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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
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. 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. 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. 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. VNO 0421742
Regular
Mar 17, 2008

CONRAD GAC vs. DAY SHIP MANAGEMENT, INC.

The WCAB affirmed the WCJ's decision dismissing the applicant's workers' compensation claim for lack of jurisdiction. The Board found the applicant's exclusive remedy lies in admiralty law against the United States, as the defendant employer acted as an agent of the U.S. government for a vessel owned by the U.S. Navy. Previously decided jurisdictional and timeliness issues were deemed law of the case and affirmed.

Workers' Compensation Appeals BoardConrad GacDay Ship ManagementInc.cumulative traumamerchant marine seamanpetition for reconsiderationlack of jurisdictionSuits in Admiralty ActPublic Vessels Act
References
Case No. ADJ10544189
Regular
Nov 09, 2018

MARTIN GARCIA vs. HARVEST CHURCH, GUIDEONE MUTUAL

This case involves an applicant seeking an increased permanent impairment rating for a psychiatric injury stemming from a physical injury to his left foot. The applicant's injury occurred when a gate fell on his foot, and he claims this constitutes a "violent act" under Labor Code section 4660.1(c)(2)(A), which allows for exceptions to a general rule against increased impairment ratings for psychiatric issues arising from physical injuries. The Appeals Board denied reconsideration, affirming the WCJ's finding that the gate falling was an accidental injury, not a violent act, based on definitions involving strong physical force or extreme threats. The Board found the applicant's experience lacked the intensity seen in prior cases of violent acts, such as being struck by a car or being crushed in a vehicle.

AOE/COEViolent ActLabor Code Section 4660.1Psychiatric InjuryPermanent Impairment RatingPetition for ReconsiderationFindings of FactWorkers' Compensation Judge (WCJ)Industrial InjuryPreponderance of the Evidence
References
Case No. ADJ9343159, ADJ1368987 (MON0362038)
Regular
Sep 15, 2017

JAMES ISAAC vs. UNITED AIRLINES

The Workers' Compensation Appeals Board (WCAB) dismissed United Airlines' petition as procedurally improper. United Airlines filed a "Petition to Set Aside Order Approving Compromise and Release" instead of the correct "Petition for Reconsideration." The WCAB will return the matter to the Workers' Compensation Judge (WCJ) to address United Airlines' original petition. This ruling does not substantively rule on the merits of setting aside the compromise and release.

Petition to Set AsideOrder Approving Compromise and ReleasePetition for ReconsiderationWorkers' Compensation Appeals BoardWCJDismissedGallagher Bassett ServicesUnited AirlinesADJ9343159ADJ1368987
References
Case No. AHM 0077308 AHM 0075910
Regular
Jul 30, 2007

CLIFFORD GAMBLE vs. UNITED AIRLINES, GALLAGHER BASSETT SERVICES, ET AL.

The Workers' Compensation Appeals Board (WCAB) dismissed United Airlines' petition for reconsideration as untimely filed. United Airlines sought to clarify VRMA liability, arguing it shouldn't extend to periods the applicant interrupted rehabilitation services. The WCAB found no bad faith or frivolousness, noting the petition was a reasonable attempt to clarify a potential ambiguity in the original decision.

Workers' Compensation Appeals BoardUnited AirlinesGallagher Bassett ServicesClifford GamblePetition for ReconsiderationDecision After RemittiturVocational Rehabilitation Maintenance AllowanceVRMAQualified Injured WorkerTimely Filing
References
Case No. ADJ7210580
Regular
Feb 17, 2012

DAVID COLLINS vs. CROWLEY TECHNICAL SERVICES, ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board reversed a finding of concurrent jurisdiction for an injured seaman. The seaman was employed by Crowley Technical Services, an agent of the U.S. Department of Transportation, and injured while working on the U.S.S. Curtis, a vessel owned by a U.S. agency. Because the seaman was a member of the crew of a U.S. government-owned vessel and employed by a U.S. agent, federal law dictates exclusive jurisdiction, precluding California from adjudicating the claim.

Exclusive JurisdictionAdmiralty LawSeaman StatusJones ActLHWCACrew MemberMaritime AdministrationSuits in Admiralty ActPublic Vessels ActConcurrent Jurisdiction
References
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