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

Case No. ADJ2409827 (VNO 0509989)
Regular
Apr 17, 2014

ALICIA EVANS vs. SOUTHERN CALIFORNIA GAS COMPANY

The Workers' Compensation Appeals Board denied reconsideration of its prior decision concerning Alicia Evans and Southern California Gas Company. While the lien claimant's petition touched upon sanctions, it failed to meet the procedural requirements for reconsideration under Labor Code sections 5902 and 5904, and WCAB Rules 10842, 10846, and 10852. Specifically, the petition lacked detailed grounds, specific record references, and legal arguments, instead presenting a conclusory assertion that the facts mandated a win. Consequently, the Board adopted the judge's report and denied the petition.

WCABPetition for ReconsiderationLabor Code section 5813WCAB Rule 10561bad faithfrivolous conductlien claimantsanctionsLab. Code§ 5902
References
Case No. AHM 0082920
Regular
Mar 10, 2008

RAUL REYES vs. DUDDY DRYWALL COMPANY, STATE COMPENSATION INSURANCE FUND

This Workers' Compensation Appeals Board decision denies a lien claimant's petition for reconsideration. The WCAB affirmed the trial judge's disallowance of a medical lien, finding the claimant failed to prove either the reasonableness of its charges or proper licensure for the services provided under the name "SB Surgery Center" on the date of service. The Board held the lien claimant bore the burden of proving licensure and did not meet that burden.

Lien claimantSB Surgery CenterS&B Surgery Centerlicensingreasonableness of chargesburden of proofsubstantial evidenceLabor Code sections 59025904Zenith Insurance Company v. Workers' Comp. Appeals Bd.
References
Case No. ADJ2089759 (FRE 0209611)
Regular
Nov 10, 2008

Alma Pena vs. HYE CUISINE, INC., FARMERS INSURANCE EXCHANGE

The Workers' Compensation Appeals Board granted reconsideration for lien claimant Summit Surgical Center (SSC) and rescinded the imposed $\$2,000.00$ sanction, finding SSC was not provided adequate notice of the basis for the sanction under Labor Code section 5813. However, the Board affirmed the decision that SSC's lien claim was untimely filed under Labor Code section 4903.5, as it was filed more than five years after the injury and nearly four years after the settlement approval, and the partial payment did not toll the statute of limitations. Therefore, SSC will take nothing further on its lien claim.

Workers' Compensation Appeals BoardLien claimantReconsiderationFindings and OrderLabor Code sections 4903.559045813California Code of Regulations title 8 section 10561Fees and costsSummit Surgical Center
References
Case No. ADJ12788878
Regular
Dec 10, 2020

MARIO LUPERCIO PEREZ vs. ARMANDO CHAN dba CHAN DRAINAGE, MARKEL INSURANCE CO.

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration because it was filed as a removal petition challenging interlocutory issues. Although the WCJ's decision contained a final threshold finding of injury AOE/COE, the defendant only disputed the specialty of a QME and the timeliness of an objection, which are interlocutory. The Board found no significant prejudice or irreparable harm to justify removal, and that reconsideration would be an adequate remedy later if a final adverse decision issues.

Workers' Compensation Appeals BoardPetition for ReconsiderationThreshold IssueInterlocutory IssueInjury AOE/COEQualified Medical Evaluator (QME)Treating Physician ReportRemoval StandardSignificant PrejudiceIrreparable Harm
References
Case No. ADJ11279401
Regular
Nov 19, 2019

NANCY PLOTKIN vs. FRASCO, INC.; EVEREST NATIONAL INSURANCE COMPANY, administered by GALLAGHER BASSETT

This case involves a Petition for Reconsideration by the defendant, Frasco, Inc. and its insurer, which the Workers' Compensation Appeals Board (WCAB) denied. The WCAB found that although the Workers' Compensation Judge's (WCJ) decision resolved a threshold issue, making it a final order, the petitioner was only challenging an interlocutory finding. Applying the removal standard for non-final decisions, the WCAB denied removal because the petitioner failed to demonstrate significant prejudice or irreparable harm. Therefore, the Petition for Reconsideration/Removal was denied.

Petition for ReconsiderationThreshold IssueFinal DecisionInterlocutory IssueRemoval StandardSignificant PrejudiceIrreparable HarmReconsideration Inadequate RemedyWCJAppeals Board
References
Case No. ADJ10948281
Regular
Mar 06, 2023

HELODORO ZAMORA PEREZ vs. RMT CONTRACTING, INC., INSURANCE COMPANY OF THE WEST

This case involves a petition for reconsideration filed by Helodoro Zamora Perez against RMT Contracting, Inc. The Workers' Compensation Appeals Board (WCAB) dismissed the petition because it was not timely filed. The WCAB explained that a decision resolving a "threshold" issue is a final order, and any challenges must be made through a timely petition for reconsideration. Since the WCJ's decision addressed a threshold issue, it was a final order subject to timely reconsideration. Furthermore, the WCAB stated that even if the petition had been timely, it would have been denied on its merits.

Petition for ReconsiderationThreshold IssueFinal DecisionInterlocutory IssuesRemoval StandardExtraordinary RemedySignificant PrejudiceIrreparable HarmAdequate RemedyWCAB
References
Case No. ADJ8229086 ADJ8229099
Regular
Sep 23, 2019

DANIEL MARTINEZ vs. CONSOLIDADTED PARTITIONS, MARKEL CORPORATION OF AMERICA, SOUTHERN INSURANCE, ZURICH INSURANCE

The Appeals Board dismissed the Petition for Removal and denied the Petition for Reconsideration. While the WCJ's decision addressed a threshold issue making it final, the petitioner only challenged an interlocutory finding. Removal was denied because the petitioner failed to demonstrate significant prejudice or irreparable harm, and that reconsideration would not be an adequate remedy. Thus, the prior decision stands, and further challenges are limited.

Petition for RemovalPetition for Reconsiderationthreshold issueinterlocutory issuefinal decisionnon-final decisionextraordinary remedysignificant prejudiceirreparable harmadequate remedy
References
Case No. ADJ10296202, ADJ10296203
Regular
Jan 29, 2020

ANDRIA STREETER vs. GOODWILL SERVING THE PEOPLE OF SOUTHERN LOS ANGELES, UNITED STATES FIRE INSURANCE COMPANY

This case concerns defendant's petition for reconsideration or removal of a Workers' Compensation Appeals Board decision. The Board denied the petition, finding the decision contained both a threshold issue (injury AOE/COE) making it final for reconsideration, and an interlocutory issue (treatment outside the medical provider network). Because the petition primarily challenged the interlocutory issue, it was evaluated under the more stringent removal standard. The Board found no evidence of significant prejudice or irreparable harm justifying removal.

Workers' Compensation Appeals BoardPetition for ReconsiderationRemovalJoint Findings of FactInjury AOE/COEThreshold IssueInterlocutory IssueMedical Provider NetworkSignificant PrejudiceIrreparable Harm
References
Case No. ADJ1 403905 (LBO 0392263)
Regular
Oct 02, 2012

LATRICE JONES vs. PAYLESS SHOES, Permissibly Self-Insured

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant argued the WCJ erred by finding an industrial injury and excluding certain witnesses. The Board found the WCJ's credibility determination of the applicant's testimony regarding the assault to be within the WCJ's purview. Additionally, the defendant failed to preserve its arguments regarding excluded witnesses as they were not properly recorded in the record. Finally, issues regarding whether the injury occurred in the course and scope of employment were waived as they were not raised at trial or in the petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationDenying PetitionAdministrative Law JudgeFindings and OrderIndustrial InjuryCredibility DeterminationsWitness TestimonyMinutes of HearingSummary of Evidence
References
Case No. ADJ9326359
Regular
Jan 17, 2020

ERNEST JOHNSON vs. JWCH INSTITUTE, INC.; CYPRESS INSURANCE, administered by BHHC

The Workers' Compensation Appeals Board denied the lien claimant's Petition for Reconsideration. The Board found that while the WCJ's decision included a threshold finding of injury AOE/COE, making it a final order, the lien claimant's challenge only pertained to an interlocutory issue regarding the nature of medical treatment. The Board determined that reconsideration was not the appropriate remedy for this interlocutory dispute and that the lien claimant failed to demonstrate the extraordinary circumstances required for removal. Therefore, the petition was denied.

Petition for ReconsiderationThreshold IssueFinal DecisionInterlocutory IssueRemoval StandardAOE/COELien ClaimantWorkers' Compensation Appeals BoardWCJ ReportSignificant Prejudice
References
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