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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ9505962; ADJ9289403
Regular
May 13, 2015

JAMILENE KANE vs. RALEYS, ATHENS ADMINISTRATORS

In this workers' compensation case, the Appeals Board granted a Petition for Removal filed by lien claimant UFCW & Employers Benefit Trust. The Board reversed a prior order that denied UFCW's request for service of medical reports. The Board found that UFCW, as a physician lien claimant defined by relevant Labor Code sections and WCAB Rule 10608(a)(5), is entitled to service of medical reports upon request under Rule 10608(b) without needing to become a formal party to the action. Therefore, the defendant and other parties were ordered to serve UFCW with all requested medical reports.

Petition for RemovalPhysician Lien ClaimantMedical Information ServiceWCAB Rule 10608(b)Due ProcessTaft-Hartley Health and Welfare FundLabor Code sections 4903.05(c)(7)Labor Code sections 4903.06(b)Medical-Legal ReportsDeclaration of Readiness to Proceed
References
Case No. ADJ9745835 ADJ9745836 ADJ9745837 ADJ9745840
Regular
Aug 06, 2019

BILLIE MILLS vs. STATE OF CALIFORNIA DEPARTMENT OF FISH AND WILDLIFE, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted removal, rescinded the WCJ's order denying the lien claimant's petition to compel, and granted the petition. This decision compels the defendant to serve the physician lien claimant with all medical reports and information related to the applicant's claimed injury. The Board found the WCJ erred by denying the petition, emphasizing that defendants must serve physician lien claimants with requested medical records under Rule 10608, regardless of the claimant's status as a party. Defendant's failure to respond or provide records for nearly four years further supported the Board's decision.

Workers' Compensation Appeals BoardPetition for RemovalPetition to Compel ServicePhysician Lien ClaimantWCJMedical ReportsDue ProcessRule 10608Industrial InjuriesMedical Information
References
Case No. ADJ3972762
Regular
Apr 11, 2014

LUCILLE MALDONADO vs. JET DELIVERY SERVICE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied a lien claimant's petition for removal, which sought to rescind an order closing discovery and continuing the trial. The lien claimant argued they had not received necessary medical reports to prove their lien. The majority adopted the WCJ's reasoning for denial, while a dissenting commissioner argued the defendant violated discovery rules by failing to serve the reports and that the case should have been postponed until service occurred. The dissenting opinion also highlighted the lien claimant's potential violation of Rule 10622 by failing to disclose reports.

Petition for RemovalLien ClaimantMedical ReportsMedical-Legal ReportsWCJWCAB Rule 10770.1(h)WCAB Rule 10608(f)WCAB Rule 10608(b)Compromise and ReleaseBurden of Proof
References
Case No. ADJ4595703 (LBO 0379028)
Regular
Jun 08, 2012

Carlos Penaloza vs. TMP SERVICES, INC., INSURANCE COMPANY OF THE WEST

The Workers' Compensation Appeals Board granted reconsideration to find defendant liable for sanctions due to its repeated failure to serve medical reports on the lien claimant as required by WCAB Rule 10608. This failure, despite multiple requests and two judicial orders, constituted sanctionable conduct for causing unnecessary delay and was not excused by inadvertence. The case is remanded to the trial level for determination of the lien claimant's reasonable expenses and any additional sanction up to $2,500.

WCAB Rule 10608Lien claimantSanctionsFrivolous litigationBad faithMedical reportsService of documentsDiscovery orderMotion to compelCompel production
References
Case No. ADJ9240709
Regular
Oct 22, 2014

Steven Baden vs. Orange County Sheriff's Department, York Insurance Services Group

The Workers' Compensation Appeals Board granted a Petition for Removal concerning an order denying the release of medical records. The lien claimant, The 4600 Group, representing Anthem Blue Cross, asserted entitlement to these records as a health care service plan, aligning with WCAB Rule 10608. The Board adopted the WCJ's recommendation to grant removal, rescind the previous order, and return the matter for further proceedings. This action ensures the lien claimant's claim regarding medical records can be properly addressed.

Petition for RemovalOrder Denying Petition for Release of Medical RecordsLien claimanthealth care service planphysician lien claimantWCAB Rule 10608Workers' Compensation Administrative Law JudgeReport and Recommendationremandmedical information
References
Case No. ADJ9235694
Regular
Jul 27, 2018

Stuart Yasutake vs. Epsilon Electronics, Liberty Mutual Insurance Company

The Workers' Compensation Appeals Board granted a lien claimant's petition for removal after an administrative law judge denied its request for medical reports. The lien claimant, Anthem Blue Cross, is a health plan that paid for the applicant's medical bills and has a lien to recover these costs. As a party to the case and a physician lien claimant, Anthem Blue Cross is entitled to service of relevant medical reports under WCAB Rule 10608. The Board found the claimant's request was not vague and ordered the defendant to serve all medical reports and information related to the applicant's claimed injury.

Petition for RemovalLien ClaimantCompel ServiceMedical ReportsWCJAdverse InferenceAppeals BoardPhysician Lien ClaimantCompromise and ReleaseBurden of Proof
References
Case No. ADJ1191428 (LBO 0310118)
Regular
Aug 09, 2010

RUBEN GOMEZ-SOTO vs. NMI, INC.

Here's a summary of the case for a lawyer in four sentences: The Appeals Board granted removal, modifying the WCJ's order to require the defendant to produce *all* medical reports in its possession to the lien claimant, not just those intended for reliance, pursuant to CCR $\S 10608$. The Board struck the WCJ's provision requiring the lien claimant to prove market rate for interpreters, finding the issue was not properly before the judge. While the lien claimant alleged WCJ bias, the Board found no sufficient evidence of enmity or prejudice based on the record. The case was returned to the trial level for further proceedings consistent with the Appeals Board's decision.

RemovalLien ClaimantWCJ OrderMedical ReportsMarket RateInterpreter FeesBiasDisqualification8 Cal. Code Reg. 10608Labor Code 5710
References
Case No. ADJ1968745; ADJ3771069; ADJ1711136
Regular
Aug 04, 2025

PETER WATSON vs. FPL ENERGY, BROADSPIRE SERVICES

The Workers' Compensation Appeals Board denied the Petition for Reconsideration filed by The Prescription Center Pharmacy. The petition challenged a Findings and Order from August 29, 2022, concerning the disallowance of medication charges for applicant Peter Watson. The Board applied equitable tolling to the statutory 60-day period for acting on the petition due to administrative delays in receiving the case file, ensuring a decision on the merits. The Board ultimately concluded that the petitioner failed to establish grounds for reopening discovery, willful suppression of evidence by the defendant FPL Energy, or the medical necessity for many of the disallowed medications, based on the findings of Agreed Medical Examiner Dr. Mark Hyman.

Workers' Compensation Appeals BoardPetition for ReconsiderationEquitable TollingLabor Code Section 5909Electronic Adjudication Management System (EAMS)Due ProcessSubstantial JusticeFindings and AwardPrescription Center PharmacyAdverse Inference
References
Case No. ADJ322417 (LAO0855230)
Regular
Oct 21, 2019

Miguel Hernandez vs. D.L. Bone & Sons, Inc., State Compensation Insurance Fund

The Workers' Compensation Appeals Board (WCAB) dismissed a petition for reconsideration of an administrative order suspending a lien claimant's Petition for Medical Information. The WCAB granted removal, finding the administrative law judge erred by issuing the order sua sponte without notice or hearing, violating due process. This procedural error caused irreparable harm and prejudice. Consequently, the WCAB rescinded the order and returned the case to the trial level for proceedings consistent with due process.

Workers Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalOrder Suspending ActionPetition for Medical InformationFranchise Tax Board (FTB) suspended corporationDue ProcessSua SponteNotice and HearingInterlocutory Order
References
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