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

Case No. ADJ3540065
En Banc
Jan 23, 2017

BRADLEY MAXHAM vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

The Appeals Board clarifies the distinction between "information" and "communication" under Labor Code § 4062.3, holding that a communication to a medical evaluator becomes "information" if it contains, references, or encloses medical or nonmedical records relevant to the medical issue, which requires prior agreement between the parties.

Workers' Compensation Appeals BoardPetition for RemovalAgreed Medical Evaluator (AME)Labor Code section 4062.3WCAB Rule 35informationcommunicationprejudiceirreparable harmex parte communication
References
20
Case No. ADJ3540065 (SAC 0361552)
Regular
Jan 23, 2017

BRADLEY MAXHAM vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted the defendants' Petition for Removal, rescinding a prior WCJ order. The Board clarified that "information" provided to an Agreed Medical Evaluator (AME) includes treating physician records and relevant medical/non-medical records. A communication becomes "information" if it contains, references, or encloses such records. The case was returned for further proceedings to determine if applicant's letters to the AMEs improperly conveyed "information" without party agreement.

Agreed Medical EvaluatorInformationCommunicationLabor Code Section 4062.3Petition for RemovalEn Banc DecisionWorkers' Compensation Appeals BoardPrejudiceIrreparable HarmSubstantial Evidence
References
14
Case No. ADJ7257372
Regular
Dec 14, 2015

Joshua Geiger vs. George Geiger, State Farm Insurance Bakersfield

This case concerns a defendant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision. The defendant argued that applicant's spouse had improper ex parte communication with the Agreed Medical Examiner (AME) by providing video and notes of the applicant's seizures. The WCAB denied reconsideration, finding that the communication occurred at the AME's request during the examination and was therefore exempt from statutory ex parte communication prohibitions. The Board concluded that the information provided was de minimis and did not warrant removal of the AME or striking of reports, especially since the seizure disorder was not a disputed issue.

Ex parte communicationAgreed Medical Examiner (AME)Labor Code Section 4062.3Rule 35Petition for ReconsiderationFindings and AwardWCJ ReportEpilepsySeizuresHome health care
References
4
Case No. ADJ10240846 ADJ12102657
Regular
Nov 05, 2019

JORGE REYES ORTIZ vs. PEDERSON FENCE & PATIO COMPANY, INC, STATE COMPENSATION INSURANCE FUND

This case involves an applicant seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that denied sanctions, costs, and attorney's fees against the defendant. The applicant argued the defendant violated Labor Code section 4062.3 by improperly communicating with a Qualified Medical Evaluator (QME). The WCAB denied reconsideration, finding no violation of the prohibition against ex parte communications because the applicant's attorney was copied on the communication. Furthermore, any alleged procedural defect in serving information on the QME was either waived or not sufficiently prejudicial to warrant the requested relief. The Board also affirmed the denial of sanctions, finding no evidence of bad faith tactics by the defendant.

Workers Compensation Appeals BoardPetition for ReconsiderationJoint Findings and OrderSanctionsAttorney's FeesReimbursementLabor Code Section 5710ViolationSection 4062.3Qualified Medical Evaluator
References
4
Case No. ADJ4158530 (LBO 0325085) ADJ332706 (LBO 0325079)
Regular
Jul 23, 2013

VICTORIA ANTUNEZ vs. SEASIDE PRINTING CO., CALIFORNIA CASUALTY, GALLAGHER BASSETT SERVICES, PACIFIC NATIONAL INSURANCE, CIGA, INTERCARE INSURANCE SERVICES

The Board granted reconsideration regarding a defendant's petition challenging findings of industrial injury and the nature of a communication with an Agreed Medical Evaluator (AME). The Board affirmed findings of compensable injury for one period and no injury for another, but amended the awards to clarify that a letter from CIGA to the AME was improper, though not an ex parte communication. The Board found the letter constituted additional information improperly sent without affording the other party an objection opportunity, leading to exclusion of a supplemental report. Jurisdiction was reserved over costs and sanctions related to this improper communication.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardIndustrial InjuryTemporary DisabilityPermanent DisabilityApportionmentAgreed Medical Evaluator (AME)Ex Parte CommunicationLabor Code Section 5412
References
0
Case No. MISSING
Regular Panel Decision
Sep 12, 2007

In Re Adelphia Communications Corp.

The case concerns Debtor Adelphia Communications Corp.'s objection to a $44.7 million claim by Lucent Technologies, Inc. Lucent sought to hold Adelphia liable for debts of Devon Mobile Communications, L.P. under Delaware's Revised Uniform Limited Partnership Act, specifically Section 17-303, alleging de facto general partnership liability. Adelphia argued Lucent's actual knowledge of its limited partner status should defeat the claim. The Court ruled that Section 17-303(a) prioritizes the limited partner's conduct in determining a third party's reasonable belief, making the third party's actual knowledge of limited partner status irrelevant. Citing material factual disputes regarding Adelphia's conduct, the Court denied Adelphia's motion for summary judgment on Lucent's Section 17-303, alter ego, and other equitable claims, scheduling the Section 17-303 claim for the first stage of trial.

Limited Partnership LiabilitySummary Judgment MotionDelaware Revised Uniform Limited Partnership ActSection 17-303De Facto General PartnerPartnership ControlVeil PiercingEquitable RemediesBreach of Contract ClaimBankruptcy Proceedings
References
41
Case No. ADJ7286862, ADJ7604060
Regular
Sep 14, 2015

Kelly Tinsley vs. VERTIS COMMUNICATIONS, ACE USA INSURANCE

This case involves a denial of a defendant's petition for reconsideration regarding a workers' compensation award. The defendant's Utilization Review (UR) of the applicant's requested continued treatment at a residential rehabilitation center was deemed invalid by the Administrative Law Judge (ALJ) due to untimeliness in communication. The Workers' Compensation Appeals Board (WCAB) affirmed the ALJ's decision, finding the UR invalid because the defendant failed to prove timely communication to the physician as required by statute. Consequently, the WCAB upheld the award of continued treatment, deeming it reasonable and supported by substantial medical evidence.

Workers' Compensation Appeals BoardPetition for ReconsiderationUtilization ReviewUntimelinessRequest for AuthorizationTransitional Living CenterResidential ProgramPost-Acute Physical RehabilitationPsychiatric InjuryIndependent Medical Review
References
14
Case No. MISSING
Regular Panel Decision

Members for a Democratic Union v. Local 1101, Communications Workers

Plaintiffs, Members for a Democratic Union (MDU) and individual members, sought mandatory injunctive relief to compel defendants, Local 1101, Communications Workers of America, AFL-CIO, and its officers, to publish an advertisement promoting a 'Defense Fund' in the union's newspaper, 'The Generator'. They argued this right under section 101(a)(2) of the Labor-Management Reporting and Disclosure Act. The defendants maintained a policy of not accepting paid advertisements, only publishing free notices for union member benefits, and argued this policy was reasonable and consistently applied. The court distinguished the case from previous rulings, noting that 'The Generator' had not 'opened the forum' to commercial speech or taken a stance on the Defense Fund issue. The court also noted that plaintiffs had other viable communication channels. Ultimately, the court found the defendants' policy to be reasonable and granted their motion for summary judgment, denying the plaintiffs' motion and dismissing the action.

Labor LawUnion DemocracyFreedom of SpeechLabor-Management Reporting and Disclosure ActSummary JudgmentUnion NewspaperAdvertising PolicyInjunctive ReliefFirst AmendmentInternal Union Affairs
References
18
Case No. MISSING
Regular Panel Decision

LIN Television Corp. v. National Ass'n of Broadcast Employees & Technicians—Communications Workers

Plaintiff LIN Television Corporation sought to vacate a labor arbitration award that reinstated employee Timothy Flynn after his termination for making threats. Defendants, National Association of Broadcast Employees and Technicians—Communications Workers of America, counter-claimed to enforce the award. The arbitration found no "just cause" for termination, converting it to a suspension and mandating a positive psychiatric evaluation for Flynn's return. The U.S. District Court, reviewing cross-motions for summary judgment, confirmed the arbitration award. The court ruled that the award drew its essence from the collective bargaining agreement and did not violate public policy regarding workplace safety, thereby denying the plaintiff's motion and granting the defendants' motion.

Labor DisputeArbitration AwardVacaturEnforcementWorkplace SafetyCollective Bargaining AgreementJust CauseEmployee TerminationMental Health EvaluationFederal Court Review
References
26
Case No. ADJ1620559 (ANA 0373462)
Regular
Apr 26, 2011

Wayne Johnson vs. Tennant Company, Sentry Claims Service

The Workers' Compensation Appeals Board (WCAB) is ordering applicant's counsel, defense counsel, and the Workers' Compensation Judge (WCJ) to provide sworn declarations regarding an alleged ex parte communication. This communication apparently led the WCJ to vacate a prior submission order, citing the applicant's upcoming surgery and a utilization review denial resolution. The defendant seeks removal, claiming the WCJ improperly obtained this information. The WCAB is also ordering all future correspondence be directed to the Commissioners.

Petition for RemovalOrder Vacating SubmissionDecision after ReconsiderationFindings and AwardIndustrial InjurySpineRight Lower ExtremityPsycheTemporary DisabilityPermanent Disability
References
0
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