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

Case No. ADJ7208535
Regular
Oct 09, 2014

MARIA DORAME vs. AZTEC HARVESTING, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of an order dismissing DNM Pharmacy's lien claim. The Board adopted the administrative law judge's report, finding DNM Pharmacy failed to demonstrate good cause for not appearing at the lien trial or for not objecting to the notice of intention to dismiss the lien. Additionally, the Board admonished DNM Pharmacy and its representative for failing to comply with specific rules regarding lien claimant representation. DNM Pharmacy's lien was for $2,089.06 for medication related to the applicant's psyche injury, which was dismissed as part of a Compromise and Release agreement.

Maria DorameAztec HarvestingZenith Insurance CompanyPetition for ReconsiderationOrder Denying PetitionLien ClaimantDNM PharmacyCalifornia Lien Claimant NetworkSection 10774.5Workers' Compensation Administrative Law Judge
References
0
Case No. ADJ6981750
Regular
Jan 13, 2017

GUMERSINDO DELEON vs. ESPARZA ENTERPRISES, INC.

This case concerns a lien claimant's failure to pay a $100.00 lien activation fee required by Labor Code section 4903.06 by the date of a lien conference. The Workers' Compensation Appeals Board (WCAB) is considering rescinding the order dismissing the lien, but only if the fee is paid within ten days of this notice. The WCAB's intention is based on a court order allowing lien activation fees to be paid between November 9, 2015, and December 31, 2015, and the lien claimant's assertion of computer problems. If payment is received, the lien claim will be returned to the trial level for further proceedings.

Lien activation feeLabor Code Section 4903.06ReconsiderationOrder Dismissing Lien ClaimWCJDWCAngelotti Chiropractic v. BakerPreliminary injunctionNinth CircuitVacating injunction
References
7
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
2
Case No. MISSING
Regular Panel Decision

Innoviant Pharmacy, Inc. v. Morganstern

Innoviant Pharmacy, Inc. sued its former sales executive, Max Morganstern, for unfair competition and breach of a non-compete agreement after he joined a competitor, Summit Pharmacy, Inc., and solicited Innoviant's customer referral sources. Innoviant sought a preliminary injunction to prevent Morganstern from contacting 114 key New York referral sources. The court found Innoviant unlikely to succeed on its breach of contract claim because the employment agreement was deemed unenforceable due to a later signed document. However, the court found Innoviant likely to succeed on its unfair competition claim, as Morganstern misappropriated a list of potential referral sources and business cards. Consequently, the court granted the preliminary injunction, restraining Morganstern from contacting the specified referral sources until February 24, 2006, conditioned on Innoviant posting a $100,000 security bond.

Preliminary InjunctionUnfair CompetitionBreach of ContractNon-compete ClauseTrade SecretsCustomer ListsConfidential InformationEmployment AgreementSales ExecutiveReferral Sources
References
50
Case No. ADJ7233690, ADJ7233689
Regular
Dec 15, 2014

, ANGELLA GALINDO vs. , SODEXO; INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA; GALLAGHER BASSETT SERVICES

The Workers' Compensation Appeals Board denied DNM Pharmacy's petition for reconsideration of a dismissed lien claim. DNM Pharmacy failed to appear at a scheduled lien conference and subsequently failed to object to the Notice of Intention to Dismiss Lien. The Board found no good cause for DNM Pharmacy's non-appearance, rejecting arguments about not receiving a Declaration of Readiness and the defendant's failure to initiate a call. The WCJ's dismissal of the lien was therefore upheld.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Dismissing LienLien ClaimantDNM PharmacyWCJDeclaration of Readiness to ProceedLien ConferenceNotice of Intention to Dismiss LienBoard Rule 10562
References
0
Case No. ADJ4713838 (MON 0335494)
Regular
Mar 15, 2013

PHYLLIS SWINK vs. AVIS RENT-A-CAR, CNA CLAIMS PLUS

This case concerns a lien claimant, KVP Pharmacy, seeking reconsideration of a prior order dismissing its lien. KVP Pharmacy argued the dismissal order was invalid due to an unsigned and undated document. However, the Appeals Board dismissed KVP Pharmacy's petition because it was filed approximately six months after the lien dismissal order was served. The Board found the petition to be untimely, as California Labor Code requires reconsideration petitions to be filed within 20 days, plus an additional five days if served by mail. Therefore, the Board lacked jurisdiction to consider the merits of KVP Pharmacy's arguments.

WCABLien ClaimantPetition for ReconsiderationUntimely PetitionOrder Dismissing LienWCJService by MailRecital of ServicePresumption of ReceiptLabor Code
References
4
Case No. ADJ8 156794
Regular
Jan 12, 2017

NURY PEREZ vs. BLUE RIVER DENIM, THE HARTFORD

The Workers' Compensation Appeals Board (WCAB) is considering rescinding an order that dismissed a lien claim due to a failure to pay a $100 lien activation fee. The lien claimant, Premier Psychological Services (PPS), claims computer issues prevented timely payment. While the WCJ recommended denial of reconsideration, the WCAB may rescind the dismissal if PPS pays the activation fee within ten days of this notice. If paid, the lien claim will be returned to the trial level for further proceedings.

Lien activation feeLabor Code section 4903.06WCABadministrative law judgereconsiderationrescissiondismissallien conferenceCompromise and Releaseindustrial injury
References
1
Case No. 2021 NY Slip Op 03820 [195 AD3d 776]
Regular Panel Decision
Jun 16, 2021

21st Century Pharmacy v. American Intl. Group

21st Century Pharmacy appealed a Supreme Court order that dismissed its declaratory judgment action against American International Group (AIG) and the New York Workers' Compensation Board (WCB). The pharmacy sought a declaration that it could pursue payment for prescription bills in a plenary court proceeding, rather than solely through the WCB, and also sought a monetary judgment. The Supreme Court dismissed the complaint, asserting the WCB had exclusive subject matter jurisdiction. The Appellate Division, Second Department, reversed this decision, clarifying that while the WCB holds primary jurisdiction over Workers' Compensation Law applicability, it does not possess exclusive jurisdiction in a declaratory judgment action. The case was remitted to the Supreme Court for a determination on the merits of AIG's motion to dismiss.

Declaratory JudgmentSubject Matter JurisdictionWorkers' Compensation LawPrimary JurisdictionExclusive JurisdictionPrescription BillsAppellate ProcedureRemittalPharmacy RightsCourt Jurisdiction
References
8
Case No. ADJ3 176427 (AHM 0148942)
Regular
Feb 03, 2016

GILBERT LUNA vs. NATIONWIDE PHARMACY, LIBERTY MUTUAL

The Workers' Compensation Appeals Board affirmed a prior decision finding that Nationwide Pharmacy and Liberty Mutual's payment of $52,481.40 for spinal surgery was reasonable. Lien claimant Monrovia Memorial Hospital sought reconsideration, arguing a higher fee was warranted and they were exempt from the Official Medical Fee Schedule. However, the Board found that while the hospital was exempt from the fee schedule, it still had the burden to prove the reasonableness of its charges. The lien claimant failed to meet this evidentiary burden by a preponderance of the evidence.

Monrovia Memorial HospitalLien claimantOfficial Medical Fee ScheduleOMFS exemptionReasonable feeUsual and customary reimbursementBurden of proofFacility feesLong term care hospitalTitle 42 Code of Regulations
References
2
Case No. ADJ9839416
Regular
Aug 21, 2018

SILVIA RAMOS vs. MILLENNIUM MAINTENANCE SYSTEMS, INC.

Mesa Pharmacy sought reconsideration of a decision that stayed its lien under Labor Code section 4615 and found another lien claimant was not the defendant's responsibility. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, rescinding the prior order. The WCAB deferred the issue of Mesa's lien stay and returned it to the trial level for evaluation regarding its exclusion from a consolidated proceeding involving thousands of other Mesa Pharmacy liens. This decision is not a final determination on the merits of Mesa's lien.

Labor Code section 4615Petition for ReconsiderationFindings and Orderlien claimantconsolidationmaster fileWCAB Rule 10589common issues of fact and lawcriminal proceedingsownership and control
References
1
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