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Case Law Database

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

Case No. ANA 0388116

Regular

May 05, 2008

CAROLINA LOPEZ vs. MARINA HOTEL\/DISNEYLAND HOTEL

In this workers' compensation case, the defendant sought to disallow a lien claim for dispensed medications, arguing the physician failed to prove compliance with specific Business and Professions Code sections regarding dispensing. The Appeals Board affirmed the lower decision, holding that the lien claimant is not required to proactively prove compliance with all dispensing statutes. Instead, the defendant bears the burden of proving that the treatment was unreasonable due to non-compliance if they raise that issue.

Workers' Compensation Appeals BoardLien ClaimCompromise and ReleaseBusiness and Professions CodePrescriber DispensingAdministrative Law JudgeReconsiderationMedical TreatmentLicensed PhysicianEnforcement Authority

References

Case No. Misc. No. 257

En Banc

Feb 18, 2016

vs. JAVIER JIMENEZ

The Appeals Board suspended the privilege of Javier Jimenez to appear as a representative for 180 days due to his failure to respond to a Notice of Intention to Suspend, which was based on non-compliance with prior sanction orders.

WCABLabor Code section 4907Representative privilege suspensionNotice of IntentionSanction ordersEn banc decisionAdministrative law judgeCompliance180-day suspensionFurther hearing

References

Case No. ADJ10483272

Regular

Mar 08, 2018

ADRIAN FRIAS vs. AVANTI CAFE, TECHNOLOGY INSURANCE COMPANY, AMTRUST NORTH AMERICA

The Workers' Compensation Appeals Board (WCAB) denied defendant Avanti Cafe's petitions for reconsideration. The WCAB reviewed the defendant's amended petitions, but found no substantial new grounds for appeal. While the WCAB adopted the workers' compensation judge's report, they specifically excluded the portion addressing the unsigned proof of service, while cautioning the defendant about future compliance. Therefore, the WCAB affirmed the prior decision and denied reconsideration.

Petitions for ReconsiderationAmended PetitionsProof of ServiceAppeals Board Rule 10505Workers' Compensation Administrative Law JudgeDenying ReconsiderationIncorporated ReportComplianceEndorsed StatementSigned Proof of Service

References

Case No. ADJ10430501

Regular

Aug 05, 2019

MARCO ESTRADA vs. INCA ONE CORP, REPUBLIC INDEMNITY COMPANY OF AMERICA

The Workers' Compensation Appeals Board denied a lien claimant's petition for reconsideration. The claimant failed to prove it possessed a valid fictitious business name permit at the time services were rendered, a requirement for maintaining its lien. While the claimant argued they cured the defect, the Board found they did not meet their burden of proof and the FNP status remained canceled. The decision upholds that lien claimants must demonstrate compliance with applicable licensure and permit requirements.

Fictitious Business Name PermitBusiness and Professions Code Section 2415Burden of ProofLien ClaimantMedical Board of CaliforniaSecretary of StateFictitious Name PermitComplianceCurable DefectPetition for Reconsideration

References

Case No. ADJ12384017

Regular

Jan 31, 2020

WESLEY VAUGHN vs. THE KROEGER COMPANY dba RALPHS GROCERY COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Appeals Board granted reconsideration and rescinded the WCJ's finding that the applicant did not properly predesignate his physician. The Board determined that the sole issue presented to the WCJ was too narrowly framed, failing to address the applicant's arguments regarding substantial compliance and the defendant's alleged failure to provide proper notice of predesignation rights. The case is remanded for further proceedings to address the issues of proper notice and denial of care, which are crucial for determining treatment outside the Medical Provider Network.

PredesignationPrimary Treating PhysicianMedical Provider Network (MPN)Notice RequirementsDenial of CareSubstantial ComplianceThreshold IssueInterlocutory IssueRemoval StandardPetition for Reconsideration

References

Case No. ADJ445617

Regular

Apr 07, 2017

EVA PALOMARES vs. ROWLAND UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board dismissed a lien claimant's petition for reconsideration and denied their petition for removal. The Board found that the Administrative Law Judge's order was not a final determination of substantive rights, therefore not ripe for reconsideration. The Board also determined that the lien claimant failed to demonstrate substantial prejudice or irreparable harm required for removal. Consequently, the matter was returned to the parties to further develop the record regarding the lien's validity and compliance with relevant statutes.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalLabor Code Section 4903.8Lien ClaimantAssignment of LienDeclaration RequirementsFinal OrderInterlocutory DecisionSubstantial Prejudice

References

Case No. ADJ3885172 (SAC 0357351)

Regular

Nov 14, 2016

LINDA O'BRIEN vs. GOLD HARVEST MARKET, STATE FARM INSURANCE

The Workers' Compensation Appeals Board denied Linda O'Brien's petition for reconsideration. O'Brien sought to challenge a prior finding that her former attorney, William J. Carlisle, had "substantially complied" with an order to deliver her workers' compensation file. The Board adopted the administrative law judge's report, which found sufficient evidence, including letters from Carlisle, to support substantial compliance despite O'Brien's claims of non-receipt. The Board also rejected O'Brien's supplemental response.

Workers' Compensation Appeals BoardPetition for ReconsiderationWorkers' compensation administrative law judgeSpecific injurySubstantial complianceSanctionsDeclaration of Readiness to ProceedMinutes of HearingFinding of FactPetitioners Contentions

References

Case No. ADJ8189198

Regular

Jan 12, 2016

ODAYR LOPEZ vs. DOLLAR TREE, INC.

This case involves a lien claim by Dr. Charles Schwarz for dispensing medication. The original decision disallowed $4,443.00 of the lien, finding Dr. Schwarz failed to prove authorization to dispense medication. The Workers' Compensation Appeals Board granted reconsideration, finding the issue of authorization under Business and Professions Code § 4170 was not clearly raised. The Board deferred the issue of reimbursement for dispensed medication, requiring Dr. Schwarz to demonstrate compliance with the statute in further proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeLien ClaimantDispensing MedicationBusiness and Professions CodePhysician Dispensing DrugsAuthorization to DispenseBurden of ProofLabor Code

References

Case No. ADJ10030458

Regular

Mar 12, 2019

Rachel Osorio vs. Agilent Technologies, Inc.

This case involves applicant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision. The WCAB denied the applicant's request for a replacement Qualified Medical Evaluator (QME) panel, finding that the original QME's failure to serve the applicant directly with his report, despite serving her attorney, constituted substantial compliance. The Board reasoned that the applicant was not significantly prejudiced as she retained rights for further discovery and that a replacement panel was not warranted. Ultimately, the WCAB denied the petition for reconsideration, upholding the prior order.

Workers Compensation Appeals BoardAgilent TechnologiesInc.Sedgwick Claims Management ServicesRachel OsorioFindings and OrderInjury AOE/COEBilateral Hands and WristsQualified Medical Evaluator (QME)Substantial Compliance

References

Case No. ADJ3587014 (MON 0284627)

Regular

Jul 20, 2009

Beverly DeRosa vs. STATE OF CALIFORNIA, DEPARTMENT OF SOCIAL SERVICES-IHSS, legally uninsured and adjusted by STATE COMPENSATION INSURANCE FUND

This case involves an employer appealing a Workers' Compensation Appeals Board (WCAB) decision imposing sanctions and attorney's fees. The sanctions arose from the employer's claims examiner's willful failure to timely provide applicant's earnings information as ordered. The WCAB denied reconsideration, upholding the sanctions and the amended attorney's fee award of nearly $3,700, finding the examiner's testimony regarding compliance lacked credibility. The employer's petition was deemed timely filed as it addressed the amended order which substantially increased the attorney's fee.

Labor Code section 5813SanctionsAttorney's feesWillful failureTimely complianceEarnings informationReconsiderationSupplemental Findings and OrderAmended Supplemental FindingsWCJ

References

Showing 1-10 of 257 results

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Updated Daily

Case Law Database

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

Case No. ANA 0388116

Regular

May 05, 2008

CAROLINA LOPEZ vs. MARINA HOTEL\/DISNEYLAND HOTEL

References

Case No. Misc. No. 257

En Banc

Feb 18, 2016

vs. JAVIER JIMENEZ

WCABLabor Code section 4907Representative privilege suspensionNotice of IntentionSanction ordersEn banc decisionAdministrative law judgeCompliance180-day suspensionFurther hearing

References

Case No. ADJ10483272

Regular

Mar 08, 2018

ADRIAN FRIAS vs. AVANTI CAFE, TECHNOLOGY INSURANCE COMPANY, AMTRUST NORTH AMERICA

References

Case No. ADJ10430501

Regular

Aug 05, 2019

MARCO ESTRADA vs. INCA ONE CORP, REPUBLIC INDEMNITY COMPANY OF AMERICA

References

Case No. ADJ12384017

Regular

Jan 31, 2020

WESLEY VAUGHN vs. THE KROEGER COMPANY dba RALPHS GROCERY COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

References

Case No. ADJ445617

Regular

Apr 07, 2017

EVA PALOMARES vs. ROWLAND UNIFIED SCHOOL DISTRICT

References

Case No. ADJ3885172 (SAC 0357351)

Regular

Nov 14, 2016

LINDA O'BRIEN vs. GOLD HARVEST MARKET, STATE FARM INSURANCE

References

Case No. ADJ8189198

Regular

Jan 12, 2016

ODAYR LOPEZ vs. DOLLAR TREE, INC.

References

Case No. ADJ10030458

Regular

Mar 12, 2019

Rachel Osorio vs. Agilent Technologies, Inc.

References

Case No. ADJ3587014 (MON 0284627)

Regular

Jul 20, 2009

Beverly DeRosa vs. STATE OF CALIFORNIA, DEPARTMENT OF SOCIAL SERVICES-IHSS, legally uninsured and adjusted by STATE COMPENSATION INSURANCE FUND

Labor Code section 5813SanctionsAttorney's feesWillful failureTimely complianceEarnings informationReconsiderationSupplemental Findings and OrderAmended Supplemental FindingsWCJ

References

Showing 1-10 of 257 results

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