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

Case No. ADJ8410672
Regular
Nov 19, 2014

HIPOLITO ZARAGOZA vs. ELECTRONIC CONTAINERS SPECIALTIES, INC., OAK RIVER INSURANCE COMPANY

Lien claimants filed a Petition for Removal seeking to rescind Notices of Intent to Sanction and challenge an order based on an "underground regulation." However, the WCJ subsequently issued Findings and Orders disallowing the liens and imposing sanctions. Consequently, the Appeals Board found the Petition for Removal to be moot. The Board dismissed the Petition, advising aggrieved parties to file a Petition for Reconsideration of the Findings and Orders.

Workers' Compensation Appeals BoardPetition for RemovalLien claimantsFindings and OrdersSanctionsAttorney feesDismissalReconsiderationUnderground regulationUltra vires
References
Case No. ADJ3274521 (POM 0289674)
Regular
Mar 06, 2012

ANTONIO ORTIZ (ANTONIO ORTIZ CUEVAS) vs. NEW REAL INC.; AMERICAN ALL RISK LOSS

The Workers' Compensation Appeals Board dismissed applicant Antonio Ortiz's petition for reconsideration. The petition was untimely as it was filed significantly after the deadline for reconsideration. Furthermore, the petition lacked proof of service on the opposing parties, and it was deemed "skeletal" for failing to cite any facts, evidence, or legal principles from the record. The Board strongly advised the applicant to consult with the Information and Assistance Officer for future filings.

Workers' Compensation Appeals BoardPetition for ReconsiderationProof of ServiceUntimely FilingSkeletal PetitionLabor Code § 5900(a)California Code of Regulations § 10507Jurisdictional Time LimitService OmissionDismissal
References
Case No. ADJ6766619 (MF) ADJ6766620
Regular
Feb 28, 2018

MARIA DURAN vs. FOREVER 21 RETAIL, INC., CHUBB GROUP

This case involves Maria Duran's request for home health care services, which was initially denied by utilization review (UR) and upheld by Independent Medical Review (IMR). The applicant argued that her need for assistance with household chores and personal hygiene fell outside the scope of the Medical Treatment Utilization Schedule (MTUS) guidelines as applied. While the Board acknowledges that the specific MTUS guideline used in this case was later found to be an invalid regulation in a related case, it affirmed the original decision. This affirmance was based on the finding that the initial request for services was too vague, lacking specific details on the type, frequency, and duration of care, and that a revised request could be made.

Workers' Compensation Appeals BoardMaria DuranForever 21 RetailInc.Chubb GroupOpinion and Decision After ReconsiderationIndependent Medical ReviewIMRUtilization ReviewUR
References
Case No. ADJ9767744
Regular
Jun 10, 2016

ROSA AGUIRRE vs. DAVID MARLEY, ORLY MARLEY, MID CENTURY INSURANCE COMPANY

This case concerns an applicant's challenge to the replacement of a chiropractic QME panel with an orthopedic one. The applicant argued that the regulation allowing this replacement conflicted with the Labor Code. The Workers' Compensation Appeals Board (WCAB) dismissed the petition for reconsideration because the challenged order was not a final one. Furthermore, the WCAB denied the petition for removal on the merits, finding no conflict between the regulation and the Labor Code.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalQualified Medical Evaluator (QME)Medical DirectorQME Regulation 31.1(b)QME Regulation 31.5(a)(10)Labor Code section 4062.2Final OrderInterim Order
References
Case No. ADJ6616107
Regular
May 16, 2013

LILIANA JARAMILLO vs. CALIFORNIA MARKETING INC, STATE FARM FIRE & CASUALTY COMPANY

This case involves a Petition for Reconsideration by lien claimants whose liens were dismissed after failing to appear at a scheduled lien conference. The Workers' Compensation Appeals Board denied the petition, finding that the lien claimants' stated reasons of inadvertence or oversight were insufficient to excuse their non-appearance. Furthermore, the Board noted that a previous requirement for defendants to contact lien claimants by phone was superseded by new regulations requiring attendance at conferences. The Board also warned the lien claimant about potential sanctions for procedural violations and disingenuous claims.

Lien claimantsPetition for ReconsiderationOrders of DismissalFailure to appearLien conferenceNotices of Intent to DismissLien regulationsRegulation 10770.1(d)WCAB Rules of Practice and ProcedureSanctions
References
Case No. ADJ4379849
Regular
Mar 06, 2012

HUGO SOTO vs. ABUNDANT LIFE AND ADOLESCENT GROWTH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the lien claimant's Petition for Reconsideration. The lien claimant failed to appear at a lien conference on August 23, 2011, which led to a Notice of Intent to Dismiss their lien. The Board adopted the WCJ's report, noting the lien claimant incorrectly stated the date of the conference and that such inattention contributed to the dismissal. The Board emphasized that lien claimants are parties after the case-in-chief is resolved and must appear unless excused by the WCJ.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ClaimantWCJ ReportNotice of Intention to Dismiss LienLien ConferenceBiocare Rx Specialty PharmacyProof of ServiceOrder of DismissalCode of Civil Procedure section 473
References
Case No. ADJ8278787
Regular
Mar 04, 2014

FERMINA GALLEGOS vs. KINDRED HEALTHCARE, SEDGWICK, CMS

The Workers' Compensation Appeals Board (WCAB) granted reconsideration for lien claimant Preferred Scan, Inc., who sought to set aside an order dismissing their lien due to non-appearance at a lien conference. The WCJ recommended granting the petition, citing excusable neglect for the lien claimant's miscalendaring. The WCAB further found procedural defects, including the failure to issue a notice of intention to dismiss and improper delegation of service. Consequently, the WCAB rescinded the dismissal order and returned the matter to the trial level for further proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Dismissing LienLien ConferenceExcusable NeglectNotice of Intention to DismissTitle 8 California Code of Regulations Section 10562Title 8 California Code of Regulations Section 10241Title 8 California Code of Regulations Section 10500Rescinded
References
Case No. ADJ2721193 (RIV 0082510)
Regular
Feb 08, 2013

MORT KAZEL vs. PHELPS CHEVROLET NISSAN, FIRST COMP OMAHA FOR ENDURANCE

The Workers' Compensation Appeals Board dismissed a lien claimant's Petition for Reconsideration because it was procedurally deficient. The claimant failed to appear at a lien conference, did not object to a Notice of Intention to Dismiss Lien, and submitted a petition that lacked specific legal arguments or record citations. This "skeletal petition" violated regulations requiring detailed references to evidence and legal principles. Therefore, the Board dismissed the petition, upholding the prior dismissal of the lien claim.

Lien claimantPetition for ReconsiderationOrder Dismissing Lien ClaimWCJNotice of Intention to Dismiss LienSkeletal PetitionLabor Code section 5902California Code of Regulations section 10846California Code of Regulations section 10842WCAB Form 45
References
Case No. ADJ6808422
Regular
Dec 03, 2012

JORGE FUENTES vs. MICKE FARMS, AMERICAN ALL RISK LOSS, RISK ENTERPRISE

The Workers' Compensation Appeals Board dismissed a lien claimant's petition for reconsideration. The petition was dismissed because it was unverified, lacked proper service on all parties as required by regulation, and was impermissibly skeletal, failing to cite legal basis or specific record references. The lien claimant failed to cure these defects despite the WCJ's report and the defendant's answer highlighting the issues.

Lien claimantPetition for ReconsiderationOrder Dismissing Lien ClaimWCJLien ConferenceNotice of Intention to Dismiss Lienunverified petitionproof of serviceskeletal petitionLabor Code section 5902
References
Case No. ADJ7019304
Regular
Aug 19, 2013

JOSE LOPEZ vs. CALABEE'S INC., PACIFIC COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed Jose Lopez's Petition for Reconsideration due to several procedural and substantive deficiencies. The petition was a "skeletal petition" lacking specific references to the record or legal grounds as required by law. Furthermore, the applicant failed to properly serve the petition on the defendant insurance company. Consequently, the Board dismissed the petition for failing to comply with the California Labor Code and WCAB regulations.

Petition for ReconsiderationWorkers' Compensation Appeals BoardDismissing PetitionOrder Dismissing ApplicationSkeletal PetitionLabor Code section 5902California Code of Regulations title 8 section 10846California Code of Regulations title 8 section 10842Failure to ServeProof of Service
References
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