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

Case No. ADJ7860847 & ADJ7860626
Regular
Nov 09, 2011

FERNANDO SARMIENTO vs. BLUE CHIP RECYCLING, WAUSAU UNDERWRITERS INSURANCE CO., LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board has granted reconsideration in the case of Fernando Sarmiento versus Blue Chip Recycling and its insurers. This decision was made due to a petition filed by defendant Wausau Underwriters Insurance Company, necessitating further review of the factual and legal issues. The Board requires additional study of the record to ensure a just and reasoned decision. All future communications in this matter should be directed to the Board's Office of the Commissioners in San Francisco.

Petition for ReconsiderationWorkers' Compensation Appeals BoardWausau UnderwritersLiberty MutualFernando SarmientoBlue Chip RecyclingStatutory time constraintsFactual and legal issuesDecision After ReconsiderationOffice of the Commissioners
References
Case No. ADJ473373 (ANA 0406381)
Regular
Feb 10, 2012

FERNANDO GUTIERREZ vs. SOCAL FRAMING aka BMHC; ACE AMERICAN INSURANCE, administered by ESIS, INC.

This case concerns applicant's claim for extended temporary disability (TD) benefits beyond 104 weeks due to a left eye injury. The Appeals Board affirmed the WCJ's denial of the "amputation" exception, ruling that the surgical removal of an eye does not fit the statutory definition. However, the Board remanded the case for further development of the record on the "high-velocity eye injury" exception, as the velocity and force of the object that struck the applicant's eye were unclear. The applicant's Petition for Removal was dismissed as reconsideration was the appropriate remedy.

Workers' Compensation Appeals BoardFernando GutierrezSoCal FramingBMHCACE American InsuranceESISInc.ADJ473373ANA 0406381Opinion and Decision
References
Case No. ADJ7839029; ADJ7841350
Regular
Jun 25, 2014

Fernando Murillo vs. Yonique Café, Inc., Zenith Insurance Company

This case involves a lien claimant, Ameri Chiropractic Group (LC), seeking disqualification of a Workers' Compensation Judge (WCJ). LC alleged bias based on a WCJ order requiring a doctor's personal appearance at trial regarding treatment and the lien's validity. However, the Workers' Compensation Appeals Board (WCAB) dismissed the petition as untimely. WCAB Rule 10452 dictates a strict 10-day filing period after notice of hearing for such petitions. LC's petition was filed three months after being served with the order, rendering it untimely regardless of when new counsel was retained.

Petition for DisqualificationUntimely FilingWCJ BiasLien ClaimantAmeri Chiropractic GroupWCAB Rule 10452Order for AppearanceDismissal of LienPinnacle Lien ServicesAdministrative Law Judge
References
Case No. ADJ859899
Regular
Feb 25, 2011

FERNANDO SOSA vs. RIGOBERTO URIARTE DBA RIGO'S PLASTERING, UNISURED EMPLOYERS FUND

This case concerns a second petition for reconsideration filed by the defendant, Rigoberto Uriarte DBA Rigo's Plastering, challenging both the original administrative law judge's decision and the Board's prior denial of reconsideration. The Workers' Compensation Appeals Board dismissed the petition as legally impermissible, citing precedent that prohibits successive petitions after a decision has been rendered. The defendant's sole recourse after the Board's denial was to petition for a writ of review.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissalConsecutive PetitionSuccessive PetitionWrit of ReviewWCJ DecisionBoard DecisionCrowe Glass CompanyNavarro v. A&A Farming
References
Case No. ADJ3299590
Regular
Sep 08, 2008

Fernando Pineda vs. Jose Casillas/JOE SNYDER (Deceased), Allied Insurnace, A Nationwide Company

The Appeals Board granted reconsideration and reversed the WCAs decision, finding that the applicant's injury was not covered by the homeowner's insurance policy because the insured was engaged in a farming business at the time of the injury.

Workers' Compensation Appeals BoardAllied InsuranceFernando PinedaJoe Snyderresidential employeefarming pursuit exclusionhomeowner's policydomestic employees endorsementbusiness activitycoverage dispute
References
Case No. ADJ7711093
Regular
Nov 10, 2014

Fernando Sosa vs. Source One Staffing, CIGA by its Servicing Facility Patriot Risk Services, For Ullico, in liquidation

The Workers' Compensation Appeals Board dismissed a lien claimant's petition for reconsideration because it was unverified. The Board also granted removal on its own motion due to the lien claimant's repeated failure to appear at lien conferences and file proper objections. This conduct, along with filing an invalid petition, suggests potential bad faith and warrants a Commissioner's Conference to determine if sanctions should be imposed. The lien claim was ultimately dismissed by the WCJ for non-appearance.

Workers' Compensation Appeals BoardFernando SosaSource One StaffingCIGAUllicoPetition for ReconsiderationLien ClaimantCalifornia Physician NetworkLLCDenise Mejia
References
Case No. ADJ7722627
Regular
Jun 01, 2012

FERNANDO FLORES vs. COUNTY OF MONTEREY

The defendant, County of Monterey, withdrew its Petition for Removal after reaching an agreement with the applicant, Fernando Flores, to utilize an agreed medical evaluator. The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's petition as a result of this withdrawal. This order effectively closes the removal process in this case.

Petition for RemovalAgreed Medical EvaluatorFindings and OrderWorkers' Compensation Appeals BoardDismissalIntercare InsuranceCounty of MontereyAdministrative Law JudgeApplicantDefendant
References
Case No. ADJ883280 (POM 0291224)
Regular
May 12, 2010

FERNANDO JIMENEZ vs. BEWLEY-ALLEN CADILLAC, HARCO INSURANCE, BROADSPIRE

This case involves Fernando Jimenez's workers' compensation claim against Bewley-Allen Cadillac and its insurer. The Workers' Compensation Appeals Board reviewed Jimenez's Petition for Reconsideration. Citing the administrative law judge's report, the Board dismissed the petition. The final order is the dismissal of the Petition for Reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationReport and RecommendationAdministrative Law JudgeDismissedBewley-Allen CadillacHarco InsuranceBroadspireADJ883280POM 0291224
References
Case No. ADJ8926229
Regular
Jul 22, 2016

FERNANDO LOPEZ vs. DELUXE LABORATORIES, ZURICH NORTH AMERICA, ESIS

This case involves applicant Fernando Lopez seeking reconsideration of a Workers' Compensation Appeals Board decision. The Board has granted reconsideration to allow for further study of the factual and legal issues. This is necessary to ensure a complete understanding of the record and to issue a just decision. All future filings related to the petition must be submitted directly to the Appeals Board Commissioners, not the district office, and settlement proposals require prompt notification of the Appeals Board.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationGranting ReconsiderationDecision After ReconsiderationStatutory Time ConstraintsFactual and Legal IssuesJust and Reasoned DecisionFurther ProceedingsOffice of the CommissionersElectronic Adjudication Management System
References
Case No. ADJ7860847, ADJ7860626
Regular
May 14, 2012

FERNANDO SARMIENTO vs. PAYROLL MANAGEMENT GROUP, INC, BLUE CHIP RECYCLING, WAUSAU UNDERWRITERS INSURANCE COMPANY, LIBERTY MUTUAL

The Appeals Board vacated its prior grant of reconsideration and dismissed the defendant's petition as untimely and based on non-final orders. The Board granted removal on its own motion to consolidate two cases and affirmed the WCJs' denial of the defendant's petitions to compel the applicant to transfer care to a Medical Provider Network (MPN). While the defendant is generally not liable for treatment outside an MPN per *Valdez*, the Board found that MPN validity and notice issues, and the applicant's right to self-procure treatment at their own expense, were not yet determined. The Board clarified that the defendant can request an expedited hearing to determine entitlement to medical treatment, rather than compel MPN transfer.

Workers' Compensation Appeals BoardMedical Provider NetworkMPNPetition to CompelReconsiderationRemovalVenueConsolidationFinal OrderLabor Code
References
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