CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. ADJ8094646
Regular
Jan 17, 2014

ALEJANDRINA BARRETO vs. OUT OF THE SHELL, SOUTHERN INSURANCE COMPANY, REPUBLIC INDEMNITY COMPANY, PHARMAFINANCE, LLC, HEALTHCARE FINANCE MANAGEMENT, LLC

This case involves lien claimants PharmaFinance and Healthcare Finance Management, and their representatives Landmark Medical Management and Brian Hall, who sought reconsideration of a decision disallowing their liens for medical treatment. The Appeals Board granted reconsideration solely to notice its intention to impose sanctions of up to $2,500 against the lien claimants and their representatives. This action is due to a pattern of allegedly filing petitions containing false statements about not receiving notices, which violates the Board's Rules of Practice and Procedure and Labor Code Section 5813. The Board found these claims not persuasive and indicative of a tactic to avoid responsibility.

Workers' Compensation Appeals BoardPetition for ReconsiderationSanctionsLien ClaimantsHearing RepresentativesIndustrial InjuryFindings and OrderCompromise and ReleaseNotice of IntentionLabor Code section 5813
References
0
Case No. ADJ2270309 (VNO 0113668) ADJ4503834 (VNO 0113665) ADJ3103605 (VNO 0113666) ADJ2309113 (VNO 0113667)
Regular
Nov 10, 2010

MARIA GARCIA vs. CITY OF LOS ABNGELES, Permissibly Self-Insured

The Workers' Compensation Appeals Board granted reconsideration of a previous award, finding merit in the applicant's contentions regarding denied medical treatments. The Board intends to admit a nurse case manager's report that was previously excluded. This reconsideration aims to further review the factual and legal issues to ensure a just decision regarding the applicant's extensive care needs stemming from long-term quadriplegia. The Board is specifically addressing disputes over various requested services, including nursing care, home modifications, and specific medical treatments.

Workers' Compensation Appeals BoardSupplemental Findings and AwardHomecareNursing ServicesBedsore TreatmentHousekeeping ServicesHospital BedQuadriplegiaInternal InjuryLabor Code §5803
References
0
Case No. MISSING
Regular Panel Decision

ABC Medical Management, Inc. v. GEICO General Insurance

The case addresses whether a plaintiff-assignee medical equipment supplier can recover no-fault first-party benefits when a chiropractor, rather than a physician, issued the prescription. Defendant GEICO General Insurance Company moved for summary judgment, arguing that Education Law § 6551 prohibits chiropractors from prescribing such items. The court denied GEICO's motion, ruling that chiropractors are permitted to prescribe TENS units, thermophore devices, and similar medical supplies, as these do not constitute 'drugs or medicines' under the Education Law. Furthermore, the court found that GEICO failed to properly present its medical necessity defense and that the contested issues should be determined by a trier of fact.

No-Fault BenefitsChiropractic PrescriptionMedical EquipmentEducation Law § 6551Summary JudgmentMedical NecessityTENS UnitThermophoreCervical CollarLumbar Support
References
29
Case No. MISSING
Regular Panel Decision

Local 144, Hotel, Hospital, Nursing Home and Allied Services Union v. CNH Management Associates, Inc.

Plaintiff Local 144 sought to confirm an arbitration award against defendant CNH Management Associates regarding unpaid wages and benefits for workers at Concourse Nursing Home. CNH cross-moved to dismiss or vacate the award, arguing it was not final and that the arbitrator exceeded his powers. The court found that the arbitrator's interim order for CNH to immediately pay over $6 million into an escrow account was ripe for confirmation, viewing it as preliminary equitable relief to preserve the integrity of the final award. Consequently, the court confirmed this specific order but dismissed other aspects of Local 144's petition as not yet ripe for judicial review. The court also rejected CNH's arguments regarding the arbitrator's authority and the nature of the award.

Arbitration AwardCollective Bargaining AgreementInterim AwardEscrow AccountJudicial ReviewRipeness DoctrineArbitrator's AuthorityEquitable ReliefLabor DisputeWages and Benefits
References
5
Case No. ADJ8546489
Regular
Oct 13, 2016

THEMAS PRUETT vs. ASCO INC., STATE COMPENSATION INSURANCE FUND

The applicant seeks reconsideration of a decision denying further nurse case manager services. The WCAB granted reconsideration, holding that an employer cannot unilaterally terminate long-term, voluntarily provided nurse case manager services without medical evidence of changed circumstances. The Board found the applicant's treating physician recommended continued services, and the defendant bears the burden to prove services are no longer medically necessary. Therefore, the defendant must reinstate nurse case manager services until such medical evidence is presented.

Nurse Case ManagerUnilateral TerminationMedical NecessityBurden of ProofVoluntary ProvisionSubstantial Medical EvidencePetition for ReconsiderationLabor Code Section 4600Industrial InjuryFindings and Order
References
3
Case No. ADJ6722110
Regular
Oct 11, 2013

SERGIO RODRIGUEZ vs. AIR COASTAL FLEET SERVICES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed an administrative law judge's order dismissing a lien claim for failure to pay the required activation fee. The lien claimant, Advance Care Specialist Medical Clinic, and its representatives, Innovative Medical Management and Louis Heard, sought reconsideration, which was granted. However, the Board found no good cause to overturn the dismissal. Subsequently, the Board imposed a $1,000 sanction against Innovative Medical Management and Louis Heard for their failure to respond to a notice of intent to impose sanctions.

Lien activation feeSanctionLabor Code section 5813Appeals Board Rule 10561ReconsiderationWCJ Order Dismissing Lien ClaimNotice of Intention to Impose SanctionsWorkers' Compensation Appeals BoardHearing RepresentativeMedical Clinic
References
0
Case No. MISSING
Regular Panel Decision

Nurse v. Lutheran Medical Center

Plaintiff Lorna Nurse, a Black Barbadian former Nurse Practitioner at Lutheran Medical Center (LMC), sued LMC alleging racial and national origin discrimination in her termination, violating Title VII of the Civil Rights Act of 1964. LMC moved for summary judgment. Nurse claimed disparate treatment, discriminatory comments by her supervisor Ms. Schwimer, and LMC's failure to follow progressive discipline. The court found that Nurse failed to establish a prima facie case of discrimination, as she did not show her termination occurred under circumstances giving rise to an inference of discrimination, nor were her identified comparators similarly situated. The court also found LMC provided a legitimate, nondiscriminatory reason for termination based on a pattern of unprofessional conduct, and Nurse failed to show this reason was a pretext for discrimination. Therefore, LMC's motion for summary judgment was granted.

DiscriminationRace DiscriminationNational Origin DiscriminationTitle VIISummary JudgmentTerminationDisparate TreatmentNurse PractitionerEmployee MisconductProgressive Discipline
References
47
Case No. MISSING
Regular Panel Decision

Beth Israel Medical Center v. 1199/S.E.I.U. United Healthcare Workers East

Beth Israel Medical Center (BIMC) petitioned to vacate an arbitration award concerning a labor dispute over wage differentials for registered nurses on flex-time schedules at its Kings Highway Division. Local 1199, the nurses' union, moved to confirm the award. The dispute arose when BIMC discontinued pro-rata wage differentials for day shift nurses, arguing a 2002 Memorandum of Agreement (MOA) adopted a different plan. The arbitrator found for Local 1199, concluding the 2002 MOA did not alter the longstanding practice established in prior MOAs. BIMC argued the arbitrator exceeded his power and violated public policy; however, the court denied BIMC's petition and granted Local 1199's motion, affirming the arbitrator's decision that drew its essence from the collective bargaining agreement.

Labor DisputeArbitration AwardWage DifferentialsCollective Bargaining AgreementFlex-Time ScheduleRegistered NursesNew YorkFederal CourtLMRAContract Interpretation
References
14
Case No. ADJ10405277
Regular
Aug 10, 2018

JULIE VISH vs. SHARP HEALTH, ACE INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and rescinded an earlier award ordering the defendant to authorize a nurse case manager. The Board found that the applicant's treating physician's recommendation for a nurse case manager, citing "complexity" and "miscommunication," lacked the specific medical reasoning required to establish necessity. The current ruling emphasizes that the applicant bears the burden of proving medical necessity through detailed evidence.

Nurse case managerUtilization reviewSubstantial medical evidenceMedical necessityLamin v. City of Los AngelesLabor Code section 4600(a)CausationCompensable injuryOpinion and OrderPetition for Reconsideration
References
4
Case No. ADJ3905924 (ANA 0339374)
Regular
Jul 24, 2014

JENNIFER PATTERSON vs. THE OAKS FARM, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for CALIFORNIA COMPENSATION INSURANCE COMPANY, in liquidation

This case concerns the unilateral termination of nurse case manager services by an employer, which the Workers' Compensation Appeals Board affirmed as a form of medical treatment. The Board held that employers cannot unilaterally cease approved nurse case manager services without substantial medical evidence showing they are no longer necessary. Additionally, the Board clarified that an injured worker does not need to obtain a Request for Authorization to challenge such a termination, and expedited hearings are appropriate for these disputes. Ultimately, the employer failed to meet its burden of proving a change in the applicant's condition justifying the discontinuation of services.

Nurse Case ManagerLabor Code 4600Expedited HearingUnilateral TerminationMedical TreatmentRequest For AuthorizationAgreed Medical EvaluatorUtilization ReviewIndependent Medical ReviewSubstantial Medical Evidence
References
11
Showing 1-10 of 10,939 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational