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

Case No. ADJ1609885 (ANA 0410274)
Regular
Jun 14, 2010

JUAN MEDINA vs. SANTA ANA PLATING, STATE COMPENSATION INSURANCE FUND SANTA ANA

This case involves a lien claimant, Main Street Specialty Surgery Center, seeking reimbursement for medical services provided to applicant Juan Medina for an industrial injury on December 13, 2002. The lien claimant filed its application for adjudication on May 29, 2008, over five years after the date of injury and the provision of medical services. The Workers' Compensation Appeals Board reversed the finding of the administrative law judge, holding that the lien claimant's claim is barred by Labor Code section 5405. The Board clarified that lien claimants initiating proceedings must adhere to the same statutes of limitations as the injured worker, and without a timely filed application, recovery is precluded.

Workers' Compensation Appeals BoardReconsiderationOpinion and DecisionFindings and AwardLien ClaimantStatute of LimitationsLachesLabor Code section 4903.5Labor Code section 5405Application for Adjudication
References
3
Case No. ADJ6711454
Regular
May 23, 2016

EDWARD GUTIERREZ vs. CITY OF SANTA ANA

The Workers' Compensation Appeals Board (WCAB) affirmed a prior decision denying jurisdiction over a lien dispute between Western Medical Center and the City of Santa Ana. The WCAB found that an interlocking chain of contracts between the medical provider and the employer/insurer, referencing Labor Code Section 5304, created an "express agreement" fixing medical treatment rates. This agreement divested the WCAB of jurisdiction, and Labor Code Section 5307.11 did not grant jurisdiction when it was otherwise excluded by Section 5304.

Workers' Compensation Appeals BoardLien DisputeJurisdictionLabor Code Section 5304Labor Code Section 4609Labor Code Section 5307.11Express AgreementContracted RateMedical TreatmentParticipating Hospital Agreement
References
1
Case No. ADJ2380227 (LBO 0376292) ADJ2803570 (AHM 0086412)
Regular
Mar 28, 2011

CHRIS FELICIJAN vs. SANTA ANA UNIFIED SCHOOL DISTRICT

In Felicijan v. Santa Ana Unified School District, the Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration as untimely. The WCAB adopted the administrative law judge's report, which found the petition was filed 36 days after the decision, exceeding the 20-day statutory limit plus a 5-day mailing extension. Therefore, the WCAB ordered the dismissal of the petition.

Workers' Compensation Appeals BoardPetition for Reconsiderationuntimelydismissadministrative law judgeReport and RecommendationFindings and OrderLab. Code§ 5903Code Civ. Proc.
References
0
Case No. ADJ4435696 [ANA 0406876] ADJ1243268 [ANA 0406877]
Regular
Sep 02, 2008

ANN JOHNSON vs. SANTA ANA UNIFIED SCHOOL DISTRICT

The School District failed to provide proper notice of its Medical Provider Network (MPN) to the applicant at the time of injury. The District is liable for reasonable medical treatment self-procured by the applicant.

Workers' Compensation Appeals BoardMedical Provider Network (MPN)Santa Ana Unified School Districtnotice requirementsAdministrative Director Rule 9767.12(a)Knight v. United Parcel Serviceburden of proofself-procured treatmentliabilityreconsideration
References
1
Case No. MISSING
Regular Panel Decision
Feb 27, 2001

Adams v. Santa Fe Construction Corp.

The Supreme Court, Bronx County, order denying the Santa Fe defendants' motion for summary judgment and granting plaintiff's cross-motion for leave to serve a supplemental bill of particulars was unanimously affirmed. The denial of summary judgment was due to unresolved questions of fact regarding whether the plaintiff was a special employee of the Santa Fe defendants, thus precluding the application of the Workers' Compensation Law § 11 exclusivity rule. Evidence suggested shared supervision and control over the construction site between the Santa Fe defendants and the plaintiff's general employer. The court also found that the supplemental bill of particulars merely amplified existing allegations under Labor Law § 241 (6) by citing specific Industrial Code chapter headings, and did not introduce new theories of liability, thus affirming its grant.

special employeeWorkers' Compensation LawLabor Lawsummary judgmentbill of particularsIndustrial Codeshared supervisionconstruction siteappellate affirmance
References
3
Case No. ADJ972426 (ANA 0405051)
Regular
Jan 14, 2010

DONALD STOW vs. SANTA ANA POLICE DEPARTMENT

The Workers' Compensation Appeals Board granted reconsideration of a prior award that found the employer liable for serious and willful misconduct. The Board rescinded the award, finding the applicant's failure to wear provided safety goggles was the proximate cause of his eye injury during a training exercise. While the employer's provision of goggles instead of a full face mask may have been negligent, it did not rise to the level of serious and willful misconduct as defined by law. Therefore, the applicant was not entitled to the 50% compensation increase.

Workers Compensation Appeals BoardDonald StowSanta Ana Police Departmentserious and willful misconductLabor Code section 4553industrial injuryright eyepolice officertraining exercisesimunition
References
5
Case No. ADJ429247 (ANA 0407707)
Regular
Nov 14, 2008

DIANE FLEMING vs. SANTA ANA UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board granted reconsideration to review a trial transcript concerning a teacher's industrial injury claim. The defendant school district disputes the finding that the applicant sustained an injury while transporting school work home, arguing it does not qualify as an exception to the going and coming rule. The Board needs the transcript to accurately assess the facts and testimony before issuing a just decision.

Workers' Compensation Appeals Boardindustrial injuryteacherbreak-inhome as second worksitegoing and coming rule exceptiontransporting school workwhite-collar exceptionreconsiderationadministrative law judge
References
0
Case No. ADJ4317262 (ANA 0327568)
Regular
Apr 13, 2009

JOSE GONZALEZ vs. BURR ROOFING, INC., SCIF INSURED SANTA ANA

The applicant sought reconsideration of a workers' compensation award, primarily arguing the permanent disability rating undervalued his urological condition and the WCJ erred in not crediting vocational rehabilitation expert opinion. The Appeals Board granted reconsideration solely to award additional attorney fees for temporary disability benefits. While the majority affirmed the WCJ's original findings on permanent disability, a dissenting commissioner argued the urological condition was significantly underestimated and requested a new rating.

Workers Compensation Appeals BoardJose GonzalezBurr RoofingSCIF Insured Santa Anapermanent disabilityapportionmentrooferupper back injurymid back injurylow back injury
References
0
Case No. ADJ262420 (ANA 0302091)
Regular
Nov 23, 2009

ROBERT ORNELAS vs. SANTA ANA UNIFIED SCHOOL DISTRICT, Permissibly Self-Insured

The WCAB granted reconsideration, rescinded the August 24, 2009 Findings and Order, and returned the matter to the trial level for further proceedings. The defendant had a contractual obligation to pay the lien claimant.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and OrderAdministrative Law JudgeLabor Code sections 4903 and 4903.1(a)(3)Compromise and ReleaseLiving ExpensesContractual ObligationBad Faith
References
0
Case No. ADJ7632437
Regular
Apr 20, 2015

MARIA GARCIA vs. HISTORIC SANTA MARIA INN, FIREMANS FUND INSURANCE COMPANY

In this workers' compensation case, the applicant sought to change venue from San Luis Obispo to Santa Barbara. The initial venue was based on her former attorney's location, but the applicant lives, worked, and was injured in Santa Barbara County, where her current attorney also practices. The Appeals Board granted removal, finding that the Santa Barbara "satellite office" functions as a full trial court office. Therefore, venue was changed to Santa Barbara, as statutory criteria for venue are met and substantial prejudice would result from maintaining the current location.

Petition for RemovalOrder Denying Change of VenueWorkers' Compensation Appeals BoardWCJVenueSan Luis ObispoSanta BarbaraSatellite OfficeLabor Code Section 5501.5Application for Adjudication of Claim
References
2
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