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

Case No. ADJ4379045 (ANA 0389616)
Regular
Mar 19, 2012

FEDERICO MARTINEZ vs. ROBERTSON'S READY MIX, INC.

Defendant Robertson's Ready Mix sought to reopen a stipulated award of 81% permanent disability for Federico Martinez based on a change in law regarding life pension calculations. The Workers' Compensation Appeals Board (WCAB) dismissed the petition for reconsideration as untimely, as it was filed significantly beyond the statutory 20-day limit. However, the WCAB returned the petition to the trial level to be considered solely as a petition to reopen based on the alleged change in law. This decision allows the parties to address the legal change at the trial judge level.

Workers' Compensation Appeals BoardPetition to ReopenPetition for ReconsiderationStipulated Findings and AwardIndustrial InjuryPermanent DisabilityLife PensionLabor Code Section 4659(c)Baker v. Workers' Comp. Appeals Bd.Untimely Filing
References
5
Case No. ADJ7928198
Regular
Mar 19, 2014

FELIPE AYALA vs. CUSTOM DELUXE LANDSCAPINT, ACE USA

The Workers' Compensation Appeals Board dismissed a petition for reconsideration because it was filed against a Notice of Intention, not a final order. The Board found the petition frivolous and warned against future similar filings. The case will be returned to the trial level for further proceedings and decision.

Petition for ReconsiderationNotice of Intention (NIT)Lien ClaimDismissalTrial LevelWCJ ReportFrivolous FilingSanctionsWorkers' Compensation Appeals BoardFinal Order
References
0
Case No. ADJ441410
Regular
Oct 03, 2008

HAYDEE NUNEZ vs. FAIRMONT MIRAMAR HOTEL, COMMERCE & INDUSTRY INSURANCE COMPANY

The Appeals Board denied the lien claimant's petition for reconsideration, affirming the WCJ's denial of the remaining lien balance. The Board is returning the case to the trial level to investigate potential sanctions against the lien claimant for its actions in filing the petition for reconsideration, citing alleged procedural defects and bad faith. The WCJ's original finding was that the outpatient fusion surgery was not permitted under Medicare Guidelines and the defendant paid more than the reasonable value of the services.

Workers Compensation Appeals BoardFairmont Miramar HotelCommerce & Industry Insurance CompanyAIG Domestic ClaimsOutpatient Spine & Surgery CenterLien claimantIndustrial injuryLow back injuryOutpatient fusion surgeryMedicare Guidelines
References
1
Case No. ADJ426447 (RDG 0129495)
Regular
Jul 16, 2010

Shane Guest vs. Barrett Business Services

The Appeals Board dismissed the applicant's petition for reconsideration as he was not aggrieved by a final order. The applicant sought to set aside a settlement concerning the Employment Development Department's (EDD) lien, arguing it was made in error. However, the Board found that the WCJ had not yet made a final determination on the EDD lien, which is a prerequisite for the Board to have jurisdiction to approve or disapprove such a settlement. Therefore, the matter is returned to the trial level for a final determination of the EDD's lien.

WCABPetition for ReconsiderationDismissalEDD LienTrial LevelFinal DeterminationTemporary DisabilityEmployment Development DepartmentStipulationDeferred Lien
References
1
Case No. ADJ3502038 (VNO 0531200) ADJ3850322 (VNO 0531201)
Regular
Oct 21, 2010

MARIA DE LA LUZ PADILLA vs. SUNRISE SENIOR LIVING, INC., HOME ASSURANCE COMPANY, SEDGWICK CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration of a Stipulations and Award (S&A) regarding applicant's neck, shoulder, and chest injuries. The defendant claimed mutual mistake and delays by applicant's attorney as grounds to set aside the S&A. However, the WCAB found these allegations insufficient to overturn the executed contract. The matter is returned to the trial level for further proceedings on the defendant's separate petition to set aside the S&A, due to apparent procedural irregularities.

Stipulations and AwardPetition for ReconsiderationPetition to Set AsideMutual Mistake of FactGood CauseDelay in ApprovalService of DocumentEthical BreachesTrial Level ProceedingsWorkers' Compensation Judge
References
2
Case No. ADJ994369
Regular
Jan 19, 2014

JOSE JUAREZ vs. WATKINS MANUFACTURING CORPORATION

The Workers' Compensation Appeals Board (WCAB) is reconsidering a decision that awarded the applicant medical mileage and a penalty for unreasonable delay in compensation payments but denied attorney's fees. The WCAB believes attorney's fees are warranted under Labor Code section 5814.5 for enforcing the payment of awarded compensation. The case is being returned to the trial level for the judge to determine and award these attorney's fees.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardMedical Mileage Expense ReimbursementAttorney's FeesLabor Code Section 5814Labor Code Section 5813Labor Code Section 5814.5Cumulative Industrial InjuryPulmonary System Injury
References
0
Case No. ADJ1393892
Regular
Aug 16, 2011

JOSE NAVARRO vs. LOCKHEED

The Appeals Board denied the applicant's Petition for Reconsideration regarding an alleged March 12, 1990 injury, upholding the WCJ's finding that no industrial injury occurred. The Board granted removal on its own motion to address potential sanctions against applicant's counsel for citing medical records not present in the official record, which is a violation of WCAB rules and attorney ethics. The Board issued a Notice of Intention to impose $1,000 in sanctions jointly against the attorney and his firm, and awarded attorney's fees to the defendant. Other outstanding issues in the consolidated cases are returned to the trial level for further proceedings by the WCJ.

Petition for ReconsiderationQualified Medical EvaluatorSubstantial EvidenceCredibility DeterminationMisleading PetitionSanctionsLabor Code Section 5813WCAB RulesAttorney's DutyEvidence Outside Record
References
4
Case No. MISSING
Regular Panel Decision
Dec 17, 1968

In re Male Child Wilkov

In a contested adoption proceeding, the natural mother appealed an order from the Family Court, Suffolk County, dated December 17, 1968. The order had concluded that she abandoned her infant child, dismissed her application for the child's return, rejected her objection to the proposed adoption, and directed the court clerk to proceed with the adoption application. The appellate court affirmed the order, despite noting an error by the trial court regarding a social worker's communication. The trial court mistakenly believed the natural mother spoke with a hospital social worker, when in fact, the social worker had only conversed with the child's grandmother. However, the appellate court found that there was ample independent evidence to support the abandonment finding, irrespective of this factual dispute.

Adoption LawChild AbandonmentFamily Court AppealParental RightsSuffolk County Family CourtAppellate AffirmationSocial Worker TestimonyFactual ErrorEvidentiary SupportChild Custody
References
1
Case No. ADJ629563
Regular
Jun 10, 2014

CLAUDIA ANDRADE vs. SOUTHERN CALIFORNIA EDISON, SEDGWICK CMS

The Workers' Compensation Appeals Board rescinded the trial judge's findings and returned the case for further proceedings due to a denial of due process. The trial judge decided issues not presented by the parties, preventing them from offering evidence or arguing their case. The Board found the trial judge's framing of the sole issue as "good cause to violate the MPN agreement" was insufficient and failed to resolve the lien claim's ultimate entitlement to recovery. The case will be returned to the trial level to properly frame all contested issues and allow parties to present evidence.

Workers' Compensation Appeals BoardMedical Provider NetworkMPNLien ClaimantDue ProcessFindings and OrdersReconsiderationExpedited HearingCompromise and ReleaseLien Trial
References
9
Case No. MISSING
Regular Panel Decision

Rowe v. Board of Education

Plaintiff sued Chatham Central School District Middle School for negligence after sustaining injuries from a fall in the school cafeteria, allegedly due to accumulated mud, water, and a lack of rain mats. The defendant School District subsequently impleaded the Chatham Central Teachers’ Association, claiming the Association was in control of the cafeteria and responsible for the plaintiff's injuries. Following a trial, the jury rendered a verdict of no cause for action in favor of both the School District and the Association. However, Special Term set aside this verdict and granted a new trial, based on evidence suggesting an accumulation of mud and water and the defendant's failure to provide janitorial services. On appeal, the Appellate Division reversed Special Term's order, reinstating the original jury verdict, concluding that the jury's finding was not against the weight of the evidence given the conflicting testimony presented at trial.

NegligencePremises LiabilitySlip and FallJury VerdictWeight of EvidenceAppellate ReviewNew Trial Order ReversedSchool CafeteriaChatham Central School DistrictColumbia County
References
3
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