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

Case No. ADJ6722110
Regular
Oct 11, 2013

SERGIO RODRIGUEZ vs. AIR COASTAL FLEET SERVICES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed an administrative law judge's order dismissing a lien claim for failure to pay the required activation fee. The lien claimant, Advance Care Specialist Medical Clinic, and its representatives, Innovative Medical Management and Louis Heard, sought reconsideration, which was granted. However, the Board found no good cause to overturn the dismissal. Subsequently, the Board imposed a $1,000 sanction against Innovative Medical Management and Louis Heard for their failure to respond to a notice of intent to impose sanctions.

Lien activation feeSanctionLabor Code section 5813Appeals Board Rule 10561ReconsiderationWCJ Order Dismissing Lien ClaimNotice of Intention to Impose SanctionsWorkers' Compensation Appeals BoardHearing RepresentativeMedical Clinic
References
0
Case No. ADJ8094646
Regular
Jan 17, 2014

ALEJANDRINA BARRETO vs. OUT OF THE SHELL, SOUTHERN INSURANCE COMPANY, REPUBLIC INDEMNITY COMPANY, PHARMAFINANCE, LLC, HEALTHCARE FINANCE MANAGEMENT, LLC

This case involves lien claimants PharmaFinance and Healthcare Finance Management, and their representatives Landmark Medical Management and Brian Hall, who sought reconsideration of a decision disallowing their liens for medical treatment. The Appeals Board granted reconsideration solely to notice its intention to impose sanctions of up to $2,500 against the lien claimants and their representatives. This action is due to a pattern of allegedly filing petitions containing false statements about not receiving notices, which violates the Board's Rules of Practice and Procedure and Labor Code Section 5813. The Board found these claims not persuasive and indicative of a tactic to avoid responsibility.

Workers' Compensation Appeals BoardPetition for ReconsiderationSanctionsLien ClaimantsHearing RepresentativesIndustrial InjuryFindings and OrderCompromise and ReleaseNotice of IntentionLabor Code section 5813
References
0
Case No. MISSING
Regular Panel Decision

ABC Medical Management, Inc. v. GEICO General Insurance

The case addresses whether a plaintiff-assignee medical equipment supplier can recover no-fault first-party benefits when a chiropractor, rather than a physician, issued the prescription. Defendant GEICO General Insurance Company moved for summary judgment, arguing that Education Law § 6551 prohibits chiropractors from prescribing such items. The court denied GEICO's motion, ruling that chiropractors are permitted to prescribe TENS units, thermophore devices, and similar medical supplies, as these do not constitute 'drugs or medicines' under the Education Law. Furthermore, the court found that GEICO failed to properly present its medical necessity defense and that the contested issues should be determined by a trier of fact.

No-Fault BenefitsChiropractic PrescriptionMedical EquipmentEducation Law § 6551Summary JudgmentMedical NecessityTENS UnitThermophoreCervical CollarLumbar Support
References
29
Case No. ADJ7048560
Regular
Nov 28, 2011

PARVEENA PRASAD vs. SACRAMENTO BEE/McCLATCHY NEWSPAPERS, INC.

This case involves sanctions imposed against lien claimant Accident Injury & Family Therapy (AIFT), its representative Innovative Medical Management (IMM), and Louis Heard for failing to attend two mandatory settlement conferences. The Workers' Compensation Appeals Board (WCAB) reversed a prior decision that allowed AIFT's lien, finding the lien claimant's excuses for non-appearance unpersuasive despite the loss of the lien itself. The WCAB sanctioned AIFT, IMM, and Heard jointly and severally $800 and awarded defendant its reasonable costs and fees incurred due to the missed appearances.

Workers' Compensation Appeals BoardDecision After RemovalSanctionsCosts and FeesAccident Injury & Family TherapyInnovative Medical ManagementLouis HeardLabor Code Section 5813Utilization ReviewCompromise and Release
References
1
Case No. ADJ3413739 (SAL 0120295)
Regular
Nov 26, 2013

YOLANDA OSUNA vs. MARRIOTT HOTEL, ARCHIE MAYS, M.D., RUBY LEYNES, M.D., SCOTT ROSENZWEIG, M.D., EDWARD KOMBERG, D.C.; INNOVATIVE MEDICAL MANAGEMENT and LOUIS HEARD

This case involves a sanction against Innovative Medical Management and Louis Heard for reasons outlined in a prior Notice of Intention. The Appeals Board received a $2,500 payment from them, which they deemed an acknowledgment of the undisputed reasons for the proposed sanction. Consequently, the Board ordered a $2,500 sanction, crediting the payment already made, thus settling the matter.

Workers' Compensation Appeals BoardRemovalSanctionNotice of Intention to Impose SanctionHearing RepresentativesInnovative Medical ManagementLouis HeardMedical ManagementAppeals BoardOpinion and Decision
References
0
Case No. ADJ3413739
Regular
Oct 24, 2013

YOLANDA OSUNA vs. MARRIOTT HOTEL

The Workers' Compensation Appeals Board (WCAB) dismissed a petition for reconsideration filed by lien claimants and their representatives, Innovative Medical Management (IMM) and Louis Heard, as untimely. The Board also removed the case to itself and gave notice of its intention to impose sanctions of up to $2,500 against IMM and Heard. This action stems from IMM and Heard filing a frivolous, untimely petition containing misrepresentations about the timing of lien withdrawals, following the original imposition of sanctions by the WCJ for their failure to appear at a scheduled lien trial. The Board noted IMM and Heard's extensive history of similar sanctionable conduct.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Granting RemovalSanctionsHearing RepresentativesInnovative Medical ManagementLouis HeardLien ClaimantsLabor Code Section 5813Frivolous Petition
References
0
Case No. ADJ1262856 (VNO 0552716)
Regular
Jan 31, 2013

MANUEL RODRIGUEZ vs. PARAGON TEXTILES, GRANITE STATE INSURANCE CO., CHARTIS INSURANCE, ENDURANCE INSURANCE CO.

This case involves a lien claimant, Tri-County Medical Group, whose lien was dismissed by the WCJ. The Appeals Board granted reconsideration to address the lien dismissal and also issued a Notice of Intention to Impose Sanction against Tri-County's representative, Lee Toney and Innovative Medical Management. As no objections were filed, the Board affirmed the lien dismissal and imposed a $1,000 sanction jointly and severally on Mr. Toney and Innovative Medical Management for failing to demonstrate good cause.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Dismissing LiensLien ClaimantTri-County Medical GroupSanctionLabor Code § 5813Cal. Code Regs. tit. 8 § 10561Lee ToneyInnovative Medical Management
References
0
Case No. MISSING
Regular Panel Decision

Lapir v. Maimonides Medical Center

Olga Lapir sued her former employer, Maimonides Medical Center (MMC), and her union, Local 1199, under the Labor Management Relations Act. She alleged that MMC breached their collective bargaining agreement by terminating her employment without good cause and that the union failed to process her grievance, breaching its duty of fair representation. Lapir was fired as a blood bank technician after an incident where she assisted a doctor in locating special blood, violating hospital confidentiality and blood segregation policies. The court found that the union's investigation and defense were not arbitrary or in bad faith, and its decision not to pursue arbitration was rational, especially given Lapir's admitted misconduct. Consequently, the defendants' motions for summary judgment were granted, dismissing Lapir's complaint.

Labor RelationsDuty of Fair RepresentationSummary Judgment MotionWrongful Termination ClaimCollective BargainingGrievance ArbitrationHospital Blood Bank PolicyEmployee ConfidentialityUnion Due DiligenceFederal District Court
References
15
Case No. ADJ6713503
Regular
May 16, 2014

MATTHEW JENSON vs. PEPSI BOTTLING GROUP, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board denied the Petition for Reconsideration filed by South Lake Medical Center and its associated entities. The Board also dismissed the successive Petition for Reconsideration filed by Accurate Medical Assessment Rating Center (AMARC). AMARC's prior petition was already denied, and successive petitions are not permitted, requiring review by the Court of Appeals instead. The Board adopted the WCJ's Report and Recommendation in support of these decisions.

WCABLien ClaimantPetition for ReconsiderationLabor Code section 5813California Code of Regulations title 8 section 10561WCJSanctionsSuccessive PetitionOrder Denying Petitions for ReconsiderationWrit of Review
References
2
Case No. MISSING
Regular Panel Decision

Polanco v. Brookdale Hospital Medical Center

Plaintiffs Pearl Polanco, Carol McCarthy, and Wilma Steel-Lopez, former employees of The Brookdale Hospital Medical Center, brought claims under the New York Labor Law (NYLL) and the Fair Labor Standards Act (FLSA), alleging they were not paid for work performed during lunch breaks and after shifts. The defendant moved to dismiss, arguing that the state claims were preempted and federal claims precluded by the Labor Management Relations Act (LMRA). The court, presided over by Senior District Judge Jack B. Weinstein, denied the defendant's motion, concluding that the plaintiffs' NYLL and FLSA claims assert independent statutory rights that are neither preempted nor precluded by the LMRA.

Wage DisputesOvertime CompensationFair Labor Standards ActNew York Labor LawLabor Management Relations ActPreemption DoctrineClaim PreclusionMotion to DismissEmployee RightsStatutory Rights
References
23
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