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Case Law Database

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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 The Appeals Board rescinded the original award and returned the matter for further proceedings, finding that certain copy services for medical records were properly considered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. ADJ9668315
Regular
Jan 10, 2020

MARTIN AMADOR vs. CAL CENTRAL HARVESTING, STAR INSURANCE COMPANY

This case concerns a lien claimant, Citywide Scanning, seeking payment for medical-legal discovery services. The Workers' Compensation Appeals Board (WCAB) affirmed the initial award but deferred the issue of the reasonable value of services. The WCAB found the defendant waived objections to the invoices by failing to provide timely explanations of review, thus incurring a penalty and interest. However, the WCAB returned the matter for further proceedings to establish a reasonable value, as the initial evidence was insufficient.

WCABReconsiderationLien ClaimantCitywide ScanningFindings of FactAward and OrderMedical-Legal Discovery ServicesCopy ServicesExplanation of Review (EOR)Labor Code Section 4622
References
Case No. ADJ8092562 MF ADJ8222911
Regular
Feb 22, 2016

JULIA OZUNA vs. KERN COUNTY SUPERINTENDENT OF SCHOOLS

The Appeals Board granted reconsideration and rescinded the WCJ's decision regarding lien claimant Associated Reproduction Services, Inc. (ARS). The Board found that ARS was acting as an agent for the applicant's attorney, making its copying services potentially compensable medical-legal expenses. Crucially, ARS is not required to prove that every copied record was specifically relied upon by the AME, only that the copying was reasonably undertaken to discover relevant information. The case is returned to the trial level for further proceedings to determine a reasonable fee for ARS's services and address the claim for interest.

Associated Reproduction ServicesAMEDr. Roger Sohnlien claimantcopy service feesmedical-legal expensesLabor Code §4620(a)Labor Code §4622interestfee schedule
References
Case No. ADJ9873183
Regular
Feb 24, 2020

WONDA BRAZILE TRAYLOR vs. COUNTY OF LOS ANGELES/PUBLIC HEALTH SERVICES; Permissibly SelfInsured, Administered by TRISTAR RISK MANAGEMENT

The WCAB affirmed the prior award finding the County of Los Angeles liable for copy services provided by lien claimant Med-Legal, LLC. The defendant failed to issue a timely and compliant Explanation of Review (EOR) for invoice 1313134, thereby waiving objections to its reasonableness. Consequently, the lien claimant is entitled to the reasonable value of the invoice, plus penalties and interest retroactive to receipt. The case is remanded to the WCJ to determine the exact reasonable value of the services.

WCABReconsiderationLien ClaimantCopy ServicesExplanation of ReviewMedical-Legal ExpensesLabor Code Section 4622PenaltiesInterestReasonable Value
References
Case No. ADJ3463668 (AHM 0129255) ADJ3379175 (AHM 0128291)
Regular
Nov 07, 2013

LEO CORCORAN vs. C.A.T., INC.; TIG SPECIALTY INSURANCE SOLUTIONS

The Workers' Compensation Appeals Board denied a petition for reconsideration filed by a lien claimant, Midas Recovery Services, representing the Sheet Metal Workers Trust Fund. The claimant sought over $330,000 for services rendered, but the Board affirmed the judge's award of only $23,694.58. This was because the lien claimant failed to meet its burden of proving the reasonableness and necessity of its services and their value. Specifically, the provided documentation did not adequately itemize or detail the goods and services rendered to support the claimed amount.

WCABPetition for Reconsiderationlien claimantburden of proofreasonablenessnecessityreasonable valueC.A.T.Inc.TIG Specialty Insurance Solutions
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. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ1158684 (GOL 0099195)
Regular
Nov 14, 2008

CAROLINA VELA vs. SERVICE MASTER CBM, AMERICAN ALL-RISK LOSS ADMINISTRATORS

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration to correct a clerical error, reducing the lien awarded to Lorena Ortiz-Schneider from $4,025.00 to $1,995.00. The Board also denied Associated Reproduction Services' petition, affirming the WCJ's decision to award copy charges at a reasonable rate of 20 cents per page, referencing precedent established by *Kunz* and *Sweet*. This decision clarifies the correct lien amount and upholds the application of reasonable rates for reproduction services.

WCABPetition for ReconsiderationLien ClaimantInterpreting ServicesCopy ChargesReasonableness of ChargesMedical-Legal ExpensesClerical ErrorDecision After ReconsiderationKunz v. Patterson
References
Case No. ADJ1448142 (AHM 0143606)
Regular
Jan 27, 2016

SONIA LEON vs. VEG FRESH FARMS, CYPRESS INSURANCE COMPANY

The Appeals Board granted reconsideration, rescinded the trial judge's decision disallowing the lien, and found that the lien claimant has legal status and is not subject to Business and Professions Code registration requirements. The Board clarified that obtaining records via subpoena is a reasonable attorney practice and not a basis to deny lien claims for copying services. The case was remanded to the trial level for further proceedings to determine the reasonable value of the services provided. The request to disqualify the trial judge was denied.

Medical-legal expensesLien claimReconsiderationFindings and OrderWCJApplicant's attorneySubpoenaPrima facie showingIndependent contractorBusiness and Professions Code
References
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