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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. LAO 0848876
Regular
Dec 27, 2007

MARIA MURILLO vs. HI POINT/NORCO RANCH, REPUBLIC INSURANCE by CRAWFORD AND COMPANY

The Workers' Compensation Appeals Board (WCAB) determined that a diskectomy is not an amputation under Labor Code section 4656(c)(2)(C), limiting temporary disability to 104 weeks. The WCAB affirmed the finding that temporary disability should have been paid from October 6, 2006, to November 24, 2006, but reversed the decision to extend benefits beyond the statutory 104-week limit due to a delay in authorizing surgery. Therefore, the applicant is entitled to additional temporary disability indemnity only for the specified period, with the last payment due November 24, 2006.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardMachine operatorIndustrial injuryBilateral shouldersBack injuryTemporary disability indemnityLabor Code section 4656Amputation
References
Case No. ADJ7970557 ADJ7234375
Regular
Aug 01, 2016

LAURA MIRANDA vs. EL SUPER MARKET, PACIFIC COMPENSATION/NORTH RIVER INSURANCE COMPANY

This case involves a lien claimant seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision barring their lien for medical services. The WCJ found the lien untimely under Labor Code section 4903.5(a) because it was filed more than 18 months after the last date of service, which occurred after July 1, 2013. The Appeals Board agreed, clarifying that the 18-month limit applies to services provided on or after July 1, 2013, and the filing on September 24, 2015, was indeed too late. The Board found the lien claimant had a reasonable time to file given the statutory amendment's effective date.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationStatute of LimitationsLabor Code Section 4903.5(a)Joint Findings and OrderWCJTimelinessDate of Services18-month limitation period
References
Case No. ADJ8730224
Regular
Dec 15, 2016

SERGIO BERMUDEZ vs. CERRITOS AUTO REPAIR CENTER, STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Tri County Medical Group's (TCMG) petition for reconsideration of a finding that its lien claim was barred by the 18-month limitation in Labor Code section 4903.5(a). The Board majority held that because TCMG's last date of service was January 29, 2015, after the July 1, 2013 effective date for the shorter period, the 18-month limit applied. TCMG's lien was filed over 18 months after this last date of service and was therefore untimely. A dissenting commissioner argued that for continuously provided services crossing the July 1, 2013 date, the three-year limit should apply to avoid requiring multiple lien filings.

Labor Code Section 4903.5(a)lien claim18-month limitation periodthree-year limitation perioddate services were providedlast date of servicecontinuously provided servicespetition for reconsiderationdenial of lienWCJ report
References
Case No. ADJ8572033
Regular
Jan 23, 2017

NELLY MOLINA vs. MACY'S CORPORATE SERVICES, Permissibly Self-Insured, Administered By MACY'S

This case involves a lien claim by Industrial Healthcare for medical services provided to applicant Nelly Molina from November 6, 2012, to September 10, 2013. The Workers' Compensation Appeals Board (WCAB) denied reconsideration of an order dismissing the lien, upholding the administrative law judge's finding that the lien was untimely. The WCAB ruled that because the last date of service (September 10, 2013) was after July 1, 2013, the 18-month statute of limitations under Labor Code section 4903.5(a) applied, making the lien filed on September 2, 2015, tardy. A dissenting opinion argued that continuous services provided both before and after July 1, 2013, should be subject to the three-year statute of limitations, allowing for a single lien filing.

Labor Code section 4903.5(a)statute of limitationslien claimreconsiderationOrder Dismissing Lienworkers' compensation administrative law judgeIndustrial HealthcareInnovative Medical ManagementMacy's Corporate Servicescontinuous treatment
References
Case No. SAC 345456
Regular
Jun 05, 2008

CONNIE SOTOLONGO vs. STATE OF CALIFORNIA / EMPLOYMENT DEVELOPMENT DEPARTMENT, STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

This case clarifies that Labor Code section 4656(c)(1) imposes an aggregate 104-week limit on temporary disability indemnity payments within a two-year period for any single injury. The Workers' Compensation Appeals Board held that this limit applies to both temporary total and temporary partial disability payments, regardless of the specific type of temporary disability. This interpretation aligns with the statutory language and the Legislature's intent to create a broad, time-based cap on temporary disability benefits.

Labor Code section 4656(c)(1)temporary total disabilitytemporary partial disabilityaggregate limitcompensable weekstwo-year periodIndustrial Disability LeaveSB 899legislative intentstatutory construction
References
Case No. ADJ87-41561
Regular
Mar 18, 2016

OMAYRA GUERRERO vs. EASY STAFFING, LUMBERMEN'S UNDERWRITING ALLIANCE

This case concerns a lien claim filed by Advance Care Specialist Medical Clinic (ACSMC) for services provided to an injured worker. The Workers' Compensation Appeals Board denied ACSMC's petition for reconsideration, affirming a prior order that barred the lien as untimely filed under Labor Code section 4903.5(a). The majority found that since the last date of service was September 23, 2013, after the July 1, 2013 amendment, the 18-month filing limitation applied, and ACSMC's August 19, 2015 filing was too late. The dissenting opinion argued that for continuously provided services spanning before and after July 1, 2013, the three-year limitation should apply to avoid requiring multiple lien filings and prevent absurd results.

Workers' Compensation Appeals BoardLabor Code 4903.5(a)Statute of LimitationsLien ClaimReconsiderationLast Date of Service18-month limitation period3-year limitation periodRetroactive applicationReasonable time
References
Case No. SAC 0340252
Regular
Oct 24, 2007

ROY HOWARD vs. MERCER STAFFING, aka AMERICAN STAFF RESOURCES, CASCADE NATIONAL INSURANCE, in liquidation, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

This case concerns whether temporary disability payments should extend indefinitely after an industrial back and shoulder injury. The Appeals Board determined that Labor Code section 4656(c)(1) limits aggregate temporary disability payments to 104 weeks within a two-year period from the *first payment* of temporary disability, not the date disability is owed. Therefore, the award was amended to terminate payments on January 28, 2007, the two-year anniversary of the initial payment.

Labor Code section 4656(c)(1)temporary disability indemnitydate of commencement of temporary disability payment104 compensable weeksaggregate disability paymentspetition for reconsiderationFindings and AwardWorkers' Compensation Appeals Boardindustrial injurytruck driver
References
Case No. ADJ2610658 (BAK 0153868)
Regular
Sep 14, 2012

EUNICE WHELDON vs. GOLDEN EMPIRE TRANSIT

The Workers' Compensation Appeals Board granted reconsideration to reverse a prior decision, finding the applicant's claim barred by the statute of limitations. The applicant, a bus driver, injured her knees in 2005 but did not file a claim until May 2008 and received medical treatment in 2010. Although the employer did not provide the statutory notice of rights, the Board found this was not required as the applicant lost no time from work and initially stated she did not need medical treatment beyond first aid. Therefore, the Board concluded the employer was not estopped from raising the statute of limitations defense.

Workers' Compensation Appeals BoardGolden Empire Transitindustrial injurybilateral kneestemporary disabilityfurther medical treatmentLabor Code section 5401(a)statute of limitationstollingApplication for Adjudication of Claim
References
Case No. ADJ9895453
Regular
Aug 21, 2017

SIR WALTERS (Dec'd), AMORN WALTERS (Widow) vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded an earlier award. The WCAB found that the death certificate alone was insufficient substantial medical evidence to establish the cause of the decedent's death, specifically concerning whether it was due to an industrial injury, a blood-borne infectious disease, or MRSA. Therefore, the case was returned to the trial level for further proceedings and development of the record. The issue of the applicable statute of limitations remains deferred pending this further evidence.

Valley FeverCoccidioidomycosisCocci meningitisMRSACorrectional officerDeath benefitsStatute of limitations240-week limitation420-week limitationLabor Code 3212.8
References
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