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

Case No. ADJ237189 (RIV 0058701)
Regular
May 22, 2009

DONALD K. SMITH vs. CITY OF SANTA ANA

This case concerns an applicant's attorney's petition for reconsideration regarding appellate costs and attorney's fees. The Workers' Compensation Appeals Board affirmed its prior decision, which had affirmed the finding of industrial injury to the heart and prostate but barred the skin cancer claim due to the statute of limitations. The Board ordered the applicant's attorney to reimburse the applicant $390 improperly solicited and received, while ordering the defendant to pay appellate costs of $382.79 upon confirmation of the reimbursement. The Board declined to increase the attorney's fee, finding it already exceeded typical ranges and that the attorney had not demonstrated entitlement to more.

Workers' Compensation Appeals BoardReconsiderationRemittiturStatute of LimitationsSkin CancerHeart InjuryProstate CancerPermanent DisabilityAttorney's FeeAppellate Costs
References
2
Case No. ADJ2834079 (SDO 0293027) ADJ2839895 (SDO 0358837)
Regular
Jun 25, 2009

THUAN CRIM-ROLFE vs. LA COSTA RESORT AND SPA, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LEGION INSURANCE COMPANY, BROADSPIRE, SAFETY NATIONAL CASUALTY INSURANCE COMPANY

This case involves a clerical error in a prior Workers' Compensation Appeals Board (WCAB) decision. The WCAB previously ordered Safety National Casualty Insurance Company (SNCC) to reimburse the California Insurance Guarantee Association (CIGA) a specific amount for bill review charges. CIGA requested clarification, noting the amount ordered was incorrect. The WCAB affirmed its earlier decision that CIGA is entitled to reimbursement for bill review costs but amended the order nunc pro tunc. The corrected order now states SNCC must reimburse CIGA for bill review charges, with the exact amount to be determined by the parties or the arbitrator.

California Insurance Guarantee AssociationLegion Insurance CompanySafety National Casualty Insurance Companynunc pro tuncclerical errorbill review chargesliquidationcovered claimsreimbursementpetition for reconsideration
References
6
Case No. ADJ7427357; ADJ7427846 ADJ7427807; ADJ7427721 ADJ7427560; ADJ7429915 ADJ7429913; ADJ7429912 ADJ7427816; ADJ7427731 ADJ7427716; ADJ7427554 ADJ7429914; ADJ7427420
Regular
Apr 12, 2012

DELVIN WILLIAMS vs. SAN FRANCISCO 49ERS and ARGONAUT INSURANCE COMPANY and FIREMAN'S FUND INSURANCE COMPANY, MIAMI DOLPHINS, Permissibly Self-Insured, Administered by MULTI-LINE CLAIMS SERVICE, GREEN BAY PACKERS and HIGHLANDS INSURANCE GROUP, in Receivership

This case concerns a professional football player seeking reimbursement for medical-legal costs incurred in his workers' compensation claims against multiple teams. The Appeals Board granted the applicant's petition for removal, rescinding a prior order that denied these costs. The Board held that a statute of limitations defense does not bar reimbursement of reasonable medical-legal expenses if the applicant is determined to be an employee. However, subject matter jurisdiction issues with certain defendants require further adjudication, and the San Francisco 49ers, who do not dispute jurisdiction, are ordered to reimburse these costs pending further proceedings.

Petition for RemovalMedical-Legal CostsStatute of LimitationsSubject Matter JurisdictionAffirmative DefenseCumulative Trauma InjurySpecific InjuriesDeclaration of Readiness to ProceedMandatory Settlement ConferencePretrial Conference Statement
References
6
Case No. ADJ422285
Regular
Jun 01, 2010

KATHLEEN JONES vs. PALMDALE SCHOOL DISTRICT; TIG administered by RISK ENTERPRISE MANAGEMENT

The defendant sought removal of an order requiring reimbursement for deposition costs, arguing procedural error and that a less costly method was available. The Appeals Board denied removal, deeming the order a final decision on costs subject to reconsideration. The Board granted reconsideration on its own motion due to the order's non-compliance with procedural rules for "walk-through" orders. Consequently, the Board rescinded the original order and returned the matter to the trial level for further proceedings.

Petition for removalOrder for costsDeposition costsSupplemental reportDue processGood cause objectionReconsideration on Board motionFinal orderSubstantive rightLiability
References
5
Case No. ADJ4399114 (POM 0281905) MF
Regular
Jun 27, 2013

RICARDO GARCIA vs. AMERICAN STAFF RESOURCES OF CALIFORNIA/TRIMCO, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for CASCADE INSURANCE COMPANY, in liquidation, STATE COMPENSATION INSURANCE FUND

This case involves the State Compensation Insurance Fund (SCIF) seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision. The WCAB ordered SCIF to reimburse the California Insurance Guarantee Association (CIGA) $27,082.67 for costs incurred in a workers' compensation claim previously settled by SCIF. SCIF argued CIGA failed to prove reasonableness of costs and timely tendered the claim. The WCAB denied SCIF's petition, affirming the prior award, finding CIGA's expenditures were reasonable and necessary given SCIF's stipulation to the amounts spent and lack of evidence to the contrary. The Board clarified CIGA's legal status but upheld the reimbursement order based on statutory obligations and public policy.

Workers' Compensation Appeals BoardState Compensation Insurance FundCalifornia Insurance Guarantee AssociationCIGAreimbursementreasonable costsnecessary expenditurecompromise and releaseinvoluntary association of insurersstatutory duties
References
2
Case No. ADJ8314191
Regular
Apr 27, 2015

JUAN MELO vs. THE SAN FRANCISCO GIANTS, ACE AMERICAN INSURANCE COMPANY, THE GOLDEN BASEBALL LEAGUE, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and rescinded a Workers' Compensation Judge's (WCJ) order for reimbursement of costs. The WCJ had ordered the State Compensation Insurance Fund (SCIF) to pay $1,350.00 to applicant's attorney for delays in clarifying insurance coverage. However, the Board clarified that Labor Code section 5811(a) does not permit the award of attorney's fees as costs, and any such award under Labor Code section 5813 would require proper notice and an opportunity to be heard, which was not provided. Therefore, the WCJ's order was improper.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder for Reimbursement of CostsLabor Code section 5811(a)State Compensation Insurance Fund (SCIF)Coverage issuesContinuous trauma claimInsurance policyRidersPolicy premium
References
4
Case No. MISSING
Regular Panel Decision

New York City Board of Education v. Ambach

This CPLR article 78 proceeding challenged a determination by the Commissioner of Education. The Commissioner ordered the petitioner, the Committee on the Handicapped, District 28 (COH), to reimburse Marilyn P. for tuition and maintenance costs for her handicapped child. The COH had initially found the child not handicapped and failed to provide timely formal written notice of its determination to the mother, violating Education Law regulations. An independent hearing officer reversed the COH's finding but denied reimbursement. Upon appeal, the Commissioner affirmed the handicapped finding and ordered reimbursement due to the COH's procedural violations. The court upheld the Commissioner's finding that the child was handicapped and the entitlement to reimbursement, citing a rational basis for the decision and deference to the agency's interpretation. However, the court modified the determination, annulling the order for the petitioner to pay the full cost, and remitted the matter for apportionment of costs between the petitioner and the State of New York, as per Education Law sections 4405 and 4407.

CPLR Article 78Administrative ReviewEducation LawHandicapped Child PlacementTuition ReimbursementProcedural Due ProcessNotice RequirementsTimeliness ViolationsAgency DeferenceCost Apportionment
References
10
Case No. ADJ2151993 (SFO 0507276)
Regular
May 18, 2018

RICHARD JOHNSON vs. CITY OF SOUTH SAN FRANCISCO, CITY OF PACIFICA

This case concerns the award of appellate costs to the City of Pacifica. The Court of Appeal previously affirmed a decision in Pacifica's favor and ordered the City of South San Francisco (CSSF) to bear Pacifica's costs. Pacifica subsequently submitted a verified petition for costs totaling $1,425.00, which included electronic filing and paper copy expenses. The Workers' Compensation Appeals Board found Pacifica's requested costs reasonable and awarded them against CSSF.

Workers' Compensation Appeals BoardRemittiturFirst District Court of AppealPetition for ReconsiderationArbitratorPetition for CostsAppellate CostsReimbursementVerified PetitionSubstantiation of Costs
References
1
Case No. ADJ7847287
Regular
Sep 20, 2011

MICHAEL WATERS vs. CHARTER COMMUNICATIONS, NEW HAMPSHIRE INSURANCE CO., BROADSPIRE

The WCAB granted reconsideration and rescinded an administrative law judge's order compelling the defendant to advance $2,000 to the applicant's attorney for a vocational expert's costs. While acknowledging that advances on permanent disability are common, the Board found the specific order to pay an attorney's trust account for potential future expert costs lacked statutory basis. The Board clarified that the applicant's attorney may incur such costs at their own expense and then seek reimbursement if deemed reasonable and necessary.

Petition for RemovalPetition for Reconsiderationvocational expertdiminished future earning capacitypermanent disabilityrehabilitation experttrust accountadvance costsreimbursementLabor Code sections 5811
References
3
Case No. MISSING
Regular Panel Decision

Bell Aircraft Corp. v. Siegler

The court affirmed both the final and intermediate orders without costs in this matter. The case primarily involved an appeal from an order that had found several defendants guilty of criminal contempt of court. Additionally, the appeal also addressed an order which denied a motion seeking to resettle an order of commitment. Furthermore, a motion to vacate and perpetually stay the orders of commitment was also denied. All presiding judges concurred with the decision.

Criminal ContemptOrder of CommitmentResettlement MotionVacate MotionStay OrdersAppellate ReviewOrder AffirmedJudicial Concurrence
References
1
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