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

Case No. ADJ7766843
Regular
Apr 25, 2013

BLANCA VILLATORO vs. BEYOND SHELTERS, INC., OAK RIVER INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

This case involves an untimely Petition for Reconsideration filed by the applicant. The Workers' Compensation Appeals Board dismissed the petition because it was filed over twenty days after the WCJ's decision was personally served. Because the decision was personally served, no mailing extension applied, making the filing unequivocally late. The Board also noted potential sanctions for factual misrepresentations within the petition.

Petition for ReconsiderationUntimely FilingLabor Code section 5903Jurisdictional Time LimitPersonal ServiceMailing ExtensionWCJ's DecisionFactual MisrepresentationsSanctionable ConductDismissal Order
References
Case No. ADJ7940254
Regular
May 02, 2014

GABRIELA CEBALLOS vs. WEST COAST VALET SERVICES, ARGONAUT INSURANCE COMPANY

This case concerns a lien claimant, Rehab Solutions, seeking reconsideration of a decision disallowing its claim for durable medical goods. The Workers' Compensation Appeals Board (WCAB) denied the petition, affirming the administrative law judge's (WCJ) findings. The WCJ disallowed the lien due to procedural defects, including improper use of authorization requests, and a lack of substantial medical evidence demonstrating benefit to the injured worker. The WCAB adopted the WCJ's report, noting factual misrepresentations and procedural errors by the lien claimant, and denied the petition for reconsideration.

Rehab SolutionsLien ClaimantPetition for ReconsiderationCompromise and ReleaseProcedural DefectsSubstantial Medical EvidenceDurable Medical GoodsRequest for AuthorizationInterferential UnitUtilization Review
References
Case No. ADJ292109 (LAO 0863163)
Regular
Oct 27, 2015

Erica Brumfield vs. County of Los Angeles, Department of Social Services, York Risk Services

The Appeals Board granted reconsideration and rescinded the WCJ's dismissal order. The dismissal was based on a defendant's petition containing material misrepresentations and improper service on the unrepresented applicant. Crucially, the defendant failed to properly serve notice of dismissal proceedings, and the applicant was actively pursuing her claim as evidenced by her communications with adjusters and medical providers. Therefore, the dismissal order is void *ab initio* due to lack of due process and material misrepresentations.

Amended Petition to Set Aside DismissalPetition to Dismiss Based On Lack of Prosecutionvoid ab initiomaterial misrepresentationPetition for Reconsiderationrescind the Orderindustrial injuryunrepresentedin propria personamisrepresentation of facts
References
Case No. ADJ3588216 (LAO 0866168) ADJ4039946 (LAO0866169)
Regular
May 20, 2009

MARIA ADELA PEREZ vs. JOSE HERNANDEZ, CRAWFORD & COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration. The defendant sought to rescind two stipulation and orders approving settlements with lien claimants, Dr. Ehyai and Dr. Dini. These orders settled the liens for $1,700 and $1,500 respectively, despite prior payments by the defendant to both doctors totaling over $4,300. The Board rescinded the orders and returned the matter for a hearing to determine if the stipulations were based on misrepresentation or mutual mistake by the lien claimants.

Workers' Compensation Appeals BoardPetition for ReconsiderationStipulation and OrderLien ClaimantDr. Reza EhyaiDr. Ali DiniRescissionMisrepresentationMutual MistakeGood Cause
References
Case No. ADJ4642991
Regular
Mar 09, 2011

RICHARD ANTONETTE vs. VOLT INFORMATION SCIENCES, MAJESTIC INSURANCE COMPANY, GALLAGHER BASSETT CLAIMS SERVICES

The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for removal, finding it an extraordinary remedy not warranted here. The defendant sought removal to challenge a prior award of spinal disk replacement surgery, alleging fraud and misrepresentation. The WCAB treated the defendant's petition as one for reconsideration and granted it. This allows the WCAB to further review the case's factual and legal issues before issuing a final decision.

Workers' Compensation Appeals BoardPetition for RemovalPetition for ReconsiderationFindings of Fact and Awardspinal disk replacement surgeryfraudmisrepresentationadministrative law judgeextraordinary remedysubstantial prejudice
References
Case No. ADJ3136701 (SFO 0461921)
Regular
Jun 01, 2012

HORST ROBERT STAHL vs. COSTCO WHOLESALE CORP.

The Workers' Compensation Appeals Board denied the lien claimant's petition for reconsideration, upholding the WCJ's finding that their lien was barred and ordering reimbursement of defendant's travel costs. The Board also initiated removal and intended to impose sanctions of $500 on the lien claimant's representative, Mark Gangl, and Recovery Resources, Inc. This action is due to material misrepresentations in their petition regarding the trial proceedings and costs. Sanctions are proposed for filing a petition that contained substantially misleading and factually unsupported statements.

Workers' Compensation Appeals BoardPetition for ReconsiderationStatute of LimitationsLachesLien ClaimantsTravel CostsLabor Code § 5813SanctionsBad Faith ActionsFrivolous Tactics
References
Case No. ADJ7661375
Regular
Jun 03, 2013

JOSE CERVANTES vs. TOTAL RESOURCES INTERNATIONAL, INC., ZENITH INSURANCE COMPANY

The Appeals Board granted reconsideration for lien claimant PTS after their lien was dismissed for failure to prove timely payment of the activation fee. The Board dismissed TCMG's petition for reconsideration because they did not file a lien and their petition contained numerous misrepresentations and procedural violations. The Board also issued a notice of intention to impose sanctions up to $2,000 against Innovative Medical Management, the representative for both lien claimants, due to their bad faith actions and misrepresentations.

Lien activation feeProof of prior paymentSanctionsLabor Code Section 4903.06Labor Code Section 5813Appeals Board Rule 10561Due processMisrepresentation of factsStanding to appealEAMS
References
Case No. ADJ2132852 (VNO 0380163)
Regular
Jan 23, 2009

TOMAS SANCHEZ vs. ST. GEORGE TRUCKING, AMERICAN HOME ASSURANCE, Administered by AIG DOMESTIC CLAIMS

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior order imposing sanctions and costs on the applicant's attorney and hearing representative. The WCAB found that the original order was based on a critical factual error regarding the applicant's attendance at a prior trial, which was not properly corrected. Due to significant factual disputes and potential due process issues, the WCAB returned the matter to the trial level for further proceedings and a new decision on sanctions and costs by a different WCJ. The petition for removal was dismissed as reconsideration was deemed an adequate remedy.

Workers' Compensation Appeals BoardPetition for RemovalPetition for ReconsiderationFindings and OrderSanctionsCostsAdministrative Law JudgeHearing RepresentativeDue ProcessSubstantial Evidence
References
Case No. ADJ4702369 (LAO 0839192) ADJ4457073 (LAO 0863424) ADJ215002 (LAO 0863425)
Regular
Oct 07, 2013

JUAN CEBALLOS vs. ALLOY DIE CASTING, SEABRIGHT

In a workers' compensation case, the Appeals Board imposed a $1,000 sanction against a lien claimant, Innovative Medical Management, its representative Louis Heard, and Coast Plaza Doctors Hospital. This sanction was levied for filing an untimely objection with a misrepresentation regarding their failure to attend a lien conference, despite clear instructions on filing procedures. The Board found the objection's attached notes demonstrated a deliberate decision not to attend the conference, rendering their excuse of software issues for the misrepresentation unconvincing. The sanction is jointly and severally payable to the Workers' Compensation Appeals Board.

WORKERS' COMPENSATION APPEALS BOARDOPINION AND DECISION AFTER REMOVALORDER IMPOSING SANCTIONSLABOR CODE § 5813Petition for Reconsiderationlien claimantuntimely Objectionmisrepresentation of factInnovative Medical ManagementCoast Plaza Doctors Hospital
References
Case No. FRE 0245256
Regular
Jun 05, 2007

FRE 27 XYZZX vs. BUTTON TRANSPORTATION INC., STATE COMPENSATION INSURANCE FUND

The applicant sought reconsideration of an approved Compromise and Release agreement concerning his cumulative injury claim for Valley Fever. He alleged fraud based on misrepresentation of his job title and work environment by the defendant and its adjuster. The Appeals Board dismissed the petition for reconsideration because it was filed significantly outside the statutory 20-day deadline, rendering it untimely.

Valley FeverCoccidioidomycosisCompromise and ReleasePetition for ReconsiderationTimelinessJurisdictionOrder Approving Compromise and ReleaseIndustrial InjuryTruck DriverDispatcher
References
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