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

Case No. ADJ12080314
Regular
Aug 26, 2019

VICTORIA TRUJILLO vs. CHEVRON, BROADSPIRE

Applicant seeks reconsideration of an order approving a compromise and release for $\$ 25,000.00$ for bilateral wrist, hand, and finger injuries. Applicant contends the settlement was underpaid and did not reflect the negotiated agreement. The Appeals Board dismissed the petition for reconsideration as premature because no evidence was presented to support the applicant's claims regarding the payment dispute. The matter is remanded for a hearing to create a record for the WCJ to determine if good cause exists to set aside the compromise and release.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Approving Compromise and Releasebilateral wristsbilateral handsbilateral fingersbusiness analystlump sum paymentnegotiated settlement agreementunderpaid settlement proceeds
References
Case No. ADJ2831208 (GOL 0090431) ADJ894034 (GOL 0090432)
Regular
Aug 10, 2009

JOSE LOPEZ vs. QUALITY PLASTERING, GOLDEN EAGLE INSURANCE COMPANY

The applicant, Jose Lopez, was awarded a 25% penalty for the defendant's failure to pay the full settlement amount. The defendant sought reconsideration, arguing they paid the amount agreed upon in the addenda to the Compromise and Release Agreement. However, the Board found the Orders Approving Compromise and Release, which specified a higher payment to the applicant, became final when the defendant failed to seek timely reconsideration. Therefore, the defendant's petition for reconsideration was denied, affirming the penalty.

Workers' Compensation Appeals BoardQuality PlasteringGolden Eagle Insurance CompanyJose LopezReconsiderationFindings and AwardLabor Code section 5814PenaltyAttorney's FeeLabor Code section 5814.5
References
Case No. SDO 0217188
Regular
Jan 24, 2008

ROSA A. MONTES vs. LAVA ENTERPRISES, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration for a lien claimant, Lang Link Interpreting Services, Inc., regarding underpayment for services. The Board affirmed the administrative law judge's decision, finding that the lien claimant was paid appropriately at the rate set by California Code of Regulations, section 9795.3(b)(2) because they failed to present evidence of their market rate. The Amended Findings and Orders were clarified to reflect this reasoning.

Lien claimantReconsiderationWCJMarket rateTitle 8 California Code of Regulations Section 9795.3(b)(2)UnderpaidClaims administratorInterpreting servicesPetition for reconsiderationAward
References
Case No. ADJ176576 (VNO 0372379)
Regular
Oct 29, 2015

MINNIE ELLIOTT vs. CITY OF LOS ANGELES

Applicant sought reconsideration of a prior workers' compensation award, alleging the judge miscalculated indemnity payments. The applicant sustained multiple injuries, including to her low back and psyche, while employed as a recreation director. The defendant was awarded a credit for overpaid indemnity, which was commuted from the permanent disability award. The Appeals Board reviewed the petition, the judge's report, and the defendant's answer. Ultimately, the Board affirmed the judge's original decision.

Workers' Compensation Appeals BoardReconsiderationFindings Award and OrderWCJPermanent Disability IndemnityUnderpaidCreditCommutedPetition for ReconsiderationReport and Recommendation
References
Case No. ADJ3046670 (POM 234030)
Regular
May 13, 2011

CAROL ALLISON vs. MERTZ DEL AMO MOBILE ESTATES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE COMPANY, in liquidation

The Workers' Compensation Appeals Board granted CIGA's petition for reconsideration, rescinding the WCJ's prior award of penalties and underpaid permanent disability indemnity. The Board found that the WCJ prematurely calculated permanent disability and penalties because underlying disputes regarding temporary disability and vocational rehabilitation benefits, deferred in the initial stipulations, were not resolved. The case was returned to the trial level for further development of the record to determine the precise amounts owed to the applicant before any sanctions can be imposed.

CIGAliquidationstipulated awardpermanent disability indemnityunderpaymentLabor Code section 5814penaltyattorney's feesLabor Code section 5814.5vocational rehabilitation maintenance allowance
References
Case No. ANA 0405476
Regular
Apr 04, 2008

RESEANNE RAY vs. VERIZON WIRELESS, SEDGWICK CLAIMS MANAGEMEN SERVICES

This case involves Applicant Roseanne Ray's challenge to the calculated average weekly wage (AWW) and resulting temporary disability indemnity rate in her workers' compensation claim against Verizon Wireless. The Appeals Board granted reconsideration, finding a clerical error in the original award and a mutual mistake regarding the AWW calculation. The Board amended the award to increase the temporary disability indemnity rate to \$830.78 per week based on applicant's pre-injury earnings, finding she was underpaid.

Workers' Compensation Appeals BoardReconsiderationStipulations and Request for AwardTemporary Total DisabilityAverage Weekly WagesMutual Mistake of FactClerical ErrorIndemnity RatePermanent DisabilityMedical-Legal Expenses
References
Case No. ADJ7985197
Regular
Sep 29, 2015

MANUEL TORRES vs. MNR CONSTRUCTION, TRAVELERS PROPERTY & CASUALTY COMPANY OF AMERICA

This case concerns a lien claim by Monrovia Memorial Hospital for services rendered to an injured worker, Manuel Torres. The original award granted the lien claimant $\$3,141.83$ after credits. The lien claimant sought reconsideration, arguing they were underpaid based on their billed amount. The Appeals Board granted reconsideration, rescinded the original award, and issued a new order finding the lien claimant adequately compensated, disallowing the remaining balance. The Board affirmed that the lien claimant bore the burden of proving their claim, which they failed to do.

WCABPetition for ReconsiderationFindings Award and OrderLien claimantMonrovia Memorial Hospitalindustrial injurysleep disorderusual and customary chargesaffirmative burden of proofpreponderance of the evidence
References
Case No. ADJ103803 (LAO 0845173)
Regular
Sep 19, 2011

TINA CHU vs. CALIFORNIA COMMERCE CLUB CASINO, TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of the WCJ's decision that the applicant's Compromise and Release (C&R) was properly paid. The applicant argued the defendant underpaid the $105,000 settlement by $7,957.02 due to improper deductions of permanent disability advances. While the Order Approving C&R allowed credit for all permanent disability advances previously made, the Board found the defendant's payment evidence was insufficient to prove proper payment. Consequently, the case was returned to the trial level for further proceedings to determine if the C&R was correctly paid.

Workers' Compensation Appeals BoardCompromise and ReleasePermanent Disability AdvancesOrder Approving Compromise and ReleasePetition for ReconsiderationFindings and OrderAdministrative Law JudgeApplicantDefendantUnderpayment
References
Case No. ADJ6899721
Regular
Jun 01, 2016

SALLY MARTINEZ vs. COUNTY OF LOS ANGELES, Permissibly Self-Insured, SEDGWICK CMS

The Workers' Compensation Appeals Board granted reconsideration to clarify whether the defendant could take credit for permanent disability advances made prior to the formal award. The Board amended the prior decision, allowing the defendant to claim credit for all permanent disability advances made, including those before the March 20, 2012 award. However, the Board affirmed the finding that the defendant underpaid a Labor Code section 5710 fee and is liable for a penalty due to improper service and failure to timely object. The defendant's contention that improper service excused payment of the 5710 fee was rejected.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and Orderspermanent disability advancesLabor Code section 5710section 5813 penaltyStipulations with Request for Awardmaximum medical improvementcredit for paymentsdiscretionary authority
References
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