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

Case No. ADJ6843683
Regular
Dec 03, 2019

ELIZABETH FUERTE vs. B&H EDUCATION INC., ZENITH INSURANCE COMPANY, ICW GROUP

The Workers' Compensation Appeals Board (WCAB) rescinded a prior award, returning the case to the trial level for further proceedings. The WCAB clarified that lien claimants bear the burden of proving their copy services were reasonable, actual, and necessary, as clarified by the en banc decision in *Colamonico*. The Board also noted that services performed after the applicant settled her claim may require further justification. Finally, the WCAB indicated that if the lien claimant meets its initial burden, penalties and interest under Labor Code section 4622 may apply, as the defendant did not submit an Explanation of Review (EOR).

Lien claimantWCJReconsiderationFindings and AwardLabor Code section 4622PenaltyInterestCopy servicesCompromise and ReleaseColamonico
References
Case No. ADJ9981379 ADJ10049541
Regular
Oct 08, 2020

ULISES AVILA vs. LARRY GONZALES dba LARRY GONZALES FARM LABOR, STAR INSURANCE COMPANY

The Appeals Board reversed a WCJ's finding that a lien claimant's services ended on March 16, 2015, determining instead that services extended to June 8, 2015. This decision makes the lien timely filed under Labor Code section 4903.5(a). The Board affirmed the WCJ's orders except to find the lien timely filed and to defer the lien's allowance. The matter is returned to the WCJ for further proceedings consistent with the Board's decision and to assess the lien under the framework of *Colamonico*.

Workers' Compensation Appeals BoardLien ClaimantStatute of LimitationsSubpoena Duces TecumMedical-Legal ServicesReconsiderationFindings of Fact and OrdersLabor Code Section 4903.5(a)Timely FiledDeferred Issue
References
Case No. ADJ9838074 ADJ9838134
Regular
Nov 25, 2019

LEON SIMPSON vs. COLLEGE MEDICAL CENTER, NATIONAL CASUALTY INSURANCE, Administered by BROADSPIRE

The Workers' Compensation Appeals Board granted the lien claimant's petition for reconsideration regarding copy service invoices. The Board rescinded the prior decision, finding the administrative law judge's analysis inconsistent with Labor Code section 4622. The case is returned to the WCJ for further proceedings and a new decision consistent with the Board's en banc opinion in *Colamonico*, particularly addressing timely EOR submissions and the proper application of bill review statutes. Specifically, the WCJ must determine if defendants submitted timely explanations of review for all invoices.

Workers' Compensation Appeals BoardLien claimantMedical-legal expenseExplanation of Review (EOR)Labor CodePetition for ReconsiderationRescindFurther proceedingsColamonico v. Secure TransportationReasonable value
References
Case No. ADJ8236211
Regular
Oct 24, 2025

JULIE CASTELLANO vs. LOWE'S COMPANIES, INC., SEDGWICK CLAIMS MANAGEMENT SERVICES

The Appeals Board granted reconsideration to Supreme Copy Service, which challenged a Workers' Compensation Judge's (WCJ) finding that it failed to prove a contested claim existed for medical-legal reimbursement and was sanctioned for bad faith. The Board rescinded the WCJ's Findings and Order, determining that a contested claim did exist based on the employer's disagreements over various benefits. The case was returned for further proceedings to evaluate if the expenses were reasonable and necessary, and the Board found no basis for the imposed sanctions.

Medical-legal reimbursementContested claimLabor Code section 4620ColamonicoSanctionsPetition for ReconsiderationCompromise and ReleaseLachesBurden of proofWCAB Rule 10421
References
Case No. ADJ15495483; ADJ15494417
Regular
Sep 30, 2025

GLADYS SERRANO vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The cost petitioner, Platinum Copy, sought reconsideration of a WCJ's 'Joint Findings, Order, and Opinion on Decision' that denied their petitions for medical-legal costs and sanctions. The WCJ had granted defendant's motion to quash subpoenas and found Platinum Copy failed to prove their entitlement to recover costs due to unreasonableness and lack of necessity of the services. The Appeals Board affirmed the WCJ's decision, concluding that Platinum Copy failed to establish the reasonableness and necessity of the incurred services, including improper service of subpoenas, thus denying the Petition for Reconsideration.

WCABPlatinum CopyPetition for ReconsiderationMotion to QuashMedical Legal CostsSubpoenasContested ClaimLabor Code Section 5909Colamonico v. Secure TransportationAD Rule 9982
References
Case No. ADJ10717774
Regular
Oct 12, 2020

DEVON PROVENCHER vs. ELECTROLURGY, INSURANCE COMPANY OF THE WEST

This case concerns whether a lien claimant, Med-Legal LLC, is entitled to payment for services rendered. The Appeals Board rescinded a prior finding, determining that a "contested claim" existed at the time Med-Legal provided services, satisfying the initial burden under Labor Code section 4620. This determination was based on the applicant's unresolved issues regarding various benefits, including temporary and permanent disability, despite the employer initially accepting liability for the injury itself. The matter is now returned to the trial level for further proceedings to assess the reasonableness and necessity of the lien claimant's services.

Labor Code Section 4620Contested ClaimLien ClaimantMedical-Legal ExpensesEmployer LiabilityCompromise and ReleaseFindings and OrderReconsiderationSubpoena Duces TecumWorkers' Compensation Appeals Board
References
Case No. ADJ11900759
Regular
Oct 20, 2025

Luis Hernandez vs. Cesar Chavez Foundation, Berkshire Hathaway Homestate Insurance Company

The Workers' Compensation Appeals Board denied defendant Berkshire Hathaway Homestate Insurance Company's petition for reconsideration. The defendant challenged an earlier decision that found a contested claim existed when cost petitioner DocCentral provided subpoena services. The Board affirmed its previous finding, clarifying that a claim becomes contested upon an employer's delay notice, thus allowing discovery. The Board rejected the defendant's argument that a denial was required for a contested claim, citing prior en banc decisions to support its position on discovery during delay periods.

Contested claimLabor Code § 4620(b)8 CCR § 9793(b)Petition for ReconsiderationOpinion and Order DenyingDocCentralsubpoena servicesdelay noticemedical-legal expenseAdjudication of Claim
References
Case No. ADJ9344199
Regular
Feb 20, 2020

ZARAGOZA, Lima vs. DENCO ENTERPRISES, WILLIAMSBURG NATIONAL INSURANCE COMPANY, MEADOWBROOK

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to review the findings of the administrative law judge (WCJ) concerning lien claimant Citywide Scanning Service's request for payment for copy services. The WCJ awarded Citywide $2,005.00 but denied reimbursement for a filing fee and dismissed other issues as moot. The WCAB rescinded the WCJ's decision and remanded the case for further proceedings, finding that the WCJ did not adequately address the lien claimant's burden of proof regarding the reasonableness and necessity of its services. Furthermore, the WCAB indicated that the WCJ must provide a clear factual and legal basis for any awarded amount, rather than solely relying on the Copy Service Fee Schedule.

Workers' Compensation Appeals BoardLien claimantReconsiderationFindings Orders and AwardCopy Services Fee ScheduleReasonable ValueBurden of ProofLabor Code 4622Explanation of Review60-day window
References
Case No. ADJ9824600
Regular
Dec 24, 2019

MARTHA FLORES vs. REAL MEX RESTAURANTS; Administered by GALLAGHER BASSETT

The Appeals Board granted the defendant's petition for reconsideration, rescinded the WCJ's prior findings, and returned the case for further proceedings. The Board found that the WCJ failed to rule on evidentiary objections and did not provide sufficient findings to support awards for sanctions and attorney fees. This decision is based on newly clarified burdens of proof for lien claimants and the requirement for clear findings on admitted evidence. The WCJ must now address these issues and issue a new decision consistent with the Board's guidance.

Petition for ReconsiderationFindings and OrderCost PetitionerInvoicesSanctionsAttorney's FeesLabor Code § 4622Explanation of ReviewBurden of ProofAdmissibility of Exhibits
References
Case No. ADJ9542328
En Banc
Nov 14, 2019

ASHLEY COLAMONICO vs. SECURE TRANSPORTATION, NATIONAL UNION FIRE INSURANCE COMPANY

The Appeals Board held that a medical-legal provider has the initial burden to prove an expense was for a contested claim and was reasonable and necessary per Labor Code §§ 4620-4621, and a defendant does not waive these objections by failing to raise them in an Explanation of Review (EOR) under § 4622.

Med-Legal PhotocopyEn Banc DecisionPetition for ReconsiderationFindings and OrdersLien ClaimantExplanation of ReviewContested ClaimReasonable and Necessary ExpensesBurden of ProofLabor Code Section 4620
References
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