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Case Law Database

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

Case No. SBR 0315782
Regular
Jul 30, 2007

GORDON ADAMS vs. SOUTHLAND DRYWALL COMPANY, STATE COMPENSATION INSURANCE FUND

This case concerns a lien claimant, Premier Outpatient Surgery Center, Inc., whose lien was denied because it allegedly did not use its full corporate name or have a fictitious business name permit. The Appeals Board rescinded the denial and returned the case for further proceedings, finding that Premier was properly licensed as an outpatient facility and that the defendant did not timely raise the fictitious business name statement issue. The Board clarified that a facility fee lien claimant is not required to have a Medical Board fictitious-name permit, but may need to file a fictitious business name statement if operating under a name other than its legal corporate name.

Workers Compensation Appeals BoardLien ClaimantFictitious Business Name StatementFictitious-Name PermitBusiness & Professions Code Section 17910Business & Professions Code Section 2415(a)Medical Board of CaliforniaOutpatient SettingFacility FeeCompromise and Release
References
13
Case No. LAO 0878674
Regular
Mar 06, 2008

KARLA BUENO vs. PLAZA DEFENDANT LA RAZA, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision that barred a lien claim due to the alleged lack of a fictitious business name permit. The WCAB found that while the lien claimant presented a surgical clinic license, the record was unclear about its actual business name and compliance with fictitious name filing requirements. The case is remanded for further proceedings to determine the lien claimant's true name and establish its compliance with fictitious business name laws.

Fictitious Business Name StatementSurgical Clinic LicenseHealth ServicesBusiness and Professions CodeMedical BoardLien ClaimantOutpatient SettingAdministrative Law JudgeReconsiderationReasonableness of Fees
References
14
Case No. LAO 0794643
Regular
May 07, 2008

FRANCISCO CHAPA vs. GIBSON OVERSEAS, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinding the initial denial of a lien claim by S&B Surgery Center. The Board found the record insufficient regarding S&B's licensure and proper business naming, remanding the case for further development. This includes proving proper licensure as an "outpatient setting" and addressing the necessity of filing a fictitious business name statement, followed by a determination of the reasonableness of the billed fees.

Lien claimantreconsiderationlicensurefictitious business name statementoutpatient settingsurgical clinicMedical Boardcounty clerkreasonableness of feesburden of proof
References
9
Case No. LAO 0819419, LAO 0819420
Regular
Mar 06, 2008

RUBEN MARQUEZ vs. HOLLYWOOD GLASS COMPANY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior order disallowing the lien claim of S&B Surgery Center, and remanded the case for further proceedings. The Board found that while S&B Surgery Center likely met licensing requirements for its services, it needed to establish proper compliance with fictitious business name statement requirements or amend its claim to reflect its true corporate name. The case is to be returned to the trial level to address these issues and redetermine the reasonable value of S&B's services.

Fictitious Business NameLien ClaimantLicensing StatusSurgical Clinic LicenseBusiness and Professions Code Section 17910Outpatient SettingMedical BoardDepartment of Health ServicesBurden of ProofReasonable Fee
References
13
Case No. ANA 381864
Regular
Feb 25, 2008

TUAN KHANH DO vs. CONEYBEARE PERSONNEL SERVICES, STATE COMPENSATION INSURANCE FUND

This case concerns a Qualified Medical Examiner's (QME) entitlement to payment for medical-legal services. The defendant insurer argued that the QME's lien claim was invalid due to the use of a business name without a fictitious business name permit. However, the Workers' Compensation Appeals Board denied reconsideration, finding the QME rendered services and signed reports under his own name. The Board further noted that the insurer failed to properly object to the billings within the regulatory timeframe and the lien claim form was amended to reflect the QME's individual name.

WCABState Compensation Insurance FundMedical-legal servicesFictitious business name permitQualified Medical ExaminerLien claimCompromise and releaseMedical Board of CaliforniaBusiness and Professions CodeLabor Code
References
0
Case No. MISSING
Regular Panel Decision
May 08, 2007

Canal Carting, Inc. v. City of New York Business Integrity Commission

Petitioners Canal Carting, Inc. and Canal Sanitation, Inc., long-standing private sanitation businesses, challenged the Business Integrity Commission's (BIC) denial of their license renewals. The BIC cited Canal's knowing failure to provide required documentation, inability to demonstrate eligibility, and two violations for illegal dumping and operating an illegal transfer station. Canal argued the findings were arbitrary, capricious, and unprecedented, insisting their financial issues were unrelated to organized crime, which Local Law 42 (governing BIC) aimed to combat. The court found no due process violation regarding a formal hearing but concluded that the BIC's denial, effectively closing Canal's 50-year business for what amounted to poor business management, was arbitrary, unduly harsh, and shocking to one's sense of fairness. Consequently, the court granted the petition, annulled the BIC's denial, and remanded the case for reconsideration.

License RenewalAdministrative LawArticle 78 ProceedingBusiness Integrity CommissionTrade Waste IndustryDue ProcessArbitrary and CapriciousJudicial ReviewLocal Law 42Financial Responsibility
References
6
Case No. ADJ2403362 (MON 0247582) ADJ2066217 (MON 0306486)
Regular
Apr 25, 2011

EMILIA MENDOZA vs. LACMTA, THE TRAVELERS INS. CO., LOS ANGELES METROPOLITAN AUTHORITY, CONSTITUTION STATE SERVICES COMPANY

The Workers' Compensation Appeals Board affirmed the disallowance of lien claimant Care Center Rehabilitation and Pain Management's (LC) lien for unpaid medical treatment. LC failed to file a required fictitious business name statement and could not prove the treatment was reasonable and necessary. However, the Board reversed the order for LC to pay restitution to the defendants, finding they failed to meet their burden of proof for unjust enrichment.

Workers' Compensation Appeals BoardEmilia MendozaLACMTAThe Travelers Insurance CompanyConstitution State Services Companylien claimantCare Center Rehabilitation and Pain Managementindustrial injuriesneck and shouldersbus operator
References
5
Case No. ADJ197931
Regular
Oct 07, 2008

GENE DEL MASTRO vs. JOHN MANNINGER ELECTRIC, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board ruled that a lien claimant, Implantium, LLC, has standing to bill for surgical implants even if they are not covered by the Official Medical Fee Schedule (OMFS), as employer liability under Labor Code section 4600 is not limited to OMFS-covered services. The Board also found that Implantium's failure to file a fictitious business name statement until after providing services does not preclude reimbursement, as the statute only requires such filing to maintain an action, not for services rendered. Finally, the Board affirmed the consolidation of cases and deferred the issue of unjust enrichment for further proceedings.

Workers' Compensation Appeals BoardState Compensation Insurance FundSCIFImplantiumLLClien claimantOfficial Medical Fee ScheduleOMFSunjust enrichmentlicensing
References
2
Case No. MISSING
Regular Panel Decision

Wilson v. International Business MacHines, Inc.

Plaintiff Caroline Wilson sued defendants International Business Machines (IBM) and Frank Urban, alleging gender and/or pregnancy discrimination under Title VII of the Civil Rights Act of 1964 and N.Y. Executive Law § 296. Wilson's employment was terminated in 2002 during a reduction in force, shortly after returning from maternity leave. She argued she was unfairly laid off in favor of a male colleague. The defendants moved for summary judgment, asserting a legitimate, non-discriminatory business reason related to retaining the other employee's customer relationships and ongoing deals. The court found that while Wilson established a prima facie case, she failed to demonstrate that the defendants' reasons were a pretext for discrimination, or to present sufficient other evidence of unlawful discrimination. Consequently, the court granted the defendants' motions for summary judgment, dismissing the complaint.

DiscriminationGender DiscriminationPregnancy DiscriminationTitle VIIHuman Rights LawSummary JudgmentLayoffReduction in ForcePretextPrima Facie Case
References
12
Case No. MISSING
Regular Panel Decision

People v. Headley

The defendant, John E. Headley, an attorney and outside counsel for the New York City Transit Authority (NYCTA), faced charges including grand larceny, falsifying business records, and conspiracy. He was accused of fraudulently obtaining paid assignments from the NYCTA to procure independent medical examinations (IMEs) by using a fictitious name, "James Douglas," to conceal a conflict of interest. Headley moved to dismiss the indictment, arguing a lack of intent to defraud and no pecuniary loss to the NYCTA, as the contracted IME services were rendered. The court granted the dismissal of the larceny and first-degree falsifying business records counts, ruling that the prosecution failed to demonstrate criminal intent to deprive the NYCTA of property or that the submitted documents constituted "business records" for the purpose of those specific charges. However, the motion to dismiss the charges of offering a false instrument for filing in the first degree was denied, as concealing his identity frustrated the NYCTA's legitimate interests in a fair vendor selection process and accurate vendor identification, thus constituting an "intent to defraud" under that statute.

Grand LarcenyFalsifying Business RecordsConspiracyFalse PretensesIndependent Medical Examinations (IMEs)Conflict of InterestIntent to DefraudPecuniary LossSufficiency of EvidenceMotion to Dismiss
References
28
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