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

Case No. ADJ6833713
Significant
Mar 28, 2013

Luis Enriquez (deceased) vs. Couto Dairy, Zenith Insurance Company

The Appeals Board holds that the federal Airline Deregulation Act (ADA) preempts California's fee schedule for air ambulance services (AD Rule 9789.70) if the provider qualifies as an 'air carrier' under the ADA. The matter is returned to the trial level to determine the provider's legal status.

Airline Deregulation ActAD Rule 9789.70preemptionair carrierair transportationOfficial Medical Fee ScheduleOMFSFederal Aviation AdministrationFAAinterstate air transportation
References
Case No. ADJ6461309
Regular
Jul 19, 2012

JOSEPH MARTIN vs. City of Ukiah, Permissibly Self-Insured, administered by REDWOOD EMPIRE MUNICIPAL FUND

The Workers' Compensation Appeals Board denied reconsideration, upholding the WCJ's decision regarding air ambulance service fees. The board found that California Administrative Rule 9789.70, which dictates reasonable fees for ambulance services, is preempted by the federal Airline Deregulation Act. This preemption applies because the rule attempts to regulate the prices and services of air carriers, which is exclusively within federal purview. Therefore, the board concluded that the specific fee limitations in Rule 9789.70 do not apply to air ambulance services.

Workers Compensation Appeals BoardAD Rule 9789.70Air Ambulance ServicesAirline Deregulation ActADA Preemption49 U.S.C. ยง 41713(b)(1)Morales v. Trans World AirlinesState Regulation of Air CarriersWCABPetition for Reconsideration
References
Case No. ADJ7303543
Regular
Apr 08, 2013

JUAN RAMOS vs. SCI TEK STAFFING, CHARTIS

This case involves a workers' compensation claim where the Appeals Board granted reconsideration. The prior WCJ decision was found inconsistent with *Enriquez v. Couto Dairy*, which established that the Appeals Board can find preemption of Administrative Director (AD) Rule 9789.70, specifically the Official Medical Fee Schedule for air ambulance services. The Board clarified that the Airline Deregulation Act may preempt this rule if the air ambulance provider qualifies as an "air carrier" and has the burden of proving this status. Therefore, the matter was returned to the trial level for further proceedings and a new decision consistent with *Enriquez*.

Workers' Compensation Appeals BoardEnriquez v. Couto DairyArticle III section 3.5 California ConstitutionLabor Code section 5307.1preemptionAdministrative Director Rule 9789.70Official Medical Fee ScheduleOMFSair ambulance servicesAirline Deregulation Act
References
Case No. ADJ10351910
Regular
Aug 09, 2017

SELENA MCINTOSH vs. MILITARY DEPARTMENT OF THE STATE OF CALIFORNIA, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

This case concerns whether a California Army National Guard member injured during "active duty for training" under federal Title 10 is eligible for California workers' compensation benefits. The Board found that California Military and Veterans Code Section 340(b) expressly prohibits state workers' compensation benefits for service performed under Title 10. Therefore, the applicant cannot collect benefits under Division 4 of the Labor Code. While the applicant's VA benefits were denied, her recourse was to appeal that denial, not to pursue state workers' compensation.

Military Departmentlegally uninsuredState Compensation Insurance FundTitle 10Labor Code Division 4Petition for ReconsiderationFindings of FactWCJpsyche injurysexual assault
References
Case No. ADJ9385010
Regular
Oct 04, 2018

JULIO LARA vs. TONY'S MARKET, STATE COMPENSATION INSURANCE FUND

This case involved a dispute over whether the Airline Deregulation Act preempts state common law regarding air ambulance fees under Labor Code section 4600(a). The applicant's air ambulance carrier, Reach, argued that federal law preempted state regulation of its rates. However, before the Appeals Board could issue a decision after reconsideration, the parties reached a settlement agreement. Consequently, Reach withdrew its petition, and the Board vacated its prior order granting reconsideration and dismissed the petition. The matter was returned to the trial level for approval of the settlement.

Airline Deregulation ActADA preemptionair ambulance feesreasonable expense standardLabor Code section 4600(a)common law reasonablenessfederal court decisionsseverability principlessettlement agreementpetition dismissal
References
Case No. ADJ1034828
Regular
Jan 19, 2000

KELLY JOLLY vs. INPUT 1; CIGA administered by its servicing facility CAMBRIDGE INTEGRATED SERVICES GROUP, INC. for FREMONT COMPENSATION INSURANCE COMPANY; In liquidation; GRANITE STATE INSURANCE COMPANY, by AIG; STATE COMPENSATION INSURANCE FUND; AMERICAN SAFETY CASUALTY, by GALALGHER BASSETT

The Workers' Compensation Appeals Board denied reconsideration in this case. The Board adopted the arbitrator's report, which explained their prior holding. This holding established that CIGA is entitled to pre-litigation benefits from an insolvent carrier but must remit those proceeds to the insolvent carrier's trustee. Therefore, the petition for reconsideration was denied.

CIGAReconsideration DeniedInsolvent CarrierTrusteePre-litigation BenefitsLiquidated Insurance CompanyServicing FacilityWorkers' Compensation Appeals BoardArbitrator ReportAdjudication
References
Case No. BAK 0147388
Regular
Aug 22, 2007

ALVIN WILEY vs. STATE OF CALIFORNIA, CDCR - WASCO STATE PRISON, STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to clarify the application of Labor Code section 4656(c)(1) regarding the limit on temporary disability indemnity. The Board determined that Enhanced Industrial Disability Leave (EIDL) payments count towards the two-year/104-week limit on temporary disability, reversing the judge's prior finding. Consequently, the applicant is entitled to additional temporary disability only for the brief period from December 29, 2006, to January 4, 2007.

Workers' Compensation Appeals BoardAlvin WileyState of California CDCR Wasco State PrisonLegally UninsuredState Compensation Insurance FundAdjusting AgencyBAK 0147388Opinion and Order Granting Petition for ReconsiderationDecision After ReconsiderationFindings and Award
References
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. ADJ7721818 ADJ7721448
Regular
Feb 04, 2013

JERRY BONDS vs. LANDJET MOTOR CARRIER, STATE COMPENSATION INSURANCE FUND

This case involves applicant Jerry Bonds' workers' compensation claims against Landjet Motor Carrier and State Compensation Insurance Fund. The Workers' Compensation Appeals Board (WCAB) has issued an order dismissing Bonds' Petition for Reconsideration. The dismissal is based on the grounds that the petition was not timely filed. The WCAB adopted the reasoning of the workers' compensation administrative law judge's report in their decision.

Petition for ReconsiderationDismissedTimely FiledWCJ ReportWorkers' Compensation Appeals BoardLandjet Motor CarrierState Compensation Insurance FundADJ7721818ADJ7721448Pomona District Office
References
Case No. ADJ7892653
Regular
Jul 22, 2016

PETER ALVAREZ vs. CALIFORNIA NATIONAL GUARD, STATE OF CALIFORNIA, OFFICE OF THE ATTORNEY GENERAL, UNINSURED EMPLOYERS BENEFITS TRUST FUND, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted the defendant's Petition for Removal, rescinding the order that joined the Office of the Attorney General as a party. The Board found the Attorney General was not a necessary party as the applicant clearly identified the California National Guard as their employer. Furthermore, the Board raised a jurisdictional issue, as National Guard service under Title 32, which may apply here, generally precludes state workers' compensation benefits. The case is returned to the trial level for an evidentiary hearing to determine jurisdiction.

Petition for RemovalOrder Joining Party DefendantCalifornia National GuardState Active DutyTitle 32Title 10Inactive Duty TrainingMilitary and Veterans CodeNachbaurJurisdiction
References
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