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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ6843753
Regular
Jul 03, 2012

REGLO MOLINA vs. WORKFORCE STAFFING dba GENEVA STAFFING and TOWER GROUP COMPANIES (Formerly SPECIALTY UNDERWRITERS ALLIANCE/SUA) Administered By INTERCARE HOLDINGS INSURANCE SERVICES

In *Molina v. Workforce Staffing*, the Workers' Compensation Appeals Board denied a Petition for Removal. The Board adopted and incorporated the administrative law judge's report as the basis for this denial. The specific reasons for the denial are detailed in that incorporated report. The order was served on July 3, 2012.

Petition for RemovalWorkers' Compensation Appeals BoardWorkforce StaffingGeneva StaffingTower Group CompaniesSpecialty Underwriters AllianceSUAIntercare Holdings Insurance ServicesADJ6843753Marina del Rey
References
Case No. ADJ6991535
Regular
Dec 24, 2013

SILVER HERNANDEZ vs. QUALITY CAR CONNECTION, INC., PRESERVER INSURANCE COMPANY, administered by TOWER GROUP COMPANIES (formerly SPECIALTY UNDERWRITERS ALLIANCE/SUA)

This is a final order from the Workers' Compensation Appeals Board (WCAB) denying a petition for reconsideration. The WCAB adopted the findings of the administrative law judge, finding no basis to overturn the original decision. The specific details of the original decision are not provided in this excerpt, but the petition for reconsideration by the applicant, Silver Hernandez, was unsuccessful. Therefore, the defendants, Quality Car Connection, Inc. and its insurer, remain the prevailing parties regarding the WCAB's denial of the petition.

Petition for ReconsiderationAdministrative Law Judge ReportDeny ReconsiderationWorkers' Compensation Appeals BoardQuality Car ConnectionPreserver Insurance CompanyTower Group CompaniesSpecialty Underwriters Alliance/SUAADJ6991535Los Angeles District Office
References
Case No. ADJ6814425
Regular
Apr 23, 2012

JIMMY WILLIAMS vs. SAN FRANCISCO 49ers; TIG INSURANCE COMPANY Administered By RISK ENTERPRISE MANAGEMENT LIMITED; SUCCESSOR IN INTEREST BY MERGER TO GULF INSURANCE COMPANY THE TRAVELERS INDEMNITY COMPANY; BERKELEY SPECIALTY UNDERWRITING MANAGERS, LLC; NEW ORLEANS SAINTS; LOUISIANA WORKERS' COMPENSATION CORPORATION; SEATTLE SEAHAWKS; PSI; HOUSTON TEXANS; BERKELEY SPECIALTY UNDERWRITING MANAGERS, LLC.

In this Workers' Compensation Appeals Board case, applicant Jimmy Williams' Petition for Removal has been denied. The order signifies the Board's decision not to further review or remove the case from its current proceedings. The specific grounds for denial are not detailed in this excerpt. The decision was issued by the Workers' Compensation Appeals Board on April 23, 2012.

Petition for RemovalWorkers' Compensation Appeals BoardSan Francisco 49ersTIG Insurance CompanyRisk Enterprise Management LimitedGulf Insurance CompanyThe Travelers Indemnity CompanyBerkeley Specialty Underwriting Managers LLCNew Orleans SaintsLouisiana Workers' Compensation Corporation
References
Case No. ADJ7658730
Regular
Mar 27, 2014

Maria Perez vs. TS STAFFING, LUMBERMEN'S UNDERWRITING ALLIANCE

This case concerns a lien claim for interpretation services provided by Santana, Lopez & Associates, LLC. The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior order, finding that Santana failed to prove its interpreters were "qualified" for 14 medical appointments. The interpreters for these appointments were neither certified nor provisionally certified, nor were they documented as provisionally utilized by the treating physician, thus invalidating the lien for those services. Consequently, Santana is not entitled to further payment on its lien.

Santana Lopez & AssociatesLumbermen's Underwriting Alliancequalified interpretercertified interpreterprovisionally certifiedGovernment Code section 11435.55Labor Code section 4622Labor Code section 4603.2(b)Labor Code section 5813Administrative Director's Rule 9795.1
References
Case No. ADJ8139465
Regular
Apr 18, 2013

Robert Scharfe vs. VI-TEL, LUMBERMANS UNDERWRITING ALLIANCE

This case concerns applicant Robert Scharfe's petition for reconsideration of a workers' compensation award. Scharfe argued the administrative law judge erred in calculating his average weekly earnings, claiming the judge disregarded significant self-employment income. The Board denied reconsideration, affirming the judge's decision that Scharfe failed to provide substantial evidence of his self-employment earnings, as his tax returns showed a net loss. Additionally, the Board found no error in the admission of income declarations from Scharfe's child support cases, which contradicted his claimed earnings.

Robert ScharfeVi-TelLumbermans Underwriting AllianceADJ8139465Opinion and Order Denying Reconsiderationtemporary disability indemnityaverage weekly earningsself-employment incomechild support casesLos Angeles County Superior Court
References
Case No. ADJ8223018
Regular
Sep 30, 2014

GERARDO VARGAS vs. ACCOUNTABILITY INCORPORATED, administered by LUMBERMEN'S UNDERWRITING ALLIANCE

The Workers' Compensation Appeals Board (WCAB) dismissed a petition for removal filed by Accountability Incorporated. The dismissal was primarily due to a lack of proper verification on the petition. Even if it had been verified, the WCAB indicated it would have denied the petition on its merits, adopting the reasoning of the workers' compensation administrative law judge. Therefore, the petition for removal was officially dismissed.

Petition for RemovalWorkers' Compensation Appeals BoardWCJ ReportLack of VerificationDismissalCal Code Regs tit 8 § 10843(b)Deny on the MeritsAdministrative Law JudgeAccountability IncorporatedLumbermen's Underwriting Alliance
References
Case No. ADJ11211443
Regular
Sep 12, 2019

YOLANDA BARROSO vs. HARTNELL COLLEGE, KEENAN \u0026 ASSOCIATES

This case involves a defendant's petition for removal after a Workers' Compensation Appeals Board (WCAB) judge ruled that chiropractic care was an appropriate specialty for the applicant's injuries. The defendant argued that the ruling was premature and prejudicial, seeking a replacement QME panel in a different specialty. However, the WCAB denied the petition, finding the defendant waived its right to challenge the specialty by not raising the issue earlier. The WCAB also determined the defendant failed to demonstrate irreparable harm or significant prejudice.

Workers' Compensation Appeals BoardPetition for RemovalFindings and OrderQualified Medical EvaluatorQME specialtychiropracticcollateral estoppelwaiverres judicatairreparable harm
References
Case No. ADJ7917765
Regular
Mar 16, 2018

ANA MARIA GRAJEDA vs. TRISTAR STAFFING, Dba QUALITY STAFFING SERVICES, LUMBERMEN'S UNDERWRITING ALLIANCE

The Workers' Compensation Appeals Board denied reconsideration of a $500 lien settlement. The lien claimant sought to overturn the stipulation, alleging due process violations and entitlement to reimbursement for self-procured medical care. The Board found no good cause to set aside the stipulation, as petitioner was represented and failed to demonstrate mistake, inadvertence, or new evidence. Therefore, the stipulation and order approving the $500 payment remain in effect.

Workers' Compensation Appeals BoardAna Maria GrajedaTristar StaffingLumbermen's Underwriting AllianceOptimal Health InstituteJie Ci DingStipulation and OrderCompromise And Releaseindustrial injuryback injury
References
Case No. ADJ7640191
Regular
Nov 23, 2020

GLORIA MARIN vs. TRI-STATE EMPLOYMENT SERVICES, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, LUMBERMAN'S UNDERWRITING ALLIANCE

The Workers' Compensation Appeals Board (WCAB) granted CIGA's petition for reconsideration, overturning a prior ruling that denied joinder of another employer. The WCAB held that Labor Code section 5804 does not prevent the joinder of additional parties or employers after a settlement, and CIGA is not attempting to alter a prior award. The case is returned to the trial level for joinder of all appropriate parties and further proceedings. The WCAB also clarified that CIGA's liability is limited by Insurance Code section 1063.1 and subsequent case law, which prohibits apportionment of liability between CIGA and other insurers for certain benefits.

CIGALumberman's Underwriting AllianceliquidationLabor Code section 5804joinderCompromise and Releaselien claimsother insurancecovered claimsapportionment
References
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