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Case Law Database

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

Case No. SBR 0332538
Regular
Mar 28, 2009

RUBY JONES vs. STATE OF CALIFORNIA / DEPARTMENT OF MENTAL HEALTH, STATE COMPENSATION INSURANCE FUND, PREMIER OUTPATIENT SURGERY CENTER, INC.

The Appeals Board granted reconsideration, rescinded the prior order, and returned the case for further proceedings on the reasonableness of Premier Outpatient Surgery Center's (POSC) $\$16,578.00$ lien claim for surgical services. While POSC was properly licensed as a surgical clinic and did not require a fictitious-name permit, the Appeals Board found the record insufficient to establish the reasonableness of the charged fee, noting a significant disparity between the billed amount and what was paid based on Medicare rates. The Board also rescinded the award of attorney's fees to POSC's counsel, finding no basis for such an award under Labor Code sections 5811 or 5813.

Workers' Compensation Appeals BoardRuby JonesState Compensation Insurance FundPremier Outpatient Surgery Centerfictitious-name permitMedical Board of CaliforniaDepartment of Health Servicessurgical clinic licenseoutpatient settingreasonable fee
References
Case No. ADJ3347998 (LAO 0774299)
Regular
Jun 07, 2010

JOSEPH JONES vs. COUNTY OF LOS ANGELES/SHERIFF'S DEPARTMENT

The Appeals Board granted reconsideration, rescinding the WCJ's finding of employment for applicant Joseph Jones. Defendant County of Los Angeles argued applicant was not a volunteer, thus not an employee. The Board found applicant's testimony indicated he felt compelled to work as a trustee due to threat of transfer, not voluntary agreement, negating an employment relationship under Labor Code section 3351. Furthermore, applicant did not qualify under Penal Code section 4017 as he was awaiting trial and not engaged in fire suppression activities.

Workers' Compensation Appeals BoardJoseph JonesCounty of Los AngelesSheriff's DepartmentTristarFindings of FactWorkers' Compensation Judge (WCJ)Employment RelationshipVolunteerInmate
References
Case No. ADJ7817081
Regular
Jul 25, 2013

RUBY VARGAS vs. PEDIATRIC PARTNERS, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Ruby Vargas' petition for reconsideration, upholding the WCJ's finding that she did not sustain a compensable injury. The employer successfully argued Labor Code section 3600(a)(10) because Vargas failed to report her alleged injury prior to receiving notice of her termination. The Board found the WCJ's credibility determinations, favoring the employer's witnesses who testified Vargas did not report an injury, were supported by the record. Furthermore, Vargas' attempt to introduce newly discovered witness testimony was rejected as it could have been discovered with reasonable diligence prior to the hearing.

Workers' Compensation Appeals BoardRuby VargasPediatric PartnersZurich American Insurance CompanyGallagher BassettADJ7817081Opinion and Order Denying Petition for ReconsiderationLabor Code section 3600(a)(10)Affirmative DefensePost-Termination Notice
References
Case No. ADJ6473555, ADJ7393801
Regular
Sep 18, 2014

Frank Jones (Deceased), Araceli Jones, Mya Jaedyn Jones vs. CDCR KERN VALLEY STATE PRISON, State Compensation Insurance Fund

The Workers' Compensation Appeals Board affirmed a previous award for death benefits to the minor daughter of deceased correctional officer Frank Jones. The WCJ found that the daughter, Mya Jones, was entitled to the special minor's death benefit due to "good cause," as her mother is now a sole provider facing significant financial hardship after the decedent's death. The Board agreed, citing compelling evidence of the mother's financial strain and the minor's ongoing needs. This decision overrides the defendant's contentions that the award was improper and denies credit for prior permanent disability advances.

Workers' Compensation Appeals BoardCalPERSspecial death benefitminor dependentGuardian Ad LitemLabor Code section 4704good causeaverage weekly earningstemporary total disabilitypermanent disability indemnity
References
Case No. ADJ2294426 (MON 0193402)
Regular
Aug 09, 2019

SONA SIMONIAN vs. COUNTY OF LOS ANGELES, TRISTAR SERVICES GROUP

The Workers' Compensation Appeals Board granted a petition to disqualify Judge Yvonne Jones based on the appearance of bias. This was due to a sustained ethics complaint filed by lien claimant David Bressler, Ph.D., L.Ac., against Judge Jones concerning her conduct in this specific case. While Judge Jones asserted she could remain impartial, the Board found that a reasonable person could doubt her impartiality given the sustained ethics violation. The disqualification applies only to this case, and the matter will be reassigned.

Petition for DisqualificationWCJ JonesDavid BresslerPh.D.L.Ac.sustained ethics complaintappearance of biasWCAB Rule 10452Code of Civil Procedure Section 641due process
References
Case No. ADJ6472001
Regular
May 29, 2019

JAIME QUEZADA, JR. vs. NEIL JONES FOOD COMPANY DBA TOMATEK, SAFETY NATIONAL INSURANCE COMPANY

This case involves a workers' compensation claim by Jaime Quezada, Jr. against Neil Jones Food Company (Toma-Tek) and its insurer. The applicant initially received an award for permanent total disability and further medical treatment for back, leg, psyche, and hypertension injuries. Following a petition for reconsideration by the defendant, the parties submitted Stipulations With Request for Award. The Workers' Compensation Appeals Board (WCAB) approved these stipulations, rescinding the prior award and issuing a new award for permanent partial disability (63%) and further medical treatment, resolving lien claims and approving the attorneys' fee.

Workers Compensation Appeals BoardJaime Quezada Jr.Neil Jones Food CompanySafety National Insurance CompanyCannon Cochran ConcordADJ6472001ReconsiderationStipulations With Request for AwardAdministrative Law JudgeHypertension
References
Case No. ADJ4639631 (MON 0327478)
Regular
Jan 28, 2013

MARY JONES vs. UCLA MEDICAL CENTER, SEDGWICK CMS

This case involves Mary Jones's petition for reconsideration of a prior Workers' Compensation Appeals Board (WCAB) decision. The WCAB had granted a removal petition, rescinded an order continuing the case to trial, and returned it for further proceedings. Jones argued discovery should remain closed and the case proceed to trial promptly. The WCAB dismissed her petition, stating the prior decision was procedural, not a final order appealable under Labor Code section 5900(a). The Court of Appeal also dismissed Jones's subsequent petition, finding no final WCAB order existed.

Petition for ReconsiderationDecision After RemovalFinal OrderProcedural OrderLabor Code Section 5900(a)Aggrieved PartyCourt of AppealPetition for Writ of ReviewSecond Appellate DistrictDivision Four
References
Case No. ADJ7663368
Regular
Apr 11, 2013

Starla Jones vs. GALLO GLASS CO.

This case involves a dispute over the applicant's permanent disability rating following an industrial injury to her right shoulder. The Workers' Compensation Appeals Board granted reconsideration and amended the original award, increasing the permanent disability rating from the WCJ's finding of 15% to 12%, based on the Agreed Medical Evaluator's opinion of 6% Whole Person Impairment. The Board affirmed the applicant's permanent and stationary date and found no overpayment of temporary disability. Additionally, the Board applied a 15% increase to permanent disability indemnity and attorneys' fees, recognizing the employer's failure to offer modified work.

Starla JonesGallo Glass Co.ADJ7663368ReconsiderationPermanent DisabilityWhole Person ImpairmentAgreed Medical EvaluatorDr. Peter J. MandellFunctional Capacity EvaluationPermanent and Stationary Date
References
Case No. ADJ9571390
Regular
Mar 28, 2023

CALEB JONES vs. COUNTY OF MARIN, ATHENS ADMINISTRATORS

This case involves an applicant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) award. The applicant challenged the exclusion of surveillance video evidence and the reliance on medical reports based on that video. Ultimately, the parties participated in a settlement conference and reached a compromise and release agreement. The WCAB approved this settlement, rescinding the prior award and ordering that the compromise and release be the final resolution of all issues.

Workers' Compensation Appeals BoardCaleb JonesCounty of MarinPermissibly Self-InsuredAthens AdministratorsADJ9571390Opinion and Decision After Reconsiderationbilateral lower extremitiesright upper extremityneck
References
Case No. POM 0292809
Regular
Mar 14, 2008

FREDERICK JONES vs. ADECCO, INSURANCE COMPANY OF PENNSYLVANIA, BROADSPIRE

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration of an award of attorney's fees. The Board found that the Administrative Law Judge had the authority to amend a prior award to include attorney's fees, as this issue was raised at trial. The defendant's claims regarding payment and potential overpayment are not grounds to overturn the attorney's fee award, and any overpayment issues can be addressed in future proceedings.

Workers' Compensation Appeals BoardAdecco StaffingInsurance Company of PennsylvaniaBroadspireFrederick JonesPetition for ReconsiderationFindings and AwardTemporary Disability IndemnityAttorney FeesMedical Provider Network
References
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