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

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. 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. ADJ3608808
Regular
Feb 11, 2009

JUAN MARTINEZ vs. J.R. CONSTRUCTION COMPANY, STATE COMPENSATION INSURANCE FUND

This case involves a petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision. The WCAB granted reconsideration to allow the Workers' Compensation Judge (WCJ) to provide a supplemental report addressing the applicant's petition, which had been translated from Spanish. After reviewing the reports, the WCAB affirmed the original Findings and Award. The matter is now concluded with the affirmation of the prior decision.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardSupplemental ReportPetition for ReconsiderationWCJAffirmDefendantApplicantState Compensation Insurance Fund
References
Case No. ADJ7963145, ADJ7963147
Regular
Jan 02, 2015

FERNANDO GUADARRAMA vs. TIERRA DEL SOL FOUNDATION, CYPRESS INSURANCE, BERKSHIRE HATHAWAY

This case involves a petition for reconsideration by lien claimants challenging an order imposing sanctions. The Workers' Compensation Appeals Board reviewed the petition, defendant's answer, and the WCJ's report. Adopting the WCJ's reasoning, the Board affirmed the March 5, 2015 Order Imposing Sanctions. The lien claimants' request for a lien trial was effectively denied by this affirmation.

Workers' Compensation Appeals BoardReconsiderationOrder Imposing SanctionsLien ClaimantsLien TrialAdministrative Law JudgePetition for ReconsiderationReport and RecommendationAffirmationDisability
References
Case No. ADJ3158483 (SBR 0303397) ADJ7073425
Regular
Apr 23, 2012

RONALD LUCERO vs. CITY OF FONTANA

The Workers' Compensation Appeals Board affirmed a prior finding that Ronald Lucero's claim for heart injury and hypertension as a police officer is not time-barred. The Board also upheld the entitlement to the presumption of industrial heart injury under Labor Code section 3212.5. The defendant City of Fontana's petition for reconsideration, arguing the presumption was factually inappropriate, was denied. The Board adopted the Workers' Compensation Judge's report and affirmed the original award.

Workers' Compensation Appeals BoardCity of FontanaRonald LuceroJoint Findings and Award and Orderheart injuryhypertensionpolice officercumulative traumaStatute of Limitationspresumption of industrial heart injury
References
Case No. ADJ7170139, ADJ7176930
Regular
Mar 22, 2017

ROBERT GAONA vs. CAPITAL BUILDERS HARDWARE, SOUTHERN INSURANCE COMPANY, ENDURANCE REINSURANCE CORPORATION OF AMERICA

This case involves Robert Gaona's workers' compensation claims against Capital Builders Hardware and their insurers. The Court of Appeal previously annulled its writ of review and remanded the case to the Workers' Compensation Appeals Board (WCAB). The WCAB has now affirmed its prior decision from March 24, 2016, which dismissed the defendants' Petition for Reconsideration and denied their Petition for Removal. Therefore, the original Joint Findings and Orders issued by the WCJ on June 5, 2015, stand affirmed.

Workers' Compensation Appeals BoardRemittiturCourt of AppealPetition for ReconsiderationPetition for RemovalJoint Findings and OrdersAdministrative Law JudgeAnnulledAffirmedSubstitution of Commissioner
References
Case No. ADJ6781238
Regular
Mar 08, 2013

JORGE MORA vs. CLP RESOURCES, INC., ESIS

This case involved a carpenter, Jorge Mora, who sustained an industrial injury to his left hand while employed by CLP Resources, Inc. The Workers' Compensation Appeals Board (WCAB) affirmed the WCJ's prior decision finding that the injury was proximately caused by CLP Resources' serious and willful misconduct. The WCAB also upheld the WCJ's determination that the serious and willful misconduct claim was not barred by the statute of limitations. The defendant's petition for reconsideration was denied, affirming the original award of compensation and attorney's fees.

Workers' Compensation Appeals BoardSerious and willful misconductIndustrial injuryCarpenterLeft hand injuryStatute of limitationsCompromise and ReleasePetition for ReconsiderationFindings and AwardWCJ Report and Recommendation
References
Case No. ADJ272980 (VNO 0474292), ADJ273175 (VNO 0474293), ADJ2241790 (VNO 0474295)
Regular
May 22, 2014

LUIS CASTANEDA vs. VALLEY TODECO, ESIS WEST WC CLAIMS, CHARTIS INSURANCE

The Appeals Board granted removal to rescind the WCJ's order vacating the dismissal of Coast Plaza Doctors Hospital's lien, as Coast's petition for reconsideration was untimely. The Board affirmed the dismissal of Coast's lien, even though the stated reason (failure to pay activation fee) was technically erroneous for a post-2013 lien. Finally, the Board affirmed the denial of the defendant's request to keep discovery closed regarding Beverly Hills Pharmacy's lien, and returned the case for further proceedings on that lien.

Petition for RemovalOrder Vacating DismissalPetition for ReconsiderationUntimely FilingLien Activation FeeLabor Code Section 4903.06WCAB Rule 10859Void Ab InitioOrder Dismissing Lien ClaimAffirmation
References
Case No. ADJ10177259
Regular
Apr 06, 2020

ROSA GUTIERREZ vs. MID VALLEY NUT COMPANY, INC., INTERCARE

The Workers' Compensation Appeals Board (WCAB) affirmed the Workers' Compensation Administrative Law Judge's (WCJ) February 11, 2020 decision. The WCAB gave great weight to the WCJ's credibility determinations, finding no substantial evidence to reject them. The applicant failed to prove that Mid Valley Nut Company, Inc. committed serious and willful misconduct, as the employee accused of such misconduct did not meet the legal definition of an executive, managing officer, or general superintendent. Therefore, the WCAB affirmed the original findings and orders.

Workers' Compensation Appeals BoardReconsiderationWCJ credibility determinationsGarza v. Workmen's Comp. Appeals Bd.serious and willful misconductemployer's managing officerexecutivegeneral superintendentBigge Crane & Rigging Co. v. Workers' Comp. Appeals BdHunt
References
Case No. ADJ6937463
Regular
Jan 16, 2015

DELIA MELENDEZ vs. VICTOR VALLEY COMMUNITY COLLEGE DISTRICT, PIPS

The Workers' Compensation Appeals Board (WCAB) reconsidered two decisions regarding applicant Delia Melendez's claims against Victor Valley Community College District. The WCAB rescinded the Findings and Order in Case No. ADJ6937463 to correctly identify the cumulative injury period and injured body parts, finding applicant sustained industrial injury to her psyche from January 5, 2009, through July 20, 2009. However, the WCAB affirmed the WCJ's determination that this psychiatric injury claim is barred by Labor Code section 3208.3(h) because it was substantially caused by a lawful, good-faith personnel action. Consequently, the WCAB affirmed the WCJ's denial of benefits for all alleged injuries in both cases.

AOE/COEpsychiatric injurycumulative traumaLabor Code section 3208.3(h)personnel actionreconsiderationrescindedaffirmedmedical treatmenttemporary disability
References
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