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

Case No. MISSING
Regular Panel Decision

Perfect Dental, PLLC v. Allstate Insurance

In this consolidated action, plaintiffs Perfect Dental Care, P.C., Zodiac Dental, PLLC, and Smooth Dental PLLC (Dental PCs) sought unpaid insurance claims from Allstate Insurance Company and State Farm Mutual Automobile Insurance Company (Insurers). The Insurers countersued alleging insurance fraud and unjust enrichment, and initiated a third-party action against various individuals and entities. The Insurers moved for partial summary judgment, seeking a declaratory judgment that Dental PCs could not recover for services provided by dentists and physical therapists, and for summary judgment on their fraud and unjust enrichment counterclaims. The court denied summary judgment concerning dentists' services, finding a triable issue of fact regarding their employment status. However, it granted summary judgment for the Insurers regarding physical therapy services, as Dental PCs conceded these services were provided by non-employees. Consequently, the court also denied summary judgment on the fraud and unjust enrichment claims, as their resolution depended on the unresolved employment status of the dentists.

Insurance ClaimsHealthcare ServicesContract LawSummary JudgmentProfessional CorporationsIndependent ContractorsEmployment LawFraud AllegationsUnjust EnrichmentDeclaratory Judgment
References
17
Case No. ADJ9317950
Regular
Nov 27, 2017

PEFLEY, Twana vs. FOOTHILL DENTAL, INC., HARTFORD INSURANCE

The Workers' Compensation Appeals Board denied Twana Pefley's Petition for Removal in the case against Foothill Dental, Inc. Removal is an extraordinary remedy granted only upon a showing of substantial prejudice or irreparable harm. The Board found that Pefley failed to demonstrate such harm, and that reconsideration would be an adequate remedy if an adverse decision were to issue. Therefore, the petition was denied.

Petition for RemovalExtraordinary RemedySubstantial PrejudiceIrreparable HarmReconsideration Adequate RemedyWorkers' Compensation Appeals BoardWCJ ReportCortez v. Workers' Comp. Appeals Bd.Kleemann v. Workers' Comp. Appeals Bd.Cal. Code Regs. tit. 8 § 10843(a)
References
2
Case No. MISSING
Regular Panel Decision

First District Dental Society v. Sencer

The petitioners, dental societies in New York City, initiated an Article 78 proceeding to challenge a directive from the New York City Department of Health. The directive, dated August 14, 1981, mandated that all radiation installation licensees, including dental offices, make complete copies of Article 175 of the New York City Health Code available for staff examination. Petitioners argued this requirement was arbitrary and capricious due to its impracticality, financial burden, and the existence of an alternative provision allowing a descriptive notice. Respondents defended the directive as a rational measure to protect public health and ensure worker instruction regarding radiation safety, aligning with state and federal regulations. The court, applying the standard for administrative review, found a rational basis for the Department's interpretation and upheld the directive, denying the petitioners' request for nullification, though a 60-day stay on enforcement was granted.

Radiation SafetyHealth CodeAdministrative LawJudicial ReviewDental PracticesRegulatory CompliancePublic HealthArticle 78 ProceedingsAgency InterpretationDirective Challenge
References
8
Case No. 2020 NY Slip Op 01355
Regular Panel Decision
Feb 26, 2020

Naula v. Utokilen, LLC

The plaintiff, Victor Naula, commenced an action for personal injuries against Utokilen, LLC, and others. The Workers' Compensation Board (WCB) found Naula's employer, Specialized Dental Construction, Inc., uninsured and Adapt Construction, LLC, to be the general contractor, awarding Naula workers' compensation benefits. Utokilen and Nancy Marin-Rojas D.D.S., P.C., initiated a third-party action against Specialized Dental for common-law indemnification and contribution. Specialized Dental moved for summary judgment, asserting exclusivity under Workers' Compensation Law § 11, but Utokilen and Marin-Rojas cross-moved, arguing Specialized Dental could not invoke § 11 due to its uninsured status. The Supreme Court granted the cross-motion and denied Specialized Dental's motion. The Appellate Division dismissed Adapt Construction, LLC's appeal as it was not an aggrieved party and affirmed the Supreme Court's order against Specialized Dental Construction, Inc.

Personal InjuriesWorkers' Compensation LawSummary JudgmentThird-Party ClaimsIndemnificationContributionGrave InjuryUninsured EmployerAppellate PracticeCollateral Estoppel
References
7
Case No. MISSING
Regular Panel Decision
Sep 09, 1999

Bulvas v. Dubrowsky

The plaintiffs appealed a judgment from the Supreme Court, Rockland County, which dismissed their complaint alleging dental malpractice. The appellate court affirmed the judgment, ruling that the plaintiffs' argument regarding insufficient evidence was not preserved for review. It further held that the jury had a rational basis to conclude that no dental malpractice occurred, and the verdict was supported by a fair interpretation of the evidence, thus dismissing the appeal.

Dental MalpracticeAppellate ReviewJury VerdictSufficiency of EvidenceWeight of EvidenceAffirmationRockland CountyCivil ProcedureMedical MalpracticeJudgment Dismissal
References
8
Case No. ADJ10121570
Regular
Oct 28, 2016

Tracy Baker vs. Foothill De Anza Community College District

In Case No. ADJ10121570, the Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision regarding applicant Tracy Baker and defendant Foothill De Anza Community College District. The WCAB found reconsideration necessary to allow further study of the factual and legal issues involved. This grant suspends any action by the Workers' Compensation Judge (WCJ) on the matter. All subsequent filings related to the reconsideration petition must be submitted directly to the WCAB Commissioners in San Francisco, not to the district office.

Workers' Compensation Appeals BoardPetition for ReconsiderationGranting ReconsiderationDecision After ReconsiderationStatutory Time ConstraintsFactual and Legal IssuesJust and Reasoned DecisionFurther ProceedingsCommissioners of the Workers' Compensation Appeals BoardElectronic Adjudication Management System (EAMS)
References
0
Case No. ADJ1566453 (AHM 0145804)
Regular
Nov 16, 2017

EVELYN SOLIS vs. CHILDREN'S DENTAL GROUP, NATIONAL LIABILITY & FIRE INSURANCE COMPANY

In Evelyn Solis v. Children's Dental Group, the Workers' Compensation Appeals Board granted reconsideration and amended the original Findings and Orders. The Board deferred specific issues concerning a lien claimant's claim and compliance with Rule 9982. The case is returned to the Workers' Compensation Judge for further proceedings on these deferred matters. The applicant's injury to her right wrist, hand, and shoulder was affirmed, but not to her cervical spine.

Workers' Compensation Appeals BoardEvelyn SolisChildren's Dental GroupNational Liability & Fire Insurance CompanyBerkshire Hathaway Homestate CompaniesCompromise and ReleaseLien TrialPetition for ReconsiderationFindings and OrdersMed-Legal LLC
References
1
Case No. ADJ7594309
Regular
Dec 08, 2014

ANA DURAND ACOSTA vs. WESTERN DENTAL SERVICE, HARTFORD ACCIDENT & INDEMNITY CO.

In this Workers' Compensation Appeals Board case, the applicant, Ana Durand Acosta, successfully established that she sustained a work-related injury to her spine and wrists while employed by Western Dental Service. The administrative law judge awarded temporary and permanent disability benefits based on this finding. The employer and their carrier sought reconsideration, arguing the trial proceeded prematurely and lacked sufficient medical evidence. The Board denied the petition, adopting the judge's report and affirming the original award.

Western Dental ServiceHartford Accident & Indemnity Co.cervical spine injurylumbar spine injurywrist injurytotal temporary disabilitypermanent disabilityapportionmentPetition for ReconsiderationFindings and Award
References
0
Case No. ADJ9202893
Regular
Aug 29, 2016

JUAN JOSE ALVAREZ vs. FOOTHILL PACKING, INC.; SPARTA INSURANCE, Administered by YORK RISK SERVICES GROUP

The Workers' Compensation Appeals Board granted Foothill Packing's petition for reconsideration, rescinding Finding of Fact No. 5. This finding ambiguously stated the applicant suffered an industrial event to his neck, shoulder, hip, back, and chest based on his credible testimony. The Board found this finding redundant and misleading, as the WCJ also determined the record needed further development regarding these orthopedic injuries. Therefore, Finding of Fact No. 5 was rescinded, but the WCJ's decision to develop the record further on these claims was affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrderIndustrial injuryLabor Code section 5310Agreed Medical EvaluatorQualified Medical EvaluatorSubstantial evidenceSpecific injuryThreshold issue
References
11
Case No. ADJ1456139
Regular
Apr 09, 2012

JOYCE TIGHE vs. LONG BEACH UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied reconsideration of a decision disallowing a lien claim from The Dental Trauma Center. The lien claimant's attorney failed to comply with Board regulations, including proper formatting and exhibit identification. The Board adopted the judge's report, which found that the lien claimant failed to meet its burden of proof in demonstrating that its dental services were reasonable and necessary to cure or relieve the effects of the applicant's stipulated industrial injuries, which did not include dental issues. Furthermore, the report of a consulting dentist, admitted over objection, also indicated that many of the services and charges were unreasonable or excessive.

Workers' Compensation Appeals BoardLong Beach Unified School DistrictPermissibly Self-InsuredADJ1456139LBO 0298310Order Denying ReconsiderationLien ClaimantPetition for ReconsiderationWCJReport of Administrative Law Judge
References
1
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