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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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 The Appeals Board rescinded the original award and returned the matter for further proceedings, finding that certain copy services for medical records were properly considered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. 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. ADJ397148 (VNO 0391584)
Regular
Jan 20, 2016

Julie Scheuer vs. COUNTY OF LOS ANGELES, ACCLAMATION INSURANCE MANAGEMENT SERVICE

The Workers' Compensation Appeals Board (WCAB) dismissed Julie Scheuer's petition for reconsideration of a prior award. The petition was dismissed because it was not properly served on all necessary parties as required by California law, including the employer and their adjusting agency. Even if the petition had been properly served, the WCAB stated it would have denied it on its merits based on the WCJ's report. Therefore, the WCAB's order is to dismiss the applicant's petition for reconsideration.

Workers' Compensation Appeals BoardJulie ScheuerCounty of Los AngelesAcclamation Insurance Management ServiceFindings of Fact and Awardpermanent disabilityapportionmentPetition for ReconsiderationLabor Code section 5905service
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. ADJ2031384 (MON 0316510)
Regular
May 29, 2012

Miguel Lopez vs. MV PUBLIC TRANSPORTATION, AMERICAN HOME ASSURANCE, BROADSPIRE

The Workers' Compensation Appeals Board granted reconsideration for lien claimant SAI Professional, rescinding the prior order disallowing its lien. The Board found significant service errors, including failure to notify the lien claimant of the hearing and improper use of designated service for the Notice of Intention (NIT). Crucially, the record lacked proof of service for the NIT, and the lien claimant timely filed an objection to it. The matter is returned to the trial level for further proceedings, emphasizing that lien claimants must receive proper notice and an opportunity to be heard.

Lien claimantPetition for reconsiderationOrder of disallowanceNotice of intentionService of noticeProof of serviceOfficial Address RecordEAMSCompromise and ReleaseDesignated service
References
Case No. ADJ587289 (LBO 0321668)
Regular
202013-05-00

TERESA BACA vs. STATE OF CALIFORNIA DPSS/CALWORKS/GAIN; TRISTAR; STATE COMPENSATION INSURANCE FUND

This case involves a Petition for Reconsideration filed by Pinnacle Lien Services on behalf of lien claimant Dynamed, Inc., challenging a prior Order Imposing Sanctions. The Workers' Compensation Appeals Board (WCAB) dismissed the petition as untimely. Although the petitioner claimed defective service of the sanctions order, the WCAB found that their own records, via the EAMS system, conclusively showed proper service of the relevant orders to Pinnacle Lien Services at their correct address. Therefore, the WCAB denied reconsideration as the petition was not filed within the statutory timeframe.

Workers' Compensation Appeals BoardPetition for ReconsiderationTimelinessOrder Imposing SanctionsNotice of ServiceElectronic Adjudication Management SystemWCABLien ClaimantAdministrative Law JudgeOfficial Record of Service
References
Case No. ADJ1814557 (ANA 0345113)
Regular
Sep 04, 2018

WILLIAM LORANGER vs. AXIUM PAYROLL SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, CREDIT GENERAL INSURANCE COMPANY, INTERCARE INSURANCE SERVICES

Defendant CIGA sought reconsideration of a WCAB decision that found an Order Terminating Temporary Disability from 2009 was not properly served on the applicant. The WCAB denied CIGA's petition, adopting the WCJ's report which found the order was ineffective due to a lack of proper service on the applicant personally, not just their attorney. The Board emphasized that failure to provide notice and an opportunity to be heard raises due process concerns. Therefore, CIGA's petition for reconsideration was denied.

CIGAOrder Terminating Temporary DisabilityService of ProcessDue ProcessPetition for ReconsiderationWCAB RulesProof of ServiceApplicant's AttorneyWorkers' Compensation JudgeFindings of Fact
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. 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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