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

Case No. OAK 0255953
Regular
Aug 04, 2008

CLINTON HENDRIX vs. GALGON INDUSTRIES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, SUPERIOR NATIONAL INSURANCE, BROADSPIRE

This case clarifies that California Labor Code sections 4607 and 5814.5 do not authorize the use of a lodestar multiplier for attorney's fees awarded to enforce medical treatment awards. The Appeals Board rescinded its previous directive to defer consideration of section 4607 fees, affirming that the enforcement of medical treatment awards aligns with social policy and the public interest. The case is returned to the trial level for recalculation of fees under these statutes, without a lodestar multiplier, but acknowledging a prior final award under section 4607.

Workers' Compensation Appeals BoardClinton HendrixGalgon IndustriesCalifornia Insurance Guarantee AssociationSuperior National InsuranceliquidationBroadsPIREreconsiderationLabor Code sections 4607 and 5814.5attorney's fees
References
6
Case No. VNO 0410313; VNO 0410283
Regular
Mar 03, 2008

WILLIAM DAVIS vs. CITY OF TORRANCE

The Workers' Compensation Appeals Board granted reconsideration to defer the issue of attorney's fees under Labor Code section 4607, pending a California Supreme Court decision. The Board affirmed the finding that the applicant is entitled to further medical treatment, including surgery, for his industrial knee injury. The attorney's fee issue hinges on whether section 4607 applies when an employer denies treatment without formally petitioning to terminate the award.

Labor Code section 4607Attorney's feesReconsiderationPetition to reopenIndustrial knee injuryStipulated findings and awardFurther medical treatmentUtilization reviewQualified medical examinerACL reconstruction surgery
References
1
Case No. ADJ2727430 (OAK 0287969)
Regular
May 22, 2009

RHONDA ANDERSON vs. TARGET STORES, P.S.I., SEDGWICK CLAIMS MANAGEMENT SERVICES

In *Anderson v. Target Stores*, the Workers' Compensation Appeals Board reconsidered an award of attorney fees under Labor Code § 4607. The Board granted reconsideration, finding the applicant was not entitled to the fees. This decision was based on the Supreme Court's ruling in *Smith v. Workers' Comp. Appeals Bd.*, which limited § 4607 attorney fees to cases where an employer seeks to terminate an entire award of medical treatment, not just challenge a specific treatment request. Therefore, the Board vacated the prior award of attorney fees.

Workers' Compensation Appeals BoardLabor Code §4607Attorney FeesReconsiderationUtilization ReviewPrimary Treating PhysicianSmith v. Workers' Comp. Appeals Bd.Interferential UnitStipulations with Request for AwardNew and Further Disability
References
3
Case No. ADJ4559849
Regular
Sep 30, 2009

PATSY VAN BUSKIRK vs. MOCEO E.V. COMPANY, CIGA

The Workers' Compensation Appeals Board affirmed a judge's decision denying attorney fees under Labor Code section 4607. The applicant's attorneys argued fees were owed because the defendant constructively terminated medical treatment without filing a formal petition to terminate the award. However, the Board found that the defendant only disputed specific treatment requests, not initiated proceedings to terminate the overall award of future medical care. Therefore, pursuant to *Smith v. Workers' Comp. Appeals Bd.*, attorney fees under section 4607 were not applicable.

Labor Code section 4607Petition for ReconsiderationPermanent DisabilityFurther Medical TreatmentQualified Medical ExaminerMedical Provider NetworkConstructively TerminatedSmith v. Workers' Comp. Appeals Bd.Termination ProceedingsAttorney Fees
References
3
Case No. ADJ1140810 (OAK 0206395)
Regular
Jul 22, 2009

FRANCISCA KOUMARIANOS vs. HADCO/ZYCON CORPORATION, ALLIANZ INSURANCE COMPANY

This case involves a dispute over attorney's fees awarded for defending an applicant's right to continuing medical treatment. The defendant sought reconsideration, arguing that Labor Code section 4607 only allows fees when an applicant *resists an attempt to terminate* an existing award, not when they challenge an informal denial of specific treatment. The Appeals Board granted reconsideration, citing *Smith v. Workers' Comp. Appeals Bd.*, which clarified that section 4607 does not permit fees for challenging a denial of specific treatment requests. Consequently, the Board rescinded the award of attorney's fees.

Workers' Compensation Appeals BoardReconsiderationAttorney's FeesLabor Code Section 4607Continuing Medical TreatmentAwardPetition to EnforceInformal DenialUtilization ReviewAgreed Medical Examiner
References
2
Case No. ADJ3905674 (SRO 0031254)
Regular
Feb 02, 2011

DAVID PELLETIER vs. UNITED STRUCTURES, INC., CIGA by its Servicing Facility CAMBRIDGE on behalf of FREMONT COMPENSATION, in liquidation

The Workers' Compensation Appeals Board denied reconsideration of its decision regarding attorney's fees. The applicant's attorney sought fees under Labor Code sections 4607 and 5814.5, arguing the defendant unreasonably failed to appoint a new case manager and pay prior bills. The Board affirmed the judge's finding that Labor Code § 4607 fees are inapplicable when the entire award is not terminated, and Labor Code § 5814.5 fees require an existing award and unreasonable refusal to pay. The Board found no evidence of unreasonable delay by the defendant in appointing a new case manager, thus denying the petition.

Workers' Compensation Appeals BoardReconsiderationAttorney's FeesLabor Code Section 4607Labor Code Section 5814.5Medical TreatmentCompromise and ReleasePetition for PenaltyNurse Case ManagerStipulations
References
2
Case No. ADJ4494642 (SBA 0026287)
Regular
Jun 18, 2009

MARY CONTRERAS vs. DAVID EARTHCRAFT, INC., ZENITH INSURANCE COMPANY

In this case, the applicant, Mary Contreras, sought attorney fees under Labor Code section 4607 after successfully challenging the denial of specific requested medications by the defendant. The Workers' Compensation Appeals Board (WCAB) reversed a prior award of attorney fees, holding that section 4607 only applies when an employee successfully resists an employer's attempt to terminate an entire award of medical treatment, not just specific treatment requests. The WCAB relied on the California Supreme Court's decision in *Smith v. Workers' Comp. Appeals Bd.*, which clarified this statutory interpretation. Therefore, the applicant was denied attorney fees as the defendant did not attempt to terminate the applicant's ongoing medical treatment award.

Utilization reviewAgreed medical evaluatorsAttorney feesSection 4607Termination of awardMedical treatmentMedication authorizationPermanent disabilityIndustrial injuryWCJ
References
1
Case No. ADJ2444225 (GRO 0016225) ADJ811699 (GRO 0016226) ADJ4137711 (GRO 0016352)
Regular
Aug 04, 2009

DWIGHT SMITH vs. STATE OF CALIFORNIA, CALIFORNIA YOUTH AUTHORITY, legally uninsured, STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES, adjusting agency

This case involves a California Supreme Court decision that reversed an award of attorney's fees to the applicant's counsel. The Court found that Labor Code section 4607 did not authorize such fees, overturning previous decisions by the WCJ and the Appeals Board. Consequently, the Appeals Board reinstated its original order denying reconsideration and attorney's fees.

Workers' Compensation Appeals BoardRemittiturAttorney's feesLabor Code section 4607ReconsiderationDenying ReconsiderationCalifornia Supreme CourtCourt of AppealLegally uninsuredAdjusting agency
References
0
Case No. ADJ126075
Regular
Nov 20, 2008

JOAN HANNIS-GERFEN vs. VALLEY OAKS CHILDREN'S SERVICES, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant who sustained industrial injuries and was initially unrepresented when the employer's insurer filed an Application for Adjudication of Claim. The Workers' Compensation Appeals Board affirmed an award of attorney's fees to the applicant under Labor Code section 4064(c), finding the employer liable because the applicant was unrepresented at the time the insurer initiated the adjudication process. The Board did not reach the issue of attorney's fees under Labor Code section 4607.

JOAN HANNIS-GERFENVALLEY OAKS CHILDREN'S SERVICESSTATE COMPENSATION INSURANCE FUNDADJ126075RDG 0120996OPINION AND DECISION AFTER RECONSIDERATIONCUMULATIVE INJURYNECKBILATERAL WRISTSTRIGGER FINGERS
References
4
Case No. ADJ4046748 (GOL 087878)
Regular
Oct 14, 2008

VIOLA MIRANDA vs. LOMPOC HOSPITAL DISTRICT, WORKERS' COMPENSATION ADMINISTRATORS

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior denial, and ordered the defendant to provide applicant Viola Miranda with an orthopedic mattress. The Board found that the applicant's treating physician and Qualified Medical Evaluator supported the necessity of the mattress, and the defendant's utilization review did not present sufficient evidence to deny the request. The issue of attorney's fees under Labor Code §4607 was deferred pending a Supreme Court decision.

Workers' Compensation Appeals Boardorthopedic mattressutilization reviewACOEM GuidelinesLabor Code § 4604.5medical treatmentindustrial injurytreating physicianqualified medical evaluatorpermanent disability
References
1
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