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

Case No. ADJ724329 (LAO 0863195)
Regular
Jan 28, 2010

BRAMBILA vs. VONS, INC.

The Workers' Compensation Appeals Board denied reconsideration to MH Express Pharmacy. The lien claimant sought additional payment for medications provided to the applicant, arguing they were prescribed by MPN physicians. However, the employer had established a Pharmacy Benefit Network (PBN) before the applicant's injury, and the lien claimant was not part of this network. The Board found the lien claimant misrepresented the record by claiming the PBN contract was not in evidence, and affirmed the denial of further payment for medications dispensed outside the PBN.

Workers' Compensation Appeals BoardLien ClaimantPharmacy Benefit NetworkMedical Provider NetworkFindings and OrderReconsiderationLabor Code section 4600.2(a)Compromise and ReleaseOfficial Medical Fee ScheduleBad Faith Tactics
References
Case No. ADJ4449218
Regular
Mar 04, 2010

LUIS ALVARADO vs. STAFFING SERVICES, INC., STATE COMPENSATION INSURANCE FUND

Here is a summary of the case in a maximum of four sentences for a lawyer: The Workers' Compensation Appeals Board denied reconsideration of the Administrative Law Judge's (ALJ) decision, which found jurisdiction over a dispute between an injured worker's applicant and defendant Staffing Services, Inc. The ALJ correctly determined that there was no express agreement between Staffing Services and the lien claimant, Beverly Hills Pharmacy, fixing payment amounts, thus Labor Code section 5304 did not divest the Board of jurisdiction. The Board also found that removal was not appropriate for this final determination. Procedural arguments regarding a denied continuance due to the defense attorney's illness were also rejected.

Workers' Compensation Appeals BoardReconsiderationRemovalLien ClaimantExpress AgreementLabor Code Section 5304JurisdictionStaffing Services Inc.State Compensation Insurance FundBeverly Hills Pharmacy
References
Case No. ADJ7627116
Regular
Nov 03, 2015

Arturo Gallegos vs. Barrett Business Services

The Appeals Board dismissed MH Express Pharmacy's Petition for Reconsideration as untimely filed. However, it granted reconsideration for other lien claimants, rescinded the dismissal of their liens, and returned the matter to the WCJ for a hearing on the merits. This decision was based on the fact that the liens predated the relevant statutory changes and the claimants eventually provided the required supporting documentation. The Board noted that the WCJ should consider sanctions for the delayed compliance.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissal of LienLabor Code Section 4903.8(e)Labor Code Section 4903.5(d)Labor Code Section 4903.8(d)untimely petitionsubstantial justicedisposition on meritsrescinded order
References
Case No. ADJ3049369
Regular
Oct 22, 2013

LONA REED vs. SIERRA TELECOMMUNICATIONS, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied a petition for reconsideration, upholding the dismissal of MH Express Pharmacy's lien claim. The lien claimant failed to appear at a properly noticed hearing in case ADJ3049369, despite initiating the hearing process. The Board clarified that a cancellation notice for a different case (ADJ643038) did not apply to this matter, and no valid reason for the absence was presented. Consequently, the WCJ's order dismissing the lien was affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ reportcumulative traumaspecific injurylien conferenceOrder Dismissing LienMH Express PharmacyCIGADOR
References
Case No. ADJ3177262
Regular
Dec 18, 2013

ALEJANDRO LLARENA vs. KOYO GRAPHICS INTERNATIONAL, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, INTERCARE INSURANCE SERVICES, INC., CREDIT GENERAL INSURANCE CO.

This case involves a Petition for Removal filed by CIGA challenging the denial of their Petition to Quash a Subpoena duces Tecum. The Appeals Board denied the removal petition because CIGA failed to demonstrate substantial prejudice or irreparable harm, or that reconsideration would be an inadequate remedy. The WCJ's report, adopted by the Board, noted that CIGA's petition lacked necessary supporting documentation and factual basis. Therefore, the extraordinary remedy of removal was not warranted.

Workers' Compensation Appeals BoardPetition for RemovalSubpoena duces TecumCalifornia Insurance Guarantee AssociationCIGAExtraordinary RemedyIrreparable HarmWCJ ReportReport and RecommendationCompromise and Release
References
Case No. ADJ11167540
Regular
Feb 15, 2019

CHARLES SENIFF vs. FEDERAL EXPRESS CORPORATION

The Workers' Compensation Appeals Board denied Federal Express's petition for reconsideration, upholding the administrative law judge's finding of jurisdiction. Federal Express argued the Board lacked jurisdiction because the applicant did not work in California after 2006. The Board adopted the judge's report, which found California jurisdiction supported by Labor Code section 3600.5(a) and precedent case law, deeming these sufficient grounds despite the defendant's jurisdictional challenge.

Workers' Compensation Appeals BoardFederal Express CorporationSedgwick Claims Management ServicesADJ11167540Santa Ana District OfficeAmended Findings and AwardWorkers' Compensation Administrative Law JudgejurisdictionLabor Code section 3600.5(a)Alaska Packers Asso. v. Industrial Acci. Com.
References
Case No. ADJ7215395
Regular
Apr 30, 2012

MATTY CAMPOS vs. UNIVERSITY OF SOUTHERN CALIFORNIA, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board (WCAB) granted the applicant's Petition for Reconsideration of a prior decision. This action was taken due to statutory time constraints and the need for a more thorough review of the factual and legal issues. The WCAB requires further study of the record to ensure a just and reasoned decision. All future filings are to be submitted in writing directly to the WCAB Commissioners' office.

Matty CamposUniversity of Southern CaliforniaSedgwick Claims Management ServicesADJ7215395Petition for ReconsiderationWorkers' Compensation Appeals BoardReconsideration GrantedDecision After ReconsiderationOffice of the CommissionersElectronic Adjudication Management System
References
Case No. ADJ287866 LAO 0813289 ADJ7596806
Regular
Apr 30, 2012

CHESTER JACKSON vs. FEDERAL EXPRESS

This case involves a workers' compensation claim by Chester Jackson against Federal Express. The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior decision. The WCAB affirmed the original decision but amended it to include penalties and interest owed to Dr. Friedman, pursuant to Labor Code section 4622(b), for specific dates of service. The exact amounts are to be adjusted by the parties.

Workers' Compensation Appeals BoardReconsiderationAmended DecisionPenaltiesInterestLC4622(b)Dates of ServiceFederal ExpressChester JacksonFriedman Psychiatric Med
References
Case No. ADJ741218 (OAK 0217902)
Regular
Sep 14, 2018

ROBIN JOHNSON vs. FEDERAL EXPRESS, BROADSPIRE, SEDGWICK CMS

This case involves a Petition for Reconsideration and Removal filed by the applicant, Robin Johnson, in a workers' compensation matter against Federal Express and its adjusters. The Workers' Compensation Appeals Board (WCAB) dismissed the Petition for Reconsideration because reconsideration is only appropriate for final orders that determine substantive rights, not interlocutory or procedural decisions. The WCAB also denied the Petition for Removal, finding that the applicant failed to demonstrate substantial prejudice or irreparable harm justifying such action. Therefore, the WCAB dismissed the petition and denied removal.

Workers' Compensation Appeals BoardPetition for ReconsiderationFinal OrderSubstantive Right or LiabilityInterlocutory OrdersProcedural DecisionsEvidentiary DecisionsPetition for RemovalSubstantial PrejudiceIrreparable Harm
References
Case No. ADJ240659 (MON 0358311)
Regular
Mar 25, 2009

JOHN PELLETIER vs. CVS PHARMACY, AMERICAN HOME ASSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration regarding an industrial injury to the applicant's bilateral wrists sustained while employed at CVS Pharmacy. The Board found the date of injury, for the purpose of Labor Code sections 5412 and 5500.5, was February 11, 2008, when the applicant first knew his disability was work-related and received medical confirmation. This date was subsequent to his termination, thus negating the post-termination defense under Labor Code section 3600(a)(10) due to exceptions that applied.

Workers' Compensation Appeals BoardCVS PharmacyAmerican Home AssuranceJohn Pelletiercumulative injurybilateral wristsLabor Code section 5412date of injurycompensable disabilitymedical confirmation
References
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