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

Case No. ADJ4130207 (ANA 0407943)
Regular
Jan 14, 2013

ALEJANDRA ZATARAIN, aka WENDY OSUNA vs. onE SOURCE; ACE as administered by ESIS

The Workers' Compensation Appeals Board granted reconsideration and rescinded an order dismissing lien claimant New Age Translations' lien. The dismissal occurred without notice to the lien claimant, and the Board found this procedurally improper. A subsequent agreement between parties settling the lien would have been meaningless if the dismissal remained in place. The Board's order allows the parties to resolve the lien in accordance with their agreement.

Lien DismissalPetition for ReconsiderationWorkers' Compensation Appeals BoardLien ClaimantOrder of Lien DismissalNotice of Intent to DismissWCJRescindedSettlement AgreementAdministrative Law Judge
References
Case No. ADJ7206906
Regular
Oct 01, 2013

GERARDO BOLLAS vs. CALPAK LANDSCAPE, INC., DELOS INSURANCE CO.

The Workers' Compensation Appeals Board (WCAB) affirmed a judge's order dismissing lien claimant New Age Translations and its representative, Gina Correla, for failing to appear at a lien conference without good cause. The WCAB also imposed a $\$1,000$ sanction against them jointly and severally. This decision followed their failure to respond to the WCAB's notice of intent to sanction and their continued failure to verify their petition for reconsideration.

Lien claimantSanctionReconsiderationWCJLien conferenceGood causeFailure to appearUnverified petitionAppeals BoardJointly and severally
References
Case No. ADJ6502736
Regular
Nov 21, 2011

JUAN BARCENAS vs. THE BEST MASTER ENTERPRISES, INC., STATE COMPENSATION INSURANCE FUND, New Age Imaging Copy Service

This order imposes a $500.00 sanction against lien claimant New Age Imaging Copy Service for filing a frivolous petition for reconsideration without justification. The Board previously provided notice of its intent to sanction and allowed an opportunity to object, which the lien claimant failed to do. The sanction is for violating Labor Code section 5813 and WCAB Rule 10561(b)(2) regarding frivolous filings. Payment is due within twenty days to the Workers' Compensation Appeals Board for transmittal to the General Fund.

Frivolous petitionSanctionLabor Code section 5813WCAB Rule 10561(b)(2)Lien claimantPetition for reconsiderationNotice of intentionGood causeOpinion and Order Dismissing Petition for ReconsiderationGranting Removal
References
Case No. ADJ3888750 (SAC 0277341)
Regular
Apr 20, 2012

JEROME LACKNER, Deceased vs. DEPARTMENT OF CORRECTIONS, STATE OF CALIFORNIA, STATE COMPENSATION INSURANCE FUND

This case involves a petition to reopen a prior workers' compensation award for new and further disability. The Appeals Board granted reconsideration, finding that the applicant did suffer new and further temporary total disability from July 14, 2003, to October 8, 2004. This finding was based on medical evidence indicating a deterioration in the applicant's condition, necessitating a new period of treatment. The decision reversed the administrative law judge's prior finding that the disability was solely due to aging.

Petition for ReconsiderationNew and Further DisabilityTemporary Total DisabilityLabor Code Section 5410Stipulated AwardPermanent DisabilityTreating Physician ReportMaximum Medical ImprovementJurisdictionDate of Injury
References
Case No. ADJ6710001 (ANA) MF ADJ7803228 (ANA) ADJ8017966 (ANA) ADJ8064588 (ANA) ADJ8262934 (ANA) ADJ9093396 (ANA) ADJ9076943 (ANA) ADJ9083545 (SDO) ADJ6925792 (ANA) ADJ8907815 (ANA) ADJ8819925 (ANA) ADJ9087879 (ANA) ADJ9093460 (ANA) ADJ8443963 (ANA) ADJ6829099 (ANA) ADJ6843222 (ANA)
Regular
May 07, 2015

LARRY WATKINS, GORDON BELL, DANIEL BUGGS, JAMES STIENKE, WILLIAM BRYANT, RONALD JOHNSON, ROBERT HYLAND, WALKER GILLETTE, REGGIE RUCKER, ANDREW SELFRIDGE, DOUG VAN HORN, ANANIAS CARSON, JACK GREGORY, THOMAS MULLEN, WILLIE YOUNG, JOHN HICKS vs. NEW YORK GIANTS, NEW YORK STATE INSURANCE FUND

This case concerns the New York State Insurance Fund's (NYSIF) liability for workers' compensation claims filed by former New York Giants employees. NYSIF argued it was not liable due to sovereign immunity and limitations in its New York-centric insurance policies. The Workers' Compensation Appeals Board affirmed the Arbitrator's decision, finding that Coverage B of the policy broadly indemnified the Giants for employee injuries sustained "wherever such injuries may be sustained," without clear exclusionary language. This coverage extended despite NYSIF's arguments about its New York origin and lack of authorization to write insurance in California. The Board also deferred the jurisdictional question for individual claims to the Workers' Compensation Judge.

Workers' Compensation Appeals BoardNew York State Insurance FundNew York Giantssovereign immunitycomitycoverageextraterritorial injuriesinsurance policy interpretationCoverage Bbusiness operations
References
Case No. ADJ6710001 (ANA) MF ADJ7803228 (ANA) ADJ8017966 (ANA) ADJ8064588 (ANA) ADJ8262934 (ANA) ADJ9093396 (ANA) ADJ9076943 (ANA) ADJ9083545 (SDO) ADJ6925792 (ANA) ADJ8907815 (ANA) ADJ8819925 (ANA) ADJ9087879 (ANA) ADJ9093460 (ANA) ADJ8443963 (ANA) ADJ6829099 (ANA) ADJ6843222 (ANA)
Regular
May 07, 2015

LARRY WATKINS, GORDON BELL, DANIEL BUGGS, JAMES STIENKE, WILLIAM BRYANT, RONALD JOHNSON, ROBERT HYLAND, WALKER GILLETTE, REGGIE RUCKER, ANDREW SELFRIDGE, DOUG VAN HORN, ANANIAS CARSON, JACK GREGORY, THOMAS MULLEN, WILLIE YOUNG, JOHN HICKS vs. NEW YORK GIANTS, NEW YORK STATE INSURANCE FUND, et al.

The Workers' Compensation Appeals Board affirmed an Arbitrator's decision finding the New York State Insurance Fund (NYSIF) liable for workers' compensation claims against the New York Giants. Despite NYSIF's claims of sovereign immunity and limitations to New York coverage, the Board found that the policy's Coverage B provided indemnity for injuries sustained by employees "wherever such injuries may be sustained." The Board emphasized that insurance policy exclusions must be clear, and NYSIF failed to demonstrate any such limitations for injuries occurring outside New York, especially given the team's extensive operations outside the state. The Board also noted that NYSIF's contentions regarding California jurisdiction would be determined on a claim-by-claim basis.

Workers' Compensation Appeals BoardNew York State Insurance FundNew York GiantsSovereign ImmunityComityCalifornia JurisdictionCoverage BOut-of-State InjuriesInsurance Policy LimitationsIndemnify
References
Case No. ADJ7219865
Regular
May 06, 2014

JUVENAL DIAZ vs. CALPAK LANDSCAPE, INC.

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's decision disallowing the lien of New Age Imaging. The Board found the WCJ misapplied the burden of proof by focusing on injury AOE/COE and medical necessity, rather than whether the copy services were "reasonably, actually, and necessarily incurred" as medical-legal expenses for a contested claim. Consequently, the Board rescinded the WCJ's decision, affirmed the disallowance of another lien claimant (True Scan), and returned New Age Imaging's lien to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationMedical-legal expenseContested claimLabor Code section 4620Injury AOE/COESelf-procured servicesBurden of proofRescind
References
Case No. ADJ1938020 LAO 0877660
Regular
Sep 26, 2019

FRANCISCO PEREZ vs. KING TACO RESTAURANT, INC., AMERICAN CASUALTY COMPANY

Lien claimant New Age Imaging sought reconsideration of a finding that defendant King Taco Restaurant fully satisfied its lien for $\$ 595.00$. The Appeals Board granted reconsideration because the defendant failed to provide sufficient evidence, such as an endorsed check or testimony of mailing, to prove lien claimant received the payment. The WCJ's original finding is rescinded and the case is returned to the trial level for further proceedings to develop the record on payment and receipt. This ensures a fair hearing and substantial justice for all parties.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and OrderBurden of ProofMailing PresumptionEvidence Code 641Due ProcessFair HearingFurther Proceedings
References
Case No. ADJ4348361 (STK 0170600)
Regular
Aug 02, 2012

Richard Horton vs. Crown Cork and Seal, American Protection Insurance Company, BROADSPIRE, Travelers Property Casualty Company of America

This case concerns defendant American Protection Insurance Company's (APIC) petition for contribution from Travelers Insurance Company for benefits paid to applicant Richard Horton. The Arbitrator denied APIC's petition, finding contribution was precluded because a prior stipulated award did not grant "new and distinct benefits." The Appeals Board granted reconsideration, rescinding the Arbitrator's decision. The Board determined that a supplemental award granting new and further permanent disability, including a psyche injury claim, constituted new and distinct benefits subject to contribution, even if the original award was time-barred. The matter was returned for further proceedings to determine the extent of APIC's contribution rights.

ContributionReconsiderationPetition to ReopenNew and Further DisabilityInjury to the PsycheCompensable ConsequenceStipulated AwardArbitrator"New and Distinct Benefits"Labor Code Section 5500.5
References
Case No. ADJ3699036 (MON 0237012)
Regular
Apr 10, 2009

KAREN TYARS vs. NEW AGE GROUP; CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, By Its Servicing Facility BROADSPIRE, For CALIFORNIA COMPENSATION INSURANCE COMPANY, In Liquidation

This case involves a workers' compensation applicant who sustained a prior industrial injury. The defendant sought reconsideration of a WCJ's award concerning temporary disability and the validity of their Medical Provider Network (MPN). The Appeals Board granted reconsideration because the record was insufficient to determine the basis for the WCJ's decision, particularly regarding the MPN notices and temporary disability entitlement. The matter was returned to the trial level for further proceedings and a new decision with a properly developed record.

WORKERS' COMPENSATION APPEALS BOARDMEDICAL PROVIDER NETWORK (MPN)TEMPORARY DISABILITY INDEMNITY (TDI)FINDINGS AND AWARDPETITION FOR RECONSIDERATIONLABOR CODE SECTION 4616ADMINISTRATIVE DIRECTOR RULE 9767.9TRANSFER OF CAREINDUSTRIAL INJURYSTIPULATED AWARD
References
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