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

Case No. ADJ3034844 (LBO 0392601) ADJ 4614655 (LBO 0396565)
Regular
Oct 17, 2014

ANGEL AVILA vs. PHILIPPS SERVICES CORPORATION, CIGA, SEDGWICK CMS, RELIANCE INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of orders dismissing lien claims from several medical providers. These lien claimants argued the dismissal was erroneous because they had not abandoned their liens and deserved a continued hearing to identify witnesses. The WCAB found the Petition for Reconsideration timely and determined that lien claimants may have been denied due process if their representative left the hearing prematurely without adequate notice. Therefore, the WCAB is providing an opportunity for lien claimants to demonstrate good cause why the dismissal orders should not be affirmed, and ordering the defendant to respond to any filings.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ClaimsWCJDismissal of LiensMedical Lien ManagementRepresentative AbandonmentPrima Facie ShowingDue ProcessNotice of Intention to Dismiss
References
0
Case No. MISSING
Regular Panel Decision

Prentice v. Levy

Plaintiff sustained a work-related cervical spine injury in 1998 and underwent surgery by defendant Dr. Walter J. Levy in 1999. After the first surgery failed and a second surgery in 2002 to remove loosened hardware, plaintiff settled a medical malpractice action against Levy for $400,000. The self-insured employer, Tops, Inc., and its administrator, MAC Risk Management, as "the carrier," asserted a workers' compensation lien against the settlement. The Supreme Court provisionally set the lien at $22,442.91 and appointed a referee to determine the final lien and offset amounts, with the carrier bearing the costs. The appellate court affirmed the order, ruling that the interim lien was "without prejudice" and the referee's hearing scope was sufficient to conduct a comprehensive evidentiary hearing, thus causing no prejudice to the carrier.

Workers' Compensation LienMedical MalpracticeSettlement LienInterim LienWorkers' Compensation LawAppellate ReviewReferee AppointmentLien EstablishmentOffset PaymentsEvidentiary Hearing
References
2
Case No. ADJ9307293
Regular
Jan 08, 2016

JUAN GARCIA vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION

The Workers' Compensation Appeals Board denied the CCPOA Benefit Trust Fund's petition for reconsideration. The lien claimant sought penalties, alleging bad faith because the defendant sent an award payment directly to the lien claimant instead of its hearing representative. The Board found no evidence of unreasonable delay, noting the payment was timely sent to the address on file and promptly cashed by the lien claimant, constituting substantial compliance. The Board also suggested the lien claimant's multiple claims and penalty requests, despite timely payment, could constitute bad faith.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationBad Faith ActionsHearing RepresentativeSubstantial ComplianceSanctionsLabor Code Section 5700Legal Services BureauCCPOA Benefit Trust Fund
References
2
Case No. ADJ6981750
Regular
Jan 13, 2017

GUMERSINDO DELEON vs. ESPARZA ENTERPRISES, INC.

This case concerns a lien claimant's failure to pay a $100.00 lien activation fee required by Labor Code section 4903.06 by the date of a lien conference. The Workers' Compensation Appeals Board (WCAB) is considering rescinding the order dismissing the lien, but only if the fee is paid within ten days of this notice. The WCAB's intention is based on a court order allowing lien activation fees to be paid between November 9, 2015, and December 31, 2015, and the lien claimant's assertion of computer problems. If payment is received, the lien claim will be returned to the trial level for further proceedings.

Lien activation feeLabor Code Section 4903.06ReconsiderationOrder Dismissing Lien ClaimWCJDWCAngelotti Chiropractic v. BakerPreliminary injunctionNinth CircuitVacating injunction
References
7
Case No. ADJ1035201
Regular
Oct 04, 2016

VICTOR DURAN vs. DONUT INN, STATE FARM INSURANCE COMPANY

The Appeals Board is considering rescinding an order that dismissed Metro Med Shockwave's lien claim for failure to pay a $\$100$ lien activation fee. The WCJ dismissed the lien because the fee was not paid before the lien conference, citing prior precedent. However, the lien claimant argues they had until December 31, 2015, to pay the fee based on a DWC Newsline article referencing a court order. The Board intends to rescind the dismissal if the fee is paid within ten days, allowing further proceedings on the lien claim.

Labor Code section 4903.06Lien activation feeWorkers' Compensation Appeals BoardMetro Med ShockwaveFigueroa v. B.C Doering Co.Angelotti Chiropractic v. BakerPreliminary injunctionDWC NewslineReconsiderationRescind order
References
2
Case No. MISSING
Regular Panel Decision
Feb 05, 1980

In re the Claim of Ross v. Standard Milling Co.

This case concerns an appeal from a Workers’ Compensation Board decision, filed on February 5, 1980, which approved a $50 attorney’s fee as a lien upon an award made to the claimant. The claimant had sustained a back injury in March 1978 and received compensation payments from the carrier. After retaining an attorney, a hearing in May 1979 established accident, notice, and causal relationship, formalizing the award already paid by the carrier. The carrier contested the attorney's fee as a lien, arguing the claimant had already received the full award. The Board affirmed the lien, citing relevant case law and Section 24 of the Workers’ Compensation Law. The court ultimately affirmed the Board's decision, with costs to the Workers’ Compensation Board.

Workers' CompensationAttorney's FeesLienAwardAffirmed DecisionStatutory InterpretationNew York LawBoard DecisionInsurance CarrierLegal Services
References
3
Case No. ADJ8094646
Regular
Jan 17, 2014

ALEJANDRINA BARRETO vs. OUT OF THE SHELL, SOUTHERN INSURANCE COMPANY, REPUBLIC INDEMNITY COMPANY, PHARMAFINANCE, LLC, HEALTHCARE FINANCE MANAGEMENT, LLC

This case involves lien claimants PharmaFinance and Healthcare Finance Management, and their representatives Landmark Medical Management and Brian Hall, who sought reconsideration of a decision disallowing their liens for medical treatment. The Appeals Board granted reconsideration solely to notice its intention to impose sanctions of up to $2,500 against the lien claimants and their representatives. This action is due to a pattern of allegedly filing petitions containing false statements about not receiving notices, which violates the Board's Rules of Practice and Procedure and Labor Code Section 5813. The Board found these claims not persuasive and indicative of a tactic to avoid responsibility.

Workers' Compensation Appeals BoardPetition for ReconsiderationSanctionsLien ClaimantsHearing RepresentativesIndustrial InjuryFindings and OrderCompromise and ReleaseNotice of IntentionLabor Code section 5813
References
0
Case No. ADJ6989771
Regular
May 22, 2015

JOSE CAMARENA vs. AMERICAN GOLF CORPORATION, ARCH INSURANCE COMPANY

Lien claimant, Anthem Blue Cross, sought reconsideration of an order dismissing its lien due to a single non-appearance at a hearing. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, finding the dismissal was based on mistake, inadvertence, and excusable neglect. The WCAB emphasized the policy favoring hearings on the merits and noted the lien claimant's presence at the district office on the hearing date, its lack of prior similar conduct, and a sincere apology. Consequently, the WCAB rescinded the order dismissing the lien.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationOrder Dismissing LienCode of Civil Procedure section 473(b)Excusable NeglectHeart AttackEmergency RoomPrivate Health InsuranceDenied Claim
References
4
Case No. ADJ1941485 (VNO 0263845) ADJ4137418 (VNO 0270976) ADJ1018222 (MON 0140131)
Regular
Dec 15, 2008

GERTRUDE CHISM vs. K-MART/SEARS HOLDING CORPORATION, Permissibly Self-Insured Administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

The Appeals Board dismissed the defendant's petition to remove WCJ Zarett as moot due to his retirement, and denied the request for a commissioner's hearing on sanctions as premature. The Board remanded the case to the trial level for a full evidentiary hearing on the defendant's allegations regarding the applicant's attorneys, as these factual issues are best addressed by a new Workers' Compensation Judge. The defendant's numerous petitions for removal, vacating hearings, and stays were largely dismissed or denied.

Workers' Compensation Appeals BoardGertrude ChismK-Mart/Sears Holding CorporationSedgwick Claims Management ServicesPetition for Commissioner's HearingRemoval of Judge ZarettVacate HearingStay ProceedingsImposition of SanctionsGuardian Ad Litem
References
1
Case No. ADJ780584, ADJ7543597
Regular
Feb 25, 2016

Diana Muniz vs. Edward Chen, M.D., The Hartford Insurance Company of the Midwest

The Workers' Compensation Appeals Board (WCAB) granted a lien claimant's petition for reconsideration of an order dismissing their lien. The lien claimant's representative mistakenly appeared at a different hearing, failing to appear at the scheduled lien conference. Despite the WCAB acknowledging the claimant's objection and the error, they affirmed the dismissal of the lien because the claimant failed to demonstrate good cause for their absence, as lien claimants are responsible for appearing at noticed hearings. Therefore, the lien was ultimately dismissed with prejudice due to the failure to appear and lack of good cause.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationOrder Dismissing LienNotice of Intention to DismissLien ConferenceGood CauseFailure to AppearWCJWCAB Rule 10240
References
6
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