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

Case No. ADJ1524371 (LAO 0820886) ADJ4006816 (LAO 0820887)
Regular
May 13, 2015

MARGARITA CRUZ vs. BRITISH HOME OF CALIFORNIA, BROADSPIRE SACRAMENTO

A lien claimant, Max MRI Imaging, Inc., sought reconsideration of a prior order that awarded it $2,300.00. The claimant argued it did not stipulate to the order and did not waive certain statutory requirements. The WCAB denied reconsideration, adopting the WCJ's report. The WCAB found the petition timely despite a defective service, but ultimately denied it on the merits.

Lien claimantPetition for ReconsiderationStipulations and OrderWorkers Compensation Appeals BoardWCJLabor Code section 5313personal servicedefective servicewrit denmerits
References
Case No. ADJ7466813
Regular
Apr 10, 2013

ROBERTO MENA, COBERTON MENA vs. PRIORITY BUILDING SERVICES; LUMBERMAN'S UNDERWRITING, PRIORITY BUILDING SERVICES, LLC; LUMBERMAN'S UNDERWRITING

This case involves a lien claimant, Max MRI Imaging, whose lien was dismissed due to failure to pay the mandatory lien activation fee required by Labor Code section 4903.06(a)(4). The Workers' Compensation Appeals Board denied reconsideration, upholding the dismissal despite the claimant's argument of an oversight. The Board emphasized that the statute's language is mandatory and provides no exceptions for inadvertent non-payment. The ruling also clarified procedural arguments regarding notice, appearances, and the inapplicability of the *Hamilton v. Lockheed Corp.* case.

Workers' Compensation Appeals BoardRoberto MenaPriority Building ServicesLumberman's UnderwritingADJ7466813Petition for ReconsiderationLabor Code section 4903.06Lien Activation FeeDismissal of LienMandatory Requirement
References
Case No. ADJ3701295 (AHM 0146448)
Regular
Oct 07, 2013

PAULA GUEVARA vs. NORTHGATE GONZALEZ MARKET, ZENITH ESIS

The Workers' Compensation Appeals Board granted reconsideration for lien claimant Max MRI. While affirming the denial of Max MRI's lien claim for lack of evidence, the Board vacated the sanctions imposed. The Board found that Max MRI was denied due process regarding the sanctions, as the issue was not properly noticed or heard. The case is returned to the trial level for further proceedings and a decision on costs and sanctions.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien claimantMax MRIFrivolous lienSanctionsDue processMedical Provider NetworkCompromise and ReleaseFindings and Order
References
Case No. SAC 0345394
Regular
Feb 22, 2008

DIANA RICHMOND vs. STATE OF CALIFORNIA, DEPARTMENT OF JUSTICE, legally uninsured

The Workers' Compensation Appeals Board denied reconsideration of a decision that applied the 2005 Permanent Disability Rating Schedule. The applicant argued that a pre-2005 MRI and subsequent medical opinions indicated permanent disability, thus triggering the older 1997 Schedule. The Board found that the MRI report alone was insufficient and that the AME's opinion on prior permanent disability was too late to qualify for the exception.

Workers' Compensation Appeals BoardDiana RichmondState of California Department of Justicelegally uninsuredSAC 0345394Opinion and Order Denying ReconsiderationFindings and AwardFebruary 222008industrial injury
References
Case No. ADJ441097 (MON 0347404)
Regular
Sep 07, 2017

ROBERT ESQUERRA vs. EAGLE IRON CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted Max MRI Imaging's petition for reconsideration, rescinding the prior finding of no liability for the lien. The original decision was based on an issue (RFA form) not properly identified for trial by the parties. The case is returned to the trial level to address the central dispute: whether services provided outside the defendant's Medical Provider Network (MPN) at a non-designated physician's request are compensable despite defendant's objections. The Administrative Law Judge must issue new findings on this specific issue and Max MRI's other contentions.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationMedical Provider NetworkPrimary treating physicianWritten objectionsRequest for authorizationFindings and AwardDecision After ReconsiderationAdministrative law judge
References
Case No. ADJ1083014 (POM 0275607) ADJ4477705 (POM 0275608)
Regular
May 29, 2009

LILIAN SOTO vs. PM GLOVES, INC., STATE COMPENSATION INSURANCE FUND

This case involved a lien claimant seeking payment for an MRI. The Workers' Compensation Judge initially disallowed the lien for failing to meet Labor Code section 5703 requirements. The Appeals Board granted reconsideration, finding the WCJ erred by strictly applying section 5703. They determined that other evidence, including the treating physician's report referenced in a settlement, established the validity of the MRI expense. Therefore, the Board allowed the lien claim for the MRI.

Lien claimantReconsiderationLabor Code Section 5703Labor Code Section 4626Finding and OrderWorkers' Compensation Judge (WCJ)Compromise and Release (C&R)MRILumbar SpineSelf-procured medical treatment
References
Case No. ADJ7985491
Regular
Nov 09, 2016

GEORGE GORDON vs. CITY OF LOS ANGELES, P.S.I., administered by ACME administrators, Inc.

The Workers' Compensation Appeals Board dismissed the Petition for Reconsideration because it was untimely filed. The petition was submitted after the 25-day deadline following the original August 1, 2016, decision, which disallowed the lien claimant's claim for insufficient evidence. The Board clarified that filing proof of mailing is insufficient, and the petition must be *received* by the WCAB within the statutory period. Even if timely, the petition would have been denied on the merits, as lien claimants bear the burden of proving the reasonableness of their services.

Petition for ReconsiderationUntimely FilingLabor CodeCalifornia Code of RegulationsJurisdictional Time LimitFindings of Fact & OrdersLien ClaimantBurden of ProofPreponderance of the EvidenceMedical Treatment
References
Case No. ADJ7104281
Regular
Aug 27, 2012

LUIS GUERRERO OCHOA vs. EPLICA CORPORATE SERVICES, INC., NATIONAL UNION FIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed a Petition for Reconsideration because it was filed more than 25 days after the Order of June 11, 2012, violating the 20-day statutory deadline plus 5 days for mailing. Therefore, the petition was untimely. Even if it had been timely, the Board would have denied it on the merits, adopting the reasoning of the administrative law judge. The petition is dismissed as untimely.

Workers' Compensation Appeals BoardPetition for Reconsiderationuntimelyadministrative law judgeReport and RecommendationLabor Code section 5903Code of Civil Procedure section 1013lien claimantdismissaldenied on the merits
References
Case No. ADJ8588048
Regular
Jul 18, 2018

KELLY LUHMANN vs. TORRANCE UNIFIED SCHOOL DISTRICT

This case concerns a worker's compensation applicant who sought reconsideration of a decision upholding the denial of an MRI for a knee injury. While the administrative law judge initially found the Independent Medical Review (IMR) determination untimely, the Workers' Compensation Appeals Board (WCAB) clarified that the IMR was issued within the statutory timeframe after receiving supporting documentation. Crucially, the WCAB noted that even if the IMR were late, timeliness is not grounds for appeal, and a delay does not invalidate the IMR decision based on established case law. Therefore, the applicant is bound by the IMR's decision denying the MRI, and the petition for reconsideration was denied.

Independent Medical ReviewUtilization ReviewLabor Code Section 4610.6TimelinessSupporting DocumentationDirectory vs. Mandatory Time PeriodMedical NecessityMRIKnee InjuryPsyche Injury
References
Case No. ADJ8059604 ADJ8193294
Regular
May 26, 2016

EDDI MENDOZA GUZMAN vs. DIRECT CHASSIS, LLC, CYPRESS INSURANCE, BERKSHIRE HATHAWAY HOMESTATE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a judge's sanction order against lien claimant California Imaging Solutions and its representatives. The WCAB affirmed sanctions against Maria Trujillo and Nancy Ramirez for failing to appear at a hearing as ordered, reducing their sanction to $100 each. However, the WCAB rescinded sanctions against the lien claimant and its hearing representative, finding no basis for bad faith or sanctionable conduct by them. The case was returned for further proceedings on the lien claim itself.

Workers' Compensation Appeals BoardSan Diego ImagingCalifornia Imaging SolutionsLien ClaimantWCJSanction OrderLabor Code Section 5813Hearing RepresentativeBusiness LicenseDue Process
References
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