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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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. ADJ9286923
Regular
May 28, 2019

Oscar Abrego vs. Frontline Finish, Security National Insurance

The Workers' Compensation Appeals Board granted reconsideration to Reshealth Medical Group's petition regarding its lien. The Board rescinded the prior finding that there was insufficient evidence of an assignment between Javlin Three and Reshealth for accounts receivable. This case, along with other matters involving Reshealth, has been consolidated under a master file for further proceedings to address complex issues concerning Reshealth's liens and potential stays under Labor Code section 4615. The lien is returned to the trial level for inclusion in these consolidated proceedings.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings of FactAssignmentAccounts ReceivableLabor Code Section 4615StayOrder of ConsolidationMaster File
References
Case No. ADJ9505835
Regular

FRANCISCO MEDRANO vs. ARMORCAST PRODUCTS, U.S. FIRE INSURANCE

This case concerns a lien filed by Reshealth Medical Services, which is a suspended corporation, and its assignee Javlin Three, LLC. The Appeals Board dismissed Reshealth's petition for reconsideration because the prior order was not a final determination. The Board granted removal to correct the record, clarifying that no Labor Code section 4615 stay was ordered, but affirmed Reshealth's suspension and disqualification from pursuing its lien. Javlin's request for further proceedings to prove its assignment was denied due to failure to present evidence timely during discovery and at hearings.

Workers' Compensation Appeals BoardSuspended CorporationFranchise Tax BoardLien ClaimantPetition for ReconsiderationPetition for RemovalLabor Code Section 4615Due ProcessEvidentiary HearingFinal Order
References
Case No. ADJ6699348
Regular
Mar 17, 2016

KANON MONKIEWICZ vs. RM STORE FIXTURES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) issued a Notice of Intention to find that Labor Code section 4903.8(a) does not preclude awards to lien claimants Rx Funding Solutions, LLC and PharmaFinance, LLC. This is because the 2014 amendments to section 4903.8(a)(2) specify that it does not apply to assignments completed prior to January 1, 2013. Both of the lien claimants' assignments were made before this date, thus exempting them from the preclusion. The WCAB is amending its previous order and returning the case to the trial level for further proceedings on the merits of the liens.

Labor Code 4903.8Lien claimantsAssignment of receivablesCessation of businessPharmacy lienMedical lienSB 863AB 2732Prospective vs. retrospective applicationWCAB rules
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. ADJ8323423
Regular
Nov 13, 2014

JAIME VILLEGAS vs. NOVY RANCH MARKET, STATE FARM INSURANCE COMPANY

This case involves a lien claimant, PharmaFinance, seeking to prove its lien for pharmaceuticals. The Workers' Compensation Appeals Board (WCAB) granted a petition for removal, rescinding a WCJ's order compelling the production of a contract. The WCAB found the contract irrelevant to the reasonable value of pharmaceuticals, which is governed by a statutory fee schedule. However, the lien claimant must still prove its legal assignment and identity to establish the validity of its lien. The matter was returned to the trial level for further proceedings on establishing the lien.

Petition for RemovalLien ClaimantsCompromise and ReleaseAssignment of ReceivablesPharmaceutical Fee ScheduleReasonable Value of ServicesTrade SecretDecertified OpinionBurden of ProofPreponderance of Evidence
References
Case No. ADJ9903270
Regular
Jun 17, 2019

YESENIA MELENDEZ vs. KC PHARMACEUTICALS, EVEREST NATIONAL INSURANCE COMPANY, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

In this workers' compensation case, lien claimant ResHealth Medical Group's petition for reconsideration was denied because its corporate status was suspended by the Franchise Tax Board (FTB) as of April 1, 2016. This suspension prevented ResHealth from prosecuting its lien. While Javlin Three, an alleged assignee, contended it could pursue the lien, it failed to provide evidence that the assignment covered the specific accounts receivable in question. Furthermore, Javlin's own capacity to sue as an assignee was questionable if the assignment occurred after ResHealth's FTB suspension.

Workers' Compensation Appeals BoardFTB suspensionFranchise Tax BoardResHealth Medical GroupJavlin Threelien claimantassigneeassignorLabor Code section 4903.8(a)(1)cease doing business
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. MNKOI 0000714498
Regular
Jul 03, 2018

SALVADOR MOTA vs. BOSKOVICH FARMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Workers' Compensation Appeals Board denied CIGA's petition for reconsideration regarding a lien claim. CIGA argued the lien was barred by Insurance Code section 1063.1(c)(9) because the claimant, VQ Ortho/Vision Quest Industries, Inc. (VQ), was an assignee. However, the Board found VQ was the original claimant who had temporarily assigned and then reassigned the claim back to itself. This allowed VQ to assert the lien as the original provider of services, consistent with the legislative intent of CIGA to protect original claimants.

CIGACovered ClaimInsurance Code 1063.1(c)(9)AssigneeOriginal ClaimantLien ClaimReconsiderationWCABWCJVQ Ortho/Vision Quest Industries
References
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