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Case Law Database

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

Case No. SBR 0315782
Regular
Jul 30, 2007

GORDON ADAMS vs. SOUTHLAND DRYWALL COMPANY, STATE COMPENSATION INSURANCE FUND

This case concerns a lien claimant, Premier Outpatient Surgery Center, Inc., whose lien was denied because it allegedly did not use its full corporate name or have a fictitious business name permit. The Appeals Board rescinded the denial and returned the case for further proceedings, finding that Premier was properly licensed as an outpatient facility and that the defendant did not timely raise the fictitious business name statement issue. The Board clarified that a facility fee lien claimant is not required to have a Medical Board fictitious-name permit, but may need to file a fictitious business name statement if operating under a name other than its legal corporate name.

Workers Compensation Appeals BoardLien ClaimantFictitious Business Name StatementFictitious-Name PermitBusiness & Professions Code Section 17910Business & Professions Code Section 2415(a)Medical Board of CaliforniaOutpatient SettingFacility FeeCompromise and Release
References
Case No. LAO 0878674
Regular
Mar 06, 2008

KARLA BUENO vs. PLAZA DEFENDANT LA RAZA, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision that barred a lien claim due to the alleged lack of a fictitious business name permit. The WCAB found that while the lien claimant presented a surgical clinic license, the record was unclear about its actual business name and compliance with fictitious name filing requirements. The case is remanded for further proceedings to determine the lien claimant's true name and establish its compliance with fictitious business name laws.

Fictitious Business Name StatementSurgical Clinic LicenseHealth ServicesBusiness and Professions CodeMedical BoardLien ClaimantOutpatient SettingAdministrative Law JudgeReconsiderationReasonableness of Fees
References
Case No. ADJ11039762
Regular
Aug 06, 2018

ALFRED GUILING vs. GODEFELLOW BROTHERS CONSTRUCTION, LLC, AMERICAN CONTRACTORS INSURANCE GROUP

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration and dismissed their Petition for Removal. The defendant argued the judge's finding of injury to specific body parts was premature and lacked substantial evidence, as the PQME process was incomplete. The Board found removal was inappropriate, as the injury finding is a final order subject to reconsideration. They adopted the WCJ's report, concluding the applicant met their burden of proof for industrial injury to the disputed body parts.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFindings of Factindustrial injurybody partssubstantial evidencePanel Qualified Medical EvaluationPQMEextraordinary remedy
References
Case No. ADJ4678016 (VNO 0340831), ADJ543807 (VNO 0340832), ADJ1072800 (VNO 0372652), ADJ8135564
Regular
Feb 25, 2019

WAYNE MUSGROVE vs. ASTRO BUSINESS aka PRODUCTS/CANON BUSINESS SOLUTIONS, YASUDA now SOMPO JAPAN OF AMERICA

The Workers' Compensation Appeals Board granted reconsideration of four prior decisions. The Board affirmed the findings of injury to the applicant's right shoulder in three cases (ADJ4678016, ADJ543807, ADJ1072800), finding the permanent disability percentages as determined by the WCJ. However, the Board rescinded the decision in ADJ8135564, ruling that the applicant's 1992 injury claim was not barred by the statute of limitations based on his testimony of filing worker's compensation paperwork at the time. All remaining issues, including the extent of injury to additional body parts and the admission of a vocational expert report, are deferred for further proceedings at the trial level.

Petition for ReconsiderationStatute of LimitationsWindow Period InjuryClaim FormJurisdictionVocational Expert ReportPermanent DisabilityIndustrial InjuryBody PartsMotor Vehicle Accident
References
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. LAO 0794643
Regular
May 07, 2008

FRANCISCO CHAPA vs. GIBSON OVERSEAS, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinding the initial denial of a lien claim by S&B Surgery Center. The Board found the record insufficient regarding S&B's licensure and proper business naming, remanding the case for further development. This includes proving proper licensure as an "outpatient setting" and addressing the necessity of filing a fictitious business name statement, followed by a determination of the reasonableness of the billed fees.

Lien claimantreconsiderationlicensurefictitious business name statementoutpatient settingsurgical clinicMedical Boardcounty clerkreasonableness of feesburden of proof
References
Case No. ANA 381864
Regular
Feb 25, 2008

TUAN KHANH DO vs. CONEYBEARE PERSONNEL SERVICES, STATE COMPENSATION INSURANCE FUND

This case concerns a Qualified Medical Examiner's (QME) entitlement to payment for medical-legal services. The defendant insurer argued that the QME's lien claim was invalid due to the use of a business name without a fictitious business name permit. However, the Workers' Compensation Appeals Board denied reconsideration, finding the QME rendered services and signed reports under his own name. The Board further noted that the insurer failed to properly object to the billings within the regulatory timeframe and the lien claim form was amended to reflect the QME's individual name.

WCABState Compensation Insurance FundMedical-legal servicesFictitious business name permitQualified Medical ExaminerLien claimCompromise and releaseMedical Board of CaliforniaBusiness and Professions CodeLabor Code
References
Case No. ADJ9351964 ADJ9351965
Regular
Mar 15, 2016

ROGELIO CORNEJO vs. YOUNIQUE CAFÉ, INC., ZENITH INSURANCE COMPANY

In this case, the Workers' Compensation Appeals Board granted reconsideration of its prior en banc decision. The prior decision held that Chapter 20 of Division 8 of the Business and Professions Code did not apply to a copy service lien claimant acting as an agent or independent contractor for a lawyer. Consequently, proof of registration and bonding under Business and Professions Code sections 22450 and 22455 was deemed unnecessary in such circumstances. The Board granted reconsideration to further study the factual and legal issues presented.

Workers' Compensation Appeals BoardYounique CaféZenith Insurance CompanyWestern Imaging ServicesInc.Rogelio CornejoPetition for ReconsiderationEn BancChapter 20Business and Professions Code
References
Case No. ADJ473373 (ANA 0406381)
Regular
Feb 10, 2012

FERNANDO GUTIERREZ vs. SOCAL FRAMING aka BMHC; ACE AMERICAN INSURANCE, administered by ESIS, INC.

This case concerns applicant's claim for extended temporary disability (TD) benefits beyond 104 weeks due to a left eye injury. The Appeals Board affirmed the WCJ's denial of the "amputation" exception, ruling that the surgical removal of an eye does not fit the statutory definition. However, the Board remanded the case for further development of the record on the "high-velocity eye injury" exception, as the velocity and force of the object that struck the applicant's eye were unclear. The applicant's Petition for Removal was dismissed as reconsideration was the appropriate remedy.

Workers' Compensation Appeals BoardFernando GutierrezSoCal FramingBMHCACE American InsuranceESISInc.ADJ473373ANA 0406381Opinion and Decision
References
Case No. ADJ6994190
Regular
Nov 05, 2012

JUAN GAMBOA vs. HYDRO FITTING MANUFACTURING CORPORATION, MIDWEST INSURANCE COMPANIES

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the finding that he did not prove his employer violated Labor Code section 132a. The applicant failed to demonstrate he was singled out for disadvantageous treatment due to his work-related injury. The employer presented evidence of a business slowdown and layoffs affecting both industrially and non-industrially injured employees. Therefore, the applicant did not meet his burden of proof regarding discriminatory treatment.

Labor Code section 132aPetition for ReconsiderationFindings and Orderworkers' compensation administrative law judgedisadvantageous treatmentbusiness necessityeconomic slowdowntemporary hirere-hireddisabled workers
References
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