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

Case No. SAL 0048019
Regular
May 28, 2008

CONN TRENNER vs. MONTEREY PENINSULA AIRPORT DISTRICT, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration, reversing the finding of unreasonable delay in authorizing the applicant's ablation procedure. However, the Board affirmed the finding of unreasonable delay in SCIF's payment of the applicant's co-payment for the procedure, upholding the associated penalty. The matter was returned to the trial level to determine the appropriate attorney's fee award under Labor Code section 5814.5.

Labor Code section 5814Labor Code section 4610Labor Code section 5814.5utilization reviewunreasonable delaypenaltyablation procedureco-paymentreimbursementattorney's fees
References
1
Case No. ADJ2965812 (SAC 0308365)
Regular
Apr 23, 2012

CHRISTINE KRAUSE vs. STATE OF CALIFORNIA, SECRETARY FOR RESOURCES AGENCY, Legally Uninsured, Adjusted By STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) rescinded an order compelling the defendant to provide cervical spine surgery, deferring the issue pending a final report from a Spinal Surgery Second Opinion Physician (SSSOP). The SSSOP's report was delayed beyond the statutory 45-day timeframe, but the WCAB found neither party was at fault for this delay, and obtaining the SSSOP's opinion was crucial for a proper decision. The WCAB dismissed the defendant's petition for removal. A dissenting commissioner argued the defendant should be liable for the surgery due to the delayed process, citing precedent that placed the burden on the employer to ensure timely adherence to statutory procedures.

Workers' Compensation Appeals BoardPetition for ReconsiderationSpinal Surgery Second Opinion PhysicianUtilization ReviewLabor Code Section 4062(b)Industrial InjuryCervical Spine SurgeryTreating PhysicianIndustrial InjuryDeclaration of Readiness to Proceed
References
4
Case No. ADJ3139846 (MON 292120)
Regular
Mar 23, 2009

CHAUNCEY HUGHES vs. CITY OF LOS ANGELES, Permissibly Self-Insured, TRISTAR RISK MANAGEMENT

The defendant sought reconsideration of an administrative law judge's award of a $10,000 penalty and attorney fees for allegedly delaying payment of a prior award. The Board granted reconsideration, finding the delay was not unreasonable because the defendant was not properly served with the June 26, 2008 decision under the operative procedural rules. As service was improper, the Board rescinded the penalty and attorney fees.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardUnreasonable DelayLabor Code § 5814PenaltyLabor Code § 5814.5Attorney FeesVocational Rehabilitation Maintenance AllowanceService of Process
References
2
Case No. SFO 0489777, SFO 0500802
Regular
Sep 27, 2007

DESIREE GOTUACO vs. IMPERIAL CAPITAL BANK, LIBERTY MUTUAL FIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded a $\$100$ sanction imposed on applicant's counsel. The Board found that while counsel made procedural errors by contacting the presiding judge instead of the assigned judge, there was no evidence of bad faith or intent to delay. The Board concluded that imposing sanctions under these circumstances would be unjust, as counsel acted with reasonable justification, albeit with a mistaken understanding of proper procedure.

Workers Compensation Appeals BoardPetition for ReconsiderationOrder Imposing SanctionsAdministrative Law Judge Pro TemporeIndustrial InjuryCervical SpineStipulated AwardDeclaration of Readiness to ProceedMandatory Settlement ConferenceDiscovery Closed
References
1
Case No. ADJ10834446
Regular
Sep 22, 2017

Miguel Cueva vs. Pacific American Fish, Alaska National Insurance Co.

Applicant sought reconsideration of an order approving a compromise and release, alleging the defendant unreasonably delayed payment and seeking penalties. The Appeals Board dismissed the petition, clarifying that it was not a proper petition for reconsideration of the original order. Instead, the applicant's claims regarding delayed payment should be addressed at the scheduled status conference. The Board emphasized that a petition for reconsideration must be taken from a final order, not a procedural dispute about payment execution.

Workers' Compensation Appeals BoardMiguel CuevaPacific American FishAlaska National Insurance Co.ADJ10834446Petition for ReconsiderationOrder Approving Compromise and ReleaseWCJLabor Code Section 5814(a)Penalty
References
4
Case No. SBR 0331758
Regular
Apr 21, 2008

MITZI L. THOMAS vs. BAKERS BURGERS, INC., STATE COMPENSATION INSURANCE FUND

The Appeals Board affirmed the WCJ's award for self-procured medical treatment due to the defendant's significant delay in authorizing a necessary MRI, which was requested by their own MPN physicians from the outset. The Board found that this delay, combined with other failures in providing timely and adequate treatment, excused the applicant from strictly adhering to MPN dispute resolution procedures. Therefore, the defendant was liable for the applicant's reasonable, self-procured medical expenses.

Workers Compensation Appeals BoardMitzi L. ThomasBakers Burgers Inc.State Compensation Insurance FundSBR 0331758ReconsiderationIndustrial InjuryBilateral WristsBilateral KneesNeck
References
11
Case No. ADJ543664
Regular
Oct 05, 2010

Timothy Escalera vs. PROGRAPHICS, PREFERRED EMPLOYERS

The applicant sought reconsideration of a Stipulations and Award order that omitted his attorney's fee. The original judge approved the stipulations for a shoulder and neck injury but failed to address the fee due to a procedural defect in notice. The Appeals Board granted reconsideration, rescinded the award, and returned the case to the trial level. This allows for proper proceedings to consider and award the applicant's attorney fee, emphasizing the proper use of procedural rules to avoid delays.

Workers' Compensation Appeals BoardPetition for ReconsiderationStipulations and AwardIndustrial InjuryRight ShoulderNeckWarehouse WorkerAttorney FeeWCJReport and Recommendation
References
0
Case No. AD J9690520, AD J9690521
Regular
Mar 23, 2016

BRETT BUNGE vs. BEN F. SMITH, INC.; ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board dismissed the Petition for Reconsideration because the underlying order was procedural and not a "final" order determining substantive rights or liabilities. The Board also denied the Petition for Removal, finding no substantial prejudice or irreparable harm justifying this extraordinary remedy. The Board admonished the applicant's attorney for filing an improper petition that could cause delay and potential sanctions. Ultimately, the Board affirmed the WCJ's decision regarding the procedural/evidentiary issue.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFinal OrderInterlocutory OrderThreshold IssueSubstantive LiabilityExtraordinary RemedySubstantial PrejudiceIrreparable Harm
References
0
Case No. ADJ4349754 (OXN 0124391)
Regular
Feb 08, 2013

JOSE TOSTADO vs. JM SMUCKER COMPANY, BROADSPIRE

Defendant JM Smucker Company seeks reconsideration of an award granting applicant Jose Tostado a 25% penalty for delayed life pension benefits and attorney fees. The defendant also contests sanctions imposed by the WCJ for bad faith tactics under Labor Code section 5813. The Board denied reconsideration, affirming the WCJ's finding of unreasonable delay in benefit payment. However, the Board remanded for a new Notice of Intention to Sanction due to procedural deficiencies in identifying the party to be sanctioned.

Workers' Compensation Appeals BoardJM Smucker CompanyBroadsopireJose TostadoFindings AwardSanctionsLabor Code Section 5813Bad Faith TacticsDue ProcessPetition to Reopen
References
0
Case No. ADJ6849643
Regular
May 20, 2013

CHARLES MALINOWSKI vs. HSM ELECTRONIC PROTECTION SERVICES, INC., SPECIALTY RISK

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's petition for reconsideration of an order setting the case for trial and closing discovery, as such procedural orders are not final and thus not subject to reconsideration. The WCAB granted removal on its own motion, finding the defendant's petition frivolous and indicative of bad faith tactics intended to delay proceedings. Consequently, the WCAB issued a notice of intention to sanction the defendant and its counsel jointly and severally, up to $1,500, for their improper procedural filing. The matter will proceed with trial pending the resolution of the sanctions issue.

RemovalPetition for ReconsiderationDismissalSanctionBad FaithFrivolousLabor Code Section 5813Title 8 Section 10561Interlocutory OrderVocational Rehabilitation Expert
References
9
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