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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ1385972 (LBO 0378379)
Regular
Aug 01, 2013

AMELIA CUEVAS vs. IMAGINE FULFILLMENT SERVICES, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded an administrative law judge's order awarding costs to a lien claimant for photocopying services. The Board held that medical-legal expenses, including photocopying, are not recoverable under Labor Code section 5811. The original order was also deemed vague and potentially void for not clearly defining the parties' rights and obligations. The case is returned to the trial level for further proceedings.

Workers' Compensation Appeals BoardLabor Code §5811Petition for CostsLien ClaimantPhotocopying ServicesMedical-Legal ExpensesReconsiderationWCJ OrderRescindedTimeliness of Petition
References
Case No. ADJ1784264 (MON 0302991) ADJ2898466 (MON 0339769)
Regular
Oct 14, 2011

GIRGIS FAM vs. UCLA MEDICAL CENTER, permissibly self-insured, Administered by Sedgwick Claims Management Services

This case concerns the selection of a child care provider for a permanently and totally disabled applicant. The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for reconsideration. The WCAB reversed the judge's decision, allowing the applicant to select his own child care provider, reasoning that this service is personal, similar to selecting a physician. The Board emphasized that the continuity of care and applicant's confidence in the provider outweigh the employer's desire to use a licensed and bonded provider selected by them.

Workers' Compensation Appeals BoardPetition for ReconsiderationSupplemental Findings and AwardPermanently totally disabledCaretaking servicesChild care servicesGardening servicesPool maintenance servicesStructural modificationsCauda-equina syndrome
References
Case No. ADJ8064878
Regular
Aug 07, 2018

LATASHA WOODSON vs. COUNTY OF RIVERSIDE

This case involves a lien claimant, Western Imaging Services, seeking payment for copying services. The original judge disallowed the lien, finding the services duplicative and unnecessary, and that the claimant was not a licensed professional photocopier. The Appeals Board rescinded this decision, remanding the case for further proceedings. Key issues to be re-examined include the timeliness and specificity of the defendant's objections to the lien claimant's invoices, and whether the claimant is exempt from professional photocopier registration due to their independent contractor status with the applicant's attorney.

Workers' Compensation Appeals BoardReconsiderationLien ClaimantDuplicative ServicesUnnecessary ServicesLicensed Professional PhotocopierAdministrative Law JudgeContested ClaimMedical-Legal ExpensesLabor Code
References
Case No. ADJ9128634
Regular
Apr 22, 2016

PATRICIA DECUIR vs. COLLEGE HOSPITAL; ZURICH NORTH AMERICAN, administered by PATRIOT RISK SERVICES

In this workers' compensation case, the lien claimant, Med-legal Photocopy, sought reconsideration after its lien for $1,708.69 was denied. The Workers' Compensation Appeals Board denied the petition, upholding the finding that the lien claimant failed to prove its services were reasonable and necessary to resolve a contested claim. The Board noted the lien claimant provided no evidence detailing the records obtained or their use in litigation. Furthermore, the lien claimant did not adequately justify its per-page scanning charges, which significantly exceeded the rates outlined in the copy service fee schedule.

Lien claimantPetition for ReconsiderationFindings and OrderWorkers' Compensation Appeals BoardWCJunreasonable and unnecessary servicescontested claimlien claimant burden of proofcopy service fee schedulepenalties and interest
References
Case No. ADJ8475421
Regular
Mar 30, 2017

Jessica Duncan vs. Right At Home, Travelers Diamond Bar

The Workers' Compensation Appeals Board denied reconsideration of a lien claimant's claim for medical services. The Board found that the lien, filed on June 4, 2016, was barred by the 18-month statute of limitations under Labor Code section 4903.5(a). This was because the last date of service was August 8, 2013, which fell after the July 1, 2013, implementation date of the 18-month rule. The Board also held that it lacked the authority to rule on constitutional vagueness claims.

Labor Code section 4903.5(a)Lien claimStatute of limitationsReconsiderationWorkers' Compensation Appeals BoardWCJTimelinessDate of servicesContinuous treatmentUnconstitutionally vague
References
Case No. ADJ6662542
Regular
May 11, 2018

MARIA GONZALEZ vs. SERVICIOS AGRICULO MEXICANOS, INC., REDWOOD FIRE AND CASUALTY INSURANCE COMPANY/CYPRESS INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's disallowance of a lien claimant's photocopy services. The Board found substantial evidence that the applicant's injury claim was contested at the time the services were incurred, satisfying a key element for medical-legal expenses. However, the record lacked sufficient evidence regarding the reasonableness and necessity of the services and charges. The case is returned to the WCJ for further proceedings to address these remaining issues.

Workers' Compensation Appeals BoardLien ClaimantMedical-Legal ExpensesContested ClaimExplanation of Review (EOR)Rule 9794Petition for ReconsiderationFindings and Order (F&O)Agreed Medical Examiner (AME)Compromise and Release
References
Case No. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
Case No. ADJ9116549
Regular
Mar 13, 2020

EMMA MEDINA vs. SUNRISE RESTAURANT, LLC, DENNY'S RESTAURANT, CANNON COCHRAN MANAGEMENT SERVICES, CHUBB INSURANCE

This Workers' Compensation Appeals Board case concerns the reimbursement for lien claimant Preferred Scan's copy services. The Board granted reconsideration to clarify what constitutes medical-legal expenses and the reasonable value of copy services. The Appeals Board rescinded the original award and returned the matter for further proceedings, finding that certain copy services for medical records were properly considered medical-legal expenses. However, the reasoning for doubling the copy service fee schedule was insufficient and requires further development at the trial level.

Workers' Compensation Appeals BoardReconsiderationLien ClaimantCopy ServicesMedical-Legal ServicesCopy Service Fee ScheduleLabor CodeSubpoena Duces TecumExplanation of ReviewCompromise and Release
References
Case No. ADJ736716 (ANA 0400973) ADJ3010829 (ANA 0400924) ADJ7503662 ADJ8980493
Regular
Nov 08, 2013

JAIME RAMIREZ vs. HIGH GRADE FORM, BARRETT BUSINESS SERVICES, STATE COMPENSATION INSURANCE FUND, ZURICH, CHARTIS

This case involved a Petition for Reconsideration challenging a lien dismissal. The Appeals Board dismissed the petition, adopting the WCJ's report. The lien was dismissed because the $100 lien activation fee required by Labor Code section 4903.06(a) was not paid, making the necessity of the services irrelevant. While the dismissal applied to services pre-dating July 31, 2012, the Board noted potential future claims for services rendered on May 6, 2013, would require a $150 filing fee and could be pursued as a petition for costs.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien dismissalLabor Code section 4903.06(a)Lien activation feeInterpreting servicesWCAB hearingINJAB RefundablePetition for costsCalifornia Lien Services
References
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