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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ3419685 (GRO 0029797)
Regular
Dec 10, 2000

MARLENA MOORE vs. ALBERTSONS, SPECIALTY RISK SERVICES

This case involves a Petition for Removal filed by Marlena Moore against Albertsons and Specialty Risk Services. The Workers' Compensation Appeals Board (WCAB) has reviewed the petition and the report from the workers' compensation administrative law judge. Consequently, the WCAB has denied the Petition for Removal. The decision incorporates the reasoning provided in the WCJ's report.

WORKERS' COMPENSATION APPEALS BOARDMARLENA MOOREALBERTSONSSPECIALTY RISK SERVICESPetition for RemovalWCJ reportdenial of removaladministrative law judgeADJ3419685GRO 0029797
References
Case No. ADJ3366737 (MON 0317061)
Regular
Aug 11, 2015

LOUIS ROSADO vs. AMERICAN AIRLINES, SPECIALTY RISK SERVICES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded an administrative law judge's (WCJ) order dismissing a lien claim. The lien claimant asserted it was never served with a Notice of Intention to Dismiss (NIT) and thus denied due process. The WCAB found no proof of service for the NIT in the record, agreeing that the lien claimant was denied proper notice and an opportunity to be heard. Consequently, the matter was returned to the WCJ to allow the lien claimant statutory time to respond to the NIT.

Petition for ReconsiderationOrder of DismissalLien ConferenceNotice of Intention to DismissDue ProcessProof of ServiceWCJWorkers' Compensation Appeals BoardLien ClaimantWCAB Rule 10562
References
Case No. ADJ1885105 (LAO 0822725)
Regular
May 15, 2012

SCOTT SIMONS vs. SUPERHEAT SERVICES, INC/INSPERITY, KEMPER INSURANCE, SEDGWICK CMS/ SPECIALTY RISK SERVICES

The Appeals Board granted reconsideration and rescinded the prior award, finding no unreasonable delay in the provision of medical treatment. Applicant failed to establish a delay in the provision of home care or transportation services as no bills had been submitted to the defendant. The issue of the reasonable value of home health care services was deferred pending a bill submission and potential negotiation between the parties. The Board emphasized the need for better communication between the parties to avoid further litigation.

Workers' Compensation Appeals BoardReconsiderationUnreasonable DelayMedical TreatmentHome Health CareTransportationPenaltyLabor Code Section 5814Petition for ReconsiderationFindings and Award
References
Case No. ADJ8216409
Regular
Jan 20, 2015

NORMA FLORES vs. DEPARTMENT OF SOCIAL SERVICES/IHSS, YORK RISK SERVICES

In *Flores v. Department of Social Services/IHSS*, the Workers' Compensation Appeals Board (WCAB) dismissed an applicant's petition for reconsideration as untimely. The petition was filed on November 26, 2014, more than twenty-five days after the WCJ's decision was served on October 20, 2014. The WCAB emphasized that the filing deadline for a petition for reconsideration is jurisdictional. Therefore, the Board lacked the authority to grant the petition, regardless of its merits.

Workers' Compensation Appeals BoardPetition for ReconsiderationUntimely FilingLabor Code Section 5903Jurisdictional Time LimitWCJ Report and RecommendationDismissalService of DecisionMailing ExtensionCode of Civil Procedure Section 1013
References
Case No. ADJ2398835
Regular
Sep 19, 2008

LETICIA FERNANDEZ vs. MT. ST. MARY'S COLLEGE, CIGA, BROADSPIRE SERVICES, LEGION INSURANCE COMPANY, VILLANOVA INSURANCE COMPANY, SPECIALTY RISK SERVICES, CONVERIUM INSURANCE, INC.

The Appeals Board corrects a clerical error in the applicant's name in the caption of the "Opinion and Order Granting Reconsideration and Decision After Reconsideration" of September 8, 2008, changing it from "Leticia Hernandez" to "Leticia Fernandez".

Workers' Compensation Appeals BoardClerical ErrorReconsiderationOpinion and OrderApplicant NameCaption CorrectionLiquidating InsurersFacilitating AgencyMt. St. Mary's CollegeCIGA
References
Case No. ADJ1158684 (GOL 0099195)
Regular
Nov 14, 2008

CAROLINA VELA vs. SERVICE MASTER CBM, AMERICAN ALL-RISK LOSS ADMINISTRATORS

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration to correct a clerical error, reducing the lien awarded to Lorena Ortiz-Schneider from $4,025.00 to $1,995.00. The Board also denied Associated Reproduction Services' petition, affirming the WCJ's decision to award copy charges at a reasonable rate of 20 cents per page, referencing precedent established by *Kunz* and *Sweet*. This decision clarifies the correct lien amount and upholds the application of reasonable rates for reproduction services.

WCABPetition for ReconsiderationLien ClaimantInterpreting ServicesCopy ChargesReasonableness of ChargesMedical-Legal ExpensesClerical ErrorDecision After ReconsiderationKunz v. Patterson
References
Case No. ADJ7013922
Regular
Jun 29, 2010

MANUEL REYES vs. LF STAFFING SERVICES INCORPORATED, AIG administered by SPECIALTY RISK SERVICES

In this case, the Workers' Compensation Appeals Board granted reconsideration of a WCJ's decision concerning applicant Manuel Reyes' industrial injury. While applicant's contentions regarding temporary disability and penalties were denied, the Board rescinded the entire decision to allow the WCJ to re-evaluate applicant's average weekly earnings. The Board found the current earnings calculation potentially flawed due to applicant's history as an intermittent temporary employee with irregular hours and varied pay rates. Further development of the record on earnings is required before a new, unified decision can be issued.

ADJ7013922LF STAFFING SERVICES INCORPORATEDAIGSPECIALTY RISK SERVICESindustrial injurythoracic spineaverage weekly earningstemporary disability indemnitymodified/alternative workLabor Code section 4650(d)
References
Case No. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
Case No. ADJ6650878
Regular
Dec 09, 2015

BRIDGETTE HUNTER vs. DEPARTMENT OF SOCIAL SERVICES IHSS; YORK RISK SERVICES GROUP

The Workers' Compensation Appeals Board denied Bridgette Hunter's Petition for Reconsideration regarding her Stipulated Award for industrial injuries to her spine and psyche. The Board adopted the findings of the Administrative Law Judge, who recommended denial. Although the ALJ noted the petition might be untimely, the Board found insufficient proof of service to make that determination, thus denying reconsideration on other grounds. The applicant's claims of fraud, excess of power, and insufficient evidence were rejected as the award was based on agreed-upon Agreed Medical Evaluator reports.

Workers' Compensation Appeals BoardPetition for ReconsiderationStipulated Awarduntimely filingproof of serviceAME reportsBridgette HunterDepartment of Social Services IHSSYork Risk Services GroupWorkers' Compensation Administrative Law Judge
References
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