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

Case No. ADJ240659 (MON 0358311)
Regular
Mar 25, 2009

JOHN PELLETIER vs. CVS PHARMACY, AMERICAN HOME ASSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration regarding an industrial injury to the applicant's bilateral wrists sustained while employed at CVS Pharmacy. The Board found the date of injury, for the purpose of Labor Code sections 5412 and 5500.5, was February 11, 2008, when the applicant first knew his disability was work-related and received medical confirmation. This date was subsequent to his termination, thus negating the post-termination defense under Labor Code section 3600(a)(10) due to exceptions that applied.

Workers' Compensation Appeals BoardCVS PharmacyAmerican Home AssuranceJohn Pelletiercumulative injurybilateral wristsLabor Code section 5412date of injurycompensable disabilitymedical confirmation
References
Case No. ADJ6869590
Regular
Nov 07, 2013

EDMOND HAKAKHA vs. CVS PHARMACY, NEW HAMPSHIRE INSURANCE COMPANY, GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, adopting the findings of the administrative law judge. The judge determined the applicant was not entitled to temporary disability benefits beyond a specific period, as medical reports and the applicant's own testimony indicated he was able to work. Furthermore, penalties under Labor Code Section 5814 were denied because there was no prior award of temporary disability, and the employer had a genuine doubt regarding the correct wage rate and period of disability. Attorney fees were awarded at 15% on accrued temporary disability, but not under Section 5814.5.

WORKERS' COMPENSATION APPEALS BOARDCVS PHARMACYNEW HAMPSHIRE INSURANCE COMPANYGALLAGHER BASSETT SERVICESINC.ADJ6869590ADJ6869586Petition for ReconsiderationWCJSupplemental Petition for Reconsideration
References
Case No. ADJ9822757, ADJ9826854
Regular
May 05, 2017

MIREYA CASILLAS vs. CVS PHARMACY, INC.

The Workers' Compensation Appeals Board denied CVS Pharmacy's Petition for Reconsideration. The Board adopted the WCJ's report, finding that a single physician's opinion can constitute substantial evidence, even if conflicting. This decision upholds the WCJ's findings regarding industrial injuries, including dyspepsia, fibromyalgia, rheumatological arthritis, and psyche, as reported by various medical experts. The Board specifically noted that apportionment issues were not at the forefront of the current "body parts" determination.

WORKERS' COMPENSATION APPEALS BOARDRECONSIDERATION DENIEDSUBSTANTIAL EVIDENCEWCJ REPORTAPPORTIONMENTPSYCHERHEUMATOID ARTHRITISFIBROMYALGIADYSPEPSIAGASTROINTESTINAL
References
Case No. ADJ6734934, ADJ7902780
Regular
Feb 18, 2014

LETICIA RODRIGUEZ vs. CVS PHARMACY, GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board denied CVS Pharmacy's Petition for Removal. Removal is an extraordinary remedy requiring a showing of substantial prejudice or irreparable harm, which the defendant failed to demonstrate. The Board found that a petition for reconsideration would be an adequate remedy if the ultimate decision on permanent disability is adverse. Therefore, the petition was denied, and the Board declined to consider sanctions against the defendant.

Petition for RemovalAppeals BoardWorkers' Compensation Judge (WCJ)Substantial PrejudiceIrreparable HarmReconsiderationJudicial EfficiencyPiecemeal LitigationPermanent DisabilityDeposition
References
Case No. ADJ10881718
Regular
Jul 19, 2019

WANDA JACKSON vs. CVS PHARMACY, INC., NEW HAMPSHIRE INSURANCE COMPANY

This case, *Jackson v. CVS Pharmacy, Inc.*, concerns the date of injury for a cumulative trauma claim under Labor Code section 5412. The Workers' Compensation Appeals Board denied reconsideration, upholding the finding that the applicant did not know her disability was work-related until receiving medical advice. The applicant's belief that her pain was caused by work activities was insufficient without knowledge that it constituted a compensable cumulative injury. Therefore, the date of injury was determined to be when she gained this medical knowledge, not when she first experienced symptoms or had a general belief about their origin.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code section 5412date of injurycumulative injuryoccupational diseasedisabilityknowledge of industrial origintemporary disabilitypermanent disability
References
Case No. ADJ724329 (LAO 0863195)
Regular
Jan 28, 2010

BRAMBILA vs. VONS, INC.

The Workers' Compensation Appeals Board denied reconsideration to MH Express Pharmacy. The lien claimant sought additional payment for medications provided to the applicant, arguing they were prescribed by MPN physicians. However, the employer had established a Pharmacy Benefit Network (PBN) before the applicant's injury, and the lien claimant was not part of this network. The Board found the lien claimant misrepresented the record by claiming the PBN contract was not in evidence, and affirmed the denial of further payment for medications dispensed outside the PBN.

Workers' Compensation Appeals BoardLien ClaimantPharmacy Benefit NetworkMedical Provider NetworkFindings and OrderReconsiderationLabor Code section 4600.2(a)Compromise and ReleaseOfficial Medical Fee ScheduleBad Faith Tactics
References
Case No. ADJ4449218
Regular
Mar 04, 2010

LUIS ALVARADO vs. STAFFING SERVICES, INC., STATE COMPENSATION INSURANCE FUND

Here is a summary of the case in a maximum of four sentences for a lawyer: The Workers' Compensation Appeals Board denied reconsideration of the Administrative Law Judge's (ALJ) decision, which found jurisdiction over a dispute between an injured worker's applicant and defendant Staffing Services, Inc. The ALJ correctly determined that there was no express agreement between Staffing Services and the lien claimant, Beverly Hills Pharmacy, fixing payment amounts, thus Labor Code section 5304 did not divest the Board of jurisdiction. The Board also found that removal was not appropriate for this final determination. Procedural arguments regarding a denied continuance due to the defense attorney's illness were also rejected.

Workers' Compensation Appeals BoardReconsiderationRemovalLien ClaimantExpress AgreementLabor Code Section 5304JurisdictionStaffing Services Inc.State Compensation Insurance FundBeverly Hills Pharmacy
References
Case No. ADJ7208535
Regular
Oct 09, 2014

MARIA DORAME vs. AZTEC HARVESTING, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of an order dismissing DNM Pharmacy's lien claim. The Board adopted the administrative law judge's report, finding DNM Pharmacy failed to demonstrate good cause for not appearing at the lien trial or for not objecting to the notice of intention to dismiss the lien. Additionally, the Board admonished DNM Pharmacy and its representative for failing to comply with specific rules regarding lien claimant representation. DNM Pharmacy's lien was for $2,089.06 for medication related to the applicant's psyche injury, which was dismissed as part of a Compromise and Release agreement.

Maria DorameAztec HarvestingZenith Insurance CompanyPetition for ReconsiderationOrder Denying PetitionLien ClaimantDNM PharmacyCalifornia Lien Claimant NetworkSection 10774.5Workers' Compensation Administrative Law Judge
References
Case No. ADJ4713838 (MON 0335494)
Regular
Mar 15, 2013

PHYLLIS SWINK vs. AVIS RENT-A-CAR, CNA CLAIMS PLUS

This case concerns a lien claimant, KVP Pharmacy, seeking reconsideration of a prior order dismissing its lien. KVP Pharmacy argued the dismissal order was invalid due to an unsigned and undated document. However, the Appeals Board dismissed KVP Pharmacy's petition because it was filed approximately six months after the lien dismissal order was served. The Board found the petition to be untimely, as California Labor Code requires reconsideration petitions to be filed within 20 days, plus an additional five days if served by mail. Therefore, the Board lacked jurisdiction to consider the merits of KVP Pharmacy's arguments.

WCABLien ClaimantPetition for ReconsiderationUntimely PetitionOrder Dismissing LienWCJService by MailRecital of ServicePresumption of ReceiptLabor Code
References
Case No. ADJ6953054
Regular
Mar 22, 2013

ERIKA CERVANTES vs. FACILITIES MANAGEMENT COUNTY OF RIVERSIDE, COUNTY OF RIVERSIDE, WORKERS' COMPENSATION DIVISION

This case involves a Petition for Reconsideration filed by Basso Pharmacy concerning the dismissal of its lien. The Administrative Law Judge found that Basso Pharmacy failed to appear at a scheduled lien trial and did not object to a subsequent Notice of Intent to Dismiss. The Workers' Compensation Appeals Board adopted the ALJ's report, finding no basis to overturn the dismissal. Therefore, the Board denied Basso Pharmacy's Petition for Reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder of DismissalLien ClaimantBasso PharmacyNotice of Intent to DismissLien TrialProof of ServiceFailure to AppearWCAB file
References
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