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

Case No. ADJ3874707 (ANA 0393103)
Regular
Jul 01, 2009

WILLIAM MARCHESE vs. THE HOME DEPOT, Permissibly SelfInsured, Adjusted By SEDGWICH CLAIMS MANAGEMENT SERVICES, INC.

This case involves a worker's compensation claim where the applicant's former attorney, Krishna Gulaya, is facing potential sanctions. The Workers' Compensation Appeals Board (WCAB) is investigating allegations that Gulaya submitted a falsified Compromise and Release agreement, including improper witnessing and backdating of signatures. The WCAB has scheduled a conference solely to address the imposition of sanctions against Gulaya for this misconduct. Gulaya is ordered to appear at the conference to demonstrate good cause why sanctions should not be imposed.

Workers' Compensation Appeals BoardSanctionsApplicant's AttorneyCompromise and ReleaseWCJIndustrial InjuryFindings of FactAward and OrderSet AsideWitness Signatures
References
0
Case No. ADJ3711106 (MON 0347573) ADJ2131962 (MON 0350490)
Regular
Sep 16, 2010

ELIZABETH JUANILLO NAVARRO vs. JACK IN THE BOX, GALLAGHER BASSETT, ACE AMERICAN INSURANCE

This Workers' Compensation Appeals Board case concerns a lien claimant, Arthur Malkin, D.C., and his representative, Lee Toney, who are challenging a Notice of Intention to Impose Sanctions. The lien claimant contends he was misadvised and did not receive a necessary report from the Workers' Compensation Judge (WCJ). The Board has provided the missing report and granted an additional 10 days for the lien claimant to file further objections to the $250 sanction. Failure to show good cause within this extended period will result in the imposition of sanctions under Labor Code section 5813.

Workers' Compensation Appeals BoardNotice of Intention to Impose SanctionsLien claimantArthur Malkin D.C.Lee ToneyPetition for RemovalWCJ Report and RecommendationPetition for ReconsiderationLabor Code Section 5813Sanctions
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. ADJ1370526 (LBO 0201100) MF ADJ1113744 (LBO 0201101)
Regular
May 09, 2014

GYSO JOHNSON vs. COUNTY OF LOS ANGELES/DEPARTMENT OF SOCIAL SERVICES

This case involves a lien claimant, Dr. David Silver, M.D., seeking additional payment for medical services provided to applicant Gyso Johnson, claiming the defendant, County of Los Angeles, inadequately compensated him. The Workers' Compensation Appeals Board denied Dr. Silver's petition for reconsideration and sanctions. The Board affirmed the finding that Dr. Silver was adequately compensated, finding the defendant's expert witness was qualified and that Dr. Silver failed to meet his burden of proof for additional fees. The Board also found no merit to the fraud allegations or grounds for imposing sanctions against the defendant.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationOfficial Medical Fee ScheduleExpert Witness QualificationsEvidence Code Section 720Bill Reviewer TrainingDowncodingCPT Code 99080CPT Code 99081
References
2
Case No. ADJ4230639
Regular
Nov 05, 2010

GARY FOSTER (Deceased), MANUEL VILLARREAL vs. RPI COATING, INC., SCIF INSURED FRESNO

This case involves the imposition of $\$ 250.00$ in sanctions against defendant's counsel, Sylvia Bedrossian, and her client, SCIF. The sanctions were issued for engaging in bad faith and/or frivolous conduct by failing to provide proper evidentiary citations and attaching documents not in evidence to a petition for reconsideration. The Appeals Board found this conduct wasted its limited resources. The matter was returned to the trial level for further proceedings.

Workers' Compensation Appeals BoardRemovalSanctionsLabor Code section 5813Board Rule 10561Bad Faith ConductFrivolous ConductImproper CitationsUnacknowledged ExhibitsPetition for Reconsideration
References
0
Case No. ADJ3496977 (AHM 0123782)
Regular
Aug 23, 2010

CARL DIXON vs. PHILLIPS BUICK, PONTIAC & MAZDA, CLARENDON NATIONAL INSURANCE COMPANY, Administered By AMERICAN ALL RISK LOSS ADMINISTRATORS, SECURITY INSURANCE COMPANY, Administered By LWP CLAIMS SOLUTIONS

The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration, reaffirming that Labor Code § 4610 utilization review is mandatory for challenging medical treatment requests, even when an Agreed Medical Evaluator (AME) is involved. The WCAB also imposed $900 in sanctions on the Law Offices of Robin Jacobs for filing a deficient and unserved petition for reconsideration, and for failing to disclose a non-attorney's involvement. The applicant's attorney's response failed to adequately address these grounds, leading to the imposition of sanctions. The case is returned to the WCJ to correct prior decision deficiencies.

Workers' Compensation Appeals BoardPetition for ReconsiderationSanctionsUtilization ReviewAgreed Medical EvaluatorLabor Code § 4610Labor Code § 4062SandhagenWCAB RulesNon-attorney
References
1
Case No. ADJ332528 (AHM 0104042)
Regular
Mar 22, 2011

ERNEST DANIELS vs. PIEDMONT ENGINEERS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board imposed a $250.00 sanction against the State Compensation Insurance Fund and its attorney, Maria Frias Callejas. This sanction was issued due to their failure to respond to a Notice of Intention to Impose Sanctions and their violation of the Board's Rules of Practice and Procedure. No timely objection demonstrating good cause was filed. Consequently, they are jointly and severally liable for the payment of the sanction to the Appeals Board.

Workers' Compensation Appeals BoardSanctionsState Compensation Insurance FundMaria Frias CallejasRules of Practice and ProcedureNotice of IntentionGood CauseTimely ResponseJoint and Several LiabilityAttorney for Defendant
References
0
Case No. ADJ6620175
Regular
Oct 10, 2013

CAMELLA MORA GONZALEZ vs. KAY'S CLEANERS

The Workers' Compensation Appeals Board is imposing sanctions under Labor Code § 5813 against Innovative Medical Management and lien claimant Priority Care Medical Transportation for $1,000.00, jointly and severally. Additionally, sanctions of $250.00 are imposed against Louis Heard, the lien claimant's hearing representative. These sanctions were ordered due to a failure to object to a previously issued notice of intention, following the Board's affirmation of the dismissal of the lien claim. The sanctioned parties did not provide any written objection demonstrating good cause to avoid the sanctions.

Labor Code § 5813SanctionsPetition for ReconsiderationLien ClaimDismissalPriority Care Medical TransportationInnovative Medical ManagementLouis HeardWorkers' Compensation Appeals BoardHearing Representative
References
0
Case No. ADJ962796 (ANA 0403408)
Regular
Aug 26, 2015

JAMES RODNEY RICHARD vs. HOUSTON ASTROS

Attorneys for both the applicant and defendant were sanctioned $50.00 each for failing to follow the Board's explicit instructions. The attorneys improperly filed a stipulation for appellate attorney's fees with a district office instead of the Office of Commissioners. This oversight led to an inaccurate award and necessitated further Board action. While acknowledging the attorneys' apologies and assurances of future compliance, the Board imposed the minimal sanction due to the clear disregard of its directives.

Workers' Compensation Appeals BoardSanctionsAppellate Attorney's FeesStipulationNotice of IntentionDistrict OfficeOffice of CommissionersLabor Code Section 5813WCAB Rule 10561Amended Award
References
0
Case No. ADJ7199989, ADJ7118722
Regular
Feb 13, 2012

JUAN CERVANTES vs. WESTERN MEDICAL CENTER, HARTFORD

The Workers' Compensation Appeals Board (WCAB) sanctioned applicant's attorney, Sunil Shaw, for $\$250.00$. This sanction was imposed for violating Appeals Board Rule 10842, related to proceedings before the Board. The WCAB granted removal on its own motion and issued a notice of intention to sanction, to which no objection was received. The sanction amount has been paid.

Workers' Compensation Appeals BoardRemovalSanctionLabor Code Section 5310Appeals Board Rule 10842Notice of Intention to SanctionApplicant's AttorneyShow Good CauseDecision After RemovalWestern Medical Center
References
0
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