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

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. ADJ8217279
Regular
May 05, 2017

PETER BOURASSA vs. DOLLAR TREE, SEDGWICK

The Appeals Board affirmed the WCJ's decision regarding applicant Peter Bourassa's workers' compensation claim. The lien claimant, Monrovia Memorial Hospital, sought payment exceeding $\$58,272.00$ for services rendered. The Board clarified that facility fees for long-term care hospitals exempt from the Official Medical Fee Schedule (OMFS) must be paid on a "reasonable cost basis." The lien claimant failed to meet its burden of proving the reasonableness of its charges under relevant case law.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderLien ClaimantReasonable Cost BasisOMFSKunz studyAffirmAffirmAffirm
References
Case No. ADJ2203540
Regular
Jan 11, 2012

GORDON ANTHONY vs. COUNTY OF LOS ANGELES

This case involves a petition for reconsideration filed by the Applicant, Gordon Anthony. The Workers' Compensation Appeals Board granted reconsideration to correct a clerical error in the original decision dated October 18, 2011. Specifically, the Board amended the decision to change the applicant's name from "ANTHONY GORDON" to "GORDON ANTHONY" in multiple locations of the findings and order. Otherwise, the Board affirmed the original decision.

Workers' Compensation Appeals BoardReconsiderationClerical ErrorFindings of FactOrderOpinion on DecisionApplicantDefendantSelf-InsuredAmended Decision
References
Case No. ADJ1253728 SFO 0509604
Regular
Dec 04, 2012

KENNETH BUMGARNER vs. CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration in *Bumgarner v. California Highway Patrol*. The Board affirmed the original decision but amended Finding of Fact No. 2 to clarify that there is no legal apportionment of permanent disability, specifically regarding the neck injury. This amendment clarifies the non-apportionment principle for permanent disability in this case.

Workers' Compensation Appeals BoardCalifornia Highway PatrolState Compensation Insurance FundPetition for ReconsiderationWCJ ReportDecision After ReconsiderationFinding of FactLegal ApportionmentPermanent DisabilityNeck Injury
References
Case No. ADJ6713391
Regular
Aug 15, 2013

PEDRO TELLO MENDEZ vs. MISSION FOODS GRUMA CORPORATION, TRAVELERS PROPERTY CASUALTY COMPANY

The Workers' Compensation Appeals Board granted reconsideration of the initial May 30, 2013 decision. The Board amended the decision to reflect that the defendant, Mission Foods Gruma Corporation, is estopped from opposing the applicant's petition for costs. Consequently, the applicant's Petition for Costs is now granted. The rest of the original decision remains affirmed.

Petition for ReconsiderationDecision After ReconsiderationEstoppelPetition for CostsWorkers' Compensation Appeals BoardWCJMission Foods Gruma CorporationTravelers Property Casualty CompanyPedro Tello MendezAmended Decision
References
Case No. ADJ2038785 (VNO 0426080), ADJ900602 (VNO 0426045), ADJ2562931 (VNO 0494371), ADJ7032939, ADJ7045667
Regular
Aug 01, 2019

JOSEPH PROTHRO vs. STATE COMPENSATION INSURANCE FUND as administered by ACCLAMATION INSURANCE MANAGEMENT SERVICES

This Workers' Compensation Appeals Board case, involving multiple claim numbers for Joseph Prothro against State Compensation Insurance Fund, has been granted reconsideration. The Board rescinded the prior WCJ's decision because a settlement has been proposed. The case is now returned to the WCJ to evaluate the settlement, with the option to reinstate the original decision if the settlement is not approved. This decision is not a final determination on the merits.

Workers' Compensation Appeals BoardPetition for ReconsiderationGrant ReconsiderationRescind DecisionReturn to Trial LevelWorkers' Compensation Administrative Law JudgeProposed SettlementApproval of SettlementReinstating Original DecisionFinal Decision
References
Case No. ADJ3811046 (LBO 0238656), ADJ367597 (LBO 0348091), ADJ2329312 (LBO 0288049)
Regular
Apr 09, 2012

MARISA CARLINI vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, SAN PEDRO PENINSULA HOSPITAL, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a petition for reconsideration by the Workers' Compensation Appeals Board. The Board granted reconsideration of a January 19, 2012 decision. The Board then affirmed the original decision but amended it by rescinding and striking Finding of Fact 8.

Workers' Compensation Appeals BoardMarisa CarliniLos Angeles Unified School DistrictSan Pedro Peninsula HospitalSedgwick Claims Management ServicesADJ3811046LBO 0238656Opinion and Order Granting ReconsiderationDecision After ReconsiderationPetition for Reconsideration
References
Case No. ADJ408647 (FRE 0248555)
Regular
Apr 26, 2013

PATROCINA RAMSEY vs. SKYWEST AIRLINES, SEDGWICK CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board granted reconsideration in *Ramsey v. Skywest Airlines* and amended the prior decision. Specifically, the first paragraph of the "Orders" from the February 14, 2013 decision was rescinded. The matter was then returned to the trial level for further proceedings regarding potential sanctions.

Patrocina RamseySkyWest AirlinesSedgwick Claims ManagementADJ408647FRE 0248555Workers' Compensation Appeals BoardOpinion and Order Granting ReconsiderationDecision After ReconsiderationWCJsanctions
References
Case No. ADJ7755811
Regular
Jun 21, 2013

SONIA MILLS vs. COUNTY OF FRESNO, PSI, AMERICAN ALL-RISK LOSS ADMINISTRATORS, INC.

This case involved a worker, Sonia Mills, seeking compensation from the County of Fresno for medical treatment. The Workers' Compensation Appeals Board granted reconsideration of the prior decision. The Board amended the original decision to clarify that Mills' self-procured treatment was unauthorized and not related to her industrial injury. Therefore, the defendant is not liable for this specific treatment.

Workers' Compensation Appeals BoardReconsiderationSelf-procured treatmentUnauthorized treatmentIndustrial injuryLeft trapeziusLiabilityOpinion and OrderDecision After ReconsiderationFindings of Fact
References
Case No. ADJ3346924
Regular
Oct 02, 2013

JORGE RAMIREZ vs. BOARD FORD, PACIFIC COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of the Administrative Law Judge's (ALJ) prior decision. The WCAB rescinded the ALJ's decision and remanded the case back to the trial level for further proceedings and a new decision. This action means the original decision is nullified, and the case will be re-evaluated by the ALJ. The parties retain the right to seek further reconsideration of any future ALJ ruling.

WORKERS' COMPENSATION APPEALS BOARDOPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONPetition for Reconsiderationworkers' compensation administrative law judgeWCJgrant reconsiderationrescind WCJ's decisionfurther proceedingstrial level
References
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