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

Case No. ADJ1194260 (ANA 0375551)
Regular
Jan 16, 2009

SERAFIN VASQUEZ vs. COASTAL MIRAGE LANDSCAPES, INC., STATE COMPENSATION INSURANCE FUND

"The Appeals Board grants the lien claimant's Petition for Reconsideration, rescinds the Findings and Order issued November 3, 2008, and returns the matter to the trial level to clarify whether the "Kunz Study" was admitted into evidence."

Lien claimantPetition for reconsiderationKunz v. Patterson Floor CoveringFindings and OrderWCJMedical servicesFee scheduleGeographical equivalent studyDRG valueAPC calculation
References
1
Case No. ADJ3820883 (SBR 0332538)
Regular
Dec 24, 2008

RUBY JONES vs. STATE DEPARTMENT OF MENTAL HEALTH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted removal and rescinded the WCJ's orders compelling Randall Hollien's deposition and quashed the subpoena for records. The Board found the petition for removal timely and directed parties to identify the preparer of a disputed "Kunz" study before SCIF could properly subpoena the author. The matter was returned to the trial level for further proceedings.

RemovalHearing RepresentativeAttorney-Client PrivilegeSubpoenaDiscovery OrderCMS NetworkRandall HollienComparative Kunz StudyLien ClaimantWCJ
References
1
Case No. LBO 0355987
Regular
Jul 14, 2008

EDELMA D'TRINIDAD vs. LONG BEACH UNIFIED SCHOOL DISTRICT, Permissibly Self-Insured, Adjusted by SOUTHERN CALIFORNIA RISK MANAGEMENT ASSOCIATES (SCRMA)

This case involves a lien claim for surgical services where the applicant's insurer sought to reduce the billed amount. The Workers' Compensation Appeals Board denied reconsideration, upholding the administrative law judge's finding that only $3,100.00 was a reasonable charge for the services. This decision was based on credible testimony and evidence from a defense witness who presented a "Kunz study" demonstrating that the billed amount far exceeded usual and accepted fees in the area.

Workers Compensation Appeals BoardLien ClaimantReconsiderationFindings and OrderReasonable ValueSurgery CenterIndustrial InjuryLabor Code Section 3202.5Burden of ProofKunz Study
References
4
Case No. MISSING
Regular Panel Decision

Procter & Gamble Co. v. Ultreo, Inc.

The Procter & Gamble Company (P&G) sued Ultreo, Inc. for false advertising under the Lanham Act and the New York Consumer Protection Act, specifically challenging Ultreo's claims about its toothbrush technology. P&G sought the disclosure of five scientific studies conducted by Ultreo, arguing they were discoverable business documents. Ultreo resisted, claiming the studies were protected by attorney work product privilege. The court rejected Ultreo's argument, finding that the studies were a core part of Ultreo’s business plan to substantiate its advertising claims and would have been prepared regardless of anticipated litigation. Therefore, the court ordered Ultreo to produce the studies to P&G.

False advertisingLanham ActNew York Consumer Protection ActDiscovery disputeAttorney work productPrivilegeScientific studiesClinical researchLitigation anticipationBusiness plan
References
7
Case No. ADJ6550105; ADJ6777358 ADJ6777361; ADJ6976802
Regular
Jun 24, 2014

ESTHER GARCIA vs. ANTELOPE VALLEY UNION HIGH SCHOOL DISTRICT, YORK INSURANCE SERVICES GROUP

This case involves an applicant with multiple workers' compensation claims. At a mandatory settlement conference, the judge ordered a sleep study, which the defendant challenged. The Appeals Board granted the defendant's petition for removal, finding the order for the sleep study premature. The Board rescinded the sleep study order, stating that such an order cannot be made before the case is tried or submitted, and before it's established that specific medical opinions are deficient.

Petition for RemovalDecision After RemovalMandatory Settlement ConferenceSleep StudyDiscovery OrderMedical Record AugmentationPanel Qualified Medical EvaluatorThreshold MatterDevelop the RecordAdmission of Evidence
References
0
Case No. ADJ9870999
Regular
Feb 13, 2017

ROBIN SMITH vs. CITY OF SUNNYVALE

This case involves a firefighter claiming breast cancer arose from employment exposure to carcinogens, triggering a statutory presumption of industrial causation under Labor Code section 3212.1. The employer sought to rebut this presumption by arguing a medical examiner found no studies linking applicant's specific exposures to breast cancer. However, the Appeals Board denied reconsideration, affirming that the employer failed to prove there is *no reasonable link* between workplace carcinogen exposure and the applicant's cancer, a higher bar than simply the absence of direct scientific studies. The Board reiterated that an employer must affirmatively demonstrate a lack of reasonable connection, not just highlight a lack of studies supporting causation.

Labor Code section 3212.1presumption of industrial causationpublic safety officerfirefightercarcinogen exposurebreast cancerdisputable presumptioncontroverted evidencereasonable linkburden of proof
References
3
Case No. MISSING
Regular Panel Decision

Smith v. Dow Chemical Co.

Plaintiff filed a motion to compel discovery from defendants Dow and PPG regarding documents related to ongoing research studies on the harmful effects of vinyl chloride, which her deceased husband William Smith was allegedly exposed to. Defendants countered with a motion for a protective order, citing a qualified researcher's/scholar's privilege and arguing that the incomplete studies were irrelevant and inadmissible under Daubert standards. The court granted plaintiff's motion to compel, finding that defendants failed to provide sufficient information to establish a privilege claim and that arguments concerning the admissibility of incomplete studies were premature. The court also denied defendants' motion for a protective order, instructing defendants to produce the requested documents.

DiscoveryResearcher's PrivilegeScholar's PrivilegeMotion to CompelProtective OrderVinyl Chloride ExposureScientific StudiesExpert TestimonyAdmissibility of EvidenceFederal Rules of Civil Procedure
References
17
Case No. MISSING
Regular Panel Decision

In re V. R. P-L.

The petitioners sought certification as qualified adoptive parents for M.EL. under Domestic Relations Law § 115-d, aiming to satisfy USCIS home study requirements for an I-600 petition. The USCIS had previously rejected their independent social worker's home study and suggested either an authorized agency home study or a DRL § 115-d certification. The court, however, determined that DRL § 115-d was inappropriate for foreign-born children sought for adoption as orphans, and that such cases fall under DRL § 115-a. Despite the USCIS's guidance and the petitioners' time constraints, the court was compelled by state law to dismiss the petition due to its reliance on the incorrect statutory section.

AdoptionPrivate Placement AdoptionForeign AdoptionOrphanUSCISI-600 PetitionHome StudyDomestic Relations LawNew York Family CourtStatutory Construction
References
8
Case No. 2021 NY Slip Op 03888 [195 AD3d 1270]
Regular Panel Decision
Jun 17, 2021

Matter of Spence v. State Univ. of N.Y.

This case involves an appeal concerning a salary increase for nurses at Stony Brook University Hospital, initiated by the State University of New York. Petitioners, including Wayne Spence and the New York State Public Employees Federation, argued that the salary adjustments violated Education Law and Civil Service Law due to an inadequate study, and Executive Law and the Age Discrimination in Employment Act due to disparate impact on older nurses. The Supreme Court dismissed the petition, finding the study sufficient and the age discrimination claims procedurally deficient. The Appellate Division affirmed this dismissal, concluding that the study was representative, the nonuniform pay differential was permissible under Education Law, and the age discrimination claims failed because petitioners did not file with the EEOC and the pay adjustments were based on a legitimate non-age factor.

Wage ratesPay differentialsNurse salariesAge discriminationCPLR article 78State University of New YorkPublic Employees FederationStony Brook University HospitalEducation Law § 355-aCivil Service Law § 130
References
15
Case No. FRE 0222651
Regular
Jul 15, 2008

CHRISTOPHER HUNT vs. MADERA COUNTY ROAD DEPARTMENT

The Appeals Board granted reconsideration of a WCJ's decision that limited a lien claimant's facility fees to the Official Medical Fee Schedule. The Board found the WCJ erred by not applying the correct *Kunz* standard for determining the reasonableness of outpatient surgery facility fees, which considers factors beyond the fee schedule. The case is remanded for further proceedings to properly develop the record according to *Kunz*.

KunzOfficial Medical Fee Scheduleoutpatient surgery facility feeslien claimantreconsiderationen banc decisionreasonableness of feesusual feegeographical areacontractually negotiated fees
References
5
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