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

Case No. SRO 0112855
Regular
Aug 22, 2007

KAPKA NIKOLOVA vs. J. T. ENTERPRISES, GOLDEN EAGLE/LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board denied defendant J.T. Enterprises' petition for reconsideration, affirming a judge's decision that the defendant failed to properly notify the applicant of a Medical Provider Network (MPN) transfer. The Board found that the defendant did not demonstrate proof of service of the MPN notice on the applicant's treating physician. Furthermore, the defendant failed to provide the applicant with a determination regarding her continuing care or whether it met any exceptions to the MPN transfer rules.

Workers' Compensation Appeals BoardMedical Provider NetworkMPNTransfer of Care PlanPetition to CompelFindings and AwardLabor CodeAdministrative Director's RulesPrimary Treating PhysicianNotice Requirements
References
Case No. ADJ9532869; ADJ9532720
Regular
Feb 15, 2019

JORGE AGUILAR vs. ALTMAN SPECIALTY PLANTS, TRAVELERS INSURANCE COMPANY

The WCAB granted the defendant's Petition for Removal and rescinded a prior order that had vacated a venue transfer. The Board found that the original judge who approved stipulations should retain jurisdiction for subsequent proceedings, consistent with Labor Code section 5700 and WCAB Rule 10346. Venue for both cases was transferred to the Los Angeles District Office, the applicant's attorney's principal place of business, also supporting jurisdiction under Labor Code section 5501.5. The WCAB noted that procedural irregularities justified setting aside the parties' stipulation regarding Riverside venue.

Petition for RemovalOrder RescindingOrder Transferring VenueWCABWCJVenue TransferLabor Code 5700WCAB Rule 10346Stipulations with Request for AwardMutual Mistake of Fact
References
Case No. ADJ2184096
Regular
Jun 25, 2009

MANUEL GARCIA vs. PILGRIM CONGREGATIONAL CHURCH

This case involved an applicant injured while performing work for a church. The Workers' Compensation Appeals Board granted reconsideration and reversed the administrative law judge's finding of employment. The Board determined the applicant was an independent contractor based on factors outlined in *S.G. Borello & Sons*, including the church's lack of control over work details, the applicant's distinct occupation, skill requirements, self-supply of tools, and the nature of the payment arrangement. Consequently, the applicant's claim for workers' compensation benefits was denied.

Workers' Compensation Appeals BoardIndependent ContractorEmployee StatusBorello factorsRight to ControlDistinct OccupationSkill RequiredTools and InstrumentalitiesMethod of PaymentIntegral Part of Business
References
Case No. LAO 0795696
Regular
Jul 09, 2007

DULCE MONTES vs. NATIONWIDE PAGING, INC., PREFERRED EMPLOYERS INSURANCE COMPANY

The applicant sought reconsideration of a decision mandating transfer into the defendant's Medical Provider Network (MPN) for treatment. The Workers' Compensation Appeals Board denied reconsideration, affirming that MPNs, as established by SB 899, allow for transfer of care regardless of prior treatment relationships or awards. The Board found no evidence applicant met exceptions to MPN transfer rules and rejected arguments based on pre-SB 899 law or MPN rule unconstitutionality.

MPNMedical Provider NetworkPrimary Treating PhysicianReconsiderationFindings of FactLabor Code Section 4616Appeals Board Rule 9767.9Transfer of CareSB 899Babbitt v. Ow Jing
References
Case No. ADJ8066822
Regular
May 30, 2019

SCOTT WALL vs. COUNTY OF SACRAMENTO

This case concerns a deputy sheriff sergeant, Scott Wall, who alleges discrimination under Labor Code section 132a. Wall was denied a requested transfer to a patrol division while on injury leave, despite having the seniority for it. The Workers' Compensation Appeals Board affirmed the finding that the County of Sacramento discriminated against Wall by denying the transfer, as less senior employees were transferred. The employer's defense of business necessity was rejected because the County had other options to fill the critical patrol positions.

Labor Code section 132aDiscriminationRetaliationTransfer denialSeniorityBusiness necessityPrima facie caseDisadvantageous treatmentWCJReconsideration
References
Case No. ADJ9443988
Regular
Aug 13, 2014

THELMA MANNING vs. CITY OF VACAVILLE; Permissibly Self-Insured, Administered By INNOVATIVE CLAIMS SOLUTIONS, INC.

The applicant sought reconsideration of a venue transfer order in a workers' compensation case. The Workers' Compensation Appeals Board dismissed the petition because the order transferring venue was not a final order, and thus not subject to reconsideration. Even if considered for removal, no significant prejudice or irreparable harm was demonstrated. The Board found that the defendant's timely objection to the applicant's chosen venue based on her attorney's location appropriately triggered a venue transfer to the county of the applicant's residence or place of injury.

WCABvenue transferreconsideration petitioninterlocutory orderfinal ordergood causedue processconvenience of witnessesapplicant's residenceattorney's place of business
References
Case No. ADJ3823114 (MON 0252208)
Regular
Dec 03, 2015

ILANA BENLULU vs. BEVERLY SINAI TOWERS, SEDGWICK CLAIMS MANAGEMENT SERVICES, servicing facility for CIGA for RELIANCE INSURANCE COMPANY, in liquidation

This case concerns the proper transfer of an injured worker into a defendant's Medical Provider Network (MPN). The applicant contended she pre-designated her physician, avoiding MPN requirements, but provided no supporting evidence. The Board found that the defendant's prior attempts to transfer the applicant into the MPN were invalid due to insufficient notice or the MPN's failure to meet minimum access standards. Ultimately, the Board determined that a July 15, 2014 notice, properly served and containing all required information, effectively transferred the applicant into the MPN on August 14, 2014.

MPNMedical Provider NetworkReconsiderationFindings of FactWorkers' Compensation Appeals BoardLabor CodePre-designation of PhysicianContinuity of CareTransfer of CareMinimum Access Standards
References
Case No. ADJ3714921
Regular
Mar 24, 2011

SANDRA GONZALEZ vs. VONS, Permissibly Self-Insured

The Workers' Compensation Appeals Board denied Sandra Gonzalez's petition for reconsideration. The Board adopted and incorporated the findings of the workers' compensation administrative law judge. The judge found that Gonzalez's transfer to a different store after a strike was a good faith personnel action based on legitimate business needs. The judge also gave great weight to his credibility findings, which influenced the decision to deny reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationGood Faith Personnel ActionPsychiatric InjuryTransferCollective Bargaining AgreementUnion GrievanceHearsay ObjectionCredibilityStrike
References
Case No. ADJ7106903
Regular
Sep 15, 2015

DAVID CONNOR vs. RESTAURANTS TO YOU/CAFÉ RUNNER, STATE COMPENSATION INSURANCE FUND

This order transfers venue for Case No. ADJ7106903, involving David Connor and Restaurants To You/Café Runner, from the San Luis Obispo District Office to the Santa Barbara Satellite Office. The transfer is necessitated by both parties exercising their challenges under Appeals Board Rule 10453, leaving no available judges in San Luis Obispo. The Presiding Judge in Santa Barbara will schedule the matter for trial upon receipt.

Venue transferAppeals Board rule 10453Challenge of judgePresiding Workers' Compensation JudgeSanta Barbara Satellite OfficeSan Luis Obispo District OfficeSetting for trialWorkers' Compensation Appeals BoardRestaurants to YouCafe Runner
References
Case No. ADJ9908969
Regular
Aug 28, 2015

MICHAEL MCGRATH vs. OAKLAND UNIFIED SCHOOL DISTRICT, HAZELRIGG CLAIMS MANAGEMENT SERVICE

This case involves a dispute over venue for a workers' compensation claim. The employer, Oakland Unified School District, sought to transfer the case from Oxnard to Oakland, arguing the applicant resides and was injured in Oakland's jurisdiction, despite the application initially being filed in Oxnard based on the applicant's attorney's principal place of business. The Workers' Compensation Appeals Board (WCAB) granted removal, rescinding the judge's denial of the venue change. The WCAB found the judge applied the wrong legal standard and that the employer's objection to venue, made pursuant to Labor Code section 5501.5(c), mandated a transfer to Oakland.

Petition for RemovalOrder Denying Change of VenueWCJsubstantial prejudiceirreparable harmreconsiderationWCAB District OfficeOakland WCAB District OfficeOxnard WCAB District Officevenue transfer
References
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