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

Case No. ADJ3512142 (MON 0288509)
Regular
Jan 12, 2009

JOSE LUIS LARA vs. BRATIFF HOME CORP. dba METRO DINER and SCOTT BROFFMAN as substantial shareholder; UNINSURED EMPLOYERS BENEFIT TRUST FUND

The Appeals Board reversed the WCJ's finding that the applicant was an employee of Metro Diner on the date of injury, concluding that he was an independent contractor.

Workers' Compensation Appeals BoardBratiff Home Corp.Metro DinerScott BroffmanUninsured Employers Benefit Trust FundADJ3512142MON 0288509Opinion and Order Granting ReconsiderationDecision After ReconsiderationAdministrative Law Judge
References
Case No. ADJ6742798
Regular
Jan 18, 2013

WILFREDO JUAREZ vs. CIRCUIT CITY STORES, METRO RISK MANAGEMENT

The Workers' Compensation Appeals Board dismissed lien claimants' petitions for reconsideration because they were filed untimely. The petitions challenged prior orders dismissing their liens due to non-appearance at a lien conference. Despite contentions about notice and settlement authority, the Board found the petitions were filed three days after the jurisdictional deadline. Even if timely, the petitions would have been denied on the merits based on the judge's report.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ConferenceDismissal OrderTimelinessService by MailDeclaration of ReadinessWCAB Rule 10562Presumption of ReceiptProof of Service
References
Case No. ADJ9441801 ADJ10298288
Regular
Jul 21, 2017

PAULA WALTON vs. PORTS AMERICA, DISCOVERY RE, GALLAGHER BASSETT, SSA CONTAINERS, INC., METRO RISK MANAGEMENT

In this workers' compensation matter, the Appeals Board granted Ports America's Petition for Reconsideration. The Board rescinded the Administrative Law Judge's (ALJ) Joint Findings and Order of July 17, 2017. The case is now returned to the trial level for further proceedings by the ALJ.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings and OrderWCJPorts AmericaDiscovery ReGallagher BassettSSA ContainersMetro Risk ManagementADJ9441801
References
Case No. ADJ1035201
Regular
Oct 04, 2016

VICTOR DURAN vs. DONUT INN, STATE FARM INSURANCE COMPANY

The Appeals Board is considering rescinding an order that dismissed Metro Med Shockwave's lien claim for failure to pay a $\$100$ lien activation fee. The WCJ dismissed the lien because the fee was not paid before the lien conference, citing prior precedent. However, the lien claimant argues they had until December 31, 2015, to pay the fee based on a DWC Newsline article referencing a court order. The Board intends to rescind the dismissal if the fee is paid within ten days, allowing further proceedings on the lien claim.

Labor Code section 4903.06Lien activation feeWorkers' Compensation Appeals BoardMetro Med ShockwaveFigueroa v. B.C Doering Co.Angelotti Chiropractic v. BakerPreliminary injunctionDWC NewslineReconsiderationRescind order
References
Case No. OAK 0254576, OAK 0254577, OAK 0282653
Regular
Jul 30, 2007

PATRICIA LE MELLE vs. FED EX, OAKLAND UNIFIED SCHOOL DISTRICT, METRO ONE TELECOMMUNICATIONS, LIBERTY MUTUAL INSURANCE COMPANY, COUNTY OF ALAMEDA

The Appeals Board granted reconsideration due to insufficient explanation from the trial judge regarding medical opinions, temporary disability allocation, and permanent disability apportionment. The original decision is rescinded and the case is returned for further proceedings and a new decision. Notably, the Board observed that Fed Ex likely is not liable for back treatment and that a prior finding of cumulative injury against Metro One stands.

Workers' Compensation Appeals BoardReconsiderationFindings Awards OrdersClerical ErrorIndustrial InjuryTemporary DisabilityPermanent DisabilityAgreed Medical Evaluator (AME)ApportionmentCumulative Injury
References
Case No. ADJ7765356
Regular
Jul 26, 2011

WESLEY CAIN vs. LOS ANGELES METROPOLITAN AUTHORITY

The Workers' Compensation Appeals Board denied the Los Angeles Metropolitan Authority's petition for reconsideration. The Authority sought to alter a prior stipulation that awarded applicant Wesley Cain medical treatment for an admitted industrial injury. The Board adopted the WCJ's report, which found the stipulation was a binding agreement. The WCJ determined the language of the stipulation clearly provided for ongoing medical care and the Authority provided no evidence to alter this entitlement.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeStipulation and Request for AwardMedical treatmentIndustrial injuryMetro train driverSuicide attemptContract principlesBinding agreement
References
Case No. ADJ2996723 (LAO 0841594) ADJ4157903 (LAO 0848595) ADJ4177198 (LAO 0848596)
Regular
Jan 13, 2012

JESUS HERNANDEZ vs. WARNER BROS. STUDIOS, ZURICH INSURANCE COMPANY

This case concerns a dispute over the proper procedure for developing medical evidence in a workers' compensation claim. The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for removal, rescinding an order that appointed new physicians to review the medical record. The WCAB ruled that the previous trial judge erred by appointing new physicians without formally admitting the parties' submitted medical reports into evidence or determining their sufficiency. The matter was returned for further proceedings consistent with due process and established procedures for medical record development.

RemovalPetition for RemovalLabor Code section 5701Order appointing regular physiciansWCJMedical record developmentMcDuffie v. Los Angeles Co. Metro. Transit AuthoritySubstantial evidenceDue processCross-examination
References
Case No. ADJ8845155
Regular
Dec 05, 2013

Ken Farrar vs. MAINSTAY BUSINESS SOLUTIONS, METRO RISK MANAGEMENT

This case involves Ken Farrar's workers' compensation claim for cumulative trauma injury. The original judge found the claim barred by the statute of limitations, but the Appeals Board granted reconsideration. The Board determined that the employer's denial letter, which provided incorrect information regarding the filing deadline, estopped them from asserting the statute of limitations defense. Therefore, Farrar's claim was deemed timely filed.

ADJ8845155WORKERS' COMPENSATION APPEALS BOARDRECONSIDERATIONSTATUTE OF LIMITATIONSLABOR CODE SECTION 5405APPLICATION FOR ADJUDICATION OF CLAIMWAIVERAFFIRMATIVE DEFENSESCUMULATIVE TRAUMAESTOPPEL
References
Case No. ADJ1675562
Regular
Feb 11, 2013

HECTOR ALVAREZ vs. WALL DESIGN, INC., METRO RISK MANAGEMENT

The Workers' Compensation Appeals Board denied a petition for reconsideration filed by lien claimant Caremedics, represented by Pinnacle Lien Services. The Board adopted the WCJ's report, which found Caremedics' lien was properly dismissed due to its failure to appear at a trial, a dismissal also upheld by a subsequent Notice of Intention to Dismiss. The Board also declined to rule on sanctions at this time, noting that jurisdiction was reserved for the trial level to address penalties for non-appearance. Caremedics' arguments for excusing their absence, including mis-calendaring, were deemed insufficient.

Petition for ReconsiderationLien ClaimantDismissal of LienFailure to AppearWCAB Rule 10562(e)(1)SanctionsLabor Code Section 5813Code of Civil Procedure Section 473Skeletal PetitionPinnacle Lien Services
References
Case No. ADJ8611605 ADJ8611603
Regular
Oct 13, 2017

GILMA DAVILA vs. JOBS METRO NET, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a decision disallowing a lien claim from Tri-City Health Group. The WCJ found the lien claimant failed to prove the medical treatment was necessary and reasonable. The Board agreed that the lien claimant did not sustain its burden of proof regarding medical necessity, the reasonableness of the services, or entitlement to payment under Labor Code section 5402(c). Furthermore, the Board found no evidence that the alleged injury arose out of and occurred during the course of employment, precluding employer liability for the self-procured treatment.

WCABLien ClaimantPetition for ReconsiderationJoint Findings and OrderWCJMedically Necessary TreatmentLabor Code Section 5402(c)Burden of ProofPrimary Treating PhysicianHealth Insurance Claim Form
References
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