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

Case No. MISSING
Regular Panel Decision
May 03, 1985

Wolf v. Wolf

In two support proceedings, the petitioner mother appealed two orders. The first order, entered September 7, 1984, denied her petition for an upward modification of child support. The second order, entered May 3, 1985, denied her full reimbursement for certain child counseling expenses. The Family Court's decisions were affirmed on appeal. The court properly denied a general increase in the father's child support obligation and directed the mother to seek payment for counseling expenses through the father's medical insurance coverage.

child supportupward modificationcounseling expensesparental obligationsFamily Lawappellate reviewOrange County
References
0
Case No. MISSING
Regular Panel Decision

Claim of Simpson v. Glen Aubrey Fire Co.

A volunteer fireman suffered an acute lumbosacral strain requiring frequent hospital and doctor visits. He sought reimbursement for 290 miles of travel expenses. The Workers' Compensation Board approved reimbursement at 20 cents per mile, leading to this appeal. The court examined whether travel expenses for medical treatment are reimbursable under the Volunteer Firemen’s Benefit Law and Workers’ Compensation Law. It concluded that access to medical treatment implies the financial means to obtain it, upholding the humanitarian goals of the legislation.

Volunteer FiremanLumbosacral StrainMileage ReimbursementTravel ExpensesMedical TreatmentWorkers' Compensation LawVolunteer Firemen's Benefit LawStatutory InterpretationRemedial LawLiberal Construction
References
2
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. SFO 0438557 SFO 0438562
Regular
May 05, 2008

LISA BURKE vs. WINTERLAND PRODUCTIONS, HARTFORD INDEMNITY & ACCIDENT COMPANY

The Workers' Compensation Appeals Board granted reconsideration to address whether reimbursed expenses should be included in calculating an applicant's temporary disability indemnity rate. The Board reversed the prior award, ruling that reimbursed expenses for meals, lodging, and fuel are special expenses, not remuneration, and therefore should not be included in calculating the applicant's average weekly wage. The decision clarifies that such reimbursements do not constitute "advantages received by the injured employee as part of his remuneration" under Labor Code section 4454.

Workers' Compensation Appeals BoardTemporary Disability IndemnityReimbursed ExpensesEarnings CalculationLabor Code Section 4454RemunerationSpecial ExpensesAverage Weekly WageCumulative TraumaConcert Tour Salesperson
References
9
Case No. MISSING
Regular Panel Decision
Mar 30, 2015

In re IndyMac Mortgage-Backed Securities Litigation

This Memorandum Opinion addresses a motion for attorneys' fees and expense reimbursement following a $346 million settlement in a securities class action concerning misleading mortgage pass-through certificates issued by IndyMac MBS, Inc. The lead plaintiffs, Wyoming State Treasurer and Wyoming Retirement System, had sued individual and underwriter defendants. Plaintiffs' counsel requested $44.89 million in fees, approximately 13% of the settlement fund, and $2.99 million in expenses. The Court deemed the requested fee excessive, reducing it to $28.48 million after adjusting for discovery hours and applying reduced multipliers, while approving the $2.99 million expense reimbursement. Separately, the Court denied the lead plaintiffs' request for $27,725 in their own costs and expenses.

Securities LitigationClass ActionAttorneys' FeesExpense ReimbursementSettlement FundLodestar MethodPercentage of Fund MethodMultiplierIndyMac MBS, Inc.Mortgage Pass-Through Certificates
References
32
Case No. ADJ3842696 (SAL 0105756) ADJ4430006 (SAL 0111994)
Regular
Apr 23, 2010

JOSE VILLA vs. CHALONE WINE GROUP, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ZENITH INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to allow the California Insurance Guarantee Association (CIGA) reimbursement for its bill review expenses. The Board found that bill review costs are an essential and necessary part of adjusting medical claims, akin to "incurred losses" as defined by the Uniform Statistical Reporting Plan. This decision amends a prior ruling that excluded such expenses, recognizing their role in controlling medical overpayments. The parties are now to adjust the specific amount of reimbursement for these expenses.

CIGACalifornia Insurance Guarantee Associationbill review expensesincurred lossesloss adjustment expensemedical cost containmentuniform statistical reporting planinsolvency insurancecovered claimsLabor Code
References
4
Case No. ADJ1938020 (LAO 0877660)
Regular
Jul 21, 2010

FRANCISCO PEREZ vs. KING TACO RESTAURANTS, INC., AMERICAN CASUALTY

This case involves an applicant seeking reimbursement for travel expenses incurred to attend a Qualified Medical Evaluator (QME) appointment. The applicant relocated out of state after sustaining an industrial knee injury. The defendant initially disputed medical findings, triggering the QME process, and later refused to reimburse travel expenses to the out-of-state QME. The Workers' Compensation Appeals Board ruled that the applicant was entitled to travel expenses, citing relevant Labor Code sections and precedent. Sanctions were denied, and penalty issues were deferred.

ADJ1938020LAO 0877660King Taco RestaurantsInc.American CasualtyQualified Medical EvaluatorQME panelLabor Code Section 4062.2Labor Code Section 4061Labor Code Section 4600
References
3
Case No. ADJ1868495 (VNO 0452398) ADJ4538828 (VNO 0468076)
Regular
Dec 14, 2012

JORGE HERNANDEZ vs. CRESCENT TRUCK LINES, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, SEDGWICK CLAIMS MANAGEMENT SERVICES, RELIANCE NATIONAL INSURANCE COMPANY

This case concerns the California Insurance Guarantee Association (CIGA) seeking reimbursement from the State Compensation Insurance Fund (SCIF) for costs incurred administering workers' compensation claims. The WCJ initially awarded CIGA reimbursement for benefits paid but not for associated administration expenses. The Appeals Board granted CIGA's reconsideration petition, ruling that CIGA is entitled to reimbursement for both benefits and specific claim administration expenses, including medical-legal costs. The Board amended the findings and award to reflect this, returning the matter to the trial level for further proceedings.

CIGAReliance National Insurance CompanySedgwick Claims Management ServicesState Compensation Insurance Fund (SCIF)Petition for ReconsiderationJoint Findings and Award (F&A)reimbursementassociated expensesmedical treatmentloss adjustment expense
References
10
Case No. ADJ128210 (SAL 0093437) ADJ593542 (SAL 0093436)
Regular
Apr 12, 2010

JORGE RAMIREZ vs. LINO FINATTI, JR., CIGA on behalf of RELIANCE INSURANCE COMPANY, in liquidation, administered by INTERCARE SERVICES, CLARENDON INSURANCE COMPANY, adjusted by NORTH AMERICAN RISK SERVICES

This case involves a dispute over reimbursement for workers' compensation expenses between the California Insurance Guarantee Association (CIGA) and Clarendon Insurance Company. CIGA, covering for Reliance Insurance Company in liquidation, sought reimbursement for administrative expenses in addition to indemnity and medical costs. The arbitrator initially denied administrative expenses due to insufficient justification, but the Appeals Board granted reconsideration. The Board applied the *Ramos* decision, allowing CIGA to recover administrative costs like bill review and utilization review from Clarendon for the applicant's low back injuries.

CIGAReliance Insurance CompanyClarendon Insurance Companyadministrative expensesreimbursementbill reviewmedical managementutilization reviewsubpoenaing recordsjoint and several liability
References
2
Case No. MISSING
Regular Panel Decision

In re Stein

The case concerns a petitioner seeking reimbursement from the City of New York for the tuition and maintenance of a handicapped child, Ronnie, at a residential facility and a summer program. The court previously established that financially able parents are responsible for maintenance costs. The primary novel issue addressed was whether the summer program constituted a necessary educational expense or an extra benefit. The court determined that Ronnie's summer attendance was an extension of his educational process, not recreational, and thus a necessary expense. Consequently, the petitioner was granted reimbursement for tuition for both the regular school year and the summer program, but denied reimbursement for maintenance at the residential facility.

Handicapped Education LawSpecial Needs ChildrenTuition CostsParental ContributionSummer Educational ProgramsResidential FacilityFamily Court JurisdictionEducational ReimbursementOrganic Brain SyndromeMental Retardation
References
8
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