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Case Law Database

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

Case No. ADJ310891 (LAO 0859195) (MF) ADJ109830 (LAO 0859199) ADJ469798 (LAO 0859196) ADJ1234133 (LAO 0859197) ADJ2754911 (LAO 0859198)
Regular
Jan 13, 2017

MARIA ELENA MORENO vs. SONNET TOOLS, EVEREST NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The Board affirmed the administrative law judge's finding that lien claimants Orthogear LLC and Olorun LLC lawfully assigned their lien interests to Olorun Management, Inc., satisfying Labor Code section 4903.8(a) due to Orthogear's dissolution. The Board also upheld the order for the defendant to pay $360.00 for a medical device, plus penalties and interest, due to unreasonable payment delay. The defendant failed to present evidence contradicting the lien claimant's asserted valid assignment.

Workers' Compensation Appeals BoardLien AssignmentLabor Code Section 4903.8(a)Business DissolutionOlorun ManagementOrthogear LLCOlorun LLCStacie GreenspanPetition for ReconsiderationBurden of Proof
References
Case No. ADJ164815 (SAL 0049263)
Regular
Apr 01, 2020

Pamela McGowne Willoughby vs. Hoge, Fenton, Jones \u0026 Appel, American Home Assurance

The Workers' Compensation Appeals Board (WCAB) reconsidered an administrative law judge's (ALJ) disapproval of a Compromise and Release (C&R). The ALJ found the C&R unlawful due to an alleged assignment of liability, citing Labor Code section 4900. The WCAB clarified that while an injured worker cannot assign their claim, a structured settlement where a third party pays the insurer's obligation with the worker's consent is permissible. After reviewing the financial stability of the annuity provider, the WCAB found the settlement adequate and in the applicant's best interest, thus rescinding the disapproval and approving the C&R.

Compromise and ReleaseMedicare Set AsideStructured SettlementAssignment of LiabilityLabor Code Section 4900Matthews v. Liberty Assignment Corp.WCAB Rule 10700Financially SoundPeriodic PaymentsAnnuity
References
Case No. ADJ9849559
Regular
Sep 08, 2017

MARIA ESTEVEZ vs. WALMART ASSOCIATES, INC.

The Workers' Compensation Appeals Board granted reconsideration, amending the original order to defer the disposition of Reshealth Medical Group's lien. The Board found that the WCJ failed to make necessary factual findings regarding the timing of the assignment of the lien to Javlin Three LLC, a critical issue given Reshealth's suspension by the Franchise Tax Board. The matter was returned for further proceedings to address whether the assignment was valid before or after Reshealth's corporate suspension, and potentially the validity of the assignment under Labor Code section 4903.8. The Board otherwise affirmed the original findings.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactAdministrative Law JudgeLienAssignmentFranchise Tax Board suspensionCorporate statusCapacity to sueLabor Code 5313
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. ADJ4363797
Regular
Jun 27, 2012

JOHN TRAN vs. TUNG KEE NOODLE, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT COMPENSATION in liquidation

This case concerns whether the California Insurance Guarantee Association (CIGA) can depose Lee Caballero, a non-attorney representative for lien claimant Dan Ho, D.C., regarding his relationship with Dr. Ho. CIGA seeks to determine if the lien was assigned to Caballero, which would exclude it from CIGA's coverage. The Board rescinded the prior order denying the deposition and allowed CIGA to depose Caballero about his agreement with Dr. Ho, provided a written agreement is not produced. However, the deposition is limited to questions concerning the assignment of the lien, excluding confidential communications about the claim's merits.

CIGAlien claimantnon-attorney lay representativedepositionassignmentInsurance Code section 1063.1(c)(9)(B)confidentiality privilegeattorney-client privilegeattorney work product privilegecase of first impression
References
Case No. ADJ607600 (SFO 0411600)
Regular
May 27, 2011

DELMAR GREEN vs. STATE ROOFING SYSTEMS, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, HIH AMERICA COMPENSATION & LIABILITY INSURANCE CO., INTERCARE INSURANCE SERVICES

The California Insurance Guarantee Association (CIGA) sought to compel the production of documents from Recovery Resources, Inc. to determine if a lien assigned by St. Francis Memorial Hospital to Recovery was a covered claim under Insurance Code § 1063.1(c)(9)(B). The Workers' Compensation Judge (WCJ) previously quashed a subpoena duces tecum (SDT) seeking these documents, citing privilege and overbreadth. The Appeals Board granted CIGA's Petition for Removal, rescinded the order quashing the subpoena, and returned the matter to the trial level. The Board ruled that CIGA has the right to discover evidence of the contractual relationship to prove a legal assignment, but must avoid privileged material and burdensome requests.

CIGAPetition for RemovalSubpoena Duces TecumQuashedAssignmentChose in actionInsurance Code § 1063.1(c)(9)(B)Privileged materialAttorney work productAttorney-client communication
References
Case No. ADJ3746488
Regular
Oct 07, 2010

JAVIER CHAVEZ vs. CRESCENT TRUCK LINES

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's decision which found a lien claimant to be an assignee, thus not a covered claim for CIGA. The Board found the WCJ erred in drawing an adverse inference of assignment without sufficient evidence. The matter was returned to the trial level for further proceedings on whether the lien was legally assigned. The Board clarified that the nature of the assignment (absolute vs. for representation) is crucial to determining CIGA's liability.

Workers' Compensation Appeals BoardLien Recovery ServicesNorwalk OrthopedicCalifornia Insurance Guarantee AssociationCIGAadverse inferenceassigneelegal assignmentcovered claimexhibition exclusion
References
Case No. ADJ8817942
Regular
Oct 02, 2017

JUAN MEZA vs. JVS WINES IMPORT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION on behalf of CASTLEPOINT NATIONAL INSURANCE COMPANY in liquidation, administered by TRISTAR

This case involves CIGA seeking reconsideration of a stipulation ordering it to pay Mesa Pharmacy $1,000 for a lien. CIGA argued it shouldn't pay due to an alleged assignment of Mesa's rights and Mesa's expired license. The Appeals Board denied reconsideration, treating CIGA's removal petition as a reconsideration request. The Board found CIGA failed to prove the assignment's validity and that CIGA entered the stipulation knowing of the alleged assignment, thus lacking good cause to be relieved.

CIGACastlepoint Insurance CompanyMesa PharmacyJavlin Threelien claimantstipulation and orderpetition for reconsiderationpetition for removalfinal orderinterlocutory order
References
Case No. ADJ6865467
Regular
Nov 14, 2012

TIRADO vs. OAKMOUNT COUNTRY CLUB, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION BY ITS SERVICING FACILITY, XCHANGING FOR FREMONT INSURANCE COMPANY, IN LIQUIDATION

This case concerns whether a collection agreement constituted an assignment, thereby excluding the California Insurance Guarantee Association (CIGA) from liability for a workers' compensation lien. The Workers' Compensation Appeals Board (WCAB) rescinded a prior finding that an assignment occurred. The WCAB found that the agreement with WSG & Associates, despite granting broad authority for collection and settlement, did not transfer ownership of the lien. Key factors included the lien claimant retaining the right to terminate the agreement and the ultimate payment being made to the lien claimant, aligning with precedent that such arrangements are not assignments.

Workers' Compensation Appeals BoardCIGAInsurance Code section 1063.1assignment of lienlien claimantnon-attorney representativecovered claiminsolvent insurercompromise and releaseFindings and Order
References
Case No. ADJ9928707
Regular
Oct 20, 2017

Victorino Aragon Orta vs. Classic Party Rentals, Old Republic General Insurance Co.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the Administrative Law Judge's (ALJ) order disallowing Reshealth Medical Group's lien. The ALJ had found the assignment of the lien invalid due to an undated, untitled, and illegibly signed document, and because Reshealth was a suspended corporation. However, the WCAB found that the ALJ failed to provide a sufficient opinion, develop the record regarding Reshealth's corporate status and the assignment date, and potentially denied due process by raising the assignment's validity sua sponte without notice. The case was returned to the trial level for further development of the record.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderAssignment ValiditySuspended CorporationCorporate StatusStandingLien DisallowanceDue ProcessFair Hearing
References
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