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Case Law Database

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

Case No. ADJ441410
Regular
Oct 03, 2008

HAYDEE NUNEZ vs. FAIRMONT MIRAMAR HOTEL, COMMERCE & INDUSTRY INSURANCE COMPANY

The Appeals Board denied the lien claimant's petition for reconsideration, affirming the WCJ's denial of the remaining lien balance. The Board is returning the case to the trial level to investigate potential sanctions against the lien claimant for its actions in filing the petition for reconsideration, citing alleged procedural defects and bad faith. The WCJ's original finding was that the outpatient fusion surgery was not permitted under Medicare Guidelines and the defendant paid more than the reasonable value of the services.

Workers Compensation Appeals BoardFairmont Miramar HotelCommerce & Industry Insurance CompanyAIG Domestic ClaimsOutpatient Spine & Surgery CenterLien claimantIndustrial injuryLow back injuryOutpatient fusion surgeryMedicare Guidelines
References
1
Case No. ADJ1393892
Regular
Aug 16, 2011

JOSE NAVARRO vs. LOCKHEED

The Appeals Board denied the applicant's Petition for Reconsideration regarding an alleged March 12, 1990 injury, upholding the WCJ's finding that no industrial injury occurred. The Board granted removal on its own motion to address potential sanctions against applicant's counsel for citing medical records not present in the official record, which is a violation of WCAB rules and attorney ethics. The Board issued a Notice of Intention to impose $1,000 in sanctions jointly against the attorney and his firm, and awarded attorney's fees to the defendant. Other outstanding issues in the consolidated cases are returned to the trial level for further proceedings by the WCJ.

Petition for ReconsiderationQualified Medical EvaluatorSubstantial EvidenceCredibility DeterminationMisleading PetitionSanctionsLabor Code Section 5813WCAB RulesAttorney's DutyEvidence Outside Record
References
4
Case No. ADJ4379045 (ANA 0389616)
Regular
Mar 19, 2012

FEDERICO MARTINEZ vs. ROBERTSON'S READY MIX, INC.

Defendant Robertson's Ready Mix sought to reopen a stipulated award of 81% permanent disability for Federico Martinez based on a change in law regarding life pension calculations. The Workers' Compensation Appeals Board (WCAB) dismissed the petition for reconsideration as untimely, as it was filed significantly beyond the statutory 20-day limit. However, the WCAB returned the petition to the trial level to be considered solely as a petition to reopen based on the alleged change in law. This decision allows the parties to address the legal change at the trial judge level.

Workers' Compensation Appeals BoardPetition to ReopenPetition for ReconsiderationStipulated Findings and AwardIndustrial InjuryPermanent DisabilityLife PensionLabor Code Section 4659(c)Baker v. Workers' Comp. Appeals Bd.Untimely Filing
References
5
Case No. ADJ6552779
Regular
Aug 17, 2009

LOUIE BLACKMON vs. THE HOME DEPOT, SEDGWICK 14442 ORANGE

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration because it was not filed against a final order. The WCJ had previously denied the applicant's petition for commutation without prejudice, citing failure to serve the defendant and lack of substantiating documentation. The Board remanded the case to the trial level for a status conference to assist the unrepresented applicant with understanding commutation requirements.

CommutationPetition for ReconsiderationOrder Denying Without PrejudiceStipulated Findings and AwardNewly Discovered EvidenceProof of ServiceFinal OrderLabor Code Section 5900Substantive Rights and LiabilitiesInformation and Assistance Office
References
5
Case No. ADJ426447 (RDG 0129495)
Regular
Jul 16, 2010

Shane Guest vs. Barrett Business Services

The Appeals Board dismissed the applicant's petition for reconsideration as he was not aggrieved by a final order. The applicant sought to set aside a settlement concerning the Employment Development Department's (EDD) lien, arguing it was made in error. However, the Board found that the WCJ had not yet made a final determination on the EDD lien, which is a prerequisite for the Board to have jurisdiction to approve or disapprove such a settlement. Therefore, the matter is returned to the trial level for a final determination of the EDD's lien.

WCABPetition for ReconsiderationDismissalEDD LienTrial LevelFinal DeterminationTemporary DisabilityEmployment Development DepartmentStipulationDeferred Lien
References
1
Case No. ADJ8843441
Regular
Oct 16, 2013

AUSTIN KWOMO vs. LOS ANGELES METROPOLITAN TRANSIT AUTHORITY

The Appeals Board granted the defendant's Petition for Removal, rescinding the WCJ's order to take the case off calendar. The Board found the WCJ prematurely ordered further medical record development before trial or submission for decision. Therefore, the case is returned to the trial level for proceedings consistent with *McDuffie*, with the WCJ retaining discretion to supplement the record *after* trial if necessary. The petition for disqualification of the WCJ was denied.

Petition for RemovalOrder Off CalendarFurther Development of RecordMedical OpinionsThreshold MatterTrialSubmission for DecisionExhibitsWitnessesSupplementation of Medical Record
References
1
Case No. SDO 0333985
Regular
Aug 14, 2007

DAVID KING vs. OMNI HOTEL, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration because the case was settled at the trial level. The Board rescinded the WCJ's prior decision and returned the matter to the trial level for further proceedings. This allows the WCJ to approve the settlement; if not approved, the original decision may be reinstated.

WCABSDO 0333985Omni HotelZurich American Insurance CompanyGallagher BassettReconsiderationRescindTrial LevelSettlement ApprovalWCJ Decision
References
0
Case No. ADJ188649 (LBO 0289923) ADJ668755 (LBO 0252821)
Regular
Jan 30, 2009

VERNITA CAREY vs. LONG BEACH UNIFIED SCHOOL DISTRICT, TRISTAR

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior WCJ decision because the official case file was lost. The matter is returned to the trial level for file reconstruction and a new decision by the WCJ. This process aims for efficiency at the trial level while preserving parties' rights to future reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeMissing FileRescind DecisionReturn to Trial LevelReconstruct FilePleadingsIssue DecisionAggrieved Party
References
0
Case No. ADJ4280834
Regular
Sep 27, 2012

LEVELL SMITH vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board granted reconsideration to applicant Levell Smith's petition, rescinding the prior award. The Board found the WCJ erred by failing to adequately rate upper extremity disability and potentially by merging distinct disability restrictions. Consequently, the case is returned to the trial level for further proceedings, including referral to the Disability Evaluation Unit, to ensure all factors of disability are properly evaluated. A new decision will be issued thereafter.

ReconsiderationFindings of Fact and AwardDeep Vein ThrombosisHypertensive Cardiovascular DiseaseSleep DisorderPsychePermanent Disability RatingSuccessive InjuriesMultiple InjuriesUpper Extremity Disability
References
0
Case No. ADJ7213550
Regular
Dec 30, 2013

MAURICIO AREVALOS vs. MCMANIS FAMILY VINEYARDS, MEADOWBROOK INSURANCE GROUP

The defendant sought removal, arguing that lien claimants failed to provide evidence supporting their claims, which had been dismissed and then twice reinstated by the WCJ. The Appeals Board granted removal, finding the WCJ improperly rescinded dismissal orders without a proper record, trial, or admitted evidence. While acknowledging the WCJ's attempt to preserve resources, the Board noted the elapsed trial date. The case is now returned to the trial level for setting and resolution, with discovery closed as of November 15, 2011.

Petition for RemovalRescinded OrderLien ClaimsCompromise and ReleaseLien ConferencePretrial Conference StatementDismissed LiensPetition for ReconsiderationSubmitted on the RecordAdmitted Evidence
References
1
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