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Case Law Database

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

Case No. MISSING
Regular Panel Decision
Jan 30, 2013

Soodoo v. LC, LLC

This case involves an appeal by defendants LC, LLC, and Limrink Realty Corp. against an order dismissing their cross-claims for contribution, indemnification, and breach of contract against co-defendant Atlantic Contracting of New York, Inc. The original action was brought by an unnamed plaintiff for personal injuries sustained at a construction site. The Supreme Court initially granted Atlantic's motion to dismiss the cross-claims. On appeal, the court reversed the lower court's decision, finding that the cross-claims stated cognizable causes of action. Consequently, the cross-claims were denied dismissal and converted into third-party causes of action.

Personal InjuryConstruction SiteCross-claimsContributionIndemnificationBreach of ContractMotion to DismissCPLR 3211(a)(7)Appellate DivisionThird-Party Action
References
16
Case No. ANA 0357324
Regular
Aug 20, 2007

ANDRES QUINONES vs. AN'S WORLD SERVICE INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted SCIF's petition for removal to reconsider a prior order regarding a lien claimant's (LC) right to payment. SCIF argued LC lacked standing because it failed to prove it held a required fictitious name permit from the Medical Board, while LC contended it was an "outpatient setting" exempt from such a permit. The Board rescinded the original order and returned the case for the WCJ to determine if LC is an "outpatient setting" or a "clinic" to assess its compliance with licensing and fictitious name requirements.

Workers' Compensation Appeals BoardRemovalLien ClaimantFictitious Name PermitMedical BoardOutpatient SettingClinicLicensureBusiness and Professions CodeStokes v. Patton State Hospital
References
1
Case No. ADJ2403362 (MON 0247582) ADJ2066217 (MON 0306486)
Regular
Apr 25, 2011

EMILIA MENDOZA vs. LACMTA, THE TRAVELERS INS. CO., LOS ANGELES METROPOLITAN AUTHORITY, CONSTITUTION STATE SERVICES COMPANY

The Workers' Compensation Appeals Board affirmed the disallowance of lien claimant Care Center Rehabilitation and Pain Management's (LC) lien for unpaid medical treatment. LC failed to file a required fictitious business name statement and could not prove the treatment was reasonable and necessary. However, the Board reversed the order for LC to pay restitution to the defendants, finding they failed to meet their burden of proof for unjust enrichment.

Workers' Compensation Appeals BoardEmilia MendozaLACMTAThe Travelers Insurance CompanyConstitution State Services Companylien claimantCare Center Rehabilitation and Pain Managementindustrial injuriesneck and shouldersbus operator
References
5
Case No. ADJ7839029; ADJ7841350
Regular
Jun 25, 2014

Fernando Murillo vs. Yonique Café, Inc., Zenith Insurance Company

This case involves a lien claimant, Ameri Chiropractic Group (LC), seeking disqualification of a Workers' Compensation Judge (WCJ). LC alleged bias based on a WCJ order requiring a doctor's personal appearance at trial regarding treatment and the lien's validity. However, the Workers' Compensation Appeals Board (WCAB) dismissed the petition as untimely. WCAB Rule 10452 dictates a strict 10-day filing period after notice of hearing for such petitions. LC's petition was filed three months after being served with the order, rendering it untimely regardless of when new counsel was retained.

Petition for DisqualificationUntimely FilingWCJ BiasLien ClaimantAmeri Chiropractic GroupWCAB Rule 10452Order for AppearanceDismissal of LienPinnacle Lien ServicesAdministrative Law Judge
References
1
Case No. ADJ6929619
Regular
Jun 11, 2013

SAMUEL OCEGUERA vs. RICH PRODUCTS CORPORATION, TRAVELERS INSURANCE COMPANY

This case involves a lien claimant, Western Imaging Services (LC), whose petition for costs was summarily denied by the WCJ for failing to pay a lien activation fee. The Appeals Board granted reconsideration, finding that LC was not yet required to pay the fee as no lien conference had occurred. The Board rescinded the WCJ's denial, remanding the matter for further proceedings.

Lien Activation FeeLabor Code Section 4903.06Petition for CostsDeclaration of Readiness to ProceedLien ConferencePetition for ReconsiderationWorkers' Compensation Appeals BoardWCJCompromise and ReleaseIndustrial Injuries
References
0
Case No. ADJ4303823
Regular
Dec 11, 2008

GLORIA BUSTOS vs. BAYSIDE SERVICES/STAFFING, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION through their servicing facility CAMBRIDGE INTEGRATED SERVICES, INC., for LEGION INSURANCE COMPANY, in liquidation

The Appeals Board affirmed the WCJ's denial of retroactive VRMA, finding that merely listing vocational rehabilitation as an issue in applications did not establish a good faith demand for services. However, the Board rescinded the denial of attorney's fees under LC 5814.5, remanding the issue for further determination in light of the en banc decision in *Ramirez v. Drive Financial Services*. This ruling clarifies that LC 5814.5 applies to delays occurring after January 1, 2003, regardless of the injury date.

Workers' Compensation Appeals BoardVocational Rehabilitation Maintenance AllowanceQualified Injured WorkerLabor Code section 5814.5Date of InjuryDate of AwardApplication for Adjudication of ClaimGood Faith DemandRehabilitation UnitUnreasonable Delay
References
5
Case No. VEN 104138
Regular
Jul 08, 2008

CHANDRA DOSHI vs. BLUE CROSS OF CALIFORNIA by BROADSPIRE CLAIMS SERVICES

This case involves a lien claimant seeking reconsideration of a decision that denied a psychological injury claim. The Workers' Compensation Appeals Board granted reconsideration due to uncertainty regarding the administrative law judge's application of Labor Code sections 5402(b) (presumption of compensability for timely denial) and 3208.3 (threshold for psychiatric injury). The Board remanded the case for further proceedings to clarify whether the section 5402 presumption applies and, if not, to re-evaluate the psychiatric injury claim under section 3208.3 with a clear explanation of the reasoning.

Labor Code section 5402(b)presumption of compensabilitypsychiatric injurythreshold of compensabilitypredominant causeactual events of employmentcompromise and releaselien claimantcumulative traumamedical treatment
References
1
Case No. ADJ4433104 (ANA 0381115) ADJ4664599 (ANA 0381113)
Regular
Feb 02, 2016

JOSE CHONG (deceased) vs. SPORTS GRILL, EVEREST NATIONAL INSURANCE COMPANY, AMERICAN COMMERCIAL CLAIMS ADMINISTRATORS, INC., ZENITH INSURANCE COMPANY

This case involves a lien claimant seeking reconsideration of a decision denying applicant's cumulative and specific injury claims, finding a lack of medical evidence and credibility issues with the deceased applicant. The Workers' Compensation Appeals Board granted reconsideration to amend the original order concerning Labor Code section 5402. The Board affirmed the denial of the presumption of compensability, finding the lien claimant failed to meet its burden of proof regarding timely denial by the insurer Zenith. Issues related to Labor Code section 5402(c) were deferred.

WCABLien claimantPetition for ReconsiderationJoint Findings and OrderCumulative InjurySpecific InjuryAOE/COELabor Code section 5402Presumption of CompensabilityApplicant's Credibility
References
0
Case No. ADJ3564079 (SDO 0254307)
Regular
Sep 07, 2011

RAUL PEREZ vs. USA WASTE SERVICES, NATIONAL UNION FIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration for lien claimant Langlink Interpreters, Inc. (LC) regarding their $\$5,175$ lien for interpreter services. The original judge disallowed the lien, citing lack of proof of necessity, availability of bilingual staff, and pre-authorization. The Board rescinded the original order, returning the case for further proceedings, and established that employers must provide reasonably required interpreter services under Labor Code section 4600. LC now bears the burden to prove services were reasonably required, provided, qualified, and reasonably priced, as per the *Guitron* decision.

Workers' Compensation Appeals Boardlien claimantinterpreter servicesmedical treatmentLabor Code section 4600burden of proofreasonably requiredstipulated Awardpermanent disabilityindustrial injury
References
1
Case No. VNO 400907, VNO 400906
Regular
Jan 24, 2008

JORGE ESCOBEDO vs. WESTLAKE INN RESTAURANT & HOTEL, CALIFORNIA INDEMNITY INSURANCE COMPANY, SIERRA INSURANCE GROUP

This Workers' Compensation Appeals Board case involves applicant Jorge Escobedo seeking benefits for injuries presumed compensable under Labor Code section 5402. The Appeals Board affirmed the Administrative Law Judge's (WCJ) decision, finding that the defendant failed to rebut the presumption of injury and that applicant's injuries did not require further medical treatment or result in temporary disability, largely based on the WCJ's adverse credibility finding. A dissenting opinion argued that the WCJ's findings on no treatment or disability improperly abrogated the 5402 presumption and suggested appointing a "regular physician" to resolve conflicting medical opinions.

ReconsiderationRebuttable presumptionCompensabilityLabor Code 5402Medical treatmentTemporary disabilityPermanent disabilityApportionmentAttorney's feesSubstantial evidence
References
4
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