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

Case No. ADJ6729105
Regular
Sep 16, 2009

, ## Applicant, vs. , ## Defendant(s).

The Workers' Compensation Appeals Board denied reconsideration of a ruling that utilization review for the applicant's shoulder surgery was timely. The applicant argued she did not receive the denial letter within the required timeframe, but the Board found that the denial was properly sent to the treating physician and carbon-copied to the applicant within the statutory period. The Board clarified that WCAB Rule 10505(d) regarding official address records did not apply at the time of the denial because no claim application was yet filed. Therefore, the carrier's obligation was to communicate the denial in writing within the specified time, which they did.

Workers' Compensation Appeals BoardCadbury SchweppesGallagher Bassett ServicesUtilization ReviewPetition for ReconsiderationApplication for Adjudication of ClaimWCAB Rule 10505(d)Labor Code Section 4610ArthroscopyBiceps Tenodesis
References
Case No. ADJ3630039 (MON 0266628)
Regular
Sep 24, 2013

GWENDOLYN MATTHEWS-BROWN vs. TOTAL AMERICA; LIBERTY MUTUAL

This case involves a Petition for Reconsideration filed by Gwendolyn Matthews-Brown against Total America and Liberty Mutual. The Workers' Compensation Appeals Board (WCAB) dismissed the petition. The dismissal was based on two procedural defects: the petition was not verified as required by Labor Code section 5902 and it was not properly served on all parties on the official address record per California Code of Regulations section 10505. Consequently, the WCAB found the petition procedurally deficient and ordered it dismissed.

Petition for ReconsiderationVerifiedLabor Code section 5902Serve PartiesOfficial Address RecordCalifornia Code Regulations title 8 section 10505DismissedWorkers' Compensation Appeals BoardAdministrative Law JudgeWCJ
References
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. ADJ486464
Regular
Dec 16, 2009

LINDA CASTILLO vs. FIRST STUDENT, NEW HAMPSHIRE INSURANCE CO., BROADSPIRE

The petition for removal is denied because the applicant did not demonstrate significant prejudice or irreparable harm. The petition is not dismissed despite applicant's failure to fully comply with Rule 10850.

WORKERS' COMPENSATION APPEALS BOARDPetition for RemovalOrder to Quashsubpoenaproof of serviceRule 10850Rule 10505verified petitionindustrial injurynerves
References
Case No. ADJ10321614
Regular
Nov 17, 2017

KURT SAALFELD vs. CITY OF TRACY

The Appeals Board denied applicant's Petition for Removal seeking a replacement Qualified Medical Evaluator (QME) panel. Applicant objected to defendant's letter to the QME via email, but defendant had previously informed applicant they do not accept email service. The Board found applicant's email objection improperly served as there was no agreement for electronic service. Therefore, the Board concluded that applicant failed to demonstrate substantial prejudice or irreparable harm to warrant removal.

Workers' Compensation Appeals BoardPetition for RemovalFindings and OrderQualified Medical EvaluatorQME panelLabor Code section 4062.3(b)Rule 10505service by emailobjection to QME letterpeace officer
References
Case No. ADJ2071191 (OXN 0127334)
Regular
May 29, 2013

IRENE MCLEAN vs. BRISTOL FARMS, INC., SPRINGFIELD INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed Irene McLean's Petition for Reconsideration against Bristol Farms, Inc. and Springfield Insurance Company. The petition was dismissed primarily because it was filed untimely, exceeding the statutory 20-day deadline plus 5 days for mailing. Additionally, the petition was not properly served on all adverse parties as required by law. Even if it had been timely and properly served, the WCAB would have denied it on the merits based on the administrative law judge's report.

Petition for ReconsiderationUntimelyDismissalLabor Code § 5903Code of Civil Procedure § 1013ServiceAdverse PartiesLabor Code § 5905WCAB Rules 10505WCAB Rules 10850
References
Case No. ADJ6984694, ADJ6984708, ADJ7010763
Regular
Apr 02, 2013

SONIA VARGAS vs. LA COCINA MEXICAN, FIRSTCOMP

This Workers' Compensation Appeals Board order dismisses a Petition for Reconsideration filed by a lien claimant. The primary reason for dismissal is the failure to provide proof of service on all adverse parties, as mandated by statute and board rules. The Board also noted that even if properly served, the petition would have been denied on its merits.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ ReportProof of ServiceLabor Code Section 5905WCAB Rules 10505WCAB Rules 10850EAMSAdverse PartiesDismissal
References
Case No. ADJ7526420
Regular
Aug 22, 2014

JARRED SHEPPARD vs. SCHLUMBERGER, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This Workers' Compensation Appeals Board case concerns a Petition for Reconsideration filed by a party. The Board reviewed the petition and the WCJ's report and has denied reconsideration. The denial is based on the reasoning provided in the WCJ's report, which the Board adopts. Additionally, the Board admonished the lien claimant for failing to serve the petition on all adverse parties as required by statute and regulation.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedWCJ ReportLabor Code section 5905WCAB Rules 10505WCAB Rules 10850Lien ClaimantAdverse PartiesService
References
Case No. ADJ8135969
Regular
May 06, 2013

JORGE HINOJOSA vs. BEST COACH TECHNOLOGIES, CHARTIS INSURANCE

The Workers' Compensation Appeals Board (WCAB) dismissed a lien claimant's petition for reconsideration because it was not properly served on all adverse parties. The WCAB also issued a warning to the lien claimant and their representative, Advance Acupuncture Therapeutics, regarding sanctions for frivolous claims and misrepresentation of facts. The dismissal stemmed from the lien claimant's failure to appear at a lien conference and their unsubstantiated excuses. The WCAB emphasized that such conduct demonstrates disrespect for the system and will lead to sanctions in the future.

Petition for reconsiderationLabor Code section 5905WCAB Rules 10505WCAB Rules 10850sanctionsfrivolous petitionlien claimantlien conferencenotice of intent to impose sanctionsLabor Code § 5813
References
Case No. ADJ10483272
Regular
Mar 08, 2018

ADRIAN FRIAS vs. AVANTI CAFE, TECHNOLOGY INSURANCE COMPANY, AMTRUST NORTH AMERICA

The Workers' Compensation Appeals Board (WCAB) denied defendant Avanti Cafe's petitions for reconsideration. The WCAB reviewed the defendant's amended petitions, but found no substantial new grounds for appeal. While the WCAB adopted the workers' compensation judge's report, they specifically excluded the portion addressing the unsigned proof of service, while cautioning the defendant about future compliance. Therefore, the WCAB affirmed the prior decision and denied reconsideration.

Petitions for ReconsiderationAmended PetitionsProof of ServiceAppeals Board Rule 10505Workers' Compensation Administrative Law JudgeDenying ReconsiderationIncorporated ReportComplianceEndorsed StatementSigned Proof of Service
References
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