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

Case No. ADJ2255696 (VNO 0497652)
Regular
May 15, 2009

TATIANA ZAKIANS vs. BLOOMINGDALES

Lien claimant Sam Alaiti, M.D., sought reconsideration of a WCJ's order reducing his lien by over $80\%$. The WCJ recommended granting reconsideration, noting procedural issues with the petition's timely attention by the judge. The Appeals Board found the petition timely filed, but it did not come to their attention until after the statutory reconsideration period had passed. Citing due process principles, the Board held the reconsideration period begins upon their actual notice. Therefore, the Board granted reconsideration, rescinded the prior order, and returned the matter to the trial level for further proceedings.

Lien claimantPetition for ReconsiderationOrder Reducing LienOrder to Pay Lienworkers' compensation administrative law judgeEAMSFileNetstatutory time periodAppeals Boarddue process
References
Case No. ADJ8759866
Regular
Sep 01, 2016

ERNESTINA ESCAMILLA vs. PELICAN PRODUCTS, INC., UNITED STATES FIRE INSURANCE COMPANY

This case addresses a lien claimant's petition for reconsideration of a denied lien. The Workers' Compensation Appeals Board denied the petition, affirming the administrative law judge's finding that the lien was barred by Labor Code section 4903.5(a)'s 18-month limitations period. The Board ruled that because services were provided after July 1, 2013, the lien claimant was obligated to file within 18 months of the last service date, which they failed to do. The Board reasoned that the statute provided reasonable time for filing after its enactment.

Labor Code section 4903.5(a)lien claimantreconsideration18-month limitation periodJuly 12013reasonable timeretroactive applicationproceduralvocational rehabilitation
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ8132431
Regular
Feb 12, 2018

Nichole Delgado vs. EL TEPEYAC CAFÉ; CRMBC(SIG), AMERICAN CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board affirmed a prior decision finding the defendant liable for a lien claimant's photocopying services. The Board determined the lien claimant complied with statutory requirements for valid liens, including a declaration under penalty of perjury. Furthermore, the defendant failed to timely object to the billed services or their reasonableness within the 60-day period mandated by Labor Code section 4622. Consequently, the defendant is liable for the billed amount, a 10% statutory increase, and interest.

Labor Code section 4622Labor Code section 4903.8medical-legal lienphotocopy servicesdeclaration under penalty of perjuryreasonableness of chargesstatutory increaseinterestobjection periodtimely filing
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. ADJ8363673
Regular
May 06, 2013

DIAHLO WALTON vs. THE REDWOODS GROUP, INC.; YMCA OF THE EAST BAY, SEDGWICK

This case involves a Petition for Reconsideration filed by the defendant, The Redwoods Group, Inc., YMCA of the East Bay, and Sedgwick, which has been withdrawn. The Workers' Compensation Appeals Board dismissed the petition because it was not brought to their attention until after the statutory 60-day period for review had expired. The Board tolled the statutory period due to delayed actual notice of the petition. Consequently, the reconsideration is dismissed as the petitioner withdrew their request.

Petition for ReconsiderationDismissedTolledStatutory Time PeriodActual NoticeDue ProcessAppeals BoardWorkers' CompensationLabor Code section 5909Shipley v. Workers' Comp. Appeals Bd.
References
Case No. SFO 432276
Regular
Dec 31, 2007

JANICE HOLMES vs. NEXT LEVEL COMMUNICATIONS, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration because it was untimely and improperly filed. The defendant's arguments regarding the WCJ's assessment of penalties for delayed medical treatment and mileage payments were not considered on their merits due to the procedural defect. The Board emphasized that failure to file a petition within the statutory 20-day period (plus mailing time) deprives the Board of jurisdiction.

Workers' Compensation Appeals BoardPetition for Reconsiderationuntimely filingdismissaljurisdictionstatutory time perioddelayed paymentmedical treatmentpenaltyutilization review
References
Case No. ADJ4497584
Regular
Dec 13, 2010

VICENTE RODRIGUEZ vs. GLOBE APPAREL, INC., NATIONAL LIABILITY & FIRE CO., HATHAWAY HOMESTATE COMPANY

This case involves a petition for reconsideration filed by lien claimant Joyce Altman Interpreters and Dr. Danesh/Pain Relief concerning reimbursement for services. The Workers' Compensation Appeals Board (WCAB) denied reconsideration based on the WCJ's report, which found most contentions moot. The WCJ determined that applicant's condition reached a permanent and stationary status on 05/23/06, limiting lien payments to that date, primarily relying on Dr. Lorman's medical opinion. Although the petition was timely filed, its improper e-filing format delayed the WCAB's actual notice and review until after the statutory 60-day period.

Workers' Compensation Appeals BoardPetition for ReconsiderationDue ProcessStatutory Time PeriodActual NoticeLien ClaimantPhysical TherapyInterpreter ServicesPremier MedicalPanel QME
References
Case No. ADJ14015513
Regular
Feb 15, 2023

BRADEN NANEZ vs. 3 STONEDEGGS, INC., TECHNOLOGY INSURANCE COMPANY, AMTRUST NORTH AMERICA

The Appeals Board rescinded the initial Findings and Order, finding the applicant's petition for reconsideration was timely due to defective service. The Board applied the commercial traveler rule, determining the applicant's injury arose out of and in the course of employment. The claim is not barred by the going and coming rule or intoxication, and the applicant sustained a fractured right femur. Issues of traumatic brain injury and bruised lung are deferred for further proceedings.

Workers' Compensation Appeals BoardReconsiderationOpinion and DecisionFindings and OrderApplicantEmployerAdjustedAdjudication NumberRedding District OfficeInjury Arising Out of and In the Course of Employment (AOE/COE)
References
Case No. ADJ3852069 (STK 0175466)
Regular
Dec 29, 2015

RAFAEL GOMEZ vs. DAVID REICH CONSTRUCTION, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for reconsideration, finding that the Independent Medical Review (IMR) determination was untimely. The WCAB rescinded the previous ruling and entered a new finding that the IMR was not completed within the mandatory timeframes outlined in Labor Code section 4610.6(d). Consequently, the medical treatment dispute is no longer subject to the IMR process and is returned to the trial level for a WCJ to decide. This ruling prioritizes the applicant's right to timely medical treatment, emphasizing that mandatory timeframes are crucial for protecting injured workers.

IMRLabor Code section 4610.6(d)WCAB jurisdictiontimely completionmedical treatment disputeadministrative law judgepetition for reconsiderationfindings of factutilization reviewMaximus
References
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