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

Case No. ADJ2681583 (MON 0239411)
Regular
May 01, 2012

GUILLERMINA GONZALEZ vs. SOUTHERN CALIFORNIA JOBBERS, CALIFORNIA INSURANCE GUARANTEE (CIGA) by BROADSPIRE, for CALIFORNIA COMPENSATION INSURANCE, in liquidation

In *Gonzalez v. Southern California Jobbers*, the Workers' Compensation Appeals Board granted reconsideration of the WCJ's decision. The Board rescinded the prior decision and returned the matter to the trial level for further proceedings and a new decision. This order signifies the matter is not yet finalized on its merits.

Reconsideration OrderRescindedFurther ProceedingsWorkers' Compensation Appeals BoardWCJCalifornia Insurance Guarantee AssociationCIGABroadspireLiquidationSouthern California Jobbers
References
0
Case No. ADJ8981807
Regular
Feb 04, 2019

ALEXANDRA SANDOVAL vs. STATE OF CALIFORNIA, SOUTHERN CALIFORNIA RECEPTION CENTER AND REHABILITATION, Legally Uninsured; STATE COMPENSATION INSURANCE FUND

This case involved Alexandra Sandoval's workers' compensation claim against the State of California. The Workers' Compensation Appeals Board denied Sandoval's Petition for Reconsideration. The Board adopted the WCJ's findings, giving great weight to their credibility determination of the witness. The decision hinges on the interpretation of Labor Code Section 5412, specifically the date an employee has knowledge of a cumulative injury being work-related. The Board found no substantial evidence to overturn the WCJ's determination regarding this knowledge.

Labor Code § 5412date of injurycumulative injurytemporary disabilitypermanent disabilitystatute of limitationscredibility determinationWCJ reportmedical advicereasonable diligence
References
9
Case No. ADJ2200226
Regular
Apr 08, 2014

RUDY GALLARDO vs. SOUTHERN CALIFORNIA EDISON

The WCAB reversed a prior decision, finding it lacked jurisdiction over a hospital's lien claim for unpaid services. The Appeals Board held that an "express agreement," as required by Labor Code Section 5304 to divest the WCAB of jurisdiction, existed through a chain of contracts between the hospital, a network administrator (Blue Cross), and the self-insured employer. This chain of agreements fixed the payment amounts, thus precluding the WCAB from adjudicating the fee dispute. Any claims of contract breach or non-compliance with other statutes like Section 4609 must be pursued in a different forum.

WCAB jurisdictionLabor Code Section 5304express agreementchain of contractsHuntington HospitalSouthern California EdisonBlue Cross of CaliforniaOfficial Medical Fee Schedulelien claimfee dispute
References
4
Case No. VNO 0438915
Regular
Oct 23, 2008

Applicant vs. University of Southern California

This case concerns an applicant's Petition for Reconsideration of a WCAB decision denying injury claims against the University of Southern California (USC). The applicant alleged a physical altercation with his supervisor, Mr. Pickering, during a meeting on September 20, 2001, which he claims caused various injuries. However, the WCJ found the applicant lacked credibility due to inconsistencies in his testimony and failure to report the incident promptly. The WCJ relied on testimony from witnesses who stated Mr. Pickering merely touched the applicant's shoulders and noted the applicant's history of prior injuries and medical issues not fully disclosed.

WCABPetition for ReconsiderationUniversity of Southern CaliforniaBiological Safety Specialistspecific injuryanimositycredibility issuesshoulder touchingprior injurieshypertension
References
0
Case No. ADJ3851666 (AHM 0142294) ADJ6984864
Regular
Sep 03, 2010

EDWARD NEWMAN vs. SOUTHERN CALIFORNIA EDISON

This case involves a Petition for Removal filed by Edward Newman against Southern California Edison. The Workers' Compensation Appeals Board (WCAB) reviewed the petition and the accompanying report from the administrative law judge. Finding no grounds to disturb the WCJ's findings, the WCAB has issued an order denying removal. Therefore, the petition to remove the case from its current procedural stage has been rejected.

Workers' Compensation Appeals BoardPetition for RemovalWCJ reportdenying removalSouthern California EdisonPermissibly Self-InsuredADJ3851666ADJ6984864administrative law judgeRonnie G. Caplane
References
0
Case No. ADJ3851666 (AHM 0142294)
Regular
Sep 16, 2013

EDWARD NEWMAN vs. SOUTHERN CALIFORNIA EDISON

This Workers' Compensation Appeals Board case involved applicant Edward Newman and defendant Southern California Edison. The Board granted reconsideration of a prior decision, affirming it in part but amending the orders. Specifically, the liens of Lab-Eval Services and Stanley Majcher MD were disallowed, with jurisdiction reserved for costs and sanctions against them and Scott Marks. The matter was then returned to the trial level for further proceedings.

Petition for ReconsiderationSouthern California EdisonEdward NewmanWorkers' Compensation Appeals BoardWCJ's reportgrant reconsiderationamend decisiondisallowed liensLab-Eval ServicesStanley Majcher MD
References
0
Case No. ADJ8775068
Regular
May 10, 2019

CHRIS BOTSKO vs. SOUTHERN CALIFORNIA EDISON

The Workers' Compensation Appeals Board denied Southern California Edison's petition for removal, which sought to prevent a supplemental medical report. Edison argued this would cause irreparable harm through increased expenses and delays. The Board found Edison failed to demonstrate substantial prejudice or irreparable harm, noting that utilizing an existing QME is a standard method to develop the medical record. Therefore, removal was deemed an inappropriate remedy.

Workers Compensation Appeals BoardPetition for RemovalQualified Medical ExaminerAdministrative Law JudgeSupplemental ReportPrejudiceIrreparable HarmReconsiderationAgreed Medical ExaminerRegular Physician
References
3
Case No. ADJ2200226
Regular
Jun 18, 2014

RUDY GALLARDO vs. SOUTHERN CALIFORNIA EDISON

The Workers' Compensation Appeals Board (WCAB) denied Huntington Hospital's petition for reconsideration. The WCAB affirmed its prior decision that it lacked jurisdiction over Huntington's lien claim against Southern California Edison. This denial was based on Labor Code section 5304, which precludes WCAB jurisdiction when an express agreement fixes payment amounts, as was the case with the hospital's services. Therefore, Huntington must pursue its breach of contract claims in a different forum.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationLabor Code Section 5304Express AgreementJurisdictionBreach of ContractOfficial Medical Fee ScheduleFindings of FactAdministrative Law Judge
References
0
Case No. ADJ7234303
Regular
Nov 26, 2012

KENNETH ALBERS vs. SOUTHERN CALIFORNIA EDISON

This Workers' Compensation Appeals Board decision denies Southern California Edison's petition for reconsideration. The Board affirmed the finding that applicant Kenneth Albers sustained an industrial injury to his lumbar spine and lower extremities requiring future medical treatment. The Board found the applicant's employment was a sufficient contributing cause to his injury, even if it aggravated a pre-existing condition. The Board also noted concerns regarding a Qualified Medical Evaluator's understanding of workers' compensation law.

Workers' Compensation Appeals BoardSouthern California Edisonindustrial injurylumbar spinelower extremitiesfuture medical treatmentjob analysisPanel Qualified Medical Evaluator (PQME)Labor Code section 3600arising out of and in the course of employment
References
9
Case No. ADJ9196082 (MF) ADJ10238220
Regular
Oct 02, 2019

JOHN FORKNER vs. SOUTHERN CALIFORNIA EDISON

This case involves a request for additional attorney's fees under Labor Code § 5801 following an unsuccessful writ of review by Southern California Edison. The Appeals Board found the applicant's attorney's requested rate of $450/hour reasonable. Despite the sole appellate issue being the substantiality of a medical opinion, the Board deemed the case of above-average complexity due to extensive briefing and exhibits filed by both parties. Therefore, the Board awarded $18,000.00 in appellate attorney's fees.

Workers' Compensation Appeals BoardSouthern California EdisonPetition for Writ of ReviewLabor Code § 5801attorney's feesappellate attorney's feesAgreed Medical EvaluatorAMEabove average complexityfactual issues
References
1
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