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

Case No. SAL SJO 252436 (MF); SJO 246192
Regular
Jul 02, 2007

NIHAL HORDAGODA vs. State Compensation Insurance Fund

This case involves an employer's petition for reconsideration of an order authorizing medical treatment and admitting the Qualified Medical Examiner's (QME) reports. The employer argued the QME reports were inadmissible due to an alleged ex parte communication between the applicant and the QME, and that the awarded treatments were improper. The report recommends denying the petition, finding the communication was permissible under LC § 4062.3(h) and that the QME's opinions and awarded treatments for chronic pain were reasonable and not governed by ACOEM guidelines.

Workers' Compensation Appeals BoardPetition for ReconsiderationQualified Medical EvaluatorLabor Code Section 4062.3Ophthalmological evaluationFunctional capacity evaluationUtilization ReviewACOEM GuidelinesChronic spinal conditionTreating physician
References
0
Case No. ADJ7703859
Regular
Aug 01, 2016

ELAINE CONNOR vs. SIERRA COUNCIL ON ALCOHOL AND DRUG DEPENDENCE, CARE WEST INSURANCE COMPANY

The applicant sought reconsideration of a WCJ's order that found no Labor Code section 132a discrimination. The applicant's petition primarily focused on a potential attorney's fee award for a deposition under Labor Code section 5710, which the original order did not address. The WCJ's report recommended granting reconsideration to award the requested attorney's fees, acknowledging the omission was inadvertent. The Appeals Board granted the applicant's petition, amending the order to include the $1,557.50 attorney's fee award, and otherwise affirmed the original findings. The Board also dismissed the defendant's improper supplemental petition and denied their petition for sanctions against applicant's counsel.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code 132aLabor Code 5710WCJAttorney's FeesDeposition FeesPetition for SanctionsWCAB Rule 10848Supplemental Filing
References
1
Case No. ADJ7630420
Regular
Apr 29, 2014

MARY CRUZ PATINO vs. ARAMARK AT HP PAVILION, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration because it was untimely filed. The Board also denied the defendant's petition for reconsideration. The Court adopted the findings of the administrative law judge's report and recommendation in both instances.

Petition for ReconsiderationApplicantDefendantDismissedDeniedUntimelyWorkers' Compensation Appeals BoardAdministrative Law JudgeReport and RecommendationService Made
References
0
Case No. ADJ6713503
Regular
May 16, 2014

MATTHEW JENSON vs. PEPSI BOTTLING GROUP, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board denied the Petition for Reconsideration filed by South Lake Medical Center and its associated entities. The Board also dismissed the successive Petition for Reconsideration filed by Accurate Medical Assessment Rating Center (AMARC). AMARC's prior petition was already denied, and successive petitions are not permitted, requiring review by the Court of Appeals instead. The Board adopted the WCJ's Report and Recommendation in support of these decisions.

WCABLien ClaimantPetition for ReconsiderationLabor Code section 5813California Code of Regulations title 8 section 10561WCJSanctionsSuccessive PetitionOrder Denying Petitions for ReconsiderationWrit of Review
References
2
Case No. ADJ6593388
Regular
Oct 21, 2014

JENNIFER GARRETT vs. HIGH DESERT MEMORIAL HOSPITAL DISTRICT, ALPHA FUND

The Workers' Compensation Appeals Board vacated its prior order granting reconsideration and dismissed the applicant's Petition for Reconsideration because it was filed against a non-final, procedural order directing an AME to issue a supplemental report. The Board also denied the applicant's Petition for Removal, finding no substantial prejudice or irreparable harm, as removal is an extraordinary remedy. The applicant's contention that she had a due process right to a new PQME was based on mere speculation about the AME's report. The Board admonished the applicant's counsel for filing the inappropriate petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalAgreed Medical EvaluatorSupplemental ReportQualified Medical Evaluator PanelInterlocutory OrderFinal OrderSubstantive RightIrreparable Harm
References
11
Case No. ADJ7284005 ADJ7912473
Regular
Mar 04, 2020

RONALD PHILPOT vs. PERFORMANCE DAIRY SERVICES, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ULLICO CASUALTY COMPANY, IMPERIUM INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, rescinding the prior findings and ordering that reports from Drs. Miner and Van de Bittner be admitted into the record and provided to the IME. The Board found it was error to strike these reports, as admissibility and substantiality are distinct issues, and the IME should review all relevant evidence for a complete evaluation. Consequently, the record will be further developed, and the defendant CIGA's petition for reconsideration was dismissed.

Workers' Compensation Appeals BoardCIGAULLICOIMPERIUM INSURANCE COMPANYTRISTAR RISK MANAGEMENTJoint Findings of FactAward and OpinionAOE/COEIndependent Medical EvaluatorAgreed Medical Evaluator
References
0
Case No. AHM 0142357, AHM 0142358
Regular
Jul 18, 2008

JORGE ALVAREZ vs. RICHARD COHEN LANDSCAPE & CONSTRUCTION, INC., BERKSHIRE HATHAWAY HOMESTATE INSURANCE COMPANIES for REDWOOD FIRE & CASUALTY INSURANCE COMPANY

This Workers' Compensation Appeals Board case involves a petition for reconsideration filed by an applicant. The Board has reviewed the petition and the administrative law judge's report and recommendation. Based on the judge's report, which the Board adopts, the petition for reconsideration is dismissed.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationAdministrative Law JudgeReport and RecommendationDismissedJorge AlvarezRichard Cohen Landscape & ConstructionBerkshire Hathaway Homestate InsuranceRedwood Fire & Casualty InsuranceCase Nos. AHM 0142357
References
0
Case No. ADJ7564894
Regular
Jun 07, 2013

FLOR DE MARIA DE LEON vs. PORTO'S BAKERY, INC, TRAVELERS

Here's a summary for a lawyer: This case involves a lien claimant, First Choice Health UBC, whose lien was dismissed for failure to provide proof of timely payment of the lien activation fee at a lien conference. While the claimant's representative appeared for "FCH" and later submitted proof of payment for a different, similarly named entity (First Choice Medical Group), no proof was provided for First Choice Health UBC itself. The WCJ recommended denial of reconsideration, finding that the claimant failed to meet the requirements of Labor Code section 4903.06(a)(4) by not presenting evidence of activation fee payment for the correct entity at the conference, thus warranting dismissal with prejudice. The Appeals Board adopted the WCJ's report and denied the petition.

Lien ClaimantActivation FeePetition for ReconsiderationDismissal with PrejudiceContinuous TraumaServerBack InjuryKnee InjuryLower ExtremitiesNervous/Psyche
References
0
Case No. ADJ1034130 (SAC 0249097)
Regular
Nov 04, 2014

RUSSELL CALDWELL vs. ROY E. LAY TRUCKING, SEDGWICK CMS

This case involves a petition for reconsideration filed by Russell Caldwell concerning a workers' compensation claim against Roy E. Lay Trucking. The Workers' Compensation Appeals Board (WCAB) reviewed the petition and the administrative law judge's (WCJ) report. Adopting the WCJ's report and recommendation, the WCAB dismissed Caldwell's petition for reconsideration.

Petition for ReconsiderationWorkers' Compensation Appeals BoardReport and RecommendationAdministrative Law JudgeDismissedRoy E. Lay TruckingSedgwick CMSADJ1034130SAC 0249097Russell Caldwell
References
0
Case No. ADJ2727301/ADJ3168287
Regular
Apr 14, 2011

ADOLFO SANDOVAL vs. NESTLE USA-PREPARED FOODS, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

This case concerns a petition for reconsideration filed by a lien claimant, Ronco Drugs, regarding the dismissal of its lien for $4,022.79$. The lien claimant acknowledges the underlying case was settled in 2008 but argues its due process rights were violated as it never received settlement documents and its lien dismissal order was not responded to by the WCAB for years. However, the record shows significant delays, with the accidents occurring eight years prior and settlement over three years before the petition. The judge recommends dismissal due to the claimant's apparent delay in pursuing the matter.

Petition for ReconsiderationLien DismissalRonco DrugsWylie Lien SolutionsCompromise & ReleaseDue Process ViolationStatute of LimitationsTimelinessSettled Statement on AppealWorkers' Compensation Appeals Board
References
0
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