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

Case No. ADJ6699348
Regular
Mar 17, 2016

KANON MONKIEWICZ vs. RM STORE FIXTURES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) issued a Notice of Intention to find that Labor Code section 4903.8(a) does not preclude awards to lien claimants Rx Funding Solutions, LLC and PharmaFinance, LLC. This is because the 2014 amendments to section 4903.8(a)(2) specify that it does not apply to assignments completed prior to January 1, 2013. Both of the lien claimants' assignments were made before this date, thus exempting them from the preclusion. The WCAB is amending its previous order and returning the case to the trial level for further proceedings on the merits of the liens.

Labor Code 4903.8Lien claimantsAssignment of receivablesCessation of businessPharmacy lienMedical lienSB 863AB 2732Prospective vs. retrospective applicationWCAB rules
References
Case No. ADJ66 99348
Regular
Apr 11, 2016

KANON MONKIEWICZ vs. RM STORE FIXTURES, STATE COMPENSATION INSURANCE FUND

This case involves lien claimants Rx Funding Solutions and PharmaFinance seeking payment for assigned medical expenses. The Workers' Compensation Appeals Board (WCAB) reconsidered a prior ruling that disallowed these liens under Labor Code section 4903.8(a). The WCAB found that the 2014 amendments to section 4903.8(a)(2) specifically exempt assignments made before January 1, 2013, from preclusion. Therefore, the WCAB amended the prior order to allow the lien claimants to proceed with further proceedings on the merits of their claims.

WCABReconsiderationLien ClaimantsLabor Code Section 4903.8AssignmentCeased Doing BusinessPharmacyPharmacistSB 863AB 2732
References
Case No. ADJ2609190
Regular
Jul 19, 2019

DEBORAH ORTIZ vs. KAISER PERMANENTE HOSPITAL/ SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP

The Workers' Compensation Appeals Board granted reconsideration of a lien claimant's petition, rescinding the original order and remanding the case for further proceedings. The Board found that the lien claimant failed to demonstrate "extraordinary circumstances" to justify payment above the Official Medical Fee Schedule, as those provisions were repealed in 2004. Furthermore, the Board clarified that lien claimants now bear the burden of proof for injury arising out of and occurring in the course of employment (AOE/COE), a principle established by recent legislative amendments and case law. The WCJ must now make findings on AOE/COE and other evidentiary issues.

Petition for ReconsiderationLien ClaimantFindings of Fact and OrderOfficial Medical Fee ScheduleExtraordinary CircumstancesLabor Code Section 3202.5Burden of ProofPreponderance of the EvidenceInjury AOE/COECompromise and Release
References
Case No. ADJ9178612
Regular
Aug 09, 2016

CARMELLINA GITUKU vs. ALTA HOME CARE, CYPRESS INSURANCE COMPANY

This case concerns the disallowance of liens filed by Reshealth Medical Group and Mesa Pharmacy, assigned to Javlin Three LLC, for failing to comply with Labor Code section 4903.8. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, finding the original decision improperly applied the statute and lacked sufficient evidence. The WCAB rescinded the original decision, returning the case to the trial level for further development of the record, particularly concerning the effective dates of assignments and the business status of the original lien claimants. The WCAB also noted potential due process concerns regarding service but found no actual prejudice to the parties.

Labor Code Section 4903.8Lien ClaimantAssignment of LienReshealth Medical GroupMesa PharmacyJavlin Three LLCMaximum MedicalPetition for ReconsiderationFindings and OrdersDue Process
References
Case No. LAO 0871191
Regular
May 12, 2008

FREDDY CORDERO vs. AB-HR COMPANY, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and amended a prior award, finding that the applicant's psychiatric injury was barred by Labor Code section 3208.3(d) due to his employment duration of less than six months. The Board determined that being struck in the eye by flying debris, a foreseeable risk in his work environment where safety goggles were required, did not constitute a "sudden and extraordinary employment event." Consequently, the claim for psychiatric injury was denied, and the matter was returned for further proceedings on permanent disability and attorney fees related to the admitted industrial injury to the applicant's right eye.

Labor Code section 3208.3sudden and extraordinary employment eventpsychiatric injurycompensable consequenceindustrial injurysequalaethreshold requirementsix-month employment limitationMajor Depressive Disorderpermanent disability
References
Case No. ADJ6939769
Regular
Sep 28, 2010

RONY BONILLA vs. AMERICAN TRANSPORTATION SYSTEM, INSURANCE COMPANY OF THE WEST

The Workers' Compensation Appeals Board granted defendant's Petition for Reconsideration, rescinding the prior Findings and Award. The Board found the original decision void *ab initio* due to the Administrative Law Judge's failure to serve the Minutes of Hearing and Summary of Evidence and issue a Notice of Intent to Submit. This procedural defect deprived the defendant of due process and the opportunity to object. The matter is returned to the trial level for further proceedings and a new decision.

WCABPetition for ReconsiderationFindings and AwardMinutes of HearingSummary of EvidenceLabor Code section 5313Board Rule 10562(a)(2)Notice of Intent to SubmitDue ProcessExpedited Hearing
References
Case No. ADJ292109 (LAO 0863163)
Regular
Oct 27, 2015

Erica Brumfield vs. County of Los Angeles, Department of Social Services, York Risk Services

The Appeals Board granted reconsideration and rescinded the WCJ's dismissal order. The dismissal was based on a defendant's petition containing material misrepresentations and improper service on the unrepresented applicant. Crucially, the defendant failed to properly serve notice of dismissal proceedings, and the applicant was actively pursuing her claim as evidenced by her communications with adjusters and medical providers. Therefore, the dismissal order is void *ab initio* due to lack of due process and material misrepresentations.

Amended Petition to Set Aside DismissalPetition to Dismiss Based On Lack of Prosecutionvoid ab initiomaterial misrepresentationPetition for Reconsiderationrescind the Orderindustrial injuryunrepresentedin propria personamisrepresentation of facts
References
Case No. ADJ1862937 (VNO 0503723)
Regular
May 07, 2012

TRAVIS GRANT vs. SIERRACIN CORPORATION (PPG INDUSTRIES), administered by AVIZENT RISK

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant sought to revive a December 9, 2008 dismissal order, arguing it was valid under Appeals Board Rule 10852. However, the Board found this dismissal order void *ab initio* because it was issued without the required notice of intention to dismiss and opportunity to be heard, as mandated by CCR Title 8, Section 10582. Therefore, the prior finding that the applicant's claim had not been dismissed was upheld.

Workers' Compensation Appeals BoardPetition for ReconsiderationFinding of FactOrder of DismissalRule 10852Rule 10582Lack of ProsecutionNotice of Intention to DismissVoid Ab InitioAdministrative Law Judge
References
Case No. ADJ9518031
Regular
Oct 16, 2014

MARIA LUISA GARCIA vs. GABRIEL STEFFENS AND KATHERINE E. BELL, STATE FARM INSURANCE COMPANY

In this workers' compensation case, the Appeals Board granted defendant's Petition for Removal to address the dismissal of their Petition to Quash a subpoena duces tecum (SDT). The defendant argued the SDT was improperly served only on the defendant, not their counsel, despite notice of representation being filed. The Board agreed that failure to serve counsel renders an SDT void ab initio. Consequently, the Appeals Board rescinded the WCJ's dismissal order and returned the matter to the trial level for a merits determination of the Petition to Quash.

Petition for RemovalPetition to QuashSubpoena Duces TecumService of ProcessVoid ab initioMootnessIndustrial InjuryRight Upper ExtremityPsycheBaby Sitter
References
Case No. ADJ3714425 (FRE 0234250) ADJ896033 (FRE 0171714)
Regular
Aug 22, 2014

MICHAEL WRIGHT vs. STAR MEDIA, TRAVELERS INDEMNITY COMPANY OF CONNECTICUT

The Workers' Compensation Appeals Board granted reconsideration, rescinding a WCJ's order that enforced a reimbursement order against Travelers Indemnity Company. The Board found the reimbursement order void *ab initio* due to procedural due process infirmities. Specifically, the "self-destruct" clause in the order did not comport with due process protections outlined in precedent cases like *Mitchell v. Golden Eagle Ins.*, failing to guarantee a review of objections or automatically void the order upon valid objection. Therefore, Travelers' due process rights were violated, necessitating the rescission of the WCJ's findings.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder for ReimbursementCalifornia Insurance Guarantee Association (CIGA)Cumulative Trauma InjuryAgreed Medical Examiner (AME)ApportionmentDue ProcessSelf-Destruct ClauseVoid Ab Initio
References
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