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

Case No. ADJ8964113
Regular
Jun 24, 2016

LISA LIU vs. ADVENTURER HOTEL, TOWER NATIONAL INSURANCE COMPANY

This case concerns a lien claim filed by Tri-County Medical Group for services provided to applicant Lisa Liu. The Administrative Law Judge (ALJ) dismissed the lien, finding it was filed untimely beyond the 18-month statutory limit. The lien claimant appealed, arguing the filing date of February 2, 2015, was within the period because the 18-month deadline of February 1, 2015, fell on a Sunday, extending the filing to the next business day. The Workers' Compensation Appeals Board granted reconsideration, rescinded the ALJ's order, and found the lien timely filed. The Board determined that per procedural rules, when the last day falls on a weekend, the deadline extends to the next business day.

Workers' Compensation Appeals BoardLien ClaimPetition for ReconsiderationLabor Code section 4903.5(b)Statute of Limitations18-month periodRules of Practice and ProcedureBusiness DayEAMS RecordJudicial Notice
References
Case No. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
Case No. ADJ10391495
Regular
Jun 20, 2019

EDNA DE LEON, vs. DEPALMA TERRACE SENIOR LIVING; BERKSHIRE HATHAWAY HOMESTATE COMPANIES; THE HARTFORD,

The Workers' Compensation Appeals Board dismissed Edna De Leon's Petition for Reconsideration because it was filed untimely. The Board noted that California law allows only 25 days to file a petition after a decision is served by mail. De Leon's petition was filed on April 22, 2019, which was more than 25 days after the WCJ's March 25, 2019 decision. The Board emphasized that timely filing is jurisdictional and they lacked authority to consider petitions filed outside this timeframe.

Petition for Reconsiderationuntimelydismissaljurisdictionalservice by mailtime limitWCABWCJdeadline25 days
References
Case No. ADJ7270261
Regular
Mar 01, 2012

MEKAL FARUKI vs. MACY'S DEPARTMENT STORES

This case involves Mekal Faruki's petition for reconsideration of a Workers' Compensation Appeals Board decision. The Board dismissed the petition as untimely. Labor Code section 5903 establishes a strict 20-day deadline for filing reconsideration petitions, with a possible 5-day extension for mailing. Critically, the petition is considered filed upon receipt, not mailing date. Faruki's petition was filed over 25 days after the December 10, 2010 decision, rendering it jurisdictionally barred.

Mekal FarukiMacy's Department StoresPetition for ReconsiderationUntimely FilingLabor Code Section 5903WCAB Rule 10507Jurisdictional Time LimitDismissalWorkers' Compensation Appeals BoardSacramento District Office
References
Case No. ADJ7875439
Regular
Apr 12, 2018

Mercedes Silva vs. TRI-STATE EMPLOYMENT SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LUMBERMEN'S UNDERWRITING ALLIANCE in liquidation

The Workers' Compensation Appeals Board (WCAB) dismissed a Petition for Reconsideration because it was untimely filed. California law generally allows 25 days for such petitions, with extensions for weekends or holidays, and crucially, requires the petition to be *received* by the WCAB within that period. In this case, the petition was filed three days after the deadline of February 12, 2018, rendering it jurisdictionally invalid. The WCAB therefore lacked the authority to consider the merits of the petition.

Petition for ReconsiderationUntimely FilingJurisdictional LimitWorkers' Compensation Appeals BoardAdministrative Law JudgeLumbermen's Underwriting AllianceLiquidationMail ServiceBusiness Day ExtensionReceipt of Filing
References
Case No. ADJ8013755
Regular
Mar 29, 2017

JOONG YEOL LEE vs. BCD TOFU HOUSE; TOWER

The Workers' Compensation Appeals Board dismissed the defendant's Petition for Reconsideration as untimely. The defendant had 25 days from service of the Findings and Award to file, with mail service extending the deadline. However, the petition was received by the Board one day *after* the filing deadline. Filing proof of mailing within the period is insufficient; the petition must be received by the Board. Consequently, the Board lacked jurisdiction to consider the petition due to its tardiness.

Petition for ReconsiderationUntimelyDismissedWorkers' Compensation Appeals BoardWCJFindings and AwardLab. CodeCal. Code Regs.JurisdictionalDate of Filing
References
Case No. ADJ1871643 (SDO 0291759)
Regular
Oct 23, 2017

JOSE GOMEZ vs. DEPARTMENT OF CORRECTIONS, REHABILITATION PAROLE & COMMUNITY SERVICES, Legally Uninsured, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, affirming the WCJ's award of medical treatment. The defendant's Utilization Review denial was deemed untimely because their Request for Information was served more than five business days after the initial request, excluding the day after Thanksgiving. The Board clarified that the day after Thanksgiving is considered a normal business day for UR purposes under Labor Code section 4600.4. Therefore, the defendant's untimely RFI did not extend the UR deadline, and the requested medical treatment was properly authorized.

Workers' Compensation Appeals BoardUtilization ReviewRequest for AuthorizationRequest for InformationTimelinessBusiness DayLabor Code Section 4600.4Petition for ReconsiderationFindings and AwardPrimary Treating Physician
References
Case No. ADJ11535411
Regular
Jul 19, 2019

TERRI HARRISON vs. CITY OF TORRANCE

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, overturning a prior ruling that presumed the applicant's injury compensable due to a late denial. The Board found that the defendant's denial letter, mailed on December 26, 2018, was timely because the 90-day presumption period expired on December 25, 2018, a court holiday, making the next business day the deadline. The employer's inability to definitively prove the claim form's receipt date led the Board to infer a receipt date of September 26, 2018, thus making the December 26 denial compliant with Labor Code section 5402. Consequently, the applicant's injury is not presumed compensable.

Labor Code section 5402presumption of compensabilitytimely denialclaim form filing dateCode of Civil Procedure section 1013WCAB Rule 10507(a)court holidaybusiness day extensionPetition for ReconsiderationFindings and Order
References
Case No. ADJ8286745 ADJ8327424
Regular
Jul 30, 2018

ARNULFO LOPEZ ESPARZA vs. A1 COAST SANITATION RENTALS, CIGA, by its servicing facility, INTERCARE for ULLICO, in liquidation

This Workers' Compensation Appeals Board case concerns a petition for reconsideration that was dismissed as untimely. The Board held that for a petition to be timely, it must be *received* by the Board within the statutory 25-day period, not merely mailed. Since the petition in this case was filed on June 5, 2018, after the June 4, 2018 deadline, it was dismissed for lack of jurisdiction. Had it been timely, the Board would have denied it on the merits based on the judge's report.

Petition for ReconsiderationUntimely FilingJurisdictional Time LimitProof of Mailing InsufficientWCABWCJLabor CodeCalifornia Code of RegulationsOrder Dismissing LienLien Claimant
References
Case No. ADJ9917212
Regular
Mar 17, 2016

MICHAEL GREEN vs. ELLE PLACEMENT dba GOLDEN GATE STAFFING, LUMBERMEN'S UNDERWRITING ALLIANCE

This case concerns the timeliness of a defendant's utilization review (UR) denial for requested medical treatment. The Workers' Compensation Appeals Board (WCAB) rescinded the initial decision awarding treatment, finding the defendant's UR denial was timely made and served within the five-business-day window. The key issue was whether a UR denial sent via facsimile after 5:30 p.m. on the fifth business day was valid. The Board concluded the UR decision was timely made and communicated within 24 hours of its making, rendering it valid and requiring disputes to go through the Independent Medical Review (IMR) process.

Utilization ReviewRequest for AuthorizationIndependent Medical ReviewWCJBusiness DayFacsimile Date StampAdministrative DirectorMedical TreatmentSpinal SurgeryArthroplasty
References
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