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Case Law Database

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

Case No. GOL 0098326
Regular
Jul 23, 2007

DIANE SWEET vs. SANTA MARIA JOINT UNION HIGH SCHOOL DISTRICT

This case involves a lien claimant, Associated Reproduction Services (ARS), seeking reconsideration of a decision that disallowed most of its lien for photocopying services. The Appeals Board denied reconsideration, upholding the administrative law judge's finding that ARS failed to meet its burden of proving the necessity and reasonableness of its charges. The Board affirmed that lien claimants must demonstrate that medical-legal expenses were reasonably, actually, and necessarily incurred to prove or disprove a contested claim, which ARS did not establish here.

Workers' Compensation Appeals BoardDIANE SWEETSANTA MARIA JOINT UNION HIGH SCHOOL DISTRICTAssociated Reproduction ServicesIncARSLien claimantWCJReconsiderationFindings of Fact
References
4
Case No. ADJ8201128
Regular
May 14, 2013

Barry Swartwood vs. UC DAVIS

This case concerns a lien claimant, ARS Legal, seeking payment for medical-legal copy costs incurred in the workers' compensation case of Barry Swartwood v. UC Davis. The Workers' Compensation Appeals Board (WCAB) denied ARS Legal's Petition for Reconsideration, upholding the Administrative Law Judge's (ALJ) finding. The WCAB determined that the costs were not reasonably or necessarily incurred, citing that ARS Legal obtained duplicate records after defendant Sedgwick had already objected to payment for such duplicative services. Furthermore, the records ARS Legal obtained were incomplete compared to those acquired by the defendant.

Workers' Compensation Appeals BoardBarry SwartwoodUC DavisSedgwickADJ8201128Order Denying ReconsiderationLabor Code section 4621(a)medical-legal copy costsStipulations with Request for Awardlien claimant
References
0
Case No. MISSING
Regular Panel Decision
Nov 26, 1984

Scotia Associates v. Bond

The court addresses whether legal fees are 'incurred' to allow a tenant to recover counsel fees under Real Property Law § 234, even if the attorney worked pro bono and the initial summary proceeding was dismissed on procedural grounds. The court affirmed the retroactive application of Real Property Law § 234 and determined that a procedural dismissal can constitute a 'successful defense' if a reasonable time has passed without further litigation from the landlord. Crucially, the court ruled that legal fees are 'incurred' when an attorney performs services, creating a liability, even if collection is initially foresworn due to the client's financial situation. Consequently, the court awarded the tenant $1,500 in reasonable attorneys' fees.

Landlord-Tenant LawAttorneys' FeesReal Property Law § 234Pro Bono ServicesStatutory InterpretationProcedural DismissalRent ControlSuccessful DefenseLease AgreementsStatutory Tenancy
References
30
Case No. ADJ7890528
Regular
Dec 09, 2013

RUBEN CRUZ vs. PACIFIC RIDGE FARMS, ZENITH INSURANCE COMPANY

This case concerns a defendant's petition for reconsideration of a prior decision that allowed a lien for photocopy services. The defendant argued the lien for duplicating already-obtained medical records was improperly allowed. The Appeals Board granted reconsideration, rescinded its prior order, and returned the matter to the trial level. This was because the Board found the photocopy expenses were not reasonably and necessarily incurred when the injury was admitted and the records were duplicative.

Med-Legal Photocopylien claimantPetition for ReconsiderationFindings and Orderrescindedmedical recordsLabor Code Section 4603.2medical-legal costsreimbursementapplicant's injury
References
5
Case No. ADJ10406903
Regular
Jan 11, 2019

LUIS MANUEL MENDEZ SANCHEZ vs. HARTMARK CABINET DESIGN & MANUFACTURING, INC., EVEREST NATIONAL INSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration of an order denying interpreter fees, finding that services for interpreting a Compromise and Release (C&R) may be compensable. The Board clarified that while not explicitly listed in statute, such interpretation could be considered a "similar setting" necessary to ascertain the validity and extent of injury for an applicant with limited English proficiency. The case was returned to the WCJ for further proceedings to determine if the interpreter fees were reasonably, actually, and necessarily incurred under Labor Code section 5811 and AD Rule 9795.3.

Workers' Compensation Appeals BoardPetition for ReconsiderationInterpreter FeesCompromise and ReleaseLabor Code Section 5811AD Rule 9795.3Judicial EconomyWCJPetition for CostsAdministrative Law Judge
References
0
Case No. ADJ7219865
Regular
May 06, 2014

JUVENAL DIAZ vs. CALPAK LANDSCAPE, INC.

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's decision disallowing the lien of New Age Imaging. The Board found the WCJ misapplied the burden of proof by focusing on injury AOE/COE and medical necessity, rather than whether the copy services were "reasonably, actually, and necessarily incurred" as medical-legal expenses for a contested claim. Consequently, the Board rescinded the WCJ's decision, affirmed the disallowance of another lien claimant (True Scan), and returned New Age Imaging's lien to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationMedical-legal expenseContested claimLabor Code section 4620Injury AOE/COESelf-procured servicesBurden of proofRescind
References
0
Case No. ADJ4484509
Regular
Feb 28, 2011

GANCZO CHRISTOV vs. AUCTION AUTO PREP CORPORATION, ZENITH INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to the lien claimant, Vasquez Vocational Experts, Inc., challenging the disallowance of their $2,480.00 lien for vocational expert services. The WCAB found that the original judge erred in determining there was no legal basis for reimbursement, as vocational expert costs are allowable under Labor Code section 5811. The Board held that the services were reasonably and necessarily incurred by the applicant to evaluate diminished future earning capacity, irrespective of whether a formal rating had been issued. The case was returned to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardVocational ExpertLien ClaimReconsiderationFindings and OrderCompromise and ReleasePermanent Disability RatingDiminished Earning CapacityLabor CodeCompensable Services
References
4
Case No. 2007 NY Slip Op 30531(U)
Regular Panel Decision
Apr 05, 2007

Schirmer v. Athena-Liberty Lofts, LP

This case is an appeal from an Order of the Supreme Court, New York County, regarding a personal injury action. The plaintiff, a worker at a construction site, sustained injuries, leading to the site owner, Lofts, settling the claim after being found liable under Labor Law § 240 (1). Lofts then pursued indemnity claims against lighting contractor HP and the plaintiff's employer, Burgess. The Appellate Court modified the lower court's decision, vacating the finding that Lofts' settlement amount was reasonable due to Lofts' failure to properly demonstrate reasonableness and its mischaracterization of waiver arguments by HP and Burgess. The Court also affirmed the denial of HP's motion for summary judgment, citing unresolved factual issues concerning inadequate lighting as a cause of the accident.

Personal InjuryConstruction Site AccidentSummary JudgmentIndemnity ClaimLabor Law § 240(1)Appellate DivisionThird-Party ActionSettlement ReasonablenessCross ClaimsInadequate Lighting
References
4
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
4
Case No. ADJ7143821
Regular
Jan 30, 2015

DANA ESPARZA vs. MICHAEL'S COMMUNICATION, ZURICH NORTH AMERICA

This case concerns an applicant's petition for reconsideration of a prior award regarding new and further psychiatric disability. The Appeals Board granted reconsideration, specifically amending the prior decision to allow reimbursement for a vocational expert's fee. While the Board affirmed the finding of increased permanent disability, it reversed the denial of the vocational expert's costs. The Board reasoned that the expert's report was reasonable and necessary when incurred and had the potential to prove disputed facts, even if it didn't ultimately rebut the permanent disability rating.

Petition to ReopenNew and Further DisabilityVocational Expert FeeLabor Code 5811ReconsiderationFindings and AwardWCJPermanent DisabilityRebuttal EvidenceAgreed Medical Examiner
References
3
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