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

Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. AHM 129527
Regular
Dec 10, 2007

OMAR ROSAS vs. LAURENCE HOVENIER, F.A. RICHARDS & ASSOCIATES

The Workers' Compensation Appeals Board granted reconsideration, rescinded a prior order, and found that the defendant's liability for temporary disability indemnity ended on May 26, 2007. This decision was based on Labor Code section 4656(c)(1), which limits temporary disability payments to 104 weeks within a two-year period from the commencement of payments. The Board affirmed the finding that the applicant sustained industrial injury to multiple body parts.

WORKERS' COMPENSATION APPEALS BOARDOPINION AND ORDER GRANTING RECONSIDERATIONPetition to Terminate LiabilityTemporary Disability IndemnityLabor Code section 4656subdivision (c)(1)104 compensable weeksSB 899aggregate disability paymentspermanent and stationary
References
Case No. ADJ222185
Regular
Apr 02, 2013

RONALD PEREZ vs. BLOOMINGTON HIGH SCHOOL, YORK INSURANCE COMPANY

This case involves a lien claimant, Ali Dini, M.D., whose lien was dismissed for failing to pay a required $100 lien activation fee before a scheduled conference. The lien claimant argued the dismissal was invalid due to a clerical error in the case number on the order and system issues preventing timely online payment. However, the Workers' Compensation Appeals Board denied reconsideration, finding the clerical error did not affect due process and upholding the dismissal because proof of timely payment was not provided. The Board noted the fee was due before the conference, and payment at 4:33 p.m. was too late for an 8:32 a.m. conference.

Lien activation feeDeclaration of Readiness to ProceedLien conferenceEmergency regulationProof of paymentSystem errorClerical errorLabor Code section 4903(b)Dismissal with prejudiceEAMS system
References
Case No. ADJ212916 (VNO 0334702)
Regular
Feb 09, 2011

PETER L. WASCHER vs. AIDS HEALTHCARE FOUNDATION INC., CIGA FOR CAL. COMP. (IN LIQUIDATION), STATE COMPENSATION INSURANCE FUND

This case involves a dispute over reimbursement for workers' compensation payments made by CIGA (California Insurance Guarantee Association) on behalf of an insolvent insurer. The arbitrator initially ordered State Compensation Insurance Fund (SCIF) to reimburse CIGA only $105,511.94, pending further proof of payment. CIGA petitioned for reconsideration, arguing it had provided sufficient evidence of payment for the full $719,238.12. The Workers' Compensation Appeals Board granted the petition, finding CIGA's payment records were reliable and unrebutted. Consequently, SCIF was ordered to reimburse CIGA the entire $719,238.12.

CIGASCIFreimbursementarbitrationreconsiderationindustrial injuryAids Healthcare FoundationCal Compmedical paymentsproof of payment
References
Case No. ADJ3872960
Regular
May 06, 2013

ALONZO WATKINS vs. LONG BEACH UNIFIED SCHOOL DISTRICT

This case concerns applicant Alonzo Watkins' petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision denying his claim for unpaid benefits totaling $14,269.10. The WCAB denied reconsideration, finding that Watkins failed to provide substantial evidence of non-payment, as the employer presented proof of payment via checks issued over 16 years prior. The WCAB also ruled that Watkins raised the issue of the employer's failure to produce payment records for the first time on appeal, which is impermissible. Furthermore, the WCAB clarified that the record retention requirements for adjusting agencies do not mandate indefinite maintenance of claim files.

Petition for ReconsiderationFindings and OrderIndustrial InjuryBack InjuryLower ExtremitiesTeacherCompromise and ReleasePayment RecordsProof of PaymentNon-Payment
References
Case No. ADJ13768010
Regular
May 06, 2025

ROBERT NICHOLS vs. COMCAST, ACE AMERICAN INSURANCE COMPANY

Robert Nichols, the applicant, sustained injuries while employed by Comcast. A petition for reconsideration was filed regarding whether the medical treatment received by the applicant qualified as pre-admission or emergency services, and the defendant's alleged failure to conduct a second bill review. The Workers' Compensation Appeals Board denied the petition for reconsideration, concurring with the WCJ's report that the lien claimant did not provide sufficient evidence to demonstrate that the treatment fell under pre-admission or emergency status. The Board also noted that the issue concerning the defendant's non-response to the second bill review was not a contested matter at the trial.

PETITION FOR RECONSIDERATIONLABOR CODE SECTION 5909ELECTRONIC ADJUDICATION MANAGEMENT SYSTEM (EAMS)TRANSMISSION DATEREPORT AND RECOMMENDATIONLIEN CLAIMANTPRETREATMENT SERVICESEMERGENCY SERVICESMEDICARE PROSPECTIVE PAYMENT SYSTEMSECOND BILL REVIEW
References
Case No. ADJ2214463 (VNO 0522433)
Regular
Feb 19, 2009

RICARDO DUARTE PONCE vs. ROSS STORES, INC., SEDGWICK CLAIMS MANAGEMENT SERVICES

The Appeals Board granted reconsideration to set aside the Order Approving Compromise and Release (OACR). The defendant sought to vacate the OACR because the parties' settlement agreement, which included a Medicare Set Aside (MSA) allocation, was contingent on approval by the Centers for Medicare Services (CMS) that was never obtained. Since the applicant was a Medicare beneficiary and the settlement exceeded $25,000, federal regulations require CMS approval of the MSA. The Board rescinded the OACR and returned the matter for further proceedings.

Medicare Set AsideMSA allocationCenters for Medicare ServicesCMS approvalCompromise and ReleaseOACRPetition for ReconsiderationRescind OrderGood CauseEquitable Grounds
References
Case No. SAL 0107814
En Banc
Jun 13, 2007

VALERI HAWKINS vs. AMBERWOOD PRODUCTS, STATE COMPENSATION INSURANCE FUND

The Appeals Board held that the two-year limitation on temporary disability payments under Labor Code section 4656(c)(1) begins from the date the first payment is actually made, not the date for which the benefit is first owed.

Workers' Compensation Appeals BoardEn Banc DecisionTemporary Disability PaymentLabor Code Section 4656(c)(1)Commencement of PaymentDate of InjuryCompensable WeeksAggregate Disability PaymentsSB 899Legislative Intent
References
Case No. ADJ2759696 (VNO 0492027)
Regular
Oct 11, 2010

WOON YOUNG PARK vs. FILM PAYMENT SERVICES, INC., CHARTIS INSURANCE

The Board granted reconsideration, rescinding the WCJ's decision on the defendant's credit for overpaid temporary disability. The defendant is allowed credit for temporary disability payments made from March 26, 2009, to June 3, 2009, at the temporary disability rate. Further credit is granted for payments made from June 4, 2009, to December 7, 2009, at the permanent disability rate of $185.00 per week. The Board denied further credit due to insufficient evidence regarding post-AME report overpayments.

Petition for ReconsiderationPermanent DisabilityTemporary DisabilityCreditStipulated AwardAgreed Medical ExaminationPermanent and StationarySection 4909Abuse of DiscretionDue Process
References
Case No. ADJ7454224
Regular
May 13, 2016

JEFF REECE vs. SAN BERNARDINO COUNTY PROBATION DEPARTMENT; COUNTY OF SAN BERNARDINO

The Appeals Board denied the defendant's petition for reconsideration regarding the lien of the California Law Enforcement Association (CLEA). The defendant voluntarily paid CLEA before the WCJ's decision became final, despite knowing reconsideration could negate their liability. As this voluntary payment constitutes a new issue, any claim for credit must first be addressed at the trial level. The Board affirmed its prior decision to remove CLEA's lien from the award.

Workers' Compensation Appeals BoardPetition for ReconsiderationOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings Award and OrdersLien WithdrawalVoluntary PaymentLabor Code Section 4909Credit for PaymentTrial Level Jurisdiction
References
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