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

Case No. ADJ2259921
Regular
Jan 18, 2018

LYNN TILMON vs. COUNTY OF LOS ANGELES

This case involves a workers' compensation appeal concerning a medical provider's bill. The Workers' Compensation Appeals Board (WCAB) affirmed an award for lien claimant White Memorial Medical Center, finding the defendant, County of Los Angeles, failed to properly respond to a request for second bill review regarding a PPO contract. The WCAB amended the original award to adjust the interest rate to 7% and referenced the correct statutory basis for interest and penalties. The issue of Labor Code section 5813 attorney fees and costs was deferred, with jurisdiction reserved at the trial level.

Workers' Compensation Appeals BoardLynn TilmonCounty of Los AngelesSedgwick Claims Management ServicesWhite Memorial Medical CenterFindings and AwardReconsiderationIndependent Bill Review (IBR)Explanation of Review (EOR)Official Medical Fee Schedule (OMFS)
References
Case No. ADJ8548126
Regular
Oct 09, 2017

MATIAS PUGLISI vs. JAMES GALE KERRY, FIRST AMERICAN SPECIALTY INSURANCE COMPANY, CLA-MAR, LYNN DENNIS, PREFERRED EMPLOYERS INSURANCE COMPANY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Appeals Board dismissed the Petition for Removal because the WCJ's determination of employment with Cla-Mar and Lynn Dennis constituted a threshold issue. Therefore, reconsideration, not removal, was the proper remedy. The Board denied the Petition for Reconsideration, adopting the WCJ's report and reasoning. The order dismisses removal and denies reconsideration in this workers' compensation case.

WCABPetition for RemovalPetition for ReconsiderationWCJ reportfinal ordersubstantive rightliabilitythreshold issueemployment relationshipstatute of limitations
References
Case No. ADJ14547470
Regular
Apr 17, 2025

RICHARD LYNN vs. CONTRA COSTA ELECTRIC, AMERICAN CASUALTY COMPANY OF READING, PA

The Workers' Compensation Appeals Board granted reconsideration to applicant Richard Lynn, who challenged a Workers' Compensation Arbitrator's (WCA) denial of his right to a Qualified Medical Evaluator (QME) examination. The WCA had found that Lynn forfeited this right by not attending a scheduled QME exam, citing an Alternate Dispute Resolution (ADR) agreement. The Board determined that the ADR section did not mandate forfeiture and that the WCA, like a WCJ, possessed discretion to appoint a medical examiner to ensure due process and fully adjudicate issues, especially given the lack of medical-legal reporting on industrial causation. Consequently, the Board rescinded the WCA's Findings and Order and returned the matter for further proceedings consistent with its decision.

ADR ProgramQMELabor Code Section 3600(a)(10)NECA/IBEWsubstantial justicedue processmedical-legal evaluationrescindedreturnedarbitraton
References
Case No. ADJ2090129 (SJO 0216953)
Regular
Oct 16, 2008

LYNN CANADY-SORY vs. WEST VALLEY ENGINEERING, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for PAULA INSURANCE COMPANY, INTERCARE INSURANCE SERVICES

The Workers' Compensation Appeals Board granted reconsideration and increased the applicant's permanent disability rating from 22% to 48% after apportionment. The Board amended the findings regarding apportionment of disability to the neck and upper extremities, attributing 50% to non-industrial factors for the neck injury. The WCJ's recommendation to grant reconsideration on apportionment was adopted, and other issues raised by the applicant, such as psychiatric injury and grip loss, were not addressed in this decision.

Workers Compensation Appeals BoardLynn Canady-SoryWest Valley EngineeringCalifornia Insurance Guarantee AssociationPaula Insurance CompanyliquidationIntercare Insurance Servicescumulative traumapermanent disabilityapportionment
References
Case No. ADJ1655785 (VNO 0546104)
Regular
Mar 02, 2012

DANIEL LYNN GORDON vs. COUNTY OF LOS ANGELES

The applicant, Daniel Lynn Gordon, sustained industrial injury to his cardiovascular and gastrointestinal systems as a deputy sheriff. The Workers' Compensation Appeals Board (WCAB) previously found 20% permanent disability after 80% apportionment. The applicant petitioned for reconsideration, arguing the WCJ erred in the 80% apportionment, specifically challenging the interpretation of "region of the body" under Labor Code section 4664(c)(1) and the method of combining awards rated under different schedules. After further review, the WCAB affirmed the WCJ's original findings and award, denying the applicant's petition.

ADJ1655785VNO 0546104Deputy SheriffCardiovascular injuryGastrointestinal injuryIndustrial injuryPetition for ReconsiderationFindings and AwardWorkers' Compensation Appeals BoardPermanent Disability
References
Case No. ADJ8963370
Regular
Mar 30, 2019

LYNN WADE vs. STATE OF CALIFORNIA, MILITARY DEPT., STATE COMPENSATION INSURANCE FUND

This case involves Lynn Wade's workers' compensation claim that was dismissed for lack of prosecution. The dismissal was rescinded because the Notice of Intention to Dismiss was mailed to applicant's attorney's former address. The Board found this defective service denied the applicant a fundamental right. Therefore, the applicant's objection, timely filed after actual receipt of the notice, was deemed valid, and the case was returned for further proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationLack of ProsecutionDefective ServiceNotice to DismissTimeliness of ObjectionRescind OrderReturn to Trial LevelWCJApplicant's Counsel
References
Case No. ADJ102175 (MON 0317302)
Regular
Mar 22, 2011

TERRY LYNN ROSS vs. BERNARD & SONS, INC., STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the Appeals Board affirmed a finding of 100% permanent disability for Terry Lynn Ross, a truck driver injured in 2004. The defendant contested the total disability finding, arguing the wrong rating schedule was applied and medical evidence didn't support the rating. The Board found the 2005 rating schedule was applicable and that medical opinions from multiple physicians, particularly Dr. Salick's, established the applicant's inability to compete in the open labor market, thus supporting the total disability award. The Board also reaffirmed that permanent total disability can be established under Labor Code Section 4662 based on factual inability to work, even if the scheduled rating is less than 100%.

Permanent disability rating scheduleWhole Person ImpairmentAgreed Medical ExaminerQualified Medical EvaluationPain Related ImpairmentFuture earning capacityOpen labor marketVocational rehabilitationLabor Code Section 4662AMA Guides
References
Case No. ADJ8915327
Regular
Apr 22, 2015

MARIA HERNANDEZ vs. WAREHOUSE DEMO SERVICES, INC., ESIS

This case involves a Petition for Reconsideration filed by Warehouse Demo Services, Inc. and ESIS regarding an award of total temporary disability (TTD) to applicant Maria Hernandez. The defendants argued the award was unsupported by evidence regarding Hernandez's ability to drive or perform modified duty while experiencing dizziness. The Workers' Compensation Appeals Board (WCAB) denied the petition, adopting the WCJ's reasoning. The WCAB also admonished defense counsel for improperly citing and attaching an unadmitted deposition. The WCJ found applicant's testimony credible, supported by medical reports indicating dizziness and inability to drive or work safely.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ reportADJ8915327deniedPaul E. ZayatGrancell Standerdeposition10842Lynn Devine
References
Case No. ADJ1418411 (VNO 0316233) ADJ3612505 (VNO 0316239) ADJ1412418 (VNO 0378388)
Regular
Sep 24, 2013

Marva Lynne Evans vs. CITY OF LOS ANGELES

The applicant's cases were dismissed based on a Joint Order of Dismissal issued without proper notice or opportunity to be heard, violating due process. Although the applicant filed a timely petition to set aside this order, it was not acted upon by the Appeals Board within the statutory timeframe. The Appeals Board found the dismissal improper, rescinded the order, and returned the case to the Presiding Judge to schedule a mandatory settlement conference.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Order of DismissalJurisdictionDue ProcessNoticeOpportunity to be HeardDeclaration of ReadinessLien ConferenceMandatory Settlement Conference
References
Case No. ADJ2195267
Regular
Sep 20, 2013

LYNN ASHER vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board (WCAB) dismissed the petition for reconsideration because it was not taken from a final order determining substantive rights or liabilities. The WCAB also denied the petition for removal, finding no showing of substantial prejudice or irreparable harm if removal was not granted. The WCAB adopted the Workers' Compensation Judge's Report and Recommendation for denying removal. The specific reasoning on the lien amount in the WCJ's report was excluded from adoption.

Petition for ReconsiderationRemovalFinal OrderSubstantive RightLiabilityInterlocutory OrderProcedural DecisionEvidentiary DecisionWCJ ReportSubstantial Prejudice
References
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