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

Case No. ADJ8470179 ADJ8501826
Regular
Apr 18, 2017

CARITINA REYES vs. ANAJET, INC., THE HARTFORD

Lien claimants Southland Spine & Rehabilitation Medical Center and New Age Translations sought reconsideration of a decision disallowing their liens. They argued the judge improperly admitted evidence and failed to consider their trial briefs. The Workers' Compensation Appeals Board granted reconsideration. The Board rescinded the original order, finding the judge failed to consider the trial briefs. The case is returned for further proceedings to address the lien claimants' claims.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationJoint Findings and OrderMedical Provider NetworkKnight v. United Parcel ServicePanel Qualified Medical ExaminerAgreed Medical ExaminerDue processWCAB Rule 10629
References
Case No. ADJ3863284 (OXN 0147713)
Regular
May 13, 2013

ISAIAS ORTIZ vs. WATERWAY PLASTICS, SAFETY NATIONAL INSURANCE

This case involves two lien claimants whose liens were dismissed for failing to pay an activation fee prior to trial. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, finding that Labor Code section 4903.06 only requires proof of payment of the fee at a "lien conference," not a subsequent trial. Because the lien conference occurred in 2012 and the trial in 2013, the lien claimants were not required to pay the fee prior to trial. The WCAB rescinded the dismissal orders and returned the matter for further proceedings.

Lien activation feeWCABPetition for ReconsiderationLien ConferenceLien TrialLabor Code section 4903.06Declaration of Readiness to ProceedDismissal with prejudiceRescind OrderReturn to trial level
References
Case No. ADJ441097 (MON 0347404)
Regular
Sep 07, 2017

ROBERT ESQUERRA vs. EAGLE IRON CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted Max MRI Imaging's petition for reconsideration, rescinding the prior finding of no liability for the lien. The original decision was based on an issue (RFA form) not properly identified for trial by the parties. The case is returned to the trial level to address the central dispute: whether services provided outside the defendant's Medical Provider Network (MPN) at a non-designated physician's request are compensable despite defendant's objections. The Administrative Law Judge must issue new findings on this specific issue and Max MRI's other contentions.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationMedical Provider NetworkPrimary treating physicianWritten objectionsRequest for authorizationFindings and AwardDecision After ReconsiderationAdministrative law judge
References
Case No. ADJ6733950
Regular
Jul 25, 2012

ANTHONY AVILA vs. MARK EVERETTE DRYWALL CO., EVEREST NATIONAL INSURANCE CO., AMERICAN CLAIMS MANAGEMENT

This case concerns an applicant's Petition for Reconsideration of a dismissal order. The applicant argues his due process rights were violated because the dismissal for failure to appear was improper since his counsel was present at trial dates. The Appeals Board found that as the applicant was represented by counsel at trial, dismissal was erroneous. The Board granted reconsideration, rescinded the dismissal, and returned the matter to the trial level, also noting the unresolved request for counsel to withdraw.

Petition for ReconsiderationOrder Dismissing CaseWCJdue processMandatory Settlement ConferencetrialMinutes of Hearingrelieved as counselNotice of Intention to Dismiss Casefailure to appear
References
Case No. ADJ8079708
Regular
May 06, 2013

JAMES AZBILL vs. FATORS MOTORCYCLES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to amend a prior finding, affirming the claim is not barred by the statute of limitations. However, the Board reversed the finding that the applicant was entitled to the presumption of compensability under Labor Code section 5402(b). This presumption requires the filing of a DWC-1 claim form, which was absent in this case. The Board will return the matter to the trial level for further proceedings on deferred issues.

Workers' Compensation Appeals BoardFators MotorcyclesState Compensation Insurance FundJames AzbillADJ8079708Opinion and OrderReconsiderationFindings and OrderWCJStatute of Limitations
References
Case No. ADJ9436553
Regular
Nov 03, 2014

ANA MARIA PENA, vs. SHREE AGASHIMATA INC.; dba BUDGET INN MOTEL; ILLINOIS MIDWEST INSURANCE AGENCY,

Defendant petitioned for removal after the WCJ took the case off calendar, citing the need for a Qualified Medical Evaluator. Defendant argued that a post-termination defense did not require medical evidence and the case should proceed to trial. The Appeals Board granted removal, rescinded the WCJ's order, and returned the case to the trial level. This was done because the WCJ had not yet judicially determined good cause to bifurcate the post-termination defense issue, which is a prerequisite to deciding if a QME is necessary.

Petition for Removalpost-termination defenseLab. Code § 3600(a)(10)discoveryexpert medical evidencetrialWCJoff calendarQMEbifurcate
References
Case No. ADJ7159953
Regular
Feb 17, 2012

ANTONIO CORONA vs. RANDSTAD NORTH AMERICA, ACE AMERICAN INSURANCE COMPANY

Lien claimants sought reconsideration of an administrative law judge's order disallowing their liens and imposing sanctions. The Appeals Board granted reconsideration, rescinded the order, and returned the matter for a decision on the merits. The Board found the sanctions unjustified due to unclear orders regarding trial briefs and lack of proper notice, and further noted the judge failed to issue a required opinion explaining the basis for disallowing the liens. The case is remanded for a proper decision with an explanatory opinion.

Workers' Compensation Appeals BoardLien ClaimantsReconsiderationWCJ OrderSanctionsTrial BriefsBurden of ProofCompromise and ReleaseIndustrial InjuryUtilization Review
References
Case No. ADJ8988763 ADJ8988773
Regular
Mar 06, 2018

ROSA FLORES vs. WILLIAM KING HEALTH CARE GROUP, AMTRUST, TRAVELERS

The Workers' Compensation Appeals Board granted reconsideration of a sanctions order against lien claimant VQ Healthcare and hearing representative Ana Montes Gluck. The WCJ had sanctioned them for failing to submit a trial brief and presenting insufficient evidence, violating Labor Code section 5813 and WCAB Rule 10561. The Board found that while sanctions were warranted for failing to meet their burden of proof, the initial amount was excessive. Consequently, the Board reduced the individual sanctions to $100 each and rescinded the awarded attorney fees, deeming them unwarranted.

WCABPetition for ReconsiderationOrder Imposing SanctionsLien ClaimantLabor Code Section 5813WCAB Rule 10561Trial BriefSubstantial EvidenceBad Faith ActionsFrivolous Tactics
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. ADJ803080 (LBO 0386412)
Regular
Mar 16, 2009

ANDRES SANCHEZ JUARES (Dec'd.), EVER REYES CARILLO (App.) vs. FANG CLOTHING, INC., INSURANCE COMPANY OF THE WEST GROUP/EXPLORER

The Workers' Compensation Appeals Board (WCAB) denied a petition for reconsideration from an insurer but granted removal of the case. The WCAB found that the administrative law judge (ALJ) improperly scheduled a trial conference when a status conference was requested to address discovery issues. This procedural error would cause prejudice and irreparable harm by forcing parties to trial prematurely without adequate discovery or settlement opportunity. Consequently, the WCAB rescinded the ALJ's order and returned the case for further proceedings.

Workers' Compensation Appeals BoardReconsiderationRemovalStatus ConferenceMandatory Settlement ConferenceLabor Code Section 5502Declaration of ReadinessPre-trial Conference StatementDiscovery IssuesStipulations
References
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