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

Case No. ADJ933687 OXN 0145745
Regular
Jun 12, 2012

ANTHONY RODRIGUEZ vs. SESSA MANUFACTURING, REDWOOD FIRE AND CASUALTY INSURANCE COMPANY, BERKSHIRE HATHAWAY

In this workers' compensation case, the Appeals Board granted reconsideration of a prior award to lien claimant Dr. Gross for medical services. The Board found that the initial decision incorrectly placed the burden of proof on the defendant regarding the reasonableness of the charges. Dr. Gross must now prove their charges are reasonable according to the Official Medical Fee Schedule. The Board also deferred the issue of penalties pending further proceedings.

Workers' Compensation Appeals BoardSessa ManufacturingRedwood Fire and CasualtyBerkshire HathawayDr. GrossreimbursementOfficial Medical Fee ScheduleOMFSbill reviewlien claimant
References
Case No. ADJ7263382
Regular
Dec 24, 2015

Grace Navarro vs. CITY OF OXNARD HOUSING AUTHORITY, PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE, AMERICAN CLAIMS MANAGEMENT, DELOS INSURANCE, IMPERIUM INSURANCE, ATHENS ADMINISTRATORS

In this workers' compensation case, the Appeals Board reviewed a dispute over which insurance carrier was liable for applicant Grace Navarro's cumulative trauma injury. The initial arbitrator found only Pennsylvania Manufacturers Association Insurance Company liable, excluding Delos Insurance. Pennsylvania Manufacturers sought reconsideration, arguing Delos should share liability based on its coverage period. After reviewing the complete evidence, the Appeals Board affirmed the original arbitrator's decision, finding Pennsylvania Manufacturers solely liable.

WORKERS' COMPENSATION APPEALS BOARDGRACE NAVARROCITY OF OXNARD HOUSING AUTHORITYPENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCEDELOS INSURANCEIMPERIUM INSURANCEATHENS ADMINISTRATORSADJ7263382RECONSIDERATIONCUMULATIVE TRAUMA
References
Case No. ADJ3609759
Regular
Jan 14, 2016

LEONEL COLLAZO vs. GLOBAL MANUFACTURING, AIG CLAIMS

In *Collazo v. Global Manufacturing*, the Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration of a decision filed October 30, 2015. The WCAB determined reconsideration was necessary to thoroughly review the factual and legal issues for a just decision. All future filings related to the petition must be submitted directly to the WCAB Commissioners in San Francisco, not to district offices or via e-filing, unless specifically noted otherwise. The WCAB stressed that a judge cannot act on settlement proposals while reconsideration is pending.

PETITION FOR RECONSIDERATIONWORKERS' COMPENSATION APPEALS BOARDGLOBAL MANUFACTURINGAIG CLAIMSADJ3609759LAO 0778512LOS ANGELES DISTRICT OFFICEOCTOBER 30 2015 DECISIONSTATUTORY TIME CONSTRAINTSFACTUAL AND LEGAL ISSUES
References
Case No. ADJ2033145 (LAO 0877321) ADJ1126357 (LAO 0877370)
Regular
Jun 06, 2012

PABLO RAMIREZ vs. BAU FURNITURE MANUFACTURING, BERKSHIRE HATHAWAY

This Workers' Compensation Appeals Board case involved applicant Pablo Ramirez and defendants Bau Furniture Manufacturing and Berkshire Hathaway. The Board granted reconsideration of a prior decision. The amended decision affirmed the original ruling but dismissed a remaining lien balance for Paramount Physicians Medical Group with prejudice. This modification specifically addressed a lien claim previously asserted.

WORKERS' COMPENSATION APPEALS BOARDPABLO RAMIREZBAU FURNITURE MANUFACTURINGBERKSHIRE HATHAWAYADJ2033145ADJ1126357OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONworkers' compensation administrative law judgeWCJ
References
Case No. ADJ463252 (VNO 0529697) ADJ240577 (VNO 0529698)
Regular
Sep 21, 2012

SHARON MARR vs. JBL PRO MANUFACTURING, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The Workers' Compensation Appeals Board dismissed Sharon Marr's petition for removal against JBL Pro Manufacturing and Travelers Property Casualty Company of America. The dismissal was primarily based on the petition not being timely-filed. Even if it had been timely, the Board would have denied the petition on its merits, adopting the reasons stated by the administrative law judge.

Petition for RemovalTimely-filedWCJ ReportDismissedWorkers' Compensation Appeals BoardADJ463252ADJ240577JBL PRO MANUFACTURINGTRAVELERS PROPERTY CASUALTY COMPANY OF AMERICAFrank M. Brass
References
Case No. ADJ3853778 (VNO 0514688)
Regular
May 20, 2013

HEREDIO ALONSO-USATORES vs. SPEARS MANUFACTURING COMPANY, ZURICH NORTH AMERICA

This case involves an applicant who claimed a left knee injury sustained on October 18, 2004, while employed by Spears Manufacturing Company. The defense argued the injury was not supported by evidence, questioned the applicant's credibility due to language barriers, and asserted it was not industrial or timely reported. The Workers' Compensation Appeals Board denied reconsideration, upholding the finding of an industrial left knee injury based on persuasive medical evidence from an Agreed Medical Examiner and the applicant's credible testimony. The Board gave significant weight to the judge's credibility determination, affirming the award for temporary disability and reimbursement for EDD payments.

Workers Compensation Appeals BoardSpears Manufacturing CompanyZurich North AmericaHeredio Alonso-UsatoresOrder Denying ReconsiderationGarza v. Workers' Comp. Appeals Bd.John C. GutierrezReport and RecommendationPetition for ReconsiderationLeft Knee Injury
References
Case No. ADJ3058631 (FRE 0225238) ADJ4053535 (FRE 0206567)
Regular
May 01, 2018

JOE GUTIERREZ vs. CLOVIS SANGER CABINET MANUFACTURING AND AMERICAN CLAIMS MANAGEMENT, INC., EVEREST NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board denied a Petition for Removal filed by defendants Clovis Sanger Cabinet Manufacturing and American Claims Management. The Board found that defendants failed to demonstrate substantial prejudice or irreparable harm from an interim order vacating a prior deposition order. Furthermore, the Board determined that reconsideration would be an adequate remedy. The matter is scheduled for a Mandatory Settlement Conference where the deposition issue can be revisited.

Petition for RemovalExtraordinary RemedySubstantial PrejudiceIrreparable HarmReconsiderationMandatory Settlement ConferenceDepositionVacated OrderDiscoveryEx Parte
References
Case No. ADJ1036250 (LBO 0379542)
Regular
Jan 02, 2014

RAMON BAUTISTA vs. DE LA ROSA MANUFACTURING, INC., BERKSHIRE HATHAWAY HOMESTATE INSURANCE COMPANY AND CASUALTY INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed a Petition for Reconsideration filed by a lien claimant in the case of Bautista v. De La Rosa Manufacturing, Inc. The WCAB found the petition to be untimely because it was filed more than 25 days after the October 15, 2013 order, exceeding the statutory deadline. Additionally, the petition was dismissed for being unverified. Therefore, the WCAB ordered the Petition for Reconsideration dismissed.

Petition for ReconsiderationUntimely filingLabor Code section 5903Code of Civil Procedure section 1013DismissalUnverifiedWorkers' Compensation Appeals BoardAdministrative law judgeLien claimantDe La Rosa Manufacturing
References
Case No. ADJ1271468 (LAO 0838972) ADJ3841157 (LAO 0840312) ADJ249664 (LAO 0843194)
Regular
Mar 03, 2009

JORGE PEREZ vs. REGENT MANUFACTURING, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award concerning industrial injuries sustained by Jorge Perez. The primary issue was whether the applicant was entitled to recommended dental treatment, which the defendant had denied via utilization review (UR). The Board found the record unclear regarding the timeliness of the defendant's UR denial and the applicant's subsequent objection process. Consequently, the case was remanded for further development of the record, particularly concerning the UR timeline and the dispute resolution procedures under Labor Code sections 4062 and 4062.2.

Workers' Compensation Appeals BoardRegent ManufacturingState Compensation Insurance FundJorge Perezindustrial injurieslow backright lower extremityneckleft earside of face
References
Case No. ADJ2142052 (AHM 0149913) ADJ6592788
Regular
Mar 24, 2017

CESAREO LAGOS, vs. CAMBRO MANUFACTURING COMPANY;, ZURICH NORTH AMERICA; STATE COMPENSATION INSURANCE FUND,

The Appeals Board granted reconsideration and rescinded a $500.00 sanction order against lien claimant Asher E. Esagoff and representative Lila Ramirez. Although the WCJ found they failed to meet their burden of proof at trial, the Board determined their conduct did not rise to the level of bad faith required for Labor Code section 5813 sanctions. The Board distinguished this case from prior precedent, noting the lien claimant presented medical reports and authorization requests, even if some were excluded. Therefore, the lien claimant and representative were found not subject to the sanctions.

WCABADJ2142052ADJ6592788Cambro ManufacturingZurich North AmericaState Compensation Insurance FundLabor Code 5813sanctionslien claimantAsher Esagoff
References
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