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

Case No. ADJ7523998
Regular
Nov 03, 2014

GEORGE HARVEY SMITH vs. STATE OF CALIFORNIA

The defendant sought reconsideration of an order for further development of the record regarding the applicant's competency. The applicant had previously sustained industrial injuries, including to his psyche, resulting in an $88\%$ permanent disability award. The judge ordered a comprehensive evaluation to determine the applicant's competency from 2006 to the present. The Board dismissed the petition, ruling that the order for further discovery was not a final order and thus not subject to reconsideration. The dissenting opinion argued that while the petition was procedurally flawed, the order for further development should be rescinded as the record did not support a finding of incompetency.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderIndustrial InjuryPsychePermanent DisabilityCompetencyLabor Code Section 5408Guardian Ad LitemMental Incompetency
References
Case No. ADJ8390531
Regular
Feb 21, 2018

SARA RUSH vs. PROCARE MOBILE RESPONSE, EVEREST NATIONAL INSURANCE COMPANY, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

This case concerns a medical treatment lien disallowance for non-compliance with Labor Code § 4903.8(d), which requires a declaration from a competent person attesting to services rendered and accurate billing. The Appeals Board rescinded the initial decision, finding that the lien claimant had substantially complied with the statute. The Board held that an electronic "S" signature was sufficient and that the billing clerk, Jennifer Zambrana, was competent to make the declaration given the circumstantial evidence of treatment. Consequently, the lien was not disallowed, and the case was returned for further proceedings.

WCABreconsiderationlien claimantdeclarationsection 4903.8(d)billing statementcostssanctionsJennifer Zambranacompetent witness
References
Case No. ADJ9393235
Regular
Jan 17, 2018

MARIA FLORES TORRES vs. AMERICAN BUILDING JANITORIAL, INC.

The Workers' Compensation Appeals Board rescinded a prior decision finding a medical lien invalid due to an issue with the declarant's competency. The Board found that the initial declaration under penalty of perjury, while conforming to statutory language, was deemed invalid by the trial judge solely because the declarant was not an employee of the lien claimant. However, the Board determined the record lacked sufficient evidence to establish the declarant's incompetence and that the defendant did not adequately demonstrate their efforts to present this witness at trial. Therefore, the case is remanded for further proceedings to address the admissibility of an amended declaration and to properly litigate the declarant's competency and its impact on the lien's validity.

WORKERS' COMPENSATION APPEALS BOARDRECONSIDERATIONLIEN CLAIMANTLABOR CODE SECTION 4903.8DECLARATION UNDER PENALTY OF PERJURYSTATUTE OF LIMITATIONSADMINISTRATIVE LAW JUDGECOMPROMISE AND RELEASECOMPLIANCECOMPETENT TO TESTIFY
References
Case No. ADJ498505 (SFO 0420916), ADJ4168794 (SFO 0485699), ADJ6979901
Regular
May 15, 2012

DEBORAH ROLLINS vs. COUNTY OF SOLANO, YORK INSURANCE SERVICES

The Appeals Board granted removal, rescinded a prior order, and canceled a trial date. This action prevents the relitigation of issues concerning the adequacy and applicant's competence to enter into a Compromise and Release agreement. The Board found that these issues were already decided with finality in a prior order that had res judicata effect. Therefore, the defendant would suffer prejudice by having to re-litigate settled matters.

RemovalCompromise and ReleaseAdequacyCompetenceReconsiderationFindings of Fact and LawLabor Code section 5803Petition for ReconsiderationPetition for RemovalSua Sponte
References
Case No. ADJ3461326
Regular
Aug 30, 2013

MARK CLEMENTI, TOM CLEMENTI vs. BURCH CONSTRUCTION CO., INC., CALIFORNIA INS. GUARANTEE ASSOCIATION, BROADSPIRE, SUPERIOR NATIONAL INS. CO.

The Workers' Compensation Appeals Board (WCAB) granted a petition for removal to further develop the record in this case. The WCAB rescinded the trial setting order and returned the matter to the WCJ for further proceedings. This action was taken to address questions regarding the applicant's competency to sign a compromise and release agreement in 2011. The WCAB indicated potential avenues for further discovery, including supplemental medical opinions and depositions, but left the scope to the WCJ's discretion.

Petition for RemovalGuardian ad LitemTrusteeCalifornia Ins. Guarantee AssociationSuperior National Ins. Co.LiquidationSupplemental OpinionCompromise and Release AgreementCompetencyCross-examine
References
Case No. ADJ3: (SBR 0316406) ADJ68:825 (SBR 0316740)
Regular
Sep 26, 2017

HELCIAS PUERTO vs. TRANSPORT CORPORATION OF AMERICA

This case involves an applicant's petition for reconsideration and removal challenging prior Minute Orders. The Appeals Board dismissed the petition for reconsideration, ruling that the Minute Orders were not final decisions but rather interlocutory procedural rulings. Furthermore, the petition for removal was denied as the applicant failed to demonstrate substantial prejudice or irreparable harm. The Board noted that proceedings are suspended until the applicant is found competent to participate, and that legal actions should be conducted by his appointed Guardian Ad Litem.

Labor Code Section 132aPetition for ReconsiderationPetition for RemovalGuardian Ad Litem and Trustee (GAL&T)CompetencyOff Calendar (OTOC)Final OrderInterlocutory OrderSubstantive Right or LiabilityThreshold Issue
References
Case No. SFO 492433 SFO 490100
Regular
Aug 09, 2007

AMAL KHALEK vs. YELLOW CAB COOPERATIVE, SOUTHERN CALIFORNIA RISK MANAGEMENT SERVICES (SCRMA)

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration because it was filed untimely. The applicant sought to overturn a prior order approving a compromise and release, arguing a lack of mental competency at the time of settlement. However, the petition was filed outside the statutory time limit for reconsideration, rendering it jurisdictionally deficient.

Workers' Compensation Appeals BoardAmal KhalekYellow Cab CooperativeSouthern California Risk Management ServicesSCRMAPetition for ReconsiderationOrder Approving Compromise and ReleaseWCJmental competenceuntimely petition
References
Case No. ADJ9093456, ADJ9996405, ADJ9996406
Regular
Jan 19, 2023

OTTO STOWE vs. DALLAS COWBOYS, DENVER BRONCOS, LOS ANGELES RAMS, TRAVELERS, CIGA

This case involves an applicant seeking removal of a prior order, arguing prejudice from the denial of his Labor Code section 5500.5 election and refusal to allow evidence regarding a guardian ad litem. The Appeals Board granted removal, finding that the applicant's competency and need for a guardian ad litem must be determined before proceeding. Consequently, the prior order was rescinded, and the case was returned to the trial level for a hearing on the guardian ad litem issue.

Petition for RemovalGuardian ad LitemLabor Code section 5500.5Competency determinationRescinded OrderReturn to Trial LevelIncompetent injured workerWorkers' Compensation Appeals BoardAdministrative law judgePrejudice
References
Case No. ADJ8717351
Regular
Jul 11, 2018

LUIS FUERTE vs. SLSA ENTERPRISES, EVEREST NATIONAL INSURANCE

The Workers' Compensation Appeals Board rescinded the original Findings and Order, returning the case to the trial level for further proceedings. The Board found the prior decision erred by addressing issues not properly raised at trial, specifically the reasonableness and necessity of medical treatment, and by prematurely excluding evidence based on technical filing deficiencies. The Board also clarified that while declarations under Labor Code section 4903.8 require a competent declarant, the burden to prove incompetency rests with the challenging party.

Workers' Compensation Appeals BoardLien claimantsFindings and OrderLabor Code Section 4903.8Electronic Adjudication Management SystemPre-trial conference statementThreshold issuesAdmissibility of evidenceRegulation 10629Regulation 10770.1
References
Case No. ADJ9063212
Regular
Feb 15, 2019

LUIS VILLAGOMEZ vs. WALMART STORES, INC.; ACE AMERICAN, administered by YORK

This Workers' Compensation Appeals Board case involved liens filed by Mesa Pharmacy and ResHealth Medical, which were deemed invalid by the WCJ under Labor Code section 4903.8(e). Lien claimants sought reconsideration, arguing the WCJ incorrectly placed the burden of proof regarding declarant competency on them. The Appeals Board rescinded the WCJ's decision and returned the case for further proceedings. The Board clarified that declarants under section 4903.8(d) must have personal knowledge of the services provided and billing accuracy. It also noted that all submitted declarations, not just one, should be considered when evaluating compliance with the statute.

Labor Code section 4903.8(e)declarant competencypersonal knowledgehearsaypenalty of perjurylien validityworkers' compensation liensassignment violationreconsiderationFindings of Fact and Order
References
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