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

Case No. ADJ2834079 (SDO 0293027) ADJ2839895 (SDO 0358837)
Regular
Jun 25, 2009

THUAN CRIM-ROLFE vs. LA COSTA RESORT AND SPA, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LEGION INSURANCE COMPANY, BROADSPIRE, SAFETY NATIONAL CASUALTY INSURANCE COMPANY

This case involves a clerical error in a prior Workers' Compensation Appeals Board (WCAB) decision. The WCAB previously ordered Safety National Casualty Insurance Company (SNCC) to reimburse the California Insurance Guarantee Association (CIGA) a specific amount for bill review charges. CIGA requested clarification, noting the amount ordered was incorrect. The WCAB affirmed its earlier decision that CIGA is entitled to reimbursement for bill review costs but amended the order nunc pro tunc. The corrected order now states SNCC must reimburse CIGA for bill review charges, with the exact amount to be determined by the parties or the arbitrator.

California Insurance Guarantee AssociationLegion Insurance CompanySafety National Casualty Insurance Companynunc pro tuncclerical errorbill review chargesliquidationcovered claimsreimbursementpetition for reconsideration
References
6
Case No. ADJ1643143 (SRO 0122410)
Regular
May 25, 2010

JUAN ESCUTIA vs. NICK LERAS WATER TRUCKS, et al.

The Workers' Compensation Appeals Board affirmed a prior decision holding the State Compensation Insurance Fund (SCIF) liable for reimbursement to the California Insurance Guarantee Association (CIGA). CIGA, adjusting claims for an insolvent insurer, sought reimbursement for various administrative expenses, including bill review, court reporter fees, and opposing counsel fees incurred while administering an injured worker's claim. The Board found these costs, particularly bill review expenses, were part of "incurred losses" under the California Workers' Compensation Uniform Statistical Reporting Plan and thus reimbursable. This decision establishes that CIGA can recover such administrative costs from a solvent insurer when adjusting claims for an insolvent carrier.

CIGASCIFBill ReviewIncurred LossesLoss Adjustment ExpensesInsurance Code Section 1063.1(c)(9)Labor Code Section 5500.5(e)California Workers' Compensation Uniform Statistical Reporting PlanReconsiderationFindings and Orders
References
7
Case No. ADJ2185374 (LAO 0844306)
Regular
May 15, 2014

JOHN DEL PINTO vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board affirmed an arbitrator's decision regarding reimbursement between two cities for medical treatment costs. The arbitrator awarded the City of Glendale 50% reimbursement from the City of Los Angeles for medical payments made. However, the arbitrator denied Glendale reimbursement for cost-containment expenses like bill review and utilization review. Glendale's petition for reconsideration, arguing for full apportionment recovery and reimbursement of cost-containment costs, was denied. The Appeals Board adopted the arbitrator's reasoning, affirming the original award.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardLien ClaimantReimbursementApportionmentAgreed Medical EvaluatorMedical Bill ReviewUtilization ReviewCost-Containment Expenses
References
0
Case No. ADJ9508272
Regular
Oct 11, 2017

FERESHTEH ALAEI-NIA vs. MACY'S INC.

This Workers' Compensation Appeals Board case involves an award of additional attorney's fees and costs to applicant's counsel. The Second District Court of Appeal had previously remanded the case for such an award after denying the defendant's Petition for Writ of Review. The Board reviewed the itemized request, considering factors like time, effort, skill, complexity, and the frivolous nature of the defendant's petition. Ultimately, the Board awarded $8,955.00 in attorney's fees and $120.14 in costs, totaling $9,075.14.

Writ of ReviewSupplemental Attorney's FeesLabor Code § 5801Appellate Attorney's FeesCase-by-case basisFrivolous PetitionIndustrial Psychiatric InjuryVenue ChallengeReasonable Hourly RateItemization of Attorney's Fees
References
1
Case No. ADJ3792740 (OAK 0325116)
Regular
Dec 12, 2008

BONNIE REDDRICK vs. TENET/DOCTORS MEDICAL CENTER

This case concerns an award of appellate costs to the applicant's attorney. The Court of Appeal remanded the matter for the determination of these costs following the denial of the defendant's petition for review. The Appeals Board awarded $152.21 in costs, representing verifiable delivery expenses, as in-house copying, mailing, and labor costs are considered overhead and not recoverable.

Workers' Compensation Appeals BoardPetition for Writ of ReviewAppellate CostsLabor Code § 5811Johnson v. Workers' Comp. Appeals Bd.Supreme Court of CaliforniaItemized CostsDelivery CostsMailing CostsCopying Costs
References
4
Case No. MISSING
Regular Panel Decision

Tokyo Electron Arizona, Inc. v. Discreet Industries Corp.

This order addresses the plaintiff Tokyo Electron Arizona's (TAZ) application for reasonable attorney's fees and costs against defendants Discreet Industries and Ovadia Meron (Discreet), pursuant to Federal Rule 37. The court determines the appropriate award by assessing the reasonableness of hourly rates and hours expended, applying the lodestar method. While acknowledging the high caliber of work, the court reduced Mr. Haug's hourly rate and applied a 10% overall reduction to the billed hours to account for potential overlap. Additionally, the court found TAZ's copying and transcript costs reasonable and partially awarded costs for a computer-generated Power Point presentation. Ultimately, TAZ was awarded $55,751.79 in fees and $5386.19 in costs, totaling $61,137.98.

Attorney's FeesCostsDiscovery SanctionsFederal Rule 37Lodestar MethodHourly RatesReasonable HoursEastern District of New YorkSouthern District of New YorkWork Product Doctrine
References
26
Case No. ADJ273572
Regular
Nov 14, 2008

DIANE DRUEBERT vs. KELLY STAFF LEASING, INC.

This case concerns an award of attorney's fees and costs to the applicant's counsel for successfully opposing the defendant's Petition for Writ of Review at the appellate level. The Court of Appeal remanded the matter for this specific purpose. The Appeals Board awarded $4,350.00 in attorney's fees and $142.61 in costs, totaling $4,492.61, after reviewing the attorney's itemized time and the complexity of the appellate work.

Workers' Compensation Appeals BoardPetition for Writ of ReviewSupplemental Attorney's FeesLabor Code § 5801Reasonable CostsCourt of AppealAppellate Attorney's FeesComplex IssuesLegislative IntentSocial Security Offset
References
1
Case No. FRE 192364, FRE 192365, FRE 198592
Regular
Sep 21, 2007

CAROL MCKINLEY vs. RAMALLAH, INC./GENERAL INSURANCE COMPANY OF AMERICA

This case involves a request for additional attorney's fees and costs following a successful defense against a defendant's petition for writ of review. The Appeals Board reviewed the itemized hours and requested rate, disallowing time spent on specific tasks deemed clerical or administrative. Ultimately, the Board awarded $\$ 2,100.00$ in attorney's fees and $\$ 49.45$ in costs, recognizing the applicant's attorney's experience and the outcome of the appeal.

Workers' Compensation Appeals BoardAttorney's FeesPetition for Writ of ReviewCourt of AppealRemandLabor Code § 5801Labor Code § 5811Certified Workers' Compensation SpecialistHourly RateCosts on Appeal
References
4
Case No. ADJ2340102 (LAO 0751270) ADJ4406096 (LAO 0784412)
Regular
Apr 27, 2017

JOSE MORFIN vs. WHITE MEMORIAL MEDICAL CENTER, ADVENTIST HEALTH

This case involves an award of additional attorney's fees for applicant's counsel in the California Court of Appeal. The court remanded the matter for supplemental fees after the defendant's unsuccessful Petition for Writ of Review. While applicant's attorney sought $11,480.00 in fees, the Board found this excessive and awarded $8,000.00 based on a review of the appellate work and the contentious history of the litigation. The Board also awarded the requested costs of $67.58, totaling $8,067.58 in additional appellate attorney's fees and costs.

Workers' Compensation Appeals BoardSupplemental Attorney's FeesPetition for Writ of ReviewLabor Code § 5801Labor Code § 5811Appellate Attorney's FeesItemization of Attorney's FeesExcessive Fee RequestReasonable Fee DeterminationCase-by-Case Basis
References
1
Case No. ADJ7038469
Regular
Sep 17, 2014

AZIZA SAYED vs. GIORGIO ARMANI, FEDERAL INSURANCE COMPANY

The defendant's petition to appeal an Administrative Director's Independent Bill Review (IBR) determination was dismissed. The Board found the petition premature as it was not first heard by a trial level Workers' Compensation Judge (WCJ). Additionally, the petition failed to comply with numerous procedural requirements, including proper captioning, verification, service, and stating specific grounds for appeal. Consequently, both the petition for reconsideration and the petition appealing the IBR determination were dismissed.

Workers' Compensation Appeals BoardIndependent Bill ReviewPetition for ReconsiderationAdministrative DirectorLabor Code section 4603.6MAXIMUS Federal ServicesInc.Lien claimantOfficial Medical Fee ScheduleWCAB Rules of Practice and Procedure
References
0
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