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

Case No. ADJ3863284 (OXN 0147713)
Regular
May 13, 2013

ISAIAS ORTIZ vs. WATERWAY PLASTICS, SAFETY NATIONAL INSURANCE

This case involves two lien claimants whose liens were dismissed for failing to pay an activation fee prior to trial. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, finding that Labor Code section 4903.06 only requires proof of payment of the fee at a "lien conference," not a subsequent trial. Because the lien conference occurred in 2012 and the trial in 2013, the lien claimants were not required to pay the fee prior to trial. The WCAB rescinded the dismissal orders and returned the matter for further proceedings.

Lien activation feeWCABPetition for ReconsiderationLien ConferenceLien TrialLabor Code section 4903.06Declaration of Readiness to ProceedDismissal with prejudiceRescind OrderReturn to trial level
References
Case No. ADJ12080707
Regular
Sep 04, 2019

MICHAEL OLAGUE vs. CITY SECURITY COMPANY, NATIONAL LIABILITY & FIRE INSURANCE COMPANY

The Appeals Board granted applicant's petition for removal, rescinding the trial judge's order to take the case off calendar. The applicant requested additional Qualified Medical Evaluator (QME) panels, but the judge deferred this due to pending AOE/COE issues and an initial QME exam being set. The Board found that Labor Code section 5502 mandates an expedited hearing for disputes involving medical-legal examinations, entitling the applicant to a hearing on the request for additional panels. The case is returned to the trial level for further proceedings, potentially including placement back on the expedited hearing calendar.

Petition for RemovalExpedited HearingAOE/COEInitial Physical AggressorQualified Medical Evaluator (QME)PQME panelsMedical-legal evaluationLabor Code Section 5502Off-calendarRescind Order
References
Case No. ADJ11085852
Regular
Nov 02, 2018

DEONTE WALKER vs. CITY AND COUNTY OF SAN FRANCISCO, INTERCARE HOLDINGS INSURANCE SERVICES

The applicant sought removal of a Notice of Hearing alleging prejudice from a full-day trial instead of an expedited hearing for his admitted industrial injury to the psyche and stress. The Workers' Compensation Appeals Board (WCAB) denied the petition, emphasizing that removal is an extraordinary remedy requiring a showing of irreparable harm. The WCAB found that the scheduled trial was justified by the complexity and witness testimony, and an expedited hearing was not guaranteed to be earlier. Therefore, the applicant failed to demonstrate significant prejudice or irreparable harm.

Petition for RemovalIndustrial InjuryPsycheStressWCJNotice of HearingExpedited HearingFull-Day TrialSignificant PrejudiceIrreparable Harm
References
Case No. ADJ8843441
Regular
Oct 16, 2013

AUSTIN KWOMO vs. LOS ANGELES METROPOLITAN TRANSIT AUTHORITY

The Appeals Board granted the defendant's Petition for Removal, rescinding the WCJ's order to take the case off calendar. The Board found the WCJ prematurely ordered further medical record development before trial or submission for decision. Therefore, the case is returned to the trial level for proceedings consistent with *McDuffie*, with the WCJ retaining discretion to supplement the record *after* trial if necessary. The petition for disqualification of the WCJ was denied.

Petition for RemovalOrder Off CalendarFurther Development of RecordMedical OpinionsThreshold MatterTrialSubmission for DecisionExhibitsWitnessesSupplementation of Medical Record
References
Case No. ADJ6733950
Regular
Jul 25, 2012

ANTHONY AVILA vs. MARK EVERETTE DRYWALL CO., EVEREST NATIONAL INSURANCE CO., AMERICAN CLAIMS MANAGEMENT

This case concerns an applicant's Petition for Reconsideration of a dismissal order. The applicant argues his due process rights were violated because the dismissal for failure to appear was improper since his counsel was present at trial dates. The Appeals Board found that as the applicant was represented by counsel at trial, dismissal was erroneous. The Board granted reconsideration, rescinded the dismissal, and returned the matter to the trial level, also noting the unresolved request for counsel to withdraw.

Petition for ReconsiderationOrder Dismissing CaseWCJdue processMandatory Settlement ConferencetrialMinutes of Hearingrelieved as counselNotice of Intention to Dismiss Casefailure to appear
References
Case No. STK 0201989
Regular
Oct 03, 2007

JUAN PRADO vs. PRICE SMART, INC.,, COMMERCE & INDUSTRIAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded the previous findings, remanding the case for further proceedings. The defendant argued that insurance coverage disputes must be arbitrated and that the WCJ lacked jurisdiction to determine liability. Additionally, the defendant claimed lack of notice for the hearing and that the applicant's injury occurred outside California. The Board found that the WCJ erred in not issuing a proper notice of intention before issuing the award, necessitating a new trial.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardJurisdictionInsurance Carrier LiabilityArbitrationLabor Code Section 5275WCIRBExpedited HearingNotice of Trial
References
Case No. ADJ9436553
Regular
Nov 03, 2014

ANA MARIA PENA, vs. SHREE AGASHIMATA INC.; dba BUDGET INN MOTEL; ILLINOIS MIDWEST INSURANCE AGENCY,

Defendant petitioned for removal after the WCJ took the case off calendar, citing the need for a Qualified Medical Evaluator. Defendant argued that a post-termination defense did not require medical evidence and the case should proceed to trial. The Appeals Board granted removal, rescinded the WCJ's order, and returned the case to the trial level. This was done because the WCJ had not yet judicially determined good cause to bifurcate the post-termination defense issue, which is a prerequisite to deciding if a QME is necessary.

Petition for Removalpost-termination defenseLab. Code § 3600(a)(10)discoveryexpert medical evidencetrialWCJoff calendarQMEbifurcate
References
Case No. ADJ8914330 ADJ8914334
Regular
Oct 29, 2013

LUCIA GARCIA vs. BEST WESTERN AIRPARK HOTEL, CYPRESS INSURANCE COMPANY, administered by BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's order allowing the applicant to self-procure medical treatment outside the defendant's MPN. The Board rescinded the order because the WCJ failed to ensure a complete record, clearly state the issues for determination, and base the decision on admitted evidence. The matter was returned to the trial level for further proceedings, as the original expedited hearing was improperly conducted without a clear agreement on issues and insufficient evidence.

Workers' Compensation Appeals BoardMedical Provider Network (MPN)Expedited HearingDeclaration of Readiness to Proceed (DOR)Objection to Declaration of ReadinessReconsiderationRescindTemporary DisabilitySelf-Procure Medical TreatmentSubstantial Evidence
References
Case No. ADJ12047357
Regular
Jan 29, 2020

LUIS GONZALEZ vs. M. Y. PACIFIC BUILDING dba M Y PACIFIC RESTORATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Applicant Luis Gonzalez's Petition for Removal. Applicant sought to have an order taking the case off calendar overturned and the matter reset for an expedited hearing. The Board found that removal is an extraordinary remedy not warranted here as Applicant did not demonstrate substantial prejudice or irreparable harm. The judge acted within their authority, and the applicant can refile a declaration of readiness to proceed. Allegations of sanctionable conduct should be addressed in a separate trial-level petition.

Petition for RemovalOrder Taking Off CalendarExpedited HearingSubstantial PrejudiceIrreparable HarmReconsiderationAdministrative Law JudgeAbuse of DiscretionDeclaration of ReadinessSanctionable Conduct
References
Case No. ADJ11266442
Regular
Apr 26, 2019

DONALD SEARLES vs. ROUNDTABLE PIZZA, EMPLOYERS COMPENSATION INSURANCE CO.

The WCAB granted reconsideration to address the defendant's due process claims regarding an expedited trial and the sufficiency of medical evidence for the applicant's cervical spine, right wrist, and right upper extremity injuries. The Board affirmed the WCJ's findings of injury to these body parts, finding substantial medical evidence supported them and that the defendant was aware of these claims timely. However, the Board struck the WCJ's deferral of the "nature and extent" issue, remanding for further proceedings on undeveloped claims of injury to the lumbar spine and left leg.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardExpedited TrialQualified Medical EvaluatorDue ProcessSubstantial Medical EvidenceCervical Spine InjuryRight Upper Extremity InjuryCarpal Tunnel Syndrome
References
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