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

Case No. ADJ271462 (SJO 0255768)
Regular
Apr 03, 2017

SHAWN LEWIS vs. TANEJA, INC dba PASSAGE TO INDIA, UNINSURED BENEFITS TRUST FUND OF THE STATE OF CALIFORNIA

This case involves an appeal of a $\$1,000$ sanction imposed on applicant's attorney for failing to appear at a hearing. The attorney argued he had arranged alternate representation, but the substitute attorney had a prior conflict with the applicant. The Workers' Compensation Appeals Board rescinded the sanction, finding the circumstances made imposition unjust, especially given opposing counsel's agreement to a continuance. The Board noted that while the attorney's planning was flawed, the judge should have granted the continuance due to these unusual circumstances.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationOrder Imposing SanctionsWCJAttorney SanctionsFailure to AppearAlternate RepresentationPersonal ConflictContinuance RequestWCAB Rule 10561
References
Case No. ADJ10107710
Regular
Nov 27, 2017

MORA-PEREZ, RICARDO vs. NATURE FIRST TREE CARE, INC., ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of an order sanctioning applicant's attorney $\$ 250.00$ and awarding attorney fees to the defendant. The sanctions were imposed due to the applicant's attorney failing to appear at a status conference. Applicant's counsel argued they reasonably believed the conference had been taken off calendar, but the majority found this belief was not a sufficient excuse. One Commissioner dissented, believing the attorney acted without bad faith and should have been admonished rather than sanctioned.

Petition for ReconsiderationOrder Imposing SanctionsAttorney FeesFailure to AppearStatus ConferenceWCJWCAB Rule 10561Reasonable ExcusePattern of ConductUnjust Imposition
References
Case No. LAO 0797710
Regular
Apr 21, 2008

LEONARD DI PERI vs. INTERNET CONNECT, ST. PAUL TRAVELERS SPECIAL SERVICES

This case involves an applicant who sustained an admitted industrial back injury in 2000. The Workers' Compensation Appeals Board denied reconsideration of a prior award, affirming the applicant's entitlement to temporary disability indemnity. The Board found that the applicant was properly allowed an expedited hearing on retroactive TDI, and rejected the defendant's claims of due process denial and unjust enrichment due to delayed surgery.

Expedited hearingretroactive temporary disability indemnitydue processunjust enrichmentspinal surgery authorizationmedical evaluation cancellationadmitted industrial injuryLabor Code section 5502priority calendarvocational rehabilitation
References
Case No. ADJ7447035; ADJ7447437
Regular
Mar 25, 2019

BERTHA PEREZ vs. WORLD VARIETY PRODUCE, INC., ZURICH INSURANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the prior order, remanding the case for further proceedings. The WCAB found that the original decision lacked sufficient evidence to support findings regarding restitution and sanctions against the lien claimant. Specifically, there was no admitted evidence proving unjust enrichment, fraud, or improper conduct by the lien claimant. Similarly, the record was insufficient to determine if the lien claimant engaged in bad faith tactics or frivolous delays warranting sanctions.

Lien claimantReconsiderationRestitutionUnjust enrichmentSanctionsFrivolous tacticsDiscoveryBill reviewWCJAppeals Board
References
Case No. ADJ197931
Regular
Oct 07, 2008

GENE DEL MASTRO vs. JOHN MANNINGER ELECTRIC, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board ruled that a lien claimant, Implantium, LLC, has standing to bill for surgical implants even if they are not covered by the Official Medical Fee Schedule (OMFS), as employer liability under Labor Code section 4600 is not limited to OMFS-covered services. The Board also found that Implantium's failure to file a fictitious business name statement until after providing services does not preclude reimbursement, as the statute only requires such filing to maintain an action, not for services rendered. Finally, the Board affirmed the consolidation of cases and deferred the issue of unjust enrichment for further proceedings.

Workers' Compensation Appeals BoardState Compensation Insurance FundSCIFImplantiumLLClien claimantOfficial Medical Fee ScheduleOMFSunjust enrichmentlicensing
References
Case No. ADJ1786826 (LAO0772803)
Regular
Sep 23, 2022

MICHAEL GUTIERREZ vs. ALPHA FOX TOWING COMPANY, STATE COMPENSATION INSURANCE FUND

This case concerns a dispute over $\$ 30,000$ in attorney's fees awarded to a former attorney. The applicant's current attorneys sought reconsideration of the Workers' Compensation Judge's order compelling them to pay this amount from the $\$ 180,000$ attorney fee approved in a settlement. The Board denied the petition, finding the WCJ properly allocated the fee, deeming the $\$ 30,000$ a reasonable portion of the total fee for the former counsel's services. The Board emphasized that attorney fees are subject to the Board's determination of reasonableness and that current counsel was unjustly enriched by attempting to retain the entire fee.

WCABPetition for ReconsiderationFindings and Orderattorney's feesformer counsellien claimantCompromise and ReleaseState Compensation Insurance FundOrder Approving Compromise and Releaseunjust enrichment
References
Case No. LAO 0803921
Regular
Mar 26, 2008

Amelia Acosta vs. Alpine Electronics of America, Mitsui Sumitomo Marine Management, Tokio Marine Management, Inc.

In this workers' compensation case, the Appeals Board granted reconsideration and rescinded an order for attorney fees against the defendants. The Board found that the administrative law judge failed to provide the defendants with proper due process and that the circumstances warranted finding the imposition of sanctions unjust. Consequently, the petition for removal was dismissed.

Workers' Compensation Appeals BoardPetition for RemovalPetition for ReconsiderationOrder for Attorney FeesWCJLien ClaimantCompromise & ReleaseIndustrial InjuryDue ProcessArbitrary and Capricious
References
Case No. ADJ3231538 (SJO 0237619)
Regular
Apr 23, 2009

NANCY ANN WILLIAMSON vs. XP FORESIGHT ELECTRONICS, INC., LUMBERMANS MUTUAL CASUALTY COMPANY, BROADSPIRE, a CRAWFORD COMPANY

This Workers' Compensation Appeals Board case involved a defendant challenging a Finding and Award regarding a medical lien. The defendant argued the awarded lien amount was unreasonable, citing procedural errors and witness bias, and also disputed the imposition of interest and penalties. The Board granted reconsideration to correct a clerical error, reducing the penalty increase for unpaid charges from 15% to 10% as per statutory guidance. The Board otherwise affirmed the original decision, finding the lien claimant's charges reasonable and the imposition of interest warranted.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings and AwardAdministrative Law JudgeLabor Code section 4603.2(b)Reasonable ValueUnpaid ChargesInterestPenalties
References
Case No. ADJ1818368 (VNO 0523027) ADJ3597904 (VNO 0529502)
Regular
Nov 14, 2011

EMILIA OLGUIN vs. ESIS DIVISION OF ACE/USA INSURANCE; Permissibly Self-Insured

The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration and dismissed the applicant's petition. The defendant argued that the WCJ's order to pay the EDD lien would result in undue enrichment due to prior payments, but the WCAB adopted the WCJ's reasoning that the defendant was on notice of the EDD's lien and paid benefits at its own peril. The applicant's petition was dismissed as untimely. The WCAB denied the defendant's petition, finding no error in the original award ordering payment of the EDD lien.

Workers' Compensation Appeals BoardIndustrial InjuryCervical SpineElbowsCumulative TraumaPsychological SystemPermanent DisabilityApportionmentEDD LienPetition for Reconsideration
References
Case No. ADJ9244329
Regular
Nov 23, 2016

MIGUEL AMADOR vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, SEDGWICK

The Workers' Compensation Appeals Board (WCAB) dismissed Miguel Amador's Petition for Reconsideration. This dismissal was based on the petition's failure to comply with Labor Code section 5902 and relevant WCAB Rules. Specifically, the petition was inadequate because it did not set forth specific details of the grounds for reconsideration, failed to fairly state all material evidence, and lacked specific references to the record. The WCAB adopted the administrative law judge's report, which also would have led to denial on the merits had the procedural defects not resulted in dismissal.

WCABPetition for ReconsiderationDismissalLabor Code 5902Cal. Code Regs. tit. 8 § 10842Cal. Code Regs. tit. 8 § 10846Cal. Code Regs. tit. 8 § 10852Skeletal PetitionUnjust or UnlawfulMaterial Evidence
References
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