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Case Law Database

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

Case No. MISSING
Regular Panel Decision

1199seiu Nat'l Benefit Fund v. Allergan, Inc. (In re Restasis (Cyclosporine Ophthalmic Emulsion) Antitrust Litig.)

This multi-district litigation addresses defendant Allergan's alleged anticompetitive efforts to delay FDA approval of generic versions of its dry-eye medication, Restasis®. Plaintiffs, comprising Direct Purchaser Plaintiffs and End-Payor Plaintiffs, contend Allergan engaged in various unlawful strategies, including filing sham citizen petitions, defrauding the USPTO to secure "second-wave" patents, wrongfully listing these patents, initiating sham patent infringement lawsuits, and transferring patents to a Native American tribe to invoke sovereign immunity. Allergan moved to dismiss the consolidated complaints, asserting that plaintiffs failed to plausibly allege that its actions caused any delay in generic market entry. The court, however, denied Allergan's motion, concluding that the plaintiffs had adequately pleaded that Allergan's aggressive and persistent tactics could have effectively delayed competition.

AntitrustPharmaceutical IndustryGeneric DrugsFDA ApprovalPatent InfringementCitizen PetitionsHatch-Waxman ActMonopolyRestasisDry Eye Medication
References
34
Case No. ADJ1454075
Regular
Apr 25, 2011

JOSE FONSECA vs. MIKE SANDOVAL CONCRETE, VIRGINIA SURETY COMPANY

The Appeals Board granted defendant's petition for reconsideration, reversing the WCJ's award of sanctions and costs against them. While the defendant delayed payment of a lien claimant's interpreter fee, the Board found insufficient evidence of unreasonable delay or bad-faith tactics. The lien claimant's petition for reconsideration was denied, and the Board emphasized the need for parties to resolve future disputes through communication.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings and AwardSanctionCostsLabor Code section 5814Labor Code section 5813Bad FaithWCJ
References
0
Case No. ADJ3885285 (FRE 0248529) ADJ3795787 (FRE 0247126)
Regular
Dec 30, 2008

Larry Shores vs. CITY OF MADERA; ACCLAMATION FRESNO

This case concerns a worker's compensation claim for a back and spine injury sustained by Larry Shores. The Board granted reconsideration, rescinded sanctions imposed on the defendant for litigation tactics, and rescinded a penalty for delayed temporary disability payments. However, it otherwise affirmed the finding of industrial injury, awarded penalties for unreasonable delay in medical treatment, and upheld the need for ongoing medical care, including surgery.

Workers' Compensation Appeals BoardLarry ShoresCity of MaderaAcclamation FresnoADJ3885285ADJ3795787Opinion and Order Granting ReconsiderationFindings and AwardWCJIndustrial Injury
References
27
Case No. ADJ4349754 (OXN 0124391)
Regular
Feb 08, 2013

JOSE TOSTADO vs. JM SMUCKER COMPANY, BROADSPIRE

Defendant JM Smucker Company seeks reconsideration of an award granting applicant Jose Tostado a 25% penalty for delayed life pension benefits and attorney fees. The defendant also contests sanctions imposed by the WCJ for bad faith tactics under Labor Code section 5813. The Board denied reconsideration, affirming the WCJ's finding of unreasonable delay in benefit payment. However, the Board remanded for a new Notice of Intention to Sanction due to procedural deficiencies in identifying the party to be sanctioned.

Workers' Compensation Appeals BoardJM Smucker CompanyBroadsopireJose TostadoFindings AwardSanctionsLabor Code Section 5813Bad Faith TacticsDue ProcessPetition to Reopen
References
0
Case No. ADJ9310265, ADJ9563677, ADJ9805680
Regular
Dec 07, 2015

ADAM SENF vs. CITY OF VACAVILLE

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's Petition for Reconsideration because the order closing discovery and setting a trial date was not a final order. The WCAB also denied the defendant's Petition for Removal, finding no significant prejudice or irreparable harm, especially given the extensive delays already caused by the defendant. The Board noted the defendant's pattern of seeking continuances and cautioned their attorney regarding potential sanctions for delaying tactics. Ultimately, the WCAB affirmed the WCJ's decision to move the case towards trial.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalOrder Closing DiscoverySetting for TrialWCJFinal OrderInterlocutory OrderLabor Code section 5502(d)(1)Declaration of Readiness
References
4
Case No. ADJ6766189
Regular
Jul 03, 2012

MIRNA CERRATO AGUILAR vs. BEVERLY PAVILION ASSOCIATES, FIRSTCOMP OMAHA

This case involves a petition for reconsideration filed by Anna Montes, a hearing representative, regarding a $1,500 sanction imposed by the WCJ. Montes was sanctioned for her "insolent, obstructive, disrespectful and frivolous" conduct during a workers' compensation trial involving her client, Dr. Anguizola. The Appeals Board denied Montes' petition, adopting the WCJ's report which detailed how her behavior caused unnecessary delay and wasted Board resources. The Board reiterated that representatives must conduct themselves professionally and ethically, adhering to rules against bad faith tactics that cause delay.

Workers' Compensation Appeals BoardSanctionsPetition for ReconsiderationIndustrial InjuryRoom AttendantLien ClaimantMedical TreatmentPenaltyInterestInsolent Conduct
References
0
Case No. ADJ3765992 (SRO 0132531)
Regular
Apr 06, 2011

LORRAINE O'KEEFE vs. SURGICAL STAFF NORTH, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, BROADSPIRE SERVICES for CAL COMP, COMMUNITY HOSPITAL OF MONTEREY PENINSULA, CLAIMS MANAGEMENT, INC.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration on Community Hospital of Monterey Peninsula's (CHOMP) petition regarding a penalty assessed for delayed payment to CIGA. The WCAB amended the prior order, ruling that CHOMP is not liable for a Labor Code section 5814 penalty because this section applies only to delays in payments to injured workers, not to reimbursements between defendants. However, the WCAB affirmed the prior finding that CHOMP engaged in bad-faith litigation tactics, upholding sanctions under Labor Code section 5813. The final order also clarified the amount owed to CIGA and affirmed the attorney's fees awarded to the applicant's counsel.

Workers Compensation Appeals BoardSurgical Staff NorthCalifornia Insurance Guarantee AssociationCommunity Hospital of Monterey PeninsulaUnreasonable DelayBad Faith LitigationLabor Code Section 5814Labor Code Section 5813Labor Code Section 4064(c)Permanent Disability
References
2
Case No. MISSING
Regular Panel Decision
Nov 18, 1992

United States v. Majeed

Defendant Keith Elmore moved to vacate a prior order detaining him pending trial, which had been affirmed by this Court after an appeal from Magistrate Judge Barbara A. Lee's initial decision. Elmore's motion for reconsideration was based on changed circumstances. The Court reviewed the constitutionality of pretrial detention, considering factors such as the nonspeculative length of detention, government responsibility for trial delays, and the defendant's danger to the community. Despite some governmental responsibility for trial delays and an expected ten-month detention period, the Court found Elmore's detention justified. This was primarily due to credible threats he posed, including violent extortion and witness intimidation tactics as evidenced by an alleged victim's testimony. Consequently, the Court denied Elmore's motion to vacate the detention order.

Pretrial DetentionBail Reform Act of 1984Due ProcessWitness IntimidationDanger to CommunityMotion to VacateFederal CourtCriminal ProcedureSecond CircuitJudicial Delay
References
13
Case No. ADJ6973825
Regular
May 21, 2012

MONICA BENARD vs. JENNY CRAIG, SEDGWICK CMS

This case concerns a penalty imposed on Jenny Craig for unreasonably delaying authorization for applicant Monica Benard's chiropractic treatment. The WCJ found a 25% penalty for the delay, which Jenny Craig appealed, arguing the delay was due to the applicant's choice of a chiropractor outside their Medical Provider Network (MPN). The Appeals Board affirmed the unreasonable delay finding but reduced the penalty to 20% of the delayed treatment's value, citing a failure in case management rather than intentional disregard. Jurisdiction was reserved for the parties to adjust the penalty amount.

Workers Compensation Appeals BoardMonica BenardJenny CraigSedgwick CMSADJ6973825ReconsiderationFindings and AwardLabor Code section 5814Medical Provider Network (MPN)chiropractic treatment
References
9
Case No. ADJ9932467
Regular
Oct 16, 2017

THERESA MCFARLAND vs. REDLANDS UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied an applicant's petition for reconsideration, affirming the WCJ's decision that "Return-To-Work" supplemental payments under Labor Code section 139.48 are not "compensation" as defined by Labor Code section 3207. Therefore, the applicant was not entitled to a second penalty under Labor Code section 5814 for the employer's delay in providing a Supplemental Job Displacement Benefit voucher, as that delay did not cause a delay in a compensable benefit. The Board found that the applicant's penalty claim for the voucher delay was already resolved and that imposing a second penalty for a non-compensable benefit delay would be unfair and against the principle of balancing justice.

Labor Code section 139.48Return-To-Work supplemental paymentscompensation definitionLabor Code section 3207Labor Code section 5814 penaltyLabor Code section 4658.7 voucherSupplemental Job Displacement Benefitcompromise and release agreementGage v. Workers' Comp. Appeals Bd.unreasonable delay
References
1
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