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

Case No. ADJ9474597
Regular
Jun 17, 2018

SERGIO TERRAZAS vs. SEAL SCIENCE, INC., THE HARTFORD, ADMINISTERED BY ATHENS ADMINISTRATORS

The Workers' Compensation Appeals Board (WCAB) granted The Hartford's Petition for Reconsideration concerning an Order Approving Compromise and Release (OACR). Hartford argued the original OACR incorrectly failed to deduct \$4,140.00 in permanent disability advances from the \$20,000 settlement. The WCAB rescinded the OACR, returning the matter to the trial level to determine if the Compromise and Release should be amended to reflect the advances. The WCJ will then decide whether to reinstate the original OACR or approve an amended one after further proceedings.

Petition for ReconsiderationOrder Approving Compromise and ReleaseSet Aside OrderCompromise and ReleasePermanent Disability AdvancesOffsetRescindAlterAmendContinuing Jurisdiction
References
1
Case No. ADJ6627328
Regular
Aug 16, 2010

MANUEL ALEMAN vs. TOWER CLEANING SYSTEMS, INC., LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of an Order Approving Compromise & Release (OACR) due to potential procedural issues regarding the timeliness of the applicant's petition and the adequacy of the underlying settlement. The Board found the petition timely filed as service of the OACR was not properly documented. Furthermore, there were significant deficiencies in the medical evidence available to assess the OACR's adequacy, particularly concerning the applicant's claimed injuries to the psyche, neck, back, and neurological system. Consequently, the OACR was rescinded, and the case was returned to the trial level for further proceedings.

Order Approving Compromise & ReleasePetition for ReconsiderationWCABWCJDismissal of AttorneyTimelinessService of ProcessAdequacy of Compromise & ReleaseMedical ReportsEAMS
References
10
Case No. ADJ7271033
Regular
Jan 25, 2017

JENNIFER LAWSON vs. GLEN IVY DAY SPA, COMPWEST INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The Workers' Compensation Appeals Board (WCAB) is considering rescinding an order that dismissed lien claimant Proex Diagnostics' lien for failure to pay a \$100 activation fee. Proex argues they had until December 31, 2015, to pay the fee based on a federal court order and DWC guidance. The WCAB's notice indicates they intend to rescind the dismissal if the fee is paid within ten days of the notice. If rescinded, the lien claim will return to the trial level for further proceedings.

Proex DiagnosticsGlen Ivy Day SpaCompWest Insurance CompanyBerkshire Hathaway Homestate CompaniesLien Activation FeeLabor Code Section 4903.06Workers' Compensation Appeals BoardWCJReconsiderationCompromise and Release
References
1
Case No. ADJ7491926 ADJ7174640
Regular
Apr 22, 2011

JACQUELIN ESCALANTE vs. GOODWILL INDUSTRIES, PMA GROUP

The Workers' Compensation Appeals Board granted reconsideration of an Order Approving Compromise and Release (OACR) that settled applicant's back injury claim for $5,150.00. The Board found the applicant's petition for reconsideration was timely because service of the OACR was defective due to an incorrect address. Consequently, the OACR was rescinded, and the case is returned to the trial level to determine if the compromise should be reinstated, requiring the applicant to show grounds like fraud or mistake.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Approving Compromise and ReleaseIndustrial InjuryDefective ServiceTimelinessRescindedTrial LevelEquitableFraud
References
6
Case No. ADJ2214463 (VNO 0522433)
Regular
Feb 19, 2009

RICARDO DUARTE PONCE vs. ROSS STORES, INC., SEDGWICK CLAIMS MANAGEMENT SERVICES

The Appeals Board granted reconsideration to set aside the Order Approving Compromise and Release (OACR). The defendant sought to vacate the OACR because the parties' settlement agreement, which included a Medicare Set Aside (MSA) allocation, was contingent on approval by the Centers for Medicare Services (CMS) that was never obtained. Since the applicant was a Medicare beneficiary and the settlement exceeded $25,000, federal regulations require CMS approval of the MSA. The Board rescinded the OACR and returned the matter for further proceedings.

Medicare Set AsideMSA allocationCenters for Medicare ServicesCMS approvalCompromise and ReleaseOACRPetition for ReconsiderationRescind OrderGood CauseEquitable Grounds
References
8
Case No. ADJ8339009
Regular
Jan 08, 2016

WINSTON ROCKEFELLER (Dec'd), SUZANNA ROCKEFELLER (Dependent), ERIKA OSWALD (Dependent) vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS NORTHERN TRANSPORTATION HUBQ-ADMINISTRATION; legally uninsured; administered by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board intends to rescind its prior order granting reconsideration and dismiss the applicant's petition as moot. This action is prompted by the defendant's assertion that a new Panel Qualified Medical Examiner has been appointed and has issued reports, rendering the original dispute regarding the disqualification of the previous PQME moot. The Board will proceed with rescinding and dismissing unless the applicant demonstrates good cause why the issue remains live. No decision on the merits of the original petition has been made.

WCABPetition for ReconsiderationFindings and OrderPanel Qualified Medical ExaminerPQMERule 41.5(d)(2)(A)disqualifying conflict of interestmoot issueNotice of Moot IssueOpinion and Order Granting Reconsideration
References
0
Case No. ADJ8 156794
Regular
Jan 12, 2017

NURY PEREZ vs. BLUE RIVER DENIM, THE HARTFORD

The Workers' Compensation Appeals Board (WCAB) is considering rescinding an order that dismissed a lien claim due to a failure to pay a $100 lien activation fee. The lien claimant, Premier Psychological Services (PPS), claims computer issues prevented timely payment. While the WCJ recommended denial of reconsideration, the WCAB may rescind the dismissal if PPS pays the activation fee within ten days of this notice. If paid, the lien claim will be returned to the trial level for further proceedings.

Lien activation feeLabor Code section 4903.06WCABadministrative law judgereconsiderationrescissiondismissallien conferenceCompromise and Releaseindustrial injury
References
1
Case No. ADJ1035201
Regular
Oct 04, 2016

VICTOR DURAN vs. DONUT INN, STATE FARM INSURANCE COMPANY

The Appeals Board is considering rescinding an order that dismissed Metro Med Shockwave's lien claim for failure to pay a $\$100$ lien activation fee. The WCJ dismissed the lien because the fee was not paid before the lien conference, citing prior precedent. However, the lien claimant argues they had until December 31, 2015, to pay the fee based on a DWC Newsline article referencing a court order. The Board intends to rescind the dismissal if the fee is paid within ten days, allowing further proceedings on the lien claim.

Labor Code section 4903.06Lien activation feeWorkers' Compensation Appeals BoardMetro Med ShockwaveFigueroa v. B.C Doering Co.Angelotti Chiropractic v. BakerPreliminary injunctionDWC NewslineReconsiderationRescind order
References
2
Case No. ADJ7476556
Regular
Nov 09, 2010

MAXIMA ANDRES vs. MATCHED CAREGIVERS, INC., HEALTH CARE INDUSTRY SELF INSURANCE, PRIVATE ADJUSTING RANCHO CUCAMONGA

This case involves a petition for reconsideration filed by the defendant after an Order Approving Compromise and Release (OACR). However, the Workers' Compensation Appeals Board (WCAB) dismissed the petition as moot. This is because the Administrative Law Judge (ALJ) had already rescinded the OACR on October 21, 2010, prior to the defendant's petition. Therefore, the action sought by the defendant's petition had already been taken.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Approving Compromise and ReleaseOrder RescindingWCJMootDismissalMatched CaregiversInc.Health Care Industry Self Insurance
References
0
Case No. ADJ7781989; ADJ8262771
Regular
Oct 03, 2013

MIRIAN GARCIA vs. COOPER COLD FOODS, INC., ILLINOIS MIDWEST INSURANCE AGENCY as administrator for STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) is granting reconsideration of its own prior decision and rescinding a July 23, 2013 decision that had overturned a prior finding of 2% permanent disability for applicant's right knee injury. The WCAB determined that its August 9, 2012 order granting reconsideration was improvidently granted because the applicant had already filed a successive and improper petition for reconsideration. Consequently, the prior order and the subsequent rescinded decision are vacated, and the applicant's petition for reconsideration is dismissed.

WCABReconsiderationPetition for ReconsiderationFindings and AwardAdministrative Law JudgePermanent DisabilityIndustrial InjurySuccessive PetitionImprovidently GrantedVacated
References
4
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