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

Case No. ADJ292109 (LAO 0863163)
Regular
Oct 27, 2015

Erica Brumfield vs. County of Los Angeles, Department of Social Services, York Risk Services

The Appeals Board granted reconsideration and rescinded the WCJ's dismissal order. The dismissal was based on a defendant's petition containing material misrepresentations and improper service on the unrepresented applicant. Crucially, the defendant failed to properly serve notice of dismissal proceedings, and the applicant was actively pursuing her claim as evidenced by her communications with adjusters and medical providers. Therefore, the dismissal order is void *ab initio* due to lack of due process and material misrepresentations.

Amended Petition to Set Aside DismissalPetition to Dismiss Based On Lack of Prosecutionvoid ab initiomaterial misrepresentationPetition for Reconsiderationrescind the Orderindustrial injuryunrepresentedin propria personamisrepresentation of facts
References
Case No. ADJ6865421
Regular
Sep 08, 2017

DAVID BERRIOS-SEGOVIA vs. EJ DISTRIBUTION CORPORATION, SOUTHERN INSURANCE COMPANY, MARKEL dba FIRST COMP, STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS, UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case returns to the Appeals Board after the Court of Appeal determined that the rescission of an insurance policy is subject to mandatory arbitration. The Court annulled the arbitrator's prior findings, ordering further proceedings to determine the legal effectiveness of the insurer's rescission. The insurer must prove the employer's misrepresentations were material and that rescission is not being used to circumvent policy approval requirements. The matter is remanded to the arbitrator for further proceedings and a new decision.

Workers' Compensation Appeals BoardRemittiturMandatory ArbitrationLabor Code Section 5275Policy RescissionMaterial MisrepresentationUninsured Employers Benefits Trust FundDepartment of InsuranceInsurance CommissionerPrior Approval
References
Case No. ADJ7586945
Regular
Sep 20, 2013

MICHAEL GERTH vs. LABORATORY CORPORATION OF AMERICA, ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior award, finding that the defendant's petition contained material misrepresentations and presented arguments "indisputably without merit." Specifically, the defendant misrepresented evidence regarding the Agreed Medical Examiner's opinion on injury AOE/COE and incorrectly claimed the applicant's employment was terminated for cause. The Board also issued a notice of intention to impose sanctions up to $1,200 against the defendant and their attorneys for frivolous tactics and misstatements of law, particularly regarding the non-apportionment of medical treatment costs.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAgreed Medical ExaminerAOE/COETemporary Total DisabilityKnee Replacement SurgeryLabor Code Section 5813Appeals Board Rule 10561Bad Faith Actions
References
Case No. ADJ3588216 (LAO 0866168) ADJ4039946 (LAO0866169)
Regular
May 20, 2009

MARIA ADELA PEREZ vs. JOSE HERNANDEZ, CRAWFORD & COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration. The defendant sought to rescind two stipulation and orders approving settlements with lien claimants, Dr. Ehyai and Dr. Dini. These orders settled the liens for $1,700 and $1,500 respectively, despite prior payments by the defendant to both doctors totaling over $4,300. The Board rescinded the orders and returned the matter for a hearing to determine if the stipulations were based on misrepresentation or mutual mistake by the lien claimants.

Workers' Compensation Appeals BoardPetition for ReconsiderationStipulation and OrderLien ClaimantDr. Reza EhyaiDr. Ali DiniRescissionMisrepresentationMutual MistakeGood Cause
References
Case No. ADJ4349754 (OXN 124391)
Regular
Aug 16, 2013

JOSE TOSTADO vs. JM SMUCKER COMPANY, LUMBERMENS MUTUAL CASUALTY COMPANY

This case involves a petition for reconsideration of a $\$ 2500$ sanction imposed on defense counsel by a Workers' Compensation Judge. The defense argued the sanction was settled by a Compromise and Release, lacked evidence, and infringed on attorney-client privilege. The Board denied reconsideration, finding the sanction was not settled by the C&R and that claims of privilege did not excuse the misrepresentation. The WCJ found the attorney misrepresented the filing of a Medicare Set Aside analysis, constituting a sanctionable offense despite claims of reasonable belief or privilege.

WCABPetition for ReconsiderationSanctionCompromise and ReleaseMedicare Set AsideCMSDeclaration of ReadinessAttorney-Client PrivilegeMisrepresentationOfficer of the Court
References
Case No. ADJ673354 (ANA 0365640)
Regular
Oct 22, 2013

HECTOR PASILLAS vs. JP GERGEN CONSTRUCTION, MIDCENTURY INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) imposed sanctions of $1,500 on a lien claimant and its representatives for filing an untimely and unjustified Petition for Reconsideration. The Petition contained material misrepresentations, lacked merit, and was improperly verified. The WCAB also awarded the defendant $1,650 in attorney's fees and costs. The lien claimant's untimely and insufficient response did not provide good cause to avoid sanctions. Jurisdiction was returned to the trial level after the sanctions were ordered.

Workers' Compensation Appeals BoardPetition for ReconsiderationUntimely FilingSanctionsLegal Service BureauBack Pain Chiropractic CenterDr. HewkoMisrepresentationWithout MeritDefective Verification
References
Case No. ADJ7290133
Regular
Mar 17, 2014

DANA MOORE vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board dismissed the lien claimant's Petition for Reconsideration because it was filed from a non-final order. The Appeals Board also granted removal on its own motion to address the lien claimant's failure to appear at a lien conference and contradictory statements. Due to the lien claimant's apparent bad faith and misrepresentations, the Board intends to impose a sanction of up to $500 against both the lien claimant and its representative. The lien claimant and representative have 15 days to object with good cause.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationRemoval on Board MotionNotice of Intention to Impose SanctionsLabor Code § 5813Cal. Code Regs.tit. 8§ 10562Lien Conference
References
Case No. ADJ7313244
Regular
Sep 14, 2012

KEVIN WRIGHT vs. CALIFORNIA WATER SERVICE COMPANY

The Workers' Compensation Appeals Board is issuing a notice of intention to sanction the defendant's attorneys $500 for misrepresenting the record and failing to follow procedural rules. The defendant's petition for reconsideration selectively quoted and omitted material facts from medical depositions, thereby distorting the evidence. Specifically, the defendant misrepresented a QME's opinion on industrial causation and applicant's stress levels. This failure to fairly state the evidence and provide specific record citations violates WCAB rules and warrants sanction.

Workers Compensation Appeals BoardLabor Code section 5813cumulative trauma injuryindustrial causationPetition for ReconsiderationPanel QMEWCJRules of Practice and Procedurematerial misrepresentationselective quotation
References
Case No. ADJ7144166
Regular

PAULINA CORTEZ vs. KOOSHAREM CORP. dba SELECT STAFFING, ACE AMERICAN RISK COMPANY, C/O ESIS, INC.

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration, finding it was not a final order. The WCAB granted removal on its own motion to issue a notice of intention to impose sanctions against the lien claimant and its representatives. This action stems from the lien claimant's failure to appear at a properly noticed conference, misrepresentations regarding notice, and violations of procedural rules, constituting bad-faith tactics. Sanctions of $1,000 are proposed jointly and severally against the lien claimant and its representatives for these violations.

Labor Code 5813Rule 10561Petition for ReconsiderationNotice of Intention to DismissRemovalSanctionsBad Faith ActionsFrivolous TacticsLien ClaimantUnnecessary Delay
References
Case No. ADJ9148751 ADJ9148752
Regular
Oct 13, 2017

SONIA MARTINEZ vs. IMPERIAL CARE CENTER, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

Here is a summary of the case in four sentences for a lawyer: The Workers' Compensation Appeals Board (WCAB) dismissed a lien claimant's petition for reconsideration as untimely, as it was filed after the statutory deadline. The WCAB also granted removal on its own motion to issue a notice of intention to impose sanctions against the lien claimant's representative. This action is based on alleged misrepresentation regarding proof of service and an insufficient verification in the petition. Sanctions of up to $1,500 may be imposed if the representative does not demonstrate good cause to the contrary within the specified timeframe.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ClaimantDismissalRemovalSanctionsLabor Code Section 5813WCAB Rule 10561Untimely FilingMaterial Misrepresentation
References
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