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

Case No. ADJ7865722
Regular
Feb 24, 2014

ILIA JAROSTCHUK vs. SAN FRANCISCO 49ERS, CHARTIS

The Workers' Compensation Appeals Board denied the lien claimant ARS' Petition for Reconsideration. The Board adopted the WCJ's report, finding ARS failed to support its contentions with specific record references. Furthermore, the Board found that ARS, as the lien claimant, did not meet its burden to prove its charges were reasonable and necessary. The denial is consistent with legal precedent and procedural rules.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ClaimantARS LegalCopy ServicesReasonableness of ChargesBurden of ProofProfessional AthleteStipulations with Request for AwardFindings and Award
References
Case No. ADJ7874903
Regular
Feb 22, 2018

Abraham Gonzalez vs. Jose Echeverry, Echeverry Family Trust

The Workers' Compensation Appeals Board (WCAB) rescinded the trial judge's finding that the applicant was not an employee. The applicant claimed an industrial injury while working as a laborer for the defendant, who was uninsured. The core issue was whether the applicant was an employee or an independent contractor, with the defense arguing an exemption under Business and Professions Code section 7048 for jobs under $500. The WCAB found the record insufficient, particularly regarding the total contract price of the project, and returned the case for further development and a new decision.

Workers' Compensation Appeals BoardADJ7874903Abraham GonzalezJose EcheverryEcheverry Family TrustOpinion and Decision After ReconsiderationFindingsregular hourly employeeemployment relationshipuninsured
References
Case No. ADJ4444900 (GOL 0088920)
Regular
Dec 22, 2020

JACQUELIN NORTON vs. PRICE, POSTEL & PARMA, LLP, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for HIH INSURANCE COMPANY in liquidation

The Workers' Compensation Appeals Board (WCAB) is returning the case of Jacquelin Norton v. Price, Postel & Parma, LLP to the trial level. This action is to allow the judge to review a proposed settlement reached by the parties. The original decision is rescinded, and if the settlement is not approved, the original decision can be reinstated. This decision is not a final determination on the merits.

ReconsiderationRescinded DecisionReturned to Trial LevelProposed SettlementWorkers' Compensation Appeals BoardWCJFindings of Fact and AwardLiquidationInsurance Guarantee AssociationCC&R 10961
References
Case No. ADJ1394329
Regular
Sep 17, 2008

GARY MAGEE vs. R&M ASSOCIATES, INC., ATLANTIC MUTUAL

The Appeals Board rescinded the WCJ's decision on the reasonableness of a lien claim for surgery center fees and returned the case for further proceedings.

WCABReconsiderationLien ClaimantOutpatient Surgery CenterReasonable FeeBill ReviewGeographical SurveyMedicare RateOutpatient Fee ScheduleCHSWC Study
References
Case No. LAO 0810761
Regular
May 13, 2008

LARRY D. MAXWELL vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, Administered by SEDGWICK CMS

The Workers' Compensation Appeals Board denied the lien claimant's petition for reconsideration. The lien claimant sought full payment for surgical services, arguing the judge erred by not applying the *Kunz* en banc decision and by not accepting their billed amount as proof of reasonableness. The Board affirmed the judge's decision, holding that the lien claimant bears the burden of proving the reasonableness of charges, and merely presenting a bill does not automatically establish it, even without rebuttal evidence from the defendant.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and AwardCompromise and ReleaseIndustrial InjuryUlnar Nerve TranspositionShoulder ArthroscopyKunz v. Patterson Floor CoveringsOfficial Medical Fee Schedule
References
Case No. ADJ2980735 (SBR 0315690)
Regular
Oct 24, 2008

Patrick Young vs. Ken Anderson Construction, State Compensation Insurance Fund

The Workers' Compensation Appeals Board denied reconsideration of a decision that disallowed a lien claimant's remaining balance of $\$ 31,044.00$ for surgical facility fees. The Board affirmed the finding that the lien claimant failed to prove the reasonableness of its charges, as the submitted bills were inadmissible and unauthenticated. Citing recent case law, the Board clarified that lien claimants bear the burden of proving the reasonableness of their charges.

Workers' Compensation Appeals BoardPremier Outpatient Surgery CenterLien ClaimantReconsiderationFindings and OrderFacility FeesReasonableness of ChargesLabor Code Section 5703AdmissibilityCross-examination
References
Case No. ADJ2192080 (POM 0289726)
Regular
Jan 19, 2016

MARTHA NOLASCO vs. CITIZENS BUSINESS BANK, FEDERAL INSURANCE, CHUBB GROUP

The Workers' Compensation Appeals Board granted reconsideration and affirmed the prior order, finding that Med-Legal's photocopying services were medical-legal expenses incurred to prove a contested claim. However, Med-Legal failed to demonstrate that its charges for these services were reasonable, and therefore is not entitled to additional payment beyond what the defendant already paid. Issues regarding penalties and interest were deferred.

Workers' Compensation Appeals BoardLien ClaimantMedical-Legal ExpensesPhotocopying ServicesReasonableness of ChargesPetition for CreditCompromise and ReleaseBurden of ProofMarket Rate ComparisonsFee Schedule
References
Case No. ADJ7432904
Regular
Sep 24, 2012

NEDA MOTAVAKEL vs. FANTASTIC SAM'S, TOWER SELECT INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, STAR INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, ENDURANCE WORKERS' COMPENSATION, SOUTHERN INSURANCE CO., FIRSTCOMP OMAHA

This case involves an appeal by Star and Tower Insurance Companies regarding a workers' compensation award. The primary issue is the applicant's average weekly earnings, specifically the inclusion of tip income, which was not adequately substantiated by documentary evidence. The Appeals Board found the initial decision lacked substantial evidence regarding earnings and rescinded the award. The matter is remanded for further proceedings to properly develop the evidentiary record on earnings and insurance coverage dates before a new decision is issued.

Workers' Compensation Appeals BoardNeda MotavakelFantastic Sam'sTower Select Insurance CompanyStar Insurance CompanyIllinois Midwest Insurance AgencyLLEndurance Workers' CompensationSouthern Insurance CompanyFirstComp Omaha
References
Case No. ADJ6644580
Regular
Aug 30, 2010

EVER GONZALEZ vs. PLUS INTERNATIONAL CORPORATION, CHARTIS COSTA MESA On Behalf Of GRANITE STATE INSURANCE COMPANY

This case involves a worker injured on January 26, 2009, alleging employment by Plus International Corporation. The trial judge found the worker was employed by a subcontractor, Santos, who was unlicensed and uninsured. The Appeals Board granted reconsideration, rescinding the trial judge's finding. The Board remanded the case for further proceedings to develop evidence on whether the applicant was a roofer and if the project's total cost required a contractor's license. The Board noted that if a license was required, the subcontractor's lack of insurance would automatically render them unlicensed.

Labor Code section 2750.5Blew v. Hornerunlicensed contractoruninsured contractorpresumption of employmentrooferspecialty contractorClass C-39 licenseaggregate contract priceautomatic suspension of license
References
Case No. GOL 96757
Regular
Jun 10, 2008

SA YANG LO vs. CUSTOM SENSORS & TECHNOLOGIES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a prior award, upholding the application of the 2005 Permanent Disability Rating Schedule. The Board found that exceptions allowing for the 1997 Schedule did not apply, as the applicant's temporary disability indemnity extended beyond January 1, 2005, and no qualifying pre-2005 reports indicated permanent disability. Furthermore, the Board found the applicant's vocational expert's opinion regarding diminished future earning capacity unpersuasive, thus affirming the initial 9% permanent disability rating.

Workers' Compensation Appeals BoardSA Yang LoCustom Sensors & TechnologiesInc.State Compensation Insurance FundGOL 96757Opinion and Order Denying ReconsiderationFindings and AwardWorkers' Compensation Administrative Law JudgeWCJ
References
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