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

Case No. ADJ6461309
Regular
Jul 19, 2012

JOSEPH MARTIN vs. City of Ukiah, Permissibly Self-Insured, administered by REDWOOD EMPIRE MUNICIPAL FUND

The Workers' Compensation Appeals Board denied reconsideration, upholding the WCJ's decision regarding air ambulance service fees. The board found that California Administrative Rule 9789.70, which dictates reasonable fees for ambulance services, is preempted by the federal Airline Deregulation Act. This preemption applies because the rule attempts to regulate the prices and services of air carriers, which is exclusively within federal purview. Therefore, the board concluded that the specific fee limitations in Rule 9789.70 do not apply to air ambulance services.

Workers Compensation Appeals BoardAD Rule 9789.70Air Ambulance ServicesAirline Deregulation ActADA Preemption49 U.S.C. § 41713(b)(1)Morales v. Trans World AirlinesState Regulation of Air CarriersWCABPetition for Reconsideration
References
Case No. ADJ7303543
Regular
Apr 08, 2013

JUAN RAMOS vs. SCI TEK STAFFING, CHARTIS

This case involves a workers' compensation claim where the Appeals Board granted reconsideration. The prior WCJ decision was found inconsistent with *Enriquez v. Couto Dairy*, which established that the Appeals Board can find preemption of Administrative Director (AD) Rule 9789.70, specifically the Official Medical Fee Schedule for air ambulance services. The Board clarified that the Airline Deregulation Act may preempt this rule if the air ambulance provider qualifies as an "air carrier" and has the burden of proving this status. Therefore, the matter was returned to the trial level for further proceedings and a new decision consistent with *Enriquez*.

Workers' Compensation Appeals BoardEnriquez v. Couto DairyArticle III section 3.5 California ConstitutionLabor Code section 5307.1preemptionAdministrative Director Rule 9789.70Official Medical Fee ScheduleOMFSair ambulance servicesAirline Deregulation Act
References
Case No. ADJ6833713
Significant
Mar 28, 2013

Luis Enriquez (deceased) vs. Couto Dairy, Zenith Insurance Company

The Appeals Board holds that the federal Airline Deregulation Act (ADA) preempts California's fee schedule for air ambulance services (AD Rule 9789.70) if the provider qualifies as an 'air carrier' under the ADA. The matter is returned to the trial level to determine the provider's legal status.

Airline Deregulation ActAD Rule 9789.70preemptionair carrierair transportationOfficial Medical Fee ScheduleOMFSFederal Aviation AdministrationFAAinterstate air transportation
References
Case No. GOL 0087934, GOL 0087935, GOL 0087936
En Banc
Feb 13, 2002

Alonso Navarro vs. A&A Farming, Western Growers Insurance Co.

The Board held that the applicant's claim of discrimination under Labor Code section 132a was preempted by the federal Employee Retirement Income Security Act (ERISA), as the claim was premised on the employer's termination of contributions to an ERISA-regulated health plan.

ERISA preemptionLabor Code section 132agroup health benefitsdiscrimination claimadverse actionemployee welfare benefit planworkers' compensationindustrial injuriesemployer contributionstemporary disability
References
Case No. ADJ9385010
Regular
Oct 04, 2018

JULIO LARA vs. TONY'S MARKET, STATE COMPENSATION INSURANCE FUND

This case involved a dispute over whether the Airline Deregulation Act preempts state common law regarding air ambulance fees under Labor Code section 4600(a). The applicant's air ambulance carrier, Reach, argued that federal law preempted state regulation of its rates. However, before the Appeals Board could issue a decision after reconsideration, the parties reached a settlement agreement. Consequently, Reach withdrew its petition, and the Board vacated its prior order granting reconsideration and dismissed the petition. The matter was returned to the trial level for approval of the settlement.

Airline Deregulation ActADA preemptionair ambulance feesreasonable expense standardLabor Code section 4600(a)common law reasonablenessfederal court decisionsseverability principlessettlement agreementpetition dismissal
References
Case No. ADJ4086603 (LAO 0829698) ADJ4469358 (LAO 0829699)
Regular
May 01, 2009

ADA ROZENBLAT vs. CEDARS SINAI HEALTH SYSTEM

This Workers' Compensation Appeals Board notice addresses a dispute over attorney's fees and costs awarded as sanctions. The defense seeks $800.50 for opposing a petition for reconsideration, while applicant's counsel, Daniel Escamilla, concedes only $540.00. The Board finds $800.50 reasonable and proposes to award this amount to defense counsel, Pearlman, Borska & Wax, L.L.P. This award is separate from any other sanctions payable to the General Fund.

WORKERS' COMPENSATION APPEALS BOARDADA ROZENBLATCEDARS SINAI HEALTH SYSTEMADJ4086603ADJ4469358ATTORNEY'S FEESCOSTSSANCTIONSLABOR CODE § 5813PETITION FOR RECONSIDERATION
References
Case No. ADJ4113221 (WCK0015884), ADJ3860954 (WCK 0003849), ADJ1849290 (WCK 0003852), ADJ2468456 (WCK 0015098), ADJ2798390 (WCK 0021329), ADJ4523810 (WCK 0045748)
Regular
Aug 06, 2013

David Kallaby vs. ALBERTSON'S

The Workers' Compensation Appeals Board dismissed three of applicant David Kallaby's motions as untimely petitions for reconsideration and removal, and also dismissed a motion for disqualification as the WCJ was not assigned to future proceedings. The Board lacked jurisdiction over two other motions concerning the Information and Assistance Office and ADA accommodations, remanding the matter to the Presiding Judge. The applicant's attorneys had previously been relieved of record due to irreconcilable differences.

Workers' Compensation Appeals BoardOrder Relieving AttorneyPetition for ReconsiderationPetition for RemovalPetition for DisqualificationWCJ GondakInformation and Assistance OfficeADA AccommodationTimelinessJurisdiction
References
Case No. ADJ7274196
Regular
Dec 07, 2012

RONALD PIERCE vs. CITY OF TULARE

The applicant, Ronald Pierce, requested to appear telephonically for trial as an ADA accommodation, which the Workers' Compensation Judge (WCJ) denied, citing due process and the need to observe witnesses. The Appeals Board dismissed Pierce's Petition for Reconsideration because the WCJ's ruling was not a final decision. The Board also denied his Petition for Removal, finding no significant prejudice as the substantive issue was to be decided on briefs. Pierce was also advised that he does not have a right to free legal counsel.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalTelephonic AppearanceADA AccommodationDue ProcessCross-examinationSubstantive RightFinal OrderAggrieved Party
References
Case No. ADJ8128282
Regular
Jan 23, 2014

ANGELA EGBIKUADJE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings. The defendant, California Department of Corrections and Rehabilitation, argued that the applicant's psychiatric injury claim was preempted by the ADA and not proven under Labor Code section 3208.3. The Board found the original decision lacked proper analysis regarding predominant industrial causation and the good faith personnel action defense. Therefore, the case was remanded for further development of the record, including expert medical opinion on these issues.

Workers' Compensation Appeals BoardAngela EgbikuadjeCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8128282Van Nuys District OfficeReconsiderationFindings and AwardIndustrial cumulative trauma injury
References
Case No. ADJ1151115
Regular
Apr 25, 2011

DAWN BAKER vs. CHUCKAWALLA VALLEY STATE PRISON, STATE COMPENSATION INSURANCE FUND

The WCAB granted CCPOA's Petition for Removal, rescinded the WCJ's order taking CCPOA's lien off-calendar, and returned the matter for further proceedings. The WCJ erred by incorrectly stating a lien requires applicant consent and by failing to allow CCPOA due process to argue its lien's validity. While the WCJ raised potential issues regarding ERISA preemption and statutory authorization for the lien, the Board found these require further development at the trial level. CCPOA must still present evidence and argument to establish its lien under Labor Code sections 4903 and 4903.1.

Petition for RemovalLien ClaimantWCJ OrderOff-CalendarStipulated AwardIndustrial InjuryBilateral Upper ExtremitiesTemporary DisabilityPermanent DisabilityNotice of Lien
References
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