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

Case No. ADJ7564894
Regular
Jun 07, 2013

FLOR DE MARIA DE LEON vs. PORTO'S BAKERY, INC, TRAVELERS

Here's a summary for a lawyer: This case involves a lien claimant, First Choice Health UBC, whose lien was dismissed for failure to provide proof of timely payment of the lien activation fee at a lien conference. While the claimant's representative appeared for "FCH" and later submitted proof of payment for a different, similarly named entity (First Choice Medical Group), no proof was provided for First Choice Health UBC itself. The WCJ recommended denial of reconsideration, finding that the claimant failed to meet the requirements of Labor Code section 4903.06(a)(4) by not presenting evidence of activation fee payment for the correct entity at the conference, thus warranting dismissal with prejudice. The Appeals Board adopted the WCJ's report and denied the petition.

Lien ClaimantActivation FeePetition for ReconsiderationDismissal with PrejudiceContinuous TraumaServerBack InjuryKnee InjuryLower ExtremitiesNervous/Psyche
References
0
Case No. ADJ4392577 (LBO 0392493)
Regular
Jul 18, 2011

JOSE HERNANDEZ vs. UNIVERSAL PROTECTION SERVICES, AMERICAN CASUALTY COMPANY OF READING, PA

This case addresses a lien claim for interpreter services. The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration and denied the lien claimant's petition. The WCAB found that the lien claimant failed to meet its burden of proof by not establishing that the applicant actually required interpreter services. Therefore, the lien for interpreting services was denied in its entirety.

Medical Provider NetworkMPNLien ClaimantPetition for ReconsiderationFindings and AwardCompromise and ReleaseInterpreter ServicesBurden of ProofDue ProcessLabor Code
References
2
Case No. ADJ9289375
Regular
Jan 11, 2016

ESTEBAN MIRANDA vs. HEARTLAND PRECISION, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to lien claimant California Imaging Solutions, Inc. (CIS). The prior decision disallowed CIS's lien based on its failure to register as a professional copier and meet its burden of proof for an exemption. The Board reversed, holding that CIS made an unrebutted prima facie showing that it acted as an agent or independent contractor for attorneys, thus exempting it from registration requirements under Business and Professions Code section 22451(b), consistent with the en banc decision in *Cornejo*. The case was remanded for a new decision on the lien.

WCABLien ClaimantPetition for ReconsiderationDecision After ReconsiderationBusiness and Professions Code Section 22451Independent ContractorState Bar MemberPhotocopier ServicesLicensing ExemptionCornejo v. Younique Café
References
1
Case No. ADJ8300983
Regular
Apr 28, 2014

ALBERTO CHICO vs. ONEMOR, INC., dba McDONALD'S, CALIFORNIA RESTAURANT MUTUAL BENEFIT CORP.

The Appeals Board denied reconsideration for the Jacobs-represented lien claimants, upholding the disallowance of their liens due to a failure to prove industrial injury and insufficient evidence. However, the Board granted reconsideration for the Kauffman-represented lien claimants, rescinding the sanctions previously imposed. While agreeing that the Kauffman claimants also failed to prove injury, the Board found their conduct did not rise to the level of bad faith or frivolous tactics required for sanctions.

WCABlien claimantspetition for reconsiderationFindings and OrderOrder Overruling Objection and Imposing Sanctionsindustrial injuryprobative evidencesanctionsbad-faith actionsfrivolous
References
9
Case No. ADJ7546371
Regular
Aug 13, 2018

PEGGY BREWER, vs. COUNTY OF SAN BERNARDINO,

This case involved a lien claimant, Physical Rehabilitation Services, seeking payment for medical treatment provided to applicant Peggy Brewer. The original decision denied the lien claimant's claim, finding they failed to meet their burden of proof regarding the necessity of the treatment and proper appeal procedures. The lien claimant petitioned for reconsideration, arguing that Independent Medical Review (IMR) was not required for services rendered in 2011 and that the WCJ exceeded their authority. The Appeals Board granted reconsideration solely to correct a clerical error referencing IMR procedures, which were not applicable to the services. The original decision, that the lien claimant did not meet their burden of proof for the treatment provided, was otherwise affirmed.

Lien claimantUtilization review denialIndependent Medical Review (IMR)Petition for ReconsiderationFindings and Order (F&O)Workers' Compensation Appeals Board (WCAB)Administrative law judge (WCJ)Burden of proofSubstantial medical evidenceExhaustion of remedies
References
2
Case No. ADJ8120854
Regular
Aug 29, 2017

MENG TU vs. GLOBE COMMUNICATIONS, SUSSEX INSURANCE

The Workers' Compensation Appeals Board granted reconsideration, reversing a prior award to lien claimant Rehab Solutions. The Board found that lien claimant bears the burden to prove the reasonableness and necessity of its services, and this burden was not met. Partial payments by the defendant did not constitute authorization or shift the burden of proof, and the utilization review denial of the key treatment remained unchallenged by appeal. Therefore, lien claimant is entitled to no further payment.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and AwardUtilization ReviewMedical TreatmentReasonableness and NecessityBurden of ProofLabor Code Section 4909Official Medical Fee Schedule
References
8
Case No. ADJ3732289 (RIV 0053017)
Regular
Mar 19, 2013

JOHN PAPPAS vs. TNT GRADING, INC., STATE COMPENSATION INSURANCE FUND INSURED

The Workers' Compensation Appeals Board denied the lien claimant's petition for reconsideration regarding disallowed medical services. The Board granted the defendant's petition, affirming the original finding that the applicant sustained an industrial injury. Crucially, Finding of Fact number 4 was amended to state there was insufficient evidence to determine if the lien claimant, Poway Surgery Center, was a properly licensed facility. This amendment supports the disallowance of the lien due to a lack of proof of proper licensing.

WCABPoway Surgery CenterState Compensation Insurance FundPetition for ReconsiderationFinding of FactLien ClaimantLicensed FacilitySurgery CenterRes JudicataCCR Title 8 Section 10770
References
3
Case No. STK 0187467
Regular
Sep 26, 2007

HASINA SINGH vs. MARINA VILLAGE WEST, ZENITH INSURANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a WCJ's decision, affirming the disallowance of a lien claimant's claim for medical-legal costs due to insufficient proof. However, the WCAB reversed the WCJ's imposition of sanctions against the lien claimant, finding that the defendant failed to meet its burden of proof to demonstrate the claimant's non-compliance with WCAB rules regarding availability for settlement discussions. The WCAB rescinded the sanctions order, finding the lien claimant's petition on that issue meritorious.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings and OrdersMedical-Legal CostsBad Faith ActionsSanctions OrderCompromise and ReleaseWCAB RulesMandatory Settlement Conference
References
0
Case No. ADJ8167521
Regular
Dec 22, 2016

MICHAEL HOLLAND vs. ADVANCED EYECARE CENTER OF MANHATTAN BEACH, ZENITH INSURANCE COMPANY

This case concerns a lien claimant, Med-Legal Photocopy, whose lien for record copying services was disallowed by the WCJ who also imposed attorney's fees for frivolous tactics. The Appeals Board granted reconsideration, finding the WCJ applied an incorrect standard for determining if a "contested claim" existed. The matter is returned to the trial level for the WCJ to reassess the lien claimant's burden of proof regarding the contested claim status and the reasonableness of the expenses. Sanctions may still be appropriate if the lien claimant fails to meet this burden on remand.

Workers' Compensation Appeals BoardADJ8167521Med-Legal Photocopylien claimantreasonableness and necessityfrivolous tacticsattorney's feepetition for reconsiderationcumulative trauma injuryjob stress
References
10
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
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