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

Case No. ADJ8588344
Significant
Oct 26, 2017

Applicant vs. Garden Plating Co., Intercare Holdings Insurance Services

The Appeals Board, in an en banc decision, consolidates over 1,200 Petitions for Reconsideration filed by lien claimants concerning a DWC administrative action, dismisses the petitions as moot, and returns the individual cases to the trial level for adjudication.

En BancLien CasesPetition for ReconsiderationLabor Code Section 4903.05(c) DeclarationDWC Administrative ActionMootDismissalConsolidationWCAB Rule 10589Suspension of Rule
References
11
Case No. ADJ870019 (SFO 0455266) ADJ3218516 (SFO 0428166) ADJ322513 (SFO 0423213)
Regular
Oct 05, 2015

LINDA LECHNER vs. MARIN GENERAL HOSPITAL, ARROWOOD INDEMNITY COMPANY

The Board granted reconsideration of the award for self-procured medical expenses for a walk-in bathtub. The applicant failed to provide a proper request for authorization (DWC Form RFA) from her treating physician. Therefore, the defendant was not obligated to conduct utilization review for the bathtub. The case is returned to the trial level for the applicant's physician to submit a correct request for retrospective authorization.

Utilization ReviewDWC Form RFAPrimary Treating PhysicianWalk-in BathtubSelf-Procured Medical ExpensesPetition for ReconsiderationSupplemental Findings and AwardRetrospective ReviewMedical NecessityIndustrial Injury
References
1
Case No. ADJ6903715
Regular
Apr 22, 2013

HECTOR HERNANDEZ vs. CERAMIC TILE ART, INC.; ZENITH

The Workers' Compensation Appeals Board granted reconsideration of an order dismissing lien claimants' liens with prejudice for failing to pay a lien activation fee. The lien claimants argued their representative was unable to pay due to a non-functioning DWC website. The Board found the petition for reconsideration was frivolous due to a lack of evidence supporting the website issue claim and is proposing sanctions against the lien claimants' representatives.

Lien activation feePetition for ReconsiderationWCJSanctionsLabor Code section 5813Appeals Board Rule 10561WCABDismissal with prejudiceDWC websiteLien conference
References
1
Case No. ADJ8079708
Regular
May 06, 2013

JAMES AZBILL vs. FATORS MOTORCYCLES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to amend a prior finding, affirming the claim is not barred by the statute of limitations. However, the Board reversed the finding that the applicant was entitled to the presumption of compensability under Labor Code section 5402(b). This presumption requires the filing of a DWC-1 claim form, which was absent in this case. The Board will return the matter to the trial level for further proceedings on deferred issues.

Workers' Compensation Appeals BoardFators MotorcyclesState Compensation Insurance FundJames AzbillADJ8079708Opinion and OrderReconsiderationFindings and OrderWCJStatute of Limitations
References
0
Case No. ADJ9342987, ADJ9342988
Regular
Apr 21, 2014

DEBBIE MORRISON vs. COUNTY OF SANTA BARBARA/PUBLIC HEALTH DEPARTMENT, CORVEL

This case involves an applicant's petition for removal, seeking a change of venue to a Santa Barbara office. The Workers' Compensation Appeals Board (WCAB) denied the petition, affirming the WCJ's report. The WCAB explained that the Division of Workers' Compensation (DWC) dictates office locations based on budgetary constraints and can calendar hearings at different offices due to limited resources. The applicant may petition for a change of venue to Oxnard.

Petition for RemovalWorkers' Compensation Appeals BoardDivision of Workers' CompensationVenueSatellite FacilityIrreparable HarmAdministrative Law JudgeLabor Code § 138.2(b)Labor Code § 5501.5Goleta District Office
References
1
Case No. ADJ6720393
Regular
Nov 26, 2012

PEDRO ALONSO vs. CARGO AIRCRAFT HANDLING INTERNATIONAL, GALLAGHER BASSETT

This case involves an Order Denying Reconsideration by the Workers' Compensation Appeals Board (WCAB). The WCAB adopted the findings of the workers' compensation administrative law judge (WCJ) to deny reconsideration. The denial stems from a lien claimant's "substandard level of legal practice," including objections with incorrect case numbers and untimely filings. The WCAB warned the lien claimant about potential sanctions for failing to comply with DWC and WCAB rules.

WCABPedro AlonsoCargo Aircraft Handling InternationalGallagher BassettADJ6720393Denying ReconsiderationMedi-LabVacate Dismissal OrderDWC RulesWCAB Rules
References
1
Case No. ADJ8501518
Regular
Mar 21, 2014

PAMELA LIBERA vs. COUNTY OF SANTA BARBARA SHERIFF'S DEPARTMENT, CORVEL CORPORATION

The Workers' Compensation Appeals Board (WCAB) denied Pamela Libera's Petition for Removal. The WCAB found that the Division of Workers' Compensation (DWC) is statutorily responsible for providing district office quarters within budgetary constraints. Even if venue is established, the WCAB can calendar hearings at different locations due to limited resources. The WCAB also noted available alternatives like CourtCall for parties facing travel difficulties.

WORKERS' COMPENSATION APPEALS BOARDPetition for RemovalDivision of Workers' CompensationDWCWCABvenuedistrict officecalenderingCourtCallmandatory settlement conference
References
12
Case No. ADJ10962119; ADJ11023301
Regular
Jul 10, 2018

OSCAR RENDEROS vs. SEA BREEZE CONSTRUCTION, WESCO INSURANCE, AMTRUST FINANCIAL SERVICES

The Workers' Compensation Appeals Board denied reconsideration of a decision finding the applicant's claim was not barred by the statute of limitations. The Board deferred to the Administrative Law Judge's (WCJ) credibility determination, finding no substantial evidence to reject it. The employer's letter stating they would "administratively close" the file was not deemed a denial of the claim, thus not triggering the statute of limitations. The WCJ found the employer failed to adequately inform the applicant of his rights after receiving the DWC-1 form.

WCABPetition for ReconsiderationStatute of LimitationsDWC-1 Claim FormAOE/COECredibility DeterminationLabor Code §5405Notice of RightsIndustrial InjuryClaims Administrator
References
4
Case No. ADJ12728611
Regular
Apr 09, 2020

MARTIN JACOBO vs. COKE FARM, RISICO CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board granted the defendant's Petition for Removal because the WCJ exceeded their authority by invalidating a Qualified Medical Examiner (QME) solely based on the specialty of occupational medicine for a post-surgical knee evaluation. The Board determined that an occupational medicine physician is appropriately qualified to assess such injuries according to DWC guidelines. Therefore, the WCJ's decision was rescinded, and the case was returned for further proceedings, suspending action on the Compromise and Release agreement pending further development.

Petition for RemovalPanel Qualified Medical ExaminerPQMEOccupational MedicineToxicologyPost-surgical kneeLabor Code section 4062.2(b)Administrative Director Rule 35.5Scope of practiceClinical competence
References
6
Case No. ADJ7271033
Regular
Jan 25, 2017

JENNIFER LAWSON vs. GLEN IVY DAY SPA, COMPWEST INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The Workers' Compensation Appeals Board (WCAB) is considering rescinding an order that dismissed lien claimant Proex Diagnostics' lien for failure to pay a \$100 activation fee. Proex argues they had until December 31, 2015, to pay the fee based on a federal court order and DWC guidance. The WCAB's notice indicates they intend to rescind the dismissal if the fee is paid within ten days of the notice. If rescinded, the lien claim will return to the trial level for further proceedings.

Proex DiagnosticsGlen Ivy Day SpaCompWest Insurance CompanyBerkshire Hathaway Homestate CompaniesLien Activation FeeLabor Code Section 4903.06Workers' Compensation Appeals BoardWCJReconsiderationCompromise and Release
References
1
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