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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ7594334
Regular
Dec 28, 2012

JOSEPHINE PARKER vs. HENRY MAYO NEWHALL MEMORIAL HOSPITAL, THE HARTFORD

In this case, the Workers' Compensation Appeals Board granted reconsideration of a previous decision. The Board rescinded the original decision and returned the matter to the trial level for further proceedings. This action was taken following the parties' filing of Stipulations with Request for Award on December 11, 2012. The decision emphasizes that if the settlement is not approved by the judge, the original decision may be reinstated.

Workers' Compensation Appeals BoardStipulations with Request for AwardReconsiderationRescinded DecisionTrial LevelAdministrative Law JudgePetition for ReconsiderationDecision After ReconsiderationFurther ProceedingsJosephine Parker
References
Case No. VNO 0532499
Regular
Dec 14, 2007

PATRICIA BENNETT vs. HENRY MAYO NEWHALL MEMORIAL HOSPITAL, MAJESTIC INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed Patricia Bennett's petition for reconsideration because it was filed untimely. The petition was filed more than 25 days after the Workers' Compensation Judge's decision, exceeding the jurisdictional 20-day limit plus a potential 5-day mailing extension. Consequently, the WCAB lacked the authority to grant the untimely petition and denied requests for costs, sanctions, and fees.

Petition for ReconsiderationUntimely FilingJurisdictional LimitWCJ's DecisionService of OrderCode of Civil ProcedureWCAB RuleDeemed FiledMail DepositSanctions
References
Case No. VNO 0423681, VNO 0469245
Regular
Jun 16, 2008

JANET ANN SAMBAR vs. SANTA CLARITA HEALTH CARE ASSOCIATES dba HENRY MAYO NEWHALL MEMORIAL HOSPITAL, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE COMPANY, BROADSPIRE CLAIM SERVICES, INC., TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied CIGA's petition for reconsideration, upholding its prior decision that Travelers Insurance Company is not liable for the applicant's cumulative trauma injury. The Board found that a prior stipulation by Travelers was not binding on CIGA in a separate arbitration proceeding. Furthermore, the evidence established that the applicant's date of injury was August 14, 2000, and Travelers was not the employer's insurer during the relevant one-year exposure period, thus limiting liability to Superior/CIGA.

CIGATravelers Insurance CompanySuperior National Insurance CompanyHenry Mayo Newhall Memorial Hospitalcumulative trauma injurylast year of injurious exposureLabor Code § 5500.5Petition for Contributionstipulation"other insurance"
References
Case No. ADJ483951
Regular
May 02, 2011

JUDY HICE vs. HENRY MAYO NEWHALL MEMORIAL HOSPITAL, MAJESTIC INSURANCE COMPANY, U.S. FIRE INSURANCE COMPANY/CRUM & FORSTER GROUP

In Hice v. Henry Mayo Newhall Memorial Hospital, the Workers' Compensation Appeals Board (WCAB) granted reconsideration to further review a defendant's appeal. The defendant challenged the finding of injury dates, arguing the last date of exposure should be the last day of work, and that the administrative law judge (WCJ) disregarded the agreed medical examiner's opinion. After review, the WCAB affirmed the WCJ's Amended Findings and Award. The WCAB adopted and incorporated the WCJ's reasoning in their decision to uphold the original award.

Workers' Compensation Appeals BoardReconsiderationAmended Findings and AwardIndustrial InjuryNeck InjuryBilateral Upper ExtremitiesTemporary DisabilityPermanent DisabilityDate of InjuryLabor Code Section 5500.5
References
Case No. ADJ3781289
Regular
Apr 25, 2019

MARGARET BATTEN vs. LONG BEACH MEMORIAL HOSPITAL

Here's a summary for a lawyer: The Workers' Compensation Appeals Board (WCAB) has rescinded its prior decision regarding Margaret Batten's claim against Long Beach Memorial Hospital. This action was taken because a settlement has been reached between the parties while the case was pending on reconsideration. The matter is now returned to the trial level for the Workers' Compensation Judge (WCJ) to review and approve the proposed settlement. If the settlement is not approved, the WCJ may reinstate the original decision.

Workers' Compensation Appeals BoardReconsiderationProposed SettlementRescinded DecisionTrial LevelWCJFindings and AwardOpinion of JudgeLong Beach Memorial HospitalKeenan & Associates
References
Case No. ADJ244571 (VEN 0110022) ADJ3315572 (VEN 0110023) ADJ3817980 (OXN 0145232) ADJ2004405 (OXN 0145234) ADJ4239471 (OXN 0145235)
Regular
Jan 19, 2010

DIANA HARDMAN vs. COMMUNITY MEMORIAL HOSPITAL, AIG DOMESTIC CLAIMS, INC./CHARTIS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, BROADSPIRE, CALIFORNIA COMPENSATION INSURANCE COMPANY, FREMONT COMPENSATION INSURANCE COMPANY, American Home Assurance

This case involves five workers' compensation claims by applicant Diana Hardman against Community Memorial Hospital, with American Home Assurance (AIG) as a defendant insurer. AIG seeks reconsideration of the WCJ's findings, arguing it should only be liable for permanent disability directly arising from injuries covered by its policies, not those covered by insolvent insurers now handled by CIGA. The Appeals Board granted reconsideration, rescinded the WCJ's decisions, and returned the matter for further proceedings. Key issues include the admissibility of a deposition, the apportionment of permanent disability based on recent appellate decisions, and clarification of liability for injuries that occurred during periods covered by multiple insurers, including insolvent ones.

Workers' Compensation Appeals BoardDiana HardmanCommunity Memorial HospitalAIG Domestic ClaimsCalifornia Insurance Guarantee AssociationBroads PireCalifornia Compensation Insurance CompanyFremont Compensation Insurance CompanyOpinion and Order Granting ReconsiderationDecision After Reconsideration
References
Case No. ADJ3 176427 (AHM 0148942)
Regular
Feb 03, 2016

GILBERT LUNA vs. NATIONWIDE PHARMACY, LIBERTY MUTUAL

The Workers' Compensation Appeals Board affirmed a prior decision finding that Nationwide Pharmacy and Liberty Mutual's payment of $52,481.40 for spinal surgery was reasonable. Lien claimant Monrovia Memorial Hospital sought reconsideration, arguing a higher fee was warranted and they were exempt from the Official Medical Fee Schedule. However, the Board found that while the hospital was exempt from the fee schedule, it still had the burden to prove the reasonableness of its charges. The lien claimant failed to meet this evidentiary burden by a preponderance of the evidence.

Monrovia Memorial HospitalLien claimantOfficial Medical Fee ScheduleOMFS exemptionReasonable feeUsual and customary reimbursementBurden of proofFacility feesLong term care hospitalTitle 42 Code of Regulations
References
Case No. ADJ1436245
Regular
Feb 05, 2015

RAYMUNDO ARGUETA vs. POSTAL ALARM SYSTEMS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed the finding that Huntington Memorial Hospital is a Level 2 trauma facility and thus exempt from the standard Inpatient Hospital Official Medical Fee Schedule. However, the Board rescinded the order for payment of Huntington's full lien amount because the trial judge failed to make specific findings on the reasonable value of services and the basis for penalties and interest. The case is remanded to the trial level for further proceedings to determine these amounts with supporting evidence and findings.

Workers' Compensation Appeals BoardState Compensation Insurance FundHuntington Memorial HospitalLien ClaimantInpatient Hospital Official Medical Fee ScheduleLevel 2 Trauma FacilityLabor Code section 4609Administrative Director RulesReasonable FeeSubstantial Evidence
References
Case No. ADJ8149505 ADJ8149506
Regular
Apr 10, 2018

MARTHA BELTRAN vs. KIMCO STAFFING/KIMSTAFF HR, SEDGWICK

This case involved a dispute over a hospital lien claim from Monrovia Memorial Hospital. Initially, the Workers' Compensation Judge (WCJ) found insufficient evidence on the reasonableness of the hospital charges and ordered the parties to attempt to resolve it. After the hospital petitioned for reconsideration, the parties engaged in mediation and reached a settlement. The Appeals Board approved the stipulation, ordering the defendant to pay Monrovia Memorial Hospital $70,000 for its lien claim. Additionally, the defendant was ordered to reimburse another lien claimant, Joyce Altman Interpreters, $13,020.90$.

Workers' Compensation Appeals BoardLien ClaimPetition for ReconsiderationJoint Findings and OrdersBill ReviewerStipulationsMediationWCJADJ8149505ADJ8149506
References
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