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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ736716 (ANA 0400973) ADJ3010829 (ANA 0400924) ADJ7503662 ADJ8980493
Regular
Nov 08, 2013

JAIME RAMIREZ vs. HIGH GRADE FORM, BARRETT BUSINESS SERVICES, STATE COMPENSATION INSURANCE FUND, ZURICH, CHARTIS

This case involved a Petition for Reconsideration challenging a lien dismissal. The Appeals Board dismissed the petition, adopting the WCJ's report. The lien was dismissed because the $100 lien activation fee required by Labor Code section 4903.06(a) was not paid, making the necessity of the services irrelevant. While the dismissal applied to services pre-dating July 31, 2012, the Board noted potential future claims for services rendered on May 6, 2013, would require a $150 filing fee and could be pursued as a petition for costs.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien dismissalLabor Code section 4903.06(a)Lien activation feeInterpreting servicesWCAB hearingINJAB RefundablePetition for costsCalifornia Lien Services
References
Case No. ADJ8166052
Regular
Aug 13, 2013

MARIA GARCIA vs. JOSE MARTINEZ ENTERPRISES, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied a petition for reconsideration, affirming the dismissal of lien claims for failure to pay activation fees. The lien claimants, Imperial Medical Management and Allied Injury Management, argued they did not receive notice of the lien conference. However, the Board found evidence of proper service via US mail and email, consistent with their designated methods. Presumptions of regular performance of official duty and proper service applied, and a bare assertion of non-receipt was insufficient to overcome proof of service.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ConferenceService of NoticePresumption of ServiceNon-ReceiptLien ClaimantLien Activation FeeOrder Dismissing Lien ClaimElectronic Adjudication Management System
References
Case No. ADJ1781281 (MON 0350482) ADJ4191242 (MON 0350483)
Regular
Aug 11, 2011

ANGEL ACOSTA vs. GUILDCRAFT FURNITURE MANUFACTURING COMPANY, AMERICAN CASUALTY

This case involves a lien claimant seeking payment for interpreting services provided to an injured worker. The Workers' Compensation Appeals Board affirmed the WCJ's decision to disallow the lien claimant's claim for $25,573.00. The Board found that the lien claimant failed to meet its burden of proof to establish that the interpreting services were reasonably necessary, that the interpreters were qualified, and that the fees were reasonable. Crucially, no evidence was presented demonstrating a need for an interpreter for effective doctor-patient communication or that the interpreters were certified as required by law.

Lien claimantInterpreting servicesQualified interpreterBurden of proofReasonableness of feesIndustrial injuryMedical treatmentLabor Code section 4600(f)Compensable servicesWorkers' compensation administrative law judge
References
Case No. ADJ2178733 (BAK 0154115)
Regular
May 27, 2014

LIDIA BUENO vs. RAVILA FARM LABOR SERVICES, REDWOOD FIRE AND CASUALTY INSURANCE COMPANY

This case involves a lien claimant, Biocare RX Specialty Pharmacy, whose lien was dismissed by the Workers' Compensation Appeals Board (WCAB). Biocare argued the dismissal was erroneous because it had not yet filed a lien. The WCAB granted reconsideration, rescinding the dismissal order. The Board found it lacked jurisdiction to dismiss a lien that had not been filed and that Biocare was improperly dismissed for non-appearance at a lien conference for which it received no notice.

Lien claimantPetition for ReconsiderationOrder to Dismiss LiensWCJBiocare RX Specialty PharmacyElite Lien Servicesjurisdictionfiled lienLabor Code section 4903.5industrial injury
References
Case No. ADJ7658730
Regular
Mar 27, 2014

Maria Perez vs. TS STAFFING, LUMBERMEN'S UNDERWRITING ALLIANCE

This case concerns a lien claim for interpretation services provided by Santana, Lopez & Associates, LLC. The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior order, finding that Santana failed to prove its interpreters were "qualified" for 14 medical appointments. The interpreters for these appointments were neither certified nor provisionally certified, nor were they documented as provisionally utilized by the treating physician, thus invalidating the lien for those services. Consequently, Santana is not entitled to further payment on its lien.

Santana Lopez & AssociatesLumbermen's Underwriting Alliancequalified interpretercertified interpreterprovisionally certifiedGovernment Code section 11435.55Labor Code section 4622Labor Code section 4603.2(b)Labor Code section 5813Administrative Director's Rule 9795.1
References
Case No. ADJ1972276 (LAO 0862108) ADJ2914408 (LAO 0889233)
Regular
Mar 07, 2011

AMANDA CORONADO vs. BALLY'S TOTAL FITNESS, STATE COMPENSATION INSURANCE FUND

This case involves a lien claimant, E&M Interpreting, seeking payment for alleged interpretation services during the applicant's medical treatment. The Workers' Compensation Appeals Board denied reconsideration, upholding the administrative law judge's decision that E&M failed to meet its burden of proof. Specifically, E&M did not demonstrate the qualifications of its interpreters or the necessity of the services provided. The Board affirmed that lien claimants must prove both the reasonableness and necessity of services, as well as the qualifications of the individuals providing them, to be entitled to payment.

Workers' Compensation Appeals BoardLien claimantReconsiderationQualified interpretersBurden of proofInterpretation servicesMedical treatment appointmentsAdministrative law judgeFindings and OrderBilling
References
Case No. ADJ560768 (SJO 0256445)
Regular
Nov 29, 2011

MARK CAMPAGNA vs. AMERICAN CORP./AMERICAN AIRLINES; AMERICAN HOME ASSURANCE, SPECIALTY RISK SERVICES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to lien claimant Access Mediquip's petition. The WCAB found that Access Mediquip's objection to the Order Dismissing Lien was timely filed, despite the WCJ's initial belief to the contrary. Therefore, the WCAB rescinded the dismissal order and remanded the case to the trial level for further proceedings. This decision hinges on the correct calculation of the response deadline for the Notice of Intention to Dismiss Lien.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Dismissing LienNotice of Intention to Dismiss LienLien claimantPinnacle Lien ServicesAccess MediquipWCJPermanent disabilityMedical treatment
References
Case No. ADJ779198 (SJO 0267719)
Regular
Nov 19, 2010

EVELIN GARCIA vs. SERVICE PERFORMANCE CORPORATION, ZURICH AMERICAN INSURANCE COMPANY

The WCAB granted reconsideration and reversed a prior award for interpreting services, finding the lien claimant failed to meet its burden of proof. The claimant did not demonstrate the interpreting services were reasonable, necessary, or provided by qualified interpreters. Crucially, the medical provider's office advertised Spanish-speaking staff, and the doctor himself spoke Spanish, negating the necessity for external interpretation services. Therefore, the lien for interpreter fees was disallowed.

WCABReconsiderationLien ClaimantInterpreting ServicesQualified InterpreterReasonablenessNecessityBurden of ProofLabor Code Section 4600Labor Code Section 5811
References
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