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

Case No. ADJ7112948
Regular
Mar 30, 2017

LYLE BYNUM vs. VALLEJO TRANSIT, ACE AMERICAN INSURANCE, BROADSPIRE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior award. The Board issued a Notice of Intention to Impose Sanctions against the defendant's attorney and insurance company for alleged bad faith actions. These actions included filing a petition for reconsideration with inaccurate and unsupported references to evidence, misrepresenting medical opinions, and asserting meritless contentions. The WCAB is considering sanctions of up to $2,000 and reasonable expenses due to these alleged violations of labor code and board rules.

Workers' Compensation Appeals BoardPetition for ReconsiderationSanctionsLabor Code § 5813Cal. Code Regs. tit. 8 § 10561Findings and AwardWCJBus DriverBack InjuryLeft Lower Extremity Injury
References
0
Case No. MISSING
Regular Panel Decision

In re Relativity Fashion, LLC

This Memorandum Opinion addresses a motion for attorneys' fees and expenses filed by Relativity Media, LLC (and its affiliates RML Distribution Domestic, LLC, Armored Car Productions, LLC, and DR Productions, LLC, collectively 'Relativity') and Mr. Ryan Kavanaugh against Netflix, Inc. The dispute arose from Netflix's refusal to execute 'Date Extension Amendments' related to a License Agreement, prompting Relativity to seek relief under Section 1142 of the Bankruptcy Code. The Court previously ruled that Netflix was barred by res judicata and judicial estoppel from asserting its claimed contractual rights to distribute films before theatrical release. In this opinion, the Court determined that Relativity was the 'prevailing party' under California Civil Code Section 1717 and the License Agreement's fee provision. Consequently, Relativity is entitled to reimbursement for its own reasonable attorneys' fees and litigation expenses. However, the Court denied Mr. Kavanaugh's request for reimbursement of his counsel's fees and expenses, concluding that he was not a party to the License Agreement and did not meet the exceptions for non-signatories to recover fees. The Court awarded Relativity $818,547.48, comprising $795,732.50 in attorneys’ fees and $22,814.98 in litigation expenses, against Netflix.

Attorneys FeesLitigation ExpensesContract LawCalifornia Civil Code Section 1717Bankruptcy Code Section 1142Prevailing PartyLodestar MethodHourly RatesJudicial EstoppelRes Judicata
References
85
Case No. No. 12
Regular Panel Decision
Apr 01, 2021

The Matter of the Claim of Estate of Norman Youngjohn v. Berry Plastics Corporation

Decedent Norman Youngjohn, employed by Berry Plastics Corporation, suffered work-related injuries to his right shoulder and left elbow in 2014, leading to a workers' compensation claim. Before his permanent partial disability benefits claim for a schedule loss of use (SLU) award was resolved, Youngjohn died in March 2017 from a heart attack unrelated to his work injuries. He left no surviving spouse, minor children, or qualifying dependents. His estate sought the full value of the posthumous SLU award, arguing that 2009 amendments to the Workers' Compensation Law, which permitted lump sum SLU payments, rendered WCL § 15 (4) (d) inapplicable. This section limits an estate's recovery for unaccrued SLU benefits to reasonable funeral expenses in cases of unrelated death without qualifying survivors. The Workers' Compensation Board limited the award to funeral expenses, while the Appellate Division held that the estate was entitled to the portion accrued up to the date of death plus reasonable funeral expenses. The New York Court of Appeals affirmed the Appellate Division's order, concluding that the 2009 amendments on lump sum payments did not implicitly alter WCL § 15 (4) (d)'s limitation on an estate's recovery of posthumous SLU awards. The Court emphasized that section 15 (4) (d) remains in effect and must be harmonized with the amendments, limiting recovery to benefits accrued before death and reasonable funeral expenses for the remainder.

Workers' Compensation LawPermanent Partial DisabilitySchedule Loss of Use (SLU)Lump Sum PaymentEstate RecoveryFuneral ExpensesStatutory InterpretationAccrual of BenefitsNew York Court of AppealsUnrelated Death
References
35
Case No. ADJ8878834
Regular
Dec 22, 2016

RAMIRO CALDERA vs. CAR SOUND EXHAUST SYSTEM, INC.; COMPWEST

This case involves a dispute over lien claimant Western Imaging's entitlement to reimbursement for subpoenaed records in a workers' compensation claim. The WCJ initially disallowed the lien, finding Western Imaging failed to prove the records' reasonableness and necessity. The Appeals Board granted reconsideration, rescinding the WCJ's decision and returning the case for further proceedings. The Board clarified that medical-legal expenses are recoverable if incurred to prove or disprove a contested claim and that reasonableness is assessed at the time of expense incurrence, regardless of whether the subpoenaed records ultimately proved the claim. The Board also emphasized the defendant's obligation to specifically object to such expenses within a timely manner.

Workers' Compensation Appeals BoardLien ClaimantMedical-Legal ExpensesContested ClaimLabor Code Section 4620Labor Code Section 4621Labor Code Section 4622Reasonable and NecessaryBurden of ProofDiscovery
References
9
Case No. MISSING
Regular Panel Decision

Zimnoch v. Bridge View Palace, LLC

Andrzej Zimnoch sustained injuries from a fall at a defendant-owned building, leading to a personal injury lawsuit under Labor Law § 240 (1). An initial jury verdict awarded medical expenses but no pain and suffering, prompting the Supreme Court to order a new trial on damages. During the subsequent damages trial, the jury awarded specific sums for both past and future pain and suffering and medical expenses. The appellate court reviewed this, finding the medical expense award reasonable but concluding that the pain and suffering award was excessive and materially deviated from reasonable compensation. Consequently, the court modified the damages award and upheld the denial of the defendant's request for a collateral source hearing, citing statutory exclusions.

InjuriesDamagesPain and SufferingMedical ExpensesLabor LawCPLRWorkers' CompensationAppellate ReviewJury VerdictNew Trial
References
9
Case No. VNO 0301388
Regular
Sep 05, 2007

JACQUELYN GREEN vs. GENERAL MOTORS CORPORATION, SEDGWICK CLAIMS MANAGEMENT

This case involves an employer's attempt to present non-medical evidence regarding the reasonableness of expenses for an applicant's home elevator. The Appeals Board granted removal, reversing the trial judge's exclusion of these exhibits and witnesses. The Board found that while the medical necessity of the elevator was stipulated, the "reasonable expense" of its installation was a valid issue for which non-medical evidence should be admissible.

removalevidentiary rulingnon-medical exhibitsmedical necessitydue processsubstantial prejudiceirreparable harmpermanent disabilitystipulated awardreasonable expense
References
0
Case No. ADJ8248765
Regular
Dec 22, 2016

CARELA MURGUIA vs. COUNTY OF RIVERSIDE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision that disallowed a lien for photocopying services. The WCAB found that a contested claim existed at the time the services were rendered, satisfying a key requirement for medical-legal expenses. The Board further determined that the applicant's attorney acted reasonably in subpoenaing records, as the reasonableness of the expense is judged at the time incurred, not by the outcome of the subpoena. Consequently, the WCAB rescinded the prior order and returned the matter for further proceedings to determine the lien amount.

Lien claimantMedical-legal expensesContested claimLabor Code section 4620Labor Code section 4621SubpoenaPhotocopying servicesWCJReconsiderationFindings and Order
References
8
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
4
Case No. ADJ6774605
Regular
Sep 02, 2016

Tammy Tran vs. PROFESSIONAL SERVICE INDUSTRY, ZURICH LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration of the Administrative Law Judge's (ALJ) decision, which limited reimbursement for self-procured medical treatment. The Board found that the ALJ erred by only allowing reimbursement for treatment from the claim date until the denial date. Citing *McCoy v. Industrial Accident Commission*, the Board determined that the employer is liable for all reasonably necessary self-procured medical expenses incurred after the employer denied the claim, as this denial effectively refused to provide treatment. Consequently, the Board rescinded the ALJ's award and remanded the case for further proceedings to determine the reasonableness of all self-procured medical expenses.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardSelf-Procured Medical TreatmentLabor Code Section 4600McCoy v. Industrial Accident CommissionDenial of ClaimReimbursementIndustrial InjuryReasonably Necessary Treatment
References
5
Case No. 2019 NY Slip Op 01290
Regular Panel Decision
Feb 21, 2019

Matter of Estate of Youngjohn v. Berry Plastics Corp.

Decedent Norman Youngjohn suffered work-related injuries to his right shoulder and left elbow. Prior to the finalization of his schedule loss of use (SLU) award, he passed away from unrelated causes. His estate, as claimant, sought the full SLU award. However, the Workers' Compensation Board limited the payment to reasonable funeral expenses, citing Workers' Compensation Law § 15 (4) (d). The Appellate Division, Third Department, reviewed the statutory interpretation, concluding that only the portion of the SLU award accrued at the time of death, along with reasonable funeral expenses, is payable to the estate. The court modified the Board's decision and remitted the matter for recalculation of the amount owed.

Schedule Loss of UseWorkers' Compensation BenefitsPost-Mortem AwardEstate ClaimsFuneral ExpensesStatutory InterpretationLump-Sum PaymentAccrued BenefitsMaximum Medical ImprovementAppellate Review
References
14
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