7607486
HILARIO LARRY HARO
REGENTS OF THE UNIVERSITY OF CA
SEDGWICK UC 14533 LOS ANGELES
ADJ7985110
FLOR CALLEJAS SANDOVAL
UCLA MEDICAL CENTER
SEDGWICK UC 14533 LOS ANGELES
ADJ2247649
KIM FOSTER
UNIVERSITY CORPORATION
SEDGWICK UC 14533 ROSEVILLE
ADJ6860128
AMANDA RUSSELL
THE UNIVERSITY CORPORATION
SEDGWICK UC 14533 ROSEVILLE
ADJ2898424
ANTONIA LOPEZ
ST BERNARDINE MEDICAL CENTER
SEDGWICK VAN NUYS
ADJ3369750
JAMES DAVISON
ST. MARY MEDICAL CENTER
SEDGWICK VAN NUYS
ADJ4001050
ALICIA CRUZ
CALIFORNIA HOSPITAL MEDICAL
SEDGWICK VAN NUYS
CENTER ADJ721984
CARLOTA HERNANDEZ
ST JOHNS REGIONAL MEDICAL
SEDGWICK VAN NUYS
CENTER ADJ7649727
LORENA WAGNER
CATHOLIC HEALTHCARE WEST
SEDGWICK VAN NUYS
ADJ2562769
FARAHNAZ JAHANBAHSH
TARGET STORE
SEDGWICK WALNUT CREEK
ADJ3832099
MARY PANINGSORO
U.S. AIRWAYS
SEDGWICK WALNUT CREEK
ADJ3832099
MARY PANINGSORO
US AIRWAYS
SEDGWICK WALNUT CREEK
ADJ4087514
ERMELINDA HARWOOD
DURHAM SCHOOL SERVICE
SEDGWICK WALNUT CREEK
OCHOA ADJ6815852
KENNETH GOSSETT
AMERICAN MEDICAL RESPONSE
SEDGWICK WALNUT CREEK
ADJ7175248
KARAPET TOROSYAN
COACH AMERICA
SEDGWICK WALNUT CREEK
ADJ7775441
CYNTHIA BROWN
JENNY CRAIG
SEDGWICK WALNUT CREEK
ADJ7848459
JOHN TU
NATIONAL EXPRESS CORPORATION
SEDGWICK WALNUT CREEK
ADJ8088757
MARCELINA MIRANDA
TARGET
SEDGWICK WALNUT CREEK SEDGWICK WALNUT CREEK
ADJ8416850
MARIA ALBANES
TARGET
ADJ1321545
SUSAN CHOW
RALPHS BROGERY
SELF INSURED
ADJ3345793
ROSENDO VELIZ
FAIRCHILD FASTENER GRP
SELF INSURERS SECURITY FUND OAKLAND
ADJ2449825
FILIBERTO LEON
NC DYNAMICS
SENTRY SELECT STEVENS POINT
ADJ3272542
DANIEL CRUZ
BARROT CORPORATION
SENTRY SELECT STEVENS POINT
ADJ6748095
JUAN ZAMORA
AY MAC PRECISION INC
SENTRY SELECT STEVENS POINT
ADJ7224279
MARINA BALTAZAR
KELLWOOD COMPANY
SENTRY SELECT STEVENS POINT
ADJ7395721
MONICA BECERRA
GUESS INC
SENTRY SELECT STEVENS POINT
Page 55
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7585034
IGNACIO RODRIGUEZ
BEST BRANDS CORPORATION CMS
SENTRY SELECT STEVENS POINT
BAKERY PRODUCTS ADJ7946553
MARCELINO CERVANTES
KAP MEDICAL
SENTRY SELECT STEVENS POINT
ADJ7285453
MARIA VARGAS
SMURFIT STONE
SMURFIT STONE
ADJ7854015
LARRY FLORES
SO CA GAS COMPANY
SO CA GAS COMPANY SO CALIF GAS COMPANY
ADJ8124745
ZAKEE SINGLETON
SO CALIF GAS COMPANY
ADJ6912077
VICENTE VARGAS
SOLAR TURBINES
SOLAR TURBINES
ADJ6912077
VICENTE VARGAS
SOLAR TURBINES
SOLAR TURBINES SAN DIEGO
ADJ1347189
EDWARD FROST
SOUTHERN CALIFORNIA EDISON CO
SOUTHERN CAL EDISON ROSEMEAD
ADJ259380
BENITO LASCANO
SOUTHERN CALIFORNIA EDISON CO
SOUTHERN CAL EDISON ROSEMEAD
ADJ2631422
KENNETH PRUIKSMA
SOUTHERN CALIFORNIA EDISON CO
SOUTHERN CAL EDISON ROSEMEAD
ADJ2664799
MICHELLE CUNNINGHAM
SOUTHERN CALIFORNIA EDISON
SOUTHERN CAL EDISON ROSEMEAD
ADJ2664799
MICHELLE CUNNINGHAM
SOUTHERN CALIFORNIA EDISON CO
SOUTHERN CAL EDISON ROSEMEAD
ADJ518335
VIRGINIA DIZON
SOUTHERN CALIFORNIA EDISON
SOUTHERN CAL EDISON ROSEMEAD
ADJ706831
RICHARD TERHAAR
SO CAL EDISON CO
SOUTHERN CAL EDISON ROSEMEAD
ADJ157733
FRANK FRUTOS
SOUTHERN CALIFORNIA GAS CO
SOUTHERN CAL GAS LOS ANGELES
ADJ3081053
ROBERT REEVES
SO CAL GAS CO
SOUTHERN CAL GAS LOS ANGELES
ADJ3339216
JESSE ALEX GRIJALVA
SOUTHERN CALIFORNIA GAS CO
SOUTHERN CAL GAS LOS ANGELES
ADJ3861762
LORENZO RAMIREZ
SOUTHERN CALIFORNIA GAS CO
SOUTHERN CAL GAS LOS ANGELES
ADJ4524362
BARBARA HAMILTON
SOUTHERN CALIFORNIA GAS CO
SOUTHERN CAL GAS LOS ANGELES
ADJ649840
BELINDA MIRANDA
SOUTHERN CALIFORNIA GAS CO
SOUTHERN CAL GAS LOS ANGELES
ADJ7394745
VIVIAN ALVAREZ
SO CAL GAS CO
SOUTHERN CAL GAS LOS ANGELES
ADJ7694783
RUSSELL DAHLQUIST
SOUTHERN CALIFORNIA GAS
SOUTHERN CAL GAS LOS ANGELES
COMPANY ADJ7854015
LARRY FLORES
SO CA GAS COMPANY
SOUTHERN CAL GAS LOS ANGELES
ADJ8124745 ADJ8252289
ZAKEE SINGLETON
SO CALIF GAS COMPANY
SOUTHERN CAL GAS LOS ANGELES
MANUEL SILVA
SOUTHERN CALIFORNIA GAS
SOUTHERN CAL GAS LOS ANGELES
COMPANY ADJ8689797
ROSALYN SQUIRES
SOUTHERN CALIFORNIA GAS
SOUTHERN CAL GAS LOS ANGELES
COMPANY ADJ1369161
JUDY GHORBANZADEH
VENTURA UNIFIED SCHOOL DIST
SOUTHERN CALIF RISK MGMT ASSOC
ADJ1369161
JUDY GHORBANZADEH
VENTURA UNIFIED SCHOOL DISTRICT
SOUTHERN CALIF RISK MGMT ASSOC
ADJ1347189
EDWARD FROST
SOUTHERN CALIFORNIA EDISON CO
SOUTHERN CALIF. EDISON
ADJ2770564
JAMES DAGEN
SOUTHERN CALIFORNIA EDISON
SOUTHERN CALIFORNIA EDISON
ADJ518335
VIRGINIA DIZON
SOUTHERN CALIFORNIA EDISON
SOUTHERN CALIFORNIA EDISON
ADJ157733
FRANK FRUTOS
SOUTHERN CALIFORNIA GAS CO
SOUTHERN CALIFORNIA GAS COMPANY
ADJ7510609
SALVADOR AGUIRRE
SOUTHERN CALIFORNIA GAS
SOUTHERN CALIFORNIA GAS COMPANY
COMPANY ADJ8689797
ROSALYN SQUIRES
SOUTHERN CALIFORNIA GAS COMPANY
Page 56
SOUTHERN CALIFORNIA GAS COMPANY
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7758348
CLAUDIA IBARRA
SOUTHERN CALIFORNIA
SOUTHERN CALIFORNIA PERMANENTE MEDICAL
PERMANENTE MEDICAL GROUP
GROUP
ADJ112728
EDWARD ROSS
SAVE ON / CVS PHARMACY
SPECIALTY RISK BREA
ADJ2235851
JUDY NABER
NEW ALBERTSONS
SPECIALTY RISK BREA
ADJ2924625
CATHERINE TARBET
ALBERTSON'S
SPECIALTY RISK BREA
ADJ3387029
SAVERIO BADALAMENTI
ALBERTSON'S
SPECIALTY RISK BREA
ADJ4013338
IRMA OLAQUE
LAIDLAW TRANSIT
SPECIALTY RISK BREA
ADJ4250514
ROSA DIAZ
ALBERTSONS
SPECIALTY RISK BREA
ADJ4451572
RUBEN VIGIL
ALBERTSON'S MARKET
SPECIALTY RISK BREA
ADJ6669016
ADRIANA NAVASARNIAN
ALBERTSONS
SPECIALTY RISK BREA
ADJ7271110
SUSIE MARTINEZ
ALBERTSONS
SPECIALTY RISK BREA
ADJ8357411
MARIA LARA
FRESH GRILL FOODS
SPECIALTY RISK BREA SPECIALTY RISK BREA
ADJ8667338
FRANCIS APONTE
ALBERTSONS INC
ADJ8832169
CRISTIAN CARDOZA
TIPP ENTERPRISES LP
SPECIALTY RISK BREA
ADJ2960595
CHARLYN DAVIS
TROYER CONTRACTING
SPECIALTY RISK DALLAS
ADJ6980403
DENESE DAVIDSON
AMERICAN CORPORATE SECURITY
SPECIALTY RISK DALLAS
ADJ7382345
FLORENCE GALBRAITH
JOANNE STORES
SPECIALTY RISK LEXINGTON
ADJ2092179
RONNIE WALTON
COACH USA
SPECIALTY RISK RIVERSIDE
ADJ2195921
SARA CHAVARRIA
EMBASSY SUITES
SPECIALTY RISK RIVERSIDE
ADJ4083006
BRUCE ALLEN
CERRITOS PONTIAC
SPECIALTY RISK RIVERSIDE
ADJ6477524
LUIS ACHTMANN
CENVEO ANDERSON LITHOGRAPH
SPECIALTY RISK RIVERSIDE
ADJ7374887
MICHAEL MARTINEZ
PIRTEK COMMERCE
SPECIALTY RISK RIVERSIDE
ADJ7930898
GLORIA ESTRADA
ACCENT CARE
SPECIALTY RISK RIVERSIDE
ADJ8198015
LLOYD CRABTREE
J AND L MANAGEMENT LLC
SPECIALTY RISK RIVERSIDE
ADJ3917943
PETER CASAREZ
UNIFIED WESTERN GROCERS
SPRINGFIELD COVINA
ADJ6678787
CLAUDIA ADAME
VALLARTA SUPERMARKET
SPRINGFIELD COVINA
ADJ8119925
JOSE ROSALES
SUPER KING MARKET
SPRINGFIELD COVINA
ADJ3369750
JAMES DAVISON
ST. MARY MEDICAL CENTER
ST MARY MEDICAL CENTER
ADJ2654604
PRISCILLA MAYS
ACS
ST PAUL FIRE & MARINE INS CO
ADJ1056467
RODERICK DECKER
BANSHEE CONSTRUCTION COMPANY
ST. PAUL FIRE & MARINE
ADJ1056467
RODERICK DECKER
URS CONSULTING THORTEC
ST. PAUL FIRE & MARINE
ADJ446889
DAVID HUERTA
ACI GLASS PRODUCTS
ST. PAUL TRAVELERS
ADJ136846
ELEAZAR VAZQUEZ
GOLDEN STATE TRANSPORT
STAFFING CONCEPTS, INC.
ADJ2153519
WILLIAM LITMAN
ANACAPA HOSPITAL
STATE COMP INS FUND
ADJ2295179
ANNETTE FRANCO
TECHSTYLES
STATE COMP INS FUND
ADJ3288473
AURORA REALIVASQUEZ
TUR-BO JET PRODUCTS CO INC
STATE COMP INS FUND
ADJ3304807
DEBRA COURTNEY
CAMARILLO STATE HOSPITAL
STATE COMP INS FUND
ADJ1123160
ROBERT STONE
IDEAL HOME IMPROVEMENT
STATE COMPENSATION INSURANCE FUND
ADJ1581910
LINDA BELSHE
CAL STATE UNIVERSITY LONG BEACH
STATE COMPENSATION INSURANCE FUND
ADJ1581910
LINDA BELSHE
CSULB FOUNDATION
STATE COMPENSATION INSURANCE FUND
Page 57
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ1709179
ED BYNG
CALVARY CHAPEL OF COSTA MESA
STATE COMPENSATION INSURANCE FUND
ADJ3065398
SHARON BEALES
CAL-LIFT INC
STATE COMPENSATION INSURANCE FUND
ADJ3224593
GREGORY MAYER
LINDERO MASONRY
STATE COMPENSATION INSURANCE FUND
ADJ3398419
JOSE TORRECILLAS
RICHARD G. SIMPSON
STATE COMPENSATION INSURANCE FUND
CONSTRUCTION ADJ3494021
CATHERINA YOUNG
EASTER SEALS
ADJ3815656
LINDA SCOTT
STATE COMP. INSRUANCE FUND
STATE COMPENSATION INSURANCE FUND STATE COMPENSATION INSURANCE FUND/STATE COMP INSURANCE FUND
ADJ3815656
LINDA SCOTT
STATE COMPENSATION INSURANCE
ADJ1054155
HIRITI OKUBAMICHAEL
ADJ1683484
MONICA FUENTES
I.P.M. SURGERY CENTER, INC.
STATE FARM 21567 BAKERSFIELD CLOSED
ADJ2131225
LETTIE O BRIEN
KEEPSAKES
STATE FARM 21567 BAKERSFIELD CLOSED
ADJ2147000
ARTURO NAJERA
KISMAT ENTERPRISES DBA JIFFY LUBE
STATE FARM 21567 BAKERSFIELD CLOSED
ADJ3451202
MIRIAM SCHATZ
ROSTAM KAVOOSSI MD
STATE FARM 21567 BAKERSFIELD CLOSED
FUND
STATE COMPENSATION INSURANCE FUND/STATE COMP INSURANCE FUND STATE FARM 21567 BAKERSFIELD CLOSED
ADJ1498258
SIMINDOHT SHAFIGI
DAVID B. ANDERSON, M.D.
STATE FARM BAKERSFIELD
ADJ2057887
PEDRO MEDINA
XEROGRAPHIC COMPATIBLES INC
STATE FARM BAKERSFIELD
ADJ399293
CINDY PIERCE PALMER
CANINE CAROUSEL
STATE FARM BAKERSFIELD
ADJ4116298
CATHERINE FLORES
JOHN VOLLERS
STATE FARM BAKERSFIELD
ADJ4594818
MARIA AGUILAR
MITCHEL SILVERMAN M.D
STATE FARM BAKERSFIELD
ADJ6651681
HARVEY BRESCH
MELINDA MCCOYS FLOWERS
STATE FARM BAKERSFIELD
ADJ6663281
GLORIA CRUZ
HOUSE OF BRIDES
STATE FARM BAKERSFIELD
ADJ7428121
OBDULIA BARRERA
ALLAN AND CAROLINE NAKKEN
STATE FARM BAKERSFIELD
ADJ7876007
NICOLE JACOBS
THE BONE ADVENTURE INC
STATE FARM BAKERSFIELD
ADJ6992217
DOROTHY LOPEZ
STATE OF CALIFORNIA CHP
STATE OF CALIFORNIA CHP
ADJ8199704
OLIVER ROSS
ARIZONA CARDINALS
STATE WORKERS INS FUND POTTSVILLE
ADJ2717587
MICHAEL KRUGER
RANCHO SANTIAG COM COLLEGE
SUPERIOR INDUSTRIES/SOUTHERN CALIF RISK
ADJ2717587
MICHAEL KRUGER
RANCHO SANTIAGO COMMUNITY
SUPERIOR INDUSTRIES/SOUTHERN CALIF RISK
COLLEGE
MNGMNT ASSOC
MNGMNT ASSOC
ADJ576480
ARSENIO GARCIA
TEMPSTAR SERVICES
SUPERIOR NATIONAL INSURANCE CO
ADJ576480
ARSENIO GARCIA
WET SEAL
SUPERIOR NATIONAL INSURANCE CO
ADJ1030458
ARTURO GUTIERREZ
R.G.S. SERVICE
SUPERIOR NATIONAL INSURANCE
ADJ1291083
JESUS DURAN
HEADWAY STAFFING
SUPERIOR NATIONAL INSURANCE CO/PRIVATE
ADJ7798560
JANE WOHLFEIL
SWIFT TRANSPORTATION
ADJ7318795
ELIZABETH WILLIS
THE KROGER COMPANY
THE KROGER COMPANY
ADJ8235740
STEVEN STORM
THIBIANT INTERNATIONAL INC
THIBIANT INTERNATIONAL INC
ADJ2757596
SERGIO VALENZUELA
ELITE PERSONNEL SERVICE
TOKIO MARINE PASADENA
ADJ2757596
SERGIO VALENZUELA
SOUTHLAND BOX CO.
TOKIO MARINE PASADENA
ADJ7483200
FEDERICO GUTIERREZ
K-YUGE NURSERY
TOKIO MARINE PASADENA
CO/BROADSPIRE ADJUSTING CLAIMS SERVICES
Page 58
SWIFT TRANSPORTATION
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ8275983
NGOC HOANG
PANASONIC CORPORATION OF
TOKIO MARINE PASADENA
NORTH ADJ8351265
TAIK AHN
MITSUWA
TOKIO MARINE PASADENA
ADJ8004073
EVELEEN IBRAHIM
TORRANCE UNIFIED SCHOOL
TORRANCE UNIFIED SCHOOL DISTRICT
ADJ7503235
RICARDO HERNANDEZ
SIMONIZ JANSS MALL
TOWER NATIONAL INSURANCE IRVINE
ADJ7437470
JOSE BECERRA
COAST CHEM EXTERMINATING
TOWER SELECT INSURANCE IRVINE
ADJ105997
SAMUEL HYNES
TAMCO STEEL
TRAVELERS DIAMOND BAR
ADJ1187017
ELISA ANAYA
HARMAN BECKER CALIFORNIA
TRAVELERS DIAMOND BAR
ADJ1471922
FRANCISCO MANZO
PROFESSIONAL COMMUNITY
TRAVELERS DIAMOND BAR
DISTRICT
MANAGEMENT ADJ1471922
FRANCISCO MANZO
PROFESSIONAL COMMUNITY MGMT
TRAVELERS DIAMOND BAR TRAVELERS DIAMOND BAR
ADJ167663
SANTIAGO RUIZ
DIAMOND MATTRESS
ADJ1996703
NUBIA STERTZ
COMMERCE CASINO
TRAVELERS DIAMOND BAR
ADJ2063594
PRESCILIANO LAGUNA
NORTH AMERICAN TEXTILE CO
TRAVELERS DIAMOND BAR
ADJ2276309
MARILYN JOHNSON
INVENSYS/ROBERTSHAW CONTROLS
TRAVELERS DIAMOND BAR
ADJ2875340
DUNG NGUYEN
STANDARD CONCRETE PRODUCTS
TRAVELERS DIAMOND BAR
ADJ3395228
DANIEL MERCHAIN
GARFIELD MEDICAL CENTER
TRAVELERS DIAMOND BAR
ADJ3545303
TENNE PHAM
HAWAIIAN GARDENS CASINO
TRAVELERS DIAMOND BAR
ADJ3566964
CHRISTOPHER ARDEN
LITTLE CAESAR ENTERPRISES
TRAVELERS DIAMOND BAR
ADJ3732140
GARY SIMS
BOYD COFFEE CO
TRAVELERS DIAMOND BAR
ADJ3773431
RICARDO GARCIA
TELAIR INTERNATIONAL
TRAVELERS DIAMOND BAR
ADJ3844647
JUAN JOSE MARTINEZ
FORWARD AIR, INC.
TRAVELERS DIAMOND BAR
ADJ388925
ELIS MORENO
PRIME WHEEL
TRAVELERS DIAMOND BAR
ADJ388925
ELIS MORENO
PRIME WHEEL CORPORATION
TRAVELERS DIAMOND BAR
ADJ3924904
MARIO CHAVEZ PINEDA
COROVAN/EMPLOYEES LEASING CO.
TRAVELERS DIAMOND BAR
ADJ3957764
LUZ VILLAREAL
TRAVELERS DIAMOND BAR
ADJ4083029
MARILU RUIZ
HARBOR FREIGHT
TRAVELERS DIAMOND BAR
ADJ433160
JUAN MORENO
FARA
TRAVELERS DIAMOND BAR
ADJ433160
JUAN MORENO
HOLLYWOOD PARK
TRAVELERS DIAMOND BAR
ADJ433160
JUAN MORENO
HOLLYWOOD PARK OPERATIN
TRAVELERS DIAMOND BAR
COMPANY ADJ532945
ROSA ROSALES
COMMODITY SALES
TRAVELERS DIAMOND BAR
ADJ6599389
FEDERICO QUINTOR
SCANTRON
TRAVELERS DIAMOND BAR
ADJ6648531
JOSE DIAZ CERVANTEZ
KLAUSSNER FURNITURE
TRAVELERS DIAMOND BAR
ADJ6665748
FRANK PAU
BEVERLY HILLS PROPERTIES
TRAVELERS DIAMOND BAR
ADJ6678787
CLAUDIA ADAME
VALLARTA SUPERMARKET
TRAVELERS DIAMOND BAR
ADJ6788515
CIRA ROJAS HERNANDEZ
CARLS JR
TRAVELERS DIAMOND BAR
ADJ6821725
BELINDA MILLER
ACCREDITED NURSING CARE
TRAVELERS DIAMOND BAR
ADJ6852886
CHRISTOPHER MOORE
G-2 SECURE STAFF
TRAVELERS DIAMOND BAR
ADJ6870638
ALBA ZUNIGA
TRAVELERS DIAMOND BAR
ADJ7060329
MEHDI EBRAHIMI
REHAB CARE GROUP
TRAVELERS DIAMOND BAR
ADJ7070483
ANDRES JIMENEZ
MCMASTER CARR SUPPLY CO
TRAVELERS DIAMOND BAR
Page 59
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7114141
LUPE PARRA
EUROSTAR INC
TRAVELERS DIAMOND BAR
ADJ7207474
YASSAH TROBEL
CITRUS VALLEY HEALTH PARTNERS
TRAVELERS DIAMOND BAR
ADJ7350428
RIGOBERTO JIMENEZ
INTERNATIONAL SEAL
TRAVELERS DIAMOND BAR
ADJ7428121
OBDULIA BARRERA
ALLAN AND CAROLINE NAKKEN
TRAVELERS DIAMOND BAR
ADJ7430944
GHAZALEH F ABEDALI
PACIFIC DENTAL SERVICES INC
TRAVELERS DIAMOND BAR
ADJ7486853
ALBERTO NUNEZ
SEPHORA USA INC
TRAVELERS DIAMOND BAR
ADJ7509981
BARBARA NIXTER
WHITTIER HOSPITAL MEDICAL
TRAVELERS DIAMOND BAR
CENTER ADJ7586053
GLENDY VALDEZ
CARL`S JR
TRAVELERS DIAMOND BAR
ADJ7638558
SALOMON VALENTE
CAPITAL SEAFOOD GROUP
TRAVELERS DIAMOND BAR
ADJ7665121
RAMON GONZALEZ
FLOWSERVE CORPORATION
TRAVELERS DIAMOND BAR
ADJ7692898
MARIA RODRIGUEZ
NIAGRA BOTTLING
TRAVELERS DIAMOND BAR
ADJ7717483
BETTY VELASCO
JON DONAIRE
TRAVELERS DIAMOND BAR
ADJ7724535
DA VONGIE JENNINGS
MCMASTER CARR SUPPLY COMPANY
TRAVELERS DIAMOND BAR
ADJ7843507
ELEOBARDO PERFZ
CALIFORNIA LANDSCAPE & DESIGN
TRAVELERS DIAMOND BAR
ADJ8028774
JAVIER JAUREGUI
RICH PRODUCTS CORP
TRAVELERS DIAMOND BAR
ADJ8043623
LUIS BARRAGAN
GATE GOURMET
TRAVELERS DIAMOND BAR TRAVELERS DIAMOND BAR
ADJ8058366
BENCES MONDRAGON
CONESYS INC
ADJ8206945
VIRGINIA VELASQUEZ
RICH PRODUCTS CORP
TRAVELERS DIAMOND BAR
ADJ7302699
CERELA RUIZ
BROOKVALE INTERNATIONAL LLC
TRAVELERS INSURANCE HARTFORD
ADJ7302699
CERELA RUIZ
CALIFORNIA CARTAGE CO
TRAVELERS INSURANCE HARTFORD
ADJ7302699
CERELA RUIZ
RALLY MANAGEMENT STAFFING
TRAVELERS INSURANCE HARTFORD
ADJ1229451
LEONARD SITA
QUEST SOFTWARE INC
TRAVELERS ORANGE
ADJ1548254
LAWRENCE GONZALEZ
TIMEC
TRAVELERS ORANGE
ADJ1548254
LAWRENCE GONZALEZ
TIMEC INC
TRAVELERS ORANGE
ADJ216576
EARL LEROY MENARY
HEALTHCARE SECURITY SERVICES
TRAVELERS ORANGE
ADJ2668772
CARLOS CARRILLO
ADECCO
TRAVELERS ORANGE
ADJ2715369
JOHN BAMBER
A O REED & COMPANY
TRAVELERS ORANGE
ADJ2715369
JOHN BAMBER
A.O. REED & COMPANY
TRAVELERS ORANGE
ADJ2973505
MANUEL OSUNA
CHERNE CONTRACTING
TRAVELERS ORANGE
CORPORATION ADJ3133395
DAVE INOSTROZA
FASTENAL CO
TRAVELERS ORANGE
ADJ3732140
GARY SIMS
BOYD COFFEE CO
TRAVELERS ORANGE
ADJ388925
ELIS MORENO
PRIME WHEEL
TRAVELERS ORANGE
ADJ388925
ELIS MORENO
PRIME WHEEL CORPORATION
TRAVELERS ORANGE
ADJ4455236
MARIA VEGA
VIRCO MANUFACTURING CORP.
TRAVELERS ORANGE
ADJ6821725
BELINDA MILLER
ACCREDITED NURSING CARE
TRAVELERS ORANGE
ADJ6985332
FAKHRI TAHERI
IHASET
TRAVELERS ORANGE
ADJ7427772
ANITA HERNANDEZ
MOLINA
TRAVELERS ORANGE
ADJ2974796
PATSY COLLINS
RITE AID
TRAVELERS SACRAMENTO
ADJ6804556
YOLANDA ALDANA
QUEEN BEACH PRINTERS INC
TRAVELERS SACRAMENTO
ADJ6875186
ESPERANZA MORALES
RITE AID
TRAVELERS SACRAMENTO
ADJ7600109
BRENDA NUNEZ
BECKSTROM POSTING INC
TRAVELERS SACRAMENTO
Page 60
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7762024
FLORIBERTA GALLEGOS
CALIFORNIA RICE CENTER
TRAVELERS SACRAMENTO
ADJ7923935
CRISTINA CALDERON
RITE AID CORPORATION
TRAVELERS SACRAMENTO
ADJ7968951
THONG VO
B K CORPORATION DBA B K
TRAVELERS SACRAMENTO
PRECISION ELECTRONIC TEST INSTRU ADJ8597972
CAROLINA IBLINGS
FIRST CUT ENTERPRISES
TRAVELERS SACRAMENTO
ADJ905419
DEBORAH GAY JEFFREY
EQUITY EXTERIOR INC.
TRAVELERS SACRAMENTO
ADJ1046661
LUZ VELIZ
BMK INC
TRAVELERS SAINT PAUL
ADJ1056467
RODERICK DECKER
BANSHEE CONSTRUCTION COMPANY
TRAVELERS SAINT PAUL
ADJ1056467
RODERICK DECKER
URS CONSULTING THORTEC
TRAVELERS SAINT PAUL
ADJ255494
JON RODEWALD
KOR BARNABEY'S LLC
TRAVELERS SAINT PAUL
ADJ2809626
SALVADOR COVARRUBIAS
ROSSCO HOLDINGS
TRAVELERS SAINT PAUL TRAVELERS SAINT PAUL
ADJ313584
RAYSELL VAUGHAN
POMEROY IT SOLUTION
ADJ4141695
ROSALVA SANDOVAL
PHOENIX SAHI PROPERTIES
TRAVELERS SAINT PAUL
ADJ7493212
FAREED BADAWI
UNITED INSURANCE
TRAVELERS SAINT PAUL
ADJ7932721
MARIA SOTO
MANAGEMENT APPLIED
TRAVELERS SAINT PAUL
PROGRAMMING INC ADJ1056467
RODERICK DECKER
BANSHEE CONSTRUCTION COMPANY
TRAVELERS WALNUT CREEK
ADJ1056467
RODERICK DECKER
URS CONSULTING THORTEC
TRAVELERS WALNUT CREEK
ADJ1480326
JENNIFER FRANK
CITIGROUP GLOBAL MARK
TRAVELERS WALNUT CREEK
BETANCOURT ADJ355156
MARTHA DIAZ
ADECO EMPLOYMENT SERVICES
TRAVELERS WALNUT CREEK
ADJ355156
MARTHA DIAZ
VOLT SERVICES GROUP
TRAVELERS WALNUT CREEK
ADJ4042638
RAMONA LOZANO
A RUDIN DESIGNS
TRAVELERS WALNUT CREEK
ADJ6748630
JESUS GARCIA
CLARK WESTERN BUILDING SYSTEMS
TRAVELERS WALNUT CREEK
ADJ6755119
MARGARITA MONTOYA
TOYS R US
TRAVELERS WALNUT CREEK
ADJ6966307
LUIS PINONES
ALLSCAPE ARCHITECTURAL
TRAVELERS WALNUT CREEK
LANDSCAPE LIGHTING ADJ6966307
LUIS PINONES
PHILIPS ELECTRONICS NORTH
TRAVELERS WALNUT CREEK
AMERICA CORPORATION ADJ7364504
RAQUEL RAMIREZ
BAXSTRA INC
TRAVELERS WALNUT CREEK
ADJ8137608
LOURDEZ RODRIGUEZ
TRUE FOOD KITCHEN
TRAVELERS WALNUT CREEK
QUINONEZ ADJ8242427
ESPERANZA QUEVEDO
MIKE THOMPSONS RV
TRAVELERS WALNUT CREEK
ADJ8608569
JOSE ALFREDO ANGELES
UEBTF LOS ANGELES
TRINITY INSURE SERVICES MANDEVILLE
ADJ2143562
DANNY BRADFIELD
LYNWOOD USD
TRISTAR 2805 SANTA ANA
ADJ2150534
LATRICIA GOFF
LONG BEACH TRANSIT
TRISTAR 2805 SANTA ANA
ADJ2429736
JOSE CARRILLO
ADJ2471312
ROSEMARY VAUGHN
COUNTY OF ORANGE
TRISTAR 2805 SANTA ANA
TRISTAR 2805 SANTA ANA
ADJ2471312
ROSEMARY VAUGHN
SUPERIOR COURT OF CA
TRISTAR 2805 SANTA ANA
ADJ4183226
CHERYL WRIGHT
LUCKY STORES
TRISTAR 2805 SANTA ANA
ADJ6515877
ROSA LUGO TRUJILLO
LAKE ELSINORE UNIFIED SCHOOL
TRISTAR 2805 SANTA ANA
DISTRICT ADJ2639360
JOHN HERNANDEZ
CITY OF LOS ANGELES
Page 61
TRISTAR 29104 GLENDALE
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ4370525
JAMES CARTER
CITY OF LOS ANGELES
TRISTAR 29104 GLENDALE
ADJ483721
JAMES CARTER
CITY OF LOS ANGELES
TRISTAR 29104 GLENDALE
ADJ1156697
OFELIA SARINO
CITY OF LOS ANGELES
TRISTAR 29106 GLENDALE
ADJ193017
DANIEL TAYLOR
CITY OF LOS ANGELES
TRISTAR 29106 GLENDALE
ADJ1940056
KARI RESH DAVIS
CITY OF LOS ANGELES
TRISTAR 29106 GLENDALE
ADJ221937
PHILLIP TATE
CITY OF LOS ANGELES
TRISTAR 29106 GLENDALE
ADJ2285995
ROBERT SAITO
CITY OF LOS ANGELES
TRISTAR 29106 GLENDALE
ADJ2757596
SERGIO VALENZUELA
ELITE PERSONNEL SERVICE
TRISTAR 29106 GLENDALE
ADJ2757596
SERGIO VALENZUELA
SOUTHLAND BOX CO.
TRISTAR 29106 GLENDALE
ADJ3678937
JEFFREY MULHEIM
CITY OF LOS ANGELES PSI
TRISTAR 29106 GLENDALE
ADJ475862
HOWARD CHAN
CITY OF LOS ANGELES
TRISTAR 29106 GLENDALE
ADJ6676244
MARLENE RAMOS
CITY OF LOS ANGELES
TRISTAR 29106 GLENDALE
ADJ7842154
MIKA NEAL
CITY OF LOS ANGELES
TRISTAR 29106 GLENDALE
ADJ8013900
BRENDA CASTRO
CITY OF LOS ANGELES
TRISTAR 29106 GLENDALE
ADJ2640679
GLORIA VASQUEZ
CEDARS SINAI MEDICAL CENTER
TRISTAR 880287 SAN DIEGO CLOSED
ADJ4457049
CHANDER ARORA
CEDARS SINAI MEDICAL GROUP
TRISTAR 880287 SAN DIEGO CLOSED
ADJ1638375
REINA SOLIS
RANSTAND WORK SOLUTION
TRISTAR BREA
ADJ7427348
ERNESTO PADILLA
LACNY LOGISTICS
TRISTAR BREA
ADJ7694812
SALIB MANSOUR
AMERICAN GUARD SERVICES
TRISTAR BREA
ADJ7735459
GHEORGHE MURESAN
NEW JERSEY NETS
TRISTAR BREA
ADJ7735459
GHEORGHE MURESAN
WASHINGTON WIZARDS
TRISTAR BREA
ADJ8069939
MIGUEL HERNANI
VALLARTA SUPERMARKETS #25
TRISTAR BREA
ADJ2950631
MARIAN SEATON
COUNTY OF LOS ANGELES
TRISTAR CONCORD
ADJ3345793
ROSENDO VELIZ
FAIRCHILD FASTENER GRP
TRISTAR CONCORD
ADJ4074598
LYDIA CASTILLO
INTERSTATE BRANDS
TRISTAR CONCORD
ADJ7814650
NATALIA KNOX
MARTIN LUTHER KING
TRISTAR IRVINE CLOSED
ADJ1066725
DARCUS TAYLOR
COUNTY OF L A/USC MED CNTR
TRISTAR LOS ANGELES
ADJ2246754
ANI KARAMANUKYAN
THERMADOR WASTE KING
TRISTAR LOS ANGELES
ADJ2246754
ANI KARAMANUKYAN
WASTE KING
TRISTAR LOS ANGELES
ADJ2459179
AGUSTIN CASTILLEJO
SUPERIOR INDUSTRIES
TRISTAR LOS ANGELES
INTERNATIONAL ADJ2640679
GLORIA VASQUEZ
CEDARS SINAI MEDICAL CENTER
TRISTAR LOS ANGELES
ADJ3620201
RICARDO PULIDO
CEDARS-SINAI HOSP
TRISTAR LOS ANGELES
ADJ4370507
ROSA TORRES
REMEDY TEMP INC.
TRISTAR LOS ANGELES
ADJ533246
JORGE PRIETO
COAST CONVERTER
TRISTAR LOS ANGELES
ADJ533246
JORGE PRIETO
COAST CONVERTERS
TRISTAR LOS ANGELES
ADJ8447841
SHARON GRANT BURTON
LONG BEACH USD
TRISTAR LOS ANGELES
ADJ602785
SANDRA CANDLER
RANCHO LOS AMIGOS
TRISTAR RISK MANAGEMENT
ADJ895382
LARRY WINSTON
CITY OF LOS ANGELES
TRISTAR RISK MANAGEMENT
ADJ1181919
JULIE SCHULTZ
LAKEWOOD REGIONAL MEDICAL
TRISTAR SAN DIEGO
CENTER ADJ2640679
GLORIA VASQUEZ
CEDARS SINAI MEDICAL CENTER
TRISTAR SAN DIEGO
ADJ2946283
IRENE MCKEEGAN
BROTMAN MEDICAL CENTER
TRISTAR SAN DIEGO
ADJ2999417
CHERYL SKIRVIN
VALLEY HEALTH SYSTEMS
TRISTAR SAN DIEGO
ADJ3620201
RICARDO PULIDO
CEDARS-SINAI HOSP
TRISTAR SAN DIEGO
ADJ7196437
CHAUNCENE LOCKE
CEDARS SINAI HEATH SYSTEM
TRISTAR SAN DIEGO
ADJ813859
BARBARA BLACKMORE
HCR-MANORCARE
TRISTAR SAN DIEGO
Page 62
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ1118791
ELVA ROSAS
LOS ANGELES COUNTY/USC MEDICAL
TRISTAR SANTA ANA
CTR ADJ1209527
GERARD VERITY
OLIVE VIEW UCLA MEDICAL CENTER
TRISTAR SANTA ANA
ADJ1214058
LINDA SNIPES
COUNTY OF LOS ANGELES
TRISTAR SANTA ANA
ADJ1645517
BLANCA ARREOLA
CITY OF LA/HOUSING AUTHORITY
TRISTAR SANTA ANA
ADJ1789835
YVONNE CATHEY
KING DREW MEDICAL CENTER
TRISTAR SANTA ANA
ADJ180338
PARIS YOUNG
COUNTY OF LOS ANGELES
TRISTAR SANTA ANA
ADJ1867841
EVANGELIA VITOGIANNIS
COUNTY OF LA/DEPT OF MENTAL
TRISTAR SANTA ANA
HEALTH ADJ1964625
ELIZABETH MORENO
LAC/USC
TRISTAR SANTA ANA
ADJ2121137
DELIA QUITCO
COUNTY OF L.A. HARBOR UCLA
TRISTAR SANTA ANA
ADJ2719720
ELIZABETH MORENO
LAC/USC
TRISTAR SANTA ANA
ADJ2798015
MOUNIR AZER
COUNTY OF L.A./MLK HOSPITAL
TRISTAR SANTA ANA
ADJ2872409
ROSA MARIA DURAN
LA COUNTY USC MEDICAL CENTER
TRISTAR SANTA ANA
ADJ3192400
JENNIE GYIMESI
COUNTY OF LA/OLIVE VIEW MEDICAL
TRISTAR SANTA ANA
CTR ADJ3507760
PAMELA BIDDLE
HARBOR UCLA MEDICAL CENTER
TRISTAR SANTA ANA
COUNTY OF LA/HUBERT HUMPHREY
TRISTAR SANTA ANA
MIDDLETON ADJ3632133
CHIJUANA THOMAS
HEALTH ADJ3974855
LINDA WILLIS
COUNTY OF LOS ANGELES HEALTH
ADJ4525196
DEBRA HUEY
COUNTY OF L.A./DEPT. OF HEALTH
TRISTAR SANTA ANA
SVCS TRISTAR SANTA ANA
SVC. ADJ515097
DORIS COLEMAN
LOS ANGELES COUNTY KING
TRISTAR SANTA ANA
ADJ570695
FLORA CABALLERO
WOMENS & CHILDRENS HOSPITAL
TRISTAR SANTA ANA
ADJ6438317
RENEE KELLY
LOS ANGELES COUNTY DMH
TRISTAR SANTA ANA
ADJ6478428
GERALDINE MITCHELL
COUNTY OF LA RANCHO LOS
TRISTAR SANTA ANA
AMIGOS MED CTR ADJ6515877
ROSA LUGO TRUJILLO
LAKE ELSINORE UNIFIED SCHOOL
TRISTAR SANTA ANA
DISTRICT ADJ6821476
YOLANDA DERRICO
COUNTY OF LOS ANGELES
TRISTAR SANTA ANA
ADJ6971420
PATRICIA HEWITT
COUNTY OF LOS ANGELES
TRISTAR SANTA ANA
DEPARTMENT OF HEALTH SERVICES ADJ7053772
GASTON WILSON
COUNTY OF LOS ANGELES
TRISTAR SANTA ANA
ADJ7303057
DONNA TERRY
LAC MEDICAL CENTER
TRISTAR SANTA ANA
ADJ7814650
NATALIA KNOX
MARTIN LUTHER KING
TRISTAR SANTA ANA
ADJ7921523
CARMEN AGUIRRE
LOS ANGELES COUNTY
TRISTAR SANTA ANA
ADJ796531
BERTHA GUERRERO
COUNTY OF LA/HEALTH SERVICES
TRISTAR SANTA ANA
ADJ7985110
FLOR CALLEJAS SANDOVAL
UCLA MEDICAL CENTER
UCLA MEDICAL CENTER
Page 63
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ8136599
BERNARDO ORTIZ
SIGNATURE MAINTENANCE
USF AND G
CANTERBURY BASEBALL LLC AKA
UTAH WORKERS COMPENSATION FUND
MARTINEZ ADJ8402781
CHUCK TIFFANY
FLORENCE FREEDOM ADJ8402781
CHUCK TIFFANY
GRAND PRAIRIE PROFESSIONAL
UTAH WORKERS COMPENSATION FUND
BASEBALL LP ADJ8402781
CHUCK TIFFANY
HAWAII BASEBALL LLC
UTAH WORKERS COMPENSATION FUND
ADJ8402781
CHUCK TIFFANY
LOS ANGELES DODGERS
UTAH WORKERS COMPENSATION FUND
ADJ8402781
CHUCK TIFFANY
ST GEORGE ROADRUNNERS ET AL
UTAH WORKERS COMPENSATION FUND
ADJ7192031
ROBERT PEREZ
WARNER BROS STUDIOS
WARNER BROS BURBANK
ADJ7341855
LOUIS DEARY
WARNER BROS
WARNER BROS BURBANK
ADJ1140089
SCOTT CANNELL
TIERNAY METALS
WAUSAU BEAVERTON
ADJ1140089
SCOTT CANNELL
TIERNEY METALS
WAUSAU BEAVERTON
ADJ1861342
DAWN WALKER
SKYWEST AIRLINES
WAUSAU BEAVERTON
ADJ3684365
FRANCISCO CASTANEDA
E.P.C.
WAUSAU BEAVERTON
ADJ4482163
CHARLES THOMPSON
LOCKHEED
WAUSAU BEAVERTON
ADJ4482163
CHARLES THOMPSON
LOCKHEED MARTIN
WAUSAU BEAVERTON
ADJ6777353
LEOPOLDO PADILLA
SOUTH GATE ENGINEERING LLC
WAUSAU BEAVERTON
ADJ6807404
PAULINE NGUYEN
YOSHINOYA AMERICA INC
WAUSAU BEAVERTON
ADJ7039236
KEITH RAY JEPSEN
DELTA PRINTING SOLUTIONS
WAUSAU BEAVERTON
ADJ7148268
KRISTINA CHESLOW
SEQUOIA EQUITIES
WAUSAU BEAVERTON
ADJ8012013
GENOVEVA ACEVEDO
MARKEITH ENTERPRISES INC 8904
WAUSAU BEAVERTON
ADJ8235740
STEVEN STORM
THIBIANT INTERNATIONAL INC
WAUSAU BEAVERTON
ADJ6690898
DAWN WALKER
SKYWEST AIRLINES
WAUSAU BEAVERTON
ADJ3340389
ANABERTA VILLALOBOS
NORWALK-LA MIRADA SCHOOL DIST
YORK 1498 SANTA ANA
ADJ7231621
LINDA MERCIER
SAN DIEGO UNIFIED SCHOOL
YORK 1498 SANTA ANA
DISTRICT ADJ7552608
ELIZABETH EISENFELD
SOUTHERN CALIFORNIA NESSAH
YORK 1738 SANTA ANA
EDUCATIONAL CULTURAL CENTER ADJ2776764
DAVID HARVEY
GLENDALE UNIFIED SCHOOL DIST
YORK ANAHEIM
ADJ3283627
JULIO MORALES
SAFE PLATING INC
YORK ANAHEIM
ADJ4589871
MAIDA ORELLANA
7-UP/RC BOTTLING COMPANIES OF
YORK ANAHEIM
SO CA ADJ7542206
MARIA RODRIGUEZ
THE BICYCLE CASINO
YORK ANAHEIM
ADJ7706402
CLAUDIA FUENTES
THE BICYCLE CASINO
YORK ANAHEIM
ADJ7747907
GERMAN CRUZ
STATHATOS DAMON
YORK ANAHEIM
ADJ7867789
ALEJANDRO FLORES
ENTERPRISE RENT A CAR
YORK ANAHEIM
ADJ2103884
LINDA NEGRETE
WALMART
YORK EL DORADO HILLS
ADJ4490816
GUADALUPE DE LA MORA
WALMART
YORK EL DORADO HILLS
ADJ6699463
CLEMENCIA SUAREZ LOPEZ
WAL MART
YORK EL DORADO HILLS
ADJ7483207
ANA RIVAS
WALMART
YORK EL DORADO HILLS
Page 64
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ817604
SHIRLEY BOESSNECK
SAMS CLUB
YORK EL DORADO HILLS
ADJ1369161
JUDY GHORBANZADEH
VENTURA UNIFIED SCHOOL DIST
YORK OXNARD
ADJ1369161
JUDY GHORBANZADEH
VENTURA UNIFIED SCHOOL DISTRICT
YORK OXNARD
ADJ7462108
DONALD AYALA
OXNARD SCHOOL DISTRICT
YORK OXNARD
ADJ142207
JANICE JACKSON
COUNTY OF LOS ANGELES/DIST.
YORK PASADENA
ADJ1509309
WILLIAM HORWITZ
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ1535881
YVETTE DEANS
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ1764908
JACQUELINE SPENCER
COUNTY OF LOS ANGELES
YORK PASADENA
ATTY.
INGMAN ADJ181011
ELENA MORA
LOS ANGELES COUTNY JAIL
YORK PASADENA
ADJ1976848
GEORGE VASQUEZ
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ2084889
STACEY ROUX
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ2084889
STACEY ROUX
L.A.U.S.D.
YORK PASADENA
ADJ2231855
LUIS BUSTOS
COUNTY OF LOS ANGELES SHERIFF
YORK PASADENA
DEPT ADJ2231855
LUIS BUSTOS
COUNTY OF LOS ANGELES SHERIFFS
YORK PASADENA
DEPT ADJ2320046
GEORGE AZER
L.A. SHERIFF'S DEPARTMENT
YORK PASADENA
ADJ3101004
ANA BECERRA
LA COUNTY/SHERIFF'S DEPT
ADJ3318388
MATILDA VALLES
ADJ3944658
ARMANDO BARRERA
LOS ANGELES COUNTY
YORK PASADENA
ADJ4145230
STEVEN MARTIN
LOS ANGELES COUNTY SHERIFF DEPT.
YORK PASADENA
YORK PASADENA YORK PASADENA
ADJ4250668
ROBERT TROY
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ4251528
LYDIA RICHARDSON
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ4284302
ANITA LIMBRICK
COUNTY OF L.A./SHERIFF DEPT.
YORK PASADENA
ADJ4511142
KATIE CREED
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ469607
MICHAEL SMITH
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ6648620
JESUS VILLANUEVA
COUNTY OF LOS ANGELES SHERIFFS
YORK PASADENA
DEPT ADJ6657844
RICHARD ENGERSBACH
COUNTY OF LOS ANGELES SHERIFFS
YORK PASADENA
DEPT ADJ6777137
MARY CHAVEZ
LA COUNTY SHERIFFS DEPT
YORK PASADENA
ADJ6809177
CESAR VALIENTE
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ6822493
VACHEL BROWN
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ7127050
ALLEN BUELTEL
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ7293417
TANYA GONZALES
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ7462649
LINDA CRAFT
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ7582924
LISA COLEMAN
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ7588103
KATHRYN WALKER
LOS ANGELES COUNTY SHERIFFS DEPT
YORK PASADENA
ADJ7741376
JUAN GONZALEZ
COUNTY OF LOS ANGELES SHERIFFS
YORK PASADENA
DEPT ADJ7844618
PAMELA BROOM
COUNTY OF LOS ANGELES SHERIFF
YORK PASADENA
ADJ8113583
ANITRA CHATMAN
COUNTY OF LOS ANGELES
YORK PASADENA
Page 65
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ8172800
LUIS SIORDIA
COUNTY OF LOS ANGELES
YORK PASADENA
ADJ8429424
CHRISTINE STEPHENS
LOS ANGELES SHERIFF DEPT
YORK PASADENA
ADJ912416
REGINA MIMS
LOS ANGELES COUNTY/SHERIFF'S
YORK PASADENA
DEPT. ADJ1364894
FLETCHER RAYNOR
CITY OF RIDGECREST
YORK RANCHO CUCAMONGA
ADJ1364894
FLETCHER RAYNOR
SASS
YORK RANCHO CUCAMONGA
ADJ1788202
IRENE NAVARRO
CITY OF EL MONTE
YORK RANCHO CUCAMONGA
ADJ1829880
PAMELA FOWLER
HUNTINGTON BEACH CITY SCHOOL
YORK RANCHO CUCAMONGA
DISTRI ADJ2013290
ELIZABETH GRAY
CITY OF EL SEGUNDO
YORK RANCHO CUCAMONGA
ADJ2263468
NORMA ALEGRIA
ANTELOPE VALLEY UNION HIGH
YORK RANCHO CUCAMONGA
SCHOOL ADJ2459179
AGUSTIN CASTILLEJO
SUPERIOR INDUSTRIES
YORK RANCHO CUCAMONGA
ADJ2717587
MICHAEL KRUGER
RANCHO SANTIAG COM COLLEGE
YORK RANCHO CUCAMONGA
ADJ2717587
MICHAEL KRUGER
RANCHO SANTIAGO COMMUNITY
YORK RANCHO CUCAMONGA
ADJ3053697
MARTHA GARCIA
COLTON UNIFIED SCHOOLS
YORK RANCHO CUCAMONGA
ADJ3747164
DAWN HUGHEY
EL RANCHO UNIFIED SCHOOL DIST
YORK RANCHO CUCAMONGA
ADJ3812974
JOANN TORRES
PUPIL TRANSPORTATION
YORK RANCHO CUCAMONGA
INTERNATIONAL
COLLEGE
COOPERATIVE ADJ4024963
SHARON CAMPBELL
NORWALK TRANSPORTATION
YORK RANCHO CUCAMONGA
ADJ4516491
KURTIS CUSHMAN
CENTINELA VALLEY UNION H.S. DIST.
YORK RANCHO CUCAMONGA
ADJ4518347
LYDIA RIOS CHAVEZ
POMONA UNIFIED SCHOOL DIST
YORK RANCHO CUCAMONGA
ADJ4599837
PETRA RUIZ
LINDBURGH ELEMENTARY
YORK RANCHO CUCAMONGA
ADJ4600692
NINFA MENDEZ
POMONA UNIFIED SCHOOL DISTRICT
YORK RANCHO CUCAMONGA
ADJ675842
INOCENTE RODRIGUEZ
LACCD
YORK RANCHO CUCAMONGA
ADJ7192022
DOLORES DUARTE
CITY OF NORWALK
YORK RANCHO CUCAMONGA
ADJ7400908
RONNIE STEWART
INGLEWOOD UNIFIED SCHOOL
YORK RANCHO CUCAMONGA
DISTRICT ADJ7844411
ANA CARMAN
WHITTIER CITY SCHOOL DISTRICT
YORK RANCHO CUCAMONGA
ADJ7861342
ALFIE JIMENEZ
ROWLAND UNIFIED SCHOOL
YORK RANCHO CUCAMONGA
DISTRICT ADJ8433570
MOZELLE KRISMAN
IN HOME SUPPORTIVE SERVICES INC
YORK RANCHO CUCAMONGA
ADJ898480
BERENICE VITE
LOS NIETOS UNIFIED SCHOOL
YORK RANCHO CUCAMONGA
DISTRICT ADJ1719616
LIRA LEBRON
99 CENT STORES
YORK RIVERSIDE
ADJ1719616
LIRA LEBRON
99 CENTS ONLY STORE
YORK RIVERSIDE
ADJ1928884
ROBERT TELLES
BED BATH & BEYOND
YORK RIVERSIDE
ADJ3238206
SALLY NAJAR
EL MONTE USD
YORK RIVERSIDE
ADJ3756945
DORIS AYALA
99 CENT ONLY STORE
YORK RIVERSIDE
ADJ6821729
STEPHANIE WHARTON
CITY OF BELL GARDENS
YORK RIVERSIDE
Page 66
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ6834823
BERTHA MELENDREZ
SOUTH WHITTIER SCHOOL DISTRICT
YORK RIVERSIDE
ADJ7753849
WILLIAM SENSING
OAK PARK UNIFIED SCHOOL
YORK RIVERSIDE
DISTRICT ADJ8169437
ENRIQUETA PEREDA
FULLERTON SCHOOL DISTRICT
YORK RIVERSIDE
ADJ898480
BERENICE VITE
LOS NIETOS UNIFIED SCHOOL
YORK RIVERSIDE
ADJ2971018
TERESA CANDELARIA
MONTEBELLO UNIFIED SCHOOL
DISTRICT YORK ROSEVILLE
DISTRICT ADJ6771168
GAIL WILSON
LA CITY HOUSING AUTHORITY
YORK ROSEVILLE
ADJ7313362
ROBERT CHANG
GLENDALE UNIFIED SCHOOL
YORK ROSEVILLE
DISTRICT ADJ7912831
ANDRES RODRIGUEZ
FIRST FIRE SYSTEMS
YORK ROSEVILLE
ADJ8757683
MARIA LOZA
IN HOME SUPPORT SERVICES
YORK ROSEVILLE
ADJ8486513
CLAY STOWERS
CITY OF SAN BERNARDINO
YORK SAN BERNARDINO
ADJ2029763
DEBORAH DILLON
ANTELOPE VALLEY HIGH SCHOOL
YORK VALENCIA
DIST ADJ3434817
ANA FRANCO
CITY OF LA HOUSING AUTHORITY
YORK VALENCIA
ADJ3434817
ANA FRANCO
CITY OF LA/HOUSING AUTHORITY
YORK VALENCIA
ADJ4586044
MIGUEL ORTEGA
HOUSING AUTHORITY OF LOS
YORK VALENCIA
ANGELES ADJ6771168
GAIL WILSON
LA CITY HOUSING AUTHORITY
YORK VALENCIA
ADJ7239410
JOSE ACOSTA
SAN CONRADO CATHOLIC MISSION
YORK VALENCIA
DBA ST PETERS CHURCH ADJ7431227
GUADALUPE AQUINO
PICASSO STYLE INC
YORK VALENCIA
ADJ367320
CRISTINA UGARTE
FLINKMAN REALTY
ZENITH
ADJ7169952
VIVIANO OREGON
GMC DAIRY FARMS
ZENITH FRESNO
ADJ7200740
LUIS GONZALEZ
VOLKSWAGEN SANTA MONICA INC
ZENITH ORANGE
ADJ7767174
ANA PEREZ DE
CAPAY INC DBA FARM FRESH TO YOU
ZENITH ORANGE
VILLANUEVA ADJ1685818
JOHNNY MIRANDA
GOLDEN STATE FRAMERS
ZENITH PLEASANTON
ADJ2429041
GERARDO LICEA
WGG-MARTIN BERGER
ZENITH PLEASANTON
ADJ3250542
ARMANDO MONTELONGO
BRUNTON ENTERPRISES
ZENITH PLEASANTON
ADJ4681462
BETTY CHAN
LOS ANGELES FIREMANS CREDIT
ZENITH PLEASANTON
UNION ADJ576480
ARSENIO GARCIA
TEMPSTAR SERVICES
ADJ576480
ARSENIO GARCIA
WET SEAL
ZENITH PLEASANTON ZENITH PLEASANTON
ADJ1377214
CARLOS ANGUIANO
VANDERGEEST LANDSCAPE CO
ZENITH WOODLAND HILLS
ADJ1821887
ALVIN PONDS
PROTECTION PLUS
ZENITH WOODLAND HILLS ZENITH WOODLAND HILLS
ADJ2167030
CATALINA ESCALERA
PETER PEPPER PRODUCTS INC
ADJ2956013
FLAVIANO ARROYO
BROOKS AUTO
ZENITH WOODLAND HILLS
ADJ325203
ANITA SCHAEFFER
ADMINISTAFF CO INC
ZENITH WOODLAND HILLS
ADJ325203
ANITA SCHAEFFER
ARGUS PRO HEALTH
ZENITH WOODLAND HILLS
ADJ367320
CRISTINA UGARTE
FLINKMAN REALTY
ZENITH WOODLAND HILLS
Page 67
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ4042638
RAMONA LOZANO
A RUDIN DESIGNS
ZENITH WOODLAND HILLS
ADJ4201565
MELECIO GONZALEZ
TEMPLE ISRAEL OF HOLLYWOOD
ZENITH WOODLAND HILLS
ADJ454073
IRENE GARCIA
FRIEDA'S INC
ZENITH WOODLAND HILLS
ADJ638100
MONICA REVELES
SCULLY SPORTSWEAR,INC.
ZENITH WOODLAND HILLS
ADJ6526928
ANA SALVADOR
ADJ7236242
GUSTAVO VILLALPANDO
EL MONTE RV
ZENITH WOODLAND HILLS
ADJ7431195
MARICELA SANCHEZ
AMERICAN PRINTWORKS
ZENITH WOODLAND HILLS
ADJ7562334
CUAUHTEMOC BLANCAS
SINAI CONSTRUCTION
ZENITH WOODLAND HILLS
ZENITH WOODLAND HILLS
ADJ7567245
MAYRA MARTINEZ
COLORADO FARMS
ZENITH WOODLAND HILLS
ADJ7889678
ANTONIO BELLOSO
TECHNI CAST CORP
ZENITH WOODLAND HILLS
ADJ4358198
KAREN BROWN POUNCY
PACIFIC CARE OF CALIFORNIA
ZURICH INSURANCE
ADJ1566879
HUMBERTO RIVAS
WATERHOUSE INC.
ZURICH LOS ANGELES
ADJ1628260
CLEOTILDE LARA
SEE'S CANDIER
ZURICH LOS ANGELES
ADJ172616
CHRISTIAN LEMER
CAST AND CREW PRODUCTION
ZURICH LOS ANGELES
ADJ1785177
ANDREA LOPEZ
KRAGEN AUTO PARTS
ZURICH LOS ANGELES
ADJ1928345
RAFAEL ORTIZ
TRU GREEN
ZURICH LOS ANGELES
ADJ1954265
MARY SMALL
AXIUM ENTERTAINMENT
ZURICH LOS ANGELES
ADJ1954265
MARY SMALL
CAST AND CREW PRODUCTION
ZURICH LOS ANGELES
SERVICES INC
SERVICES INC ADJ1954265
MARY SMALL
ENTERTAINMENT PARTNERS
ZURICH LOS ANGELES
ADJ199075
GUSTAVO ESTRADA
CHINO CENTRAL RENTAL
ZURICH LOS ANGELES
ADJ2245042
MARIA HERNANDEZ
JONS MARKETPLACE
ZURICH LOS ANGELES
ADJ2356027
PERRY MARTIN
EXTENDED STAY OF AMERICA
ZURICH LOS ANGELES
ADJ2464742
JOAQUIN VELASQUEZ
ISEC , INC
ZURICH LOS ANGELES
ADJ2856536
JOSE NEVAREZ
SEE'S CANDY
ZURICH LOS ANGELES
ADJ2856536
JOSE NEVAREZ
SEES CANDY
ZURICH LOS ANGELES
ADJ3136111
DAVID T DURBORAW
AXIUM INTERNATIONAL
ZURICH LOS ANGELES
ADJ3136111
DAVID T DURBORAW
CAST & CREW PRODUCTION
ZURICH LOS ANGELES
PAYROLL INC ADJ3136111
DAVID T DURBORAW
ENTERTAINMENT PARTNERS
ZURICH LOS ANGELES
ADJ3965600
MARTA SANTIZO
ELITE PERSONNEL SERVICES, INC.
ZURICH LOS ANGELES
ADJ4349278
MARIA VAZQUEZ
SEVEN-UP BOTTLING CO
ZURICH LOS ANGELES
ADJ6821401
JOSE SANDOVAL
CUEVAS MATTRESS INC DBA SPRING
ZURICH LOS ANGELES
PEDIE ADJ6827065
GLEN MURRAY
BOSTON BRUINS
ZURICH LOS ANGELES
ADJ6827065
GLEN MURRAY
PITTSBURGH PENGUINS
ZURICH LOS ANGELES
ADJ6963064
SYLVIA MCNEAL
TIMEC
ZURICH LOS ANGELES
ADJ7146789
DANNY PHILLIPS
CONTINENTAL MARBLE AND TILE
ZURICH LOS ANGELES
ADJ7146789
DANNY PHILLIPS
ESIS FREMONT
ZURICH LOS ANGELES
ADJ7171749
MELENCIO INOCENCIO
DIVERSIFIED TRANSPORTATION CO
ZURICH LOS ANGELES
ADJ7218526
SERAFIN OROZCO
POTENTIAL INDUSTRIES
ZURICH LOS ANGELES
ADJ7293368
ROSENDA SANDOVAL
CASTEC INC
ZURICH LOS ANGELES
Page 68
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ7364478
CANDY CONTRERAS
INGRAM MICRO
ZURICH LOS ANGELES
ADJ7585034
IGNACIO RODRIGUEZ
BEST BRANDS CORPORATION CMS
ZURICH LOS ANGELES
ADJ7656349
SARAH RAMIREZ
SAPUTO CHEESE USA INC
ZURICH LOS ANGELES
ADJ7804777
JUAN TORRES
PIERRE SPRINKLER AND LANDSCAPE
ZURICH LOS ANGELES
ADJ7823668
ROBERTO CASILLAS
BEAULIEU OF AMERICA
ZURICH LOS ANGELES
ADJ7884215
ELENA COVARRUBIAS
WHITE APRON INC
ZURICH LOS ANGELES
ADJ7955310
MARLAND E HARRIS
CALIFORNIA PIZZA KITCHEN LA
ZURICH LOS ANGELES
ADJ7976530
PONCIANO CONTRERAS
PF CHANG S
ZURICH LOS ANGELES
ADJ7986784
KEVIN MELLINGER
IRWIN INDUSTRIES
ZURICH LOS ANGELES
ADJ8002528
JOSE ENRIQUEZ
POTENTIAL INDUSTRIES INC
ZURICH LOS ANGELES
ADJ8100721
ANA ZEPEDA
SHRINERS HOSPITAL FOR CHILDREN
ZURICH LOS ANGELES
ADJ8319360
FRANK HWANG
WESTERN FREIGHT CARRIERS INC
ZURICH LOS ANGELES
ADJ8516241
MANUEL CARMONA
IRON MOUNTAIN RECORDS
ZURICH LOS ANGELES
ADJ902591
MARIA DIAZ
RADISSON PLAZA HOTEL
ZURICH LOS ANGELES
ADJ367675
JESUS RUBIO
CONCRETE CONCEPTS INC
ZURICH NORTH AMERICA CHICAGO
BAKERY PRODUCTS
ADJ902591
MARIA DIAZ
RADISSON PLAZA HOTEL
ZURICH NORTH AMERICA INVALID
ADJ6901241
ALEJANDRO MORENO
R L E DALMAS CONSTRUCTION
ZURICH NORTH AMERICA NEW JERSEY
ADJ6901241
ALEJANDRO MORENO
UEBTF ANAHEIM
ZURICH NORTH AMERICA NEW JERSEY
ADJ3950168
MARVIN MCCLENDON
INGLESIDE HOSPITAL
ZURICH SACRAMENTO
ADJ4069015
DEBRA CANO
HEALTH LINK MEDI VAN
ZURICH SACRAMENTO
ADJ7302699
CERELA RUIZ
BROOKVALE INTERNATIONAL LLC
ZURICH SACRAMENTO
ADJ7302699
CERELA RUIZ
CALIFORNIA CARTAGE CO
ZURICH SACRAMENTO
ADJ7302699
CERELA RUIZ
RALLY MANAGEMENT STAFFING
ZURICH SACRAMENTO
ADJ2229194
JESUS RODRIGUEZ
SPRING AIR MID ATLANTIC
ZURICH SAN FRANCISCO
ADJ362622
ROBERT SAMUELS
ST MARYS ACADEMY
ZURICH SAN FRANCISCO
ADJ6699318
VERNON NICKELL
ENSIGN
ZURICH SAN FRANCISCO
ADJ6985332
FAKHRI TAHERI
IHASET
ZURICH SAN FRANCISCO
ADJ7558457
CARL YARDE DECEASED
EIU ELECTRICAL &
ZURICH SAN FRANCISCO
INSTRUMENTATION UNLIMIT ADJ7882359
JOE ELIZALDE
ORMAT TECHNOLOGIES
ZURICH SAN FRANCISCO
ADJ1066793
OCTAVIO GARCIA
CAL SUNGOLD INC
CHARTIS COSTA MESA
CHECK MATE TEMP AGENCY
UEF
MENDOZA ADJ1141859
GLADIS ROSALES
ADJ1160990
JUVENAL PENA
JTK TEXTILES,M INC.
JTK TEXTILES,M INC.
ADJ1288464
FELICITA ZUNIGA
MAGNOLIA ROYAL RETIREMENT CTR
UEF
ADJ1288464
FELICITA ZUNIGA
RICHARD SCOTTI
UEF UEF
ADJ1288464
FELICITA ZUNIGA
UEBTF LOS ANGELES
ADJ1399217
JASWINDER SINGH
LAKHVINDER SINGH CHAHAL
UEF
ADJ1399217
JASWINDER SINGH
UEBTF LOS ANGELES
UEF
ADJ1399217
JASWINDER SINGH
VEN OAK MARKET
UEF
ADJ1410596
LORENA TINAJERO
MARIA PHARMACY
UEF
Page 69
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
ADJ1410596
LORENA TINAJERO
UEF
Claims administrator UEF
ADJ1415063
TRIEU NGUYEN
DUNG D NGUYEN
DUNG D NGUYEN
ADJ1438693
AURORA VELAZQUEZ
FRISBLE MANAGEMENT
FRISBLE MANAGEMENT
ADJ1478063
VINH DUONG
TDI ASSOCIATES
UEF
ADJ1478063
VINH DUONG
UEBTF LOS ANGELES
UEF
ADJ1496532
MIGUEL ANGEL
S.C. STAFFING SOLUTIONS, INC.
HARTFORD SACRAMENTO
ADJ1541975
FRANCISCO SANCHEZ
UEBTF LOS ANGELES
UEF
ADJ1541975
FRANCISCO SANCHEZ
UNITED SUPPLIES
UEF
ADJ1558392
ERIKA TIJERINO
SUN PACIFIC TRUCKING
SUN PACIFIC TRUCKING
ADJ1597303
NHAN NGUYEN
DMJ TRUCKING
UEF
ADJ1597303
NHAN NGUYEN
UEBTF LOS ANGELES
UEF
ADJ1634367
ALEJANDRA ORELLANA
H. K> CANNING INC
UEF
ADJ1634367
ALEJANDRA ORELLANA
UEBTF LOS ANGELES
UEF
ADJ1691794
LUIS RIVERA
ACE ROOFING SYSTEMS
ACE ROOFING SYSTEMS
ADJ1696638
MARIA ELVA RAMIREZ
KACHELLES CASTLE CLEANING INC
KACHELLES CASTLE CLEANING INC
ADJ1748184
TOMMY JACKSON
THOMAS CARR & SONS TRUCKING
UEF
ADJ1748184
TOMMY JACKSON
UEBTF LOS ANGELES
UEF
ADJ1757666
RAYMOND DAVIS
MAMMOET WESTERN
YORK
ADJ1776808
LINDA ARCARI
EXTRA SPACE STORAGE
ADJ1838077
MARTIN ROMERO
GARDNER TRUCKING
COMMERCE & INDUSTRY INSURANCE CO GARDNER TRUCKING
ADJ1851241
CESAR LOPEZ
UEBTF LOS ANGELES
UEF
ADJ1851241
CESAR LOPEZ
USA TELECOM
UEF
ADJ1884809
ARMANDO MONTELONGO
PLAS-TAL MFG
ADJ1995283
ROBERTO RUIZ RAMIREZ
JERRY SAUL DBA SUNNYMEAD
ADJ1995283
ROBERTO RUIZ RAMIREZ
SUNNYMEAD HAMBURGERS
SUNNYMEAD HAMBURGERS
ADJ1995283
ROBERTO RUIZ RAMIREZ
UEBTF LOS ANGELES
UEBTF LOS ANGELES
ADJ2031678
JESUS MANZO
BRAUN LINEN SERVICES
BROADSPIRE BREA
ADJ207112
WALTER ANTONIO
CARLOS MARTINEZ
CARLOS MARTINEZ UEF
CASTELLON
ZENITH PLEASANTON JERRY SAUL DBA SUNNYMEAD HAMBURGERS
HAMBURGERS
MELGAR ADJ2113344
ULISES ALVAREZ
FRED GAMM
ADJ2113344
ULISES ALVAREZ
UEBTF LOS ANGELES
UEF
ADJ2126841
ESPERANZA LUCIA
KELLERMEYER BUILDING SERVICES
GALLAGHER BASSETT SACRAMENTO
ADJ2182342
MARLENE DULBERG
C.W.B. SHREWBURY PLUMBING
C.W.B. SHREWBURY PLUMBING
ADJ222112
HECTOR ORTIZ
JENNIFER'S BINDERY, INC.
JENNIFER'S BINDERY, INC.
ADJ2323461
RAJINDER PAL
PRO LUBE N" TUNE BRAKES
PROTECTIVE INSURANCE INDIANAPOLIS
MELENDEZ
ADJ233735
CARLOS LOMELI
LOPEZ TIRES, INC.
LOPEZ TIRES, INC.
ADJ2496408
JOSE REYES
LATINO GROCERIES DISTRIBUTION
LATINO GROCERIES DISTRIBUTION
ADJ2590910
ROCIO VARGAS
PHITHAYA THAI RESTAURANT
UEF
ADJ2590910
ROCIO VARGAS
UEBTF LOS ANGELES
UEF
Page 70
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ2593429
CONSTANCE
HALLIBURTON ENERGY
HALLIBURTON ENERGY UEF
CUNNINGHAM ADJ2637647
JAIME URENA
CHAVEZ TRUCKING COMPANY
ADJ2637647
JAIME URENA
UEBTF LOS ANGELES
UEF
ADJ2678016
LORI MITCHELL
ANTELOPE AUTOMOTIVE
ANTELOPE AUTOMOTIVE
ADJ2683862
MARGARITA BARRERA
LAIDLAW TRANSIT
LAIDLAW TRANSIT
ADJ2715157
RAFAEL ROSAS
INDIAN RIDGE COUNTRY CLUB, INC.
LIBERTY MUTUAL ORANGE
ADJ2763427
JOSE LUEVANOS
GSG MARBLE COMPANY
UEF
ADJ2763427
JOSE LUEVANOS
MARY DEMIRJIAN
UEF
ADJ2763427
JOSE LUEVANOS
UEBTF LOS ANGELES
UEF
ADJ2789426
RAUL MARTINEZ
VOLUME DISTRIBUTORS, INC.
VOLUME DISTRIBUTORS, INC.
ADJ2839484
JULIO RAMIREZ
POWER AIR CONDITIONING
POWER AIR CONDITIONING
ADJ2870296
GUSTAVO OCHOA
CORTEZ FURNITURE MFG., INC.
UEF
ADJ2870296
GUSTAVO OCHOA
CORTEZ MUEBLERIA
UEF
ADJ2870296
GUSTAVO OCHOA
UEBTF LOS ANGELES
UEF
ADJ2884842
GUADALUPE BELTRAN
NORMAN A. SCOTT DBA TIDY
UEF
ADJ2884842
GUADALUPE BELTRAN
UEBTF LOS ANGELES
UEF
ADJ2898233
SUSANA LOPEZ
OCEANVIEW HEALTH CENTERS INC
UEF
ADJ2898233
SUSANA LOPEZ
UEBTF LOS ANGELES
UEF
ADJ3015282
YOLANDA LARIOS
SODEXHO INC
GALLAGHER BASSETT
ADJ3065099
EDITH CRISTERNA
EXCALIBER FUELS
SCIF
ADJ3159103
JOYCE KINJO
LOS ANGELES POLICE DEPARTMENT
CITY OF LOS ANGELES WORKERS'
ADJ3276569
LONNIE CURTIS
SAN DIEGO COUNTY WATER
JANITORIAL
COMPENSATION DEPT. AUTHORITY ADJ3335646
SERAFIN RECINOS
DJ WAREHOUSE
LANGTON KAZER SANTA ANA UEBTF LOS ANGELES
ADJ3335646
SERAFIN RECINOS
UNINSURED EMPLOYERS FUND
UEBTF LOS ANGELES
ADJ3438142
DARLENE GONGORA
ALL PETS VETERINARY HOSPITAL
FIREMAN'S FUND INSURANCE COMPANY
ADJ3446628
CHRISTOPHER LLOYD
CRANEMASTER/CONTRACTORS
UEBTF LOS ANGELES
CRANE CO ADJ3446628
CHRISTOPHER LLOYD
JEANETTE CHRISTINE WARD
UEBTF LOS ANGELES
ADJ3446628
CHRISTOPHER LLOYD
UEBTF LOS ANGELES
UEBTF LOS ANGELES
ADJ3476882
PAYTON ANDERSON
NEW BEGINNINGS
SCIF INSURED GLENDALE UNIT B
ADJ3581598
ANDREW SABALA
ALL CITY MANAGEMENT SERVICES
INTERCARE
ADJ3595073
ABELINA ROBLES
ALTERNATIVE CARE #1
ADJ3678787
VICTORIANO PEREZ
TERSANA INC.
UEBTF LOS ANGELES
ADJ3678787
VICTORIANO PEREZ
UEBTF LOS ANGELES
UEBTF LOS ANGELES
ADJ3683908
HECTOR SANTANA
DENNY'S RETAURANT
IMPACT SOLUTIONS
ADJ3737013
ROBERT MARTINEZ
CITY OF LOS ANGELES
CITY OF LOS ANGELES
ADJ3749601
ENRIQUETA MENDOZA
ONE SOURCE
SPECIALTY RISK LA HABRA
ADJ3782158
RICARDO CASTELAZO
WORLD OF JEANS AND TOPS INC
CIGA
ADJ379663
JUDI ALBARRAN
MCDONNELL DOUGLAS
FREMONT COMP GLENDALE
ADJ3925981
JOHN COTTRELL
INTERNATIONAL TRANSPORTATION SERVIC
Page 71
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ3928236
DARLENE HALL
AMERICAN AIRLINES
SEDGWICK 14450 LONG BEACH
ADJ3963453
SALVADOR NAVARRO
LOS ANGELES UNIFIED SCHOOL
SEDGWICK CMS
ADJ3964058
MARIA MAYA
MEE SOON LEE AND JOONG YEAL LEE
DISTRICT ELLIOTT KIM LOS ANGELES
DBA A FASHION ADJ3964058
MARIA MAYA
UEBTF LOS ANGELES
UEBTF LOS ANGELES
ADJ3987464
TRINIDAD RAMIREZ
AMERICAN RAISING
GALLAGHER BASSETT CALABASAS
ADJ4039631
ROSEMARY DOMINGUEZ
COUNTY OF LOS ANGELES
SEDGWICK CMS
ADJ4086539
ROBERTO MORENO
TRICON
ADJ409665
JOSE GUTIERREZ
TEPALCUCHECA MARKET
UEBTF LOS ANGELES SEDGWICK CMS
SANDOVAL ADJ420871
PAMELA NICHOLSON
LOS ANGELES UNIFIED SCHOOL
ADJ4232612
ENEDINA DELATORRE
FREDDY MARIN
ADJ4265930
BRENDIA HARPER
VERIZON
AIG CLAIMS SERVICES
ADJ4279056
ROBIN TAW
RAMIL ABAKHAD IND/SUBS
UEBTF LOS ANGELES
ADJ4279056
ROBIN TAW
ROMANO'S JEWELERS
UEBTF LOS ANGELES
ADJ4279056
ROBIN TAW
UEBTF LOS ANGELES
UEBTF LOS ANGELES
DISTRICT
SHAREHOLDER
ADJ4309001
ELSA VELASQUEZ
HANNY SCHWEIZER
FARMERS PLEASANTON
ADJ4493553
ELLA MEZHIBURSKAYA
SUNNY MEDICAL TRANSPORTATION
UEBTF LOS ANGELES
ADJ4493553
ELLA MEZHIBURSKAYA
UEBTF LOS ANGELES
UEBTF LOS ANGELES
ADJ4512540
SANTIAGO MEZA
G.V. CONSTRUCTION AND
UEBTF LOS ANGELES
DEVELOPMENT ADJ4512540
SANTIAGO MEZA
UEBTF LOS ANGELES
UEBTF LOS ANGELES
ADJ4514942
SHAWN SCAVO
WARNER BROTHERS ENTERTAINMENT
WARNER BROS WORKERS COMPENSATION
ADJ4573306
KIMBERLY WILLIAMS
STERLING ENTERPRISES
UEBTF LOS ANGELES
ADJ4573306
KIMBERLY WILLIAMS
UEBTF LOS ANGELES
UEBTF LOS ANGELES
ADJ4599355
BENITO VILLANUEVA
SOCORRO'S RESTUARANT
UEBTF LOS ANGELES
ADJ4599355
BENITO VILLANUEVA
UEBTF LOS ANGELES
UEBTF LOS ANGELES
ADJ4636269
JOSEPH VALDEZ
SUSANA WOODS DBA SIMI VALLEY
SCIF INSURED GLENDALE
MOBILE ADJ4664587
DAVID GARCIA
S.G. CONSTRUCTION
UEBTF LOS ANGELES
ADJ4664587
DAVID GARCIA
S.G. CONTRUCTION / SALVADOR
UEBTF LOS ANGELES
GODINEZ ADJ4664587
DAVID GARCIA
UEBTF LOS ANGELES
UEBTF LOS ANGELES
ADJ4678801
GARY CORTES
FRANCISCO SANCHEZ DBA
UEBTF LOS ANGELES
FRANCISCO'S ADJ4678801
GARY CORTES
FRANCISCO'S HALLOWEEN
UEBTF LOS ANGELES
ADJ4711416
DANIEL NAVARRETE
LA PRINCESITA TORTILLERIA, INC.
SPECIALTY RISK LA HABRA
ADJ4713590
MARIA PONCE
SOUTHERN CALIFORNIA GAS CO
SOUTHERN CAL GAS LOS ANGELES
ADJ5751571
YOLYE VEGA
LITTLE CAESAR ENTERPRISES
ST PAUL TRAVELERS
ADJ617532
GUILLERMO BADE
AAA UNDERCAR PARTS
ADJ632678
MARIA DEAC
MARGARETA CINDEA INDIV & DBA CINDEA
Page 72
UEBTF LOS ANGELES
Michael D. Drobot Pacific Hospital of Long Beach Case number
Injured Worker
Employer
Claims administrator
ADJ632678
MARIA DEAC
UEBTF LOS ANGELES
UEBTF LOS ANGELES
ADJ632678
MARIA DEAC
UEBTF SACRAMENTO
UEBTF LOS ANGELES
ADJ6425219
LORI BRANNON
KNIGHT TRANSPORTATION
COVEL CHINO
ADJ6462781
RUDOLPH SANCHEZ
KING RELOCATION
LWP CLAIMS SOLUTIONS
ADJ6555277
JULIO SALDARIAGA
R.J. WARNER CARPETS & FLOORS, INC.
UEBTF LOS ANGELES
ADJ6555277
JULIO SALDARIAGA
UNINSURED EMPLOYERS FUND
UEBTF LOS ANGELES
ADJ656318
CLAUDIA SANTANA
DIRECT PRODUCE, INC.
SCIF INSURED FRESNO
ADJ667074
EFRAIN VILLANUEVA
UEBTF LOS ANGELES
UEBTF LOS ANGELES UEBTF LOS ANGELES
ADJ667074
EFRAIN VILLANUEVA
ZAZUETA FREIGHT
ADJ6709649
GLORIA AGUAYO
QUICK TEST RESEARCH INC
CHUBB GROUP
ADJ6716944
WILLIAM KONIECZNY
UEBTF ANAHEIM
UEBTF LOS ANGELES
ADJ6733943
FEDERICO MEDINA
ROMAN FRESH BAKERY & GRILL
ILLINOIS MIDWEST INSURANCE AGENCY SCIF INSURED SACRAMENTO
ADJ6833003
EDDIE VALDEZ
BRENT SCHWEBEL PLASTERING
ADJ6870635
RAMON PALAFOX
GARCIA J CONSLTRUCTION
ADJ6871692
TERESA PICHARDO
DON DIEGO POST NO 7420 VETERANS
UEBTF LOS ANGELES
OF FOREIGN WARS OF THE UNITED STATES CORP ADJ6871692
TERESA PICHARDO
UEBTF LOS ANGELES
UEBTF LOS ANGELES
ADJ6886475
LA TRICIA ANDERSON
DAVID TOMA DDS
UEBTF LOS ANGELES
ADJ6886475
LA TRICIA ANDERSON
DAVID TOMA DDS DBA SMILEBURST
UEBTF LOS ANGELES
DENTISTRY ADJ6886475
LA TRICIA ANDERSON
SMILEBURST DENTISTRY
UEBTF LOS ANGELES
ADJ6886475
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