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

Case No. ADJ8073207
Regular
Mar 07, 2014

STEVEN PRISK vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

The Appeals Board granted reconsideration and affirmed the WCJ's decision awarding applicant industrial psychiatric injury, temporary disability, and further medical treatment against the Los Angeles Unified School District. The Board amended the decision to clarify the Labor Code section 5814 penalty for unreasonably withheld temporary disability benefits is capped at $10,000. The Board strongly condemned the defendant's petition for its numerous mischaracterizations, frivolous arguments, and unprofessional tone, cautioning against future violations. The defendant's arguments regarding asbestos exposure and termination were deemed irrelevant or unsubstantiated.

Workers' Compensation Appeals BoardPsychiatric InjuryCumulative TraumaTemporary DisabilityLabor Code Section 5814PenaltyReconsiderationAdministrative Law JudgeMedical TreatmentAsbestos Exposure
References
Case No. ADJ695519 (VNO 0423671)
Regular
Aug 06, 2009

NORMA RIVAS vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration of a prior award, affirming the reinstatement of a stipulation and award. However, the Board found error in the workers' compensation judge's award of attorney's fees and costs. The Board vacated this portion of the award, stating the judge's reasoning was insufficient and lacked specific statutory basis. The case is remanded for further proceedings to develop the record and allow the judge to address the claims for attorney's fees and costs under relevant Labor Code sections.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardStipulations With Request For AwardGood CauseAttorney's FeesCostsLabor Code Sections 581158135814.5
References
Case No. ADJ9129316
Regular

MIN CHUL SUH vs. LA GRAPHICAL; EMPLOYERS COMP

The Workers' Compensation Appeals Board denied the Applicant's Petition for Reconsideration. The Applicant sought reconsideration of the Workers' Compensation Judge's (WCJ) finding that he did not sustain an injury arising out of and in the course of employment. The Board adopted the WCJ's report, which relied on credibility determinations and found the Applicant's account of injury by a co-worker's grab or lift to be unsubstantiated by evidence. The Board gave great weight to the WCJ's credibility findings, which is a standard in workers' compensation appeals.

Petition for ReconsiderationWorkers' Compensation Appeals BoardAdministrative Law JudgeCredibility FindingInjury AOE/COEIn Pro PerVerbal ArgumentWorkplace RadioPhysical AltercationCo-worker Intervention
References
Case No. ADJ555322, ADJ1127657, ADJ3643619, ADJ3733400, ADJ615070
Regular
Jan 23, 2023

RICHARD CORTEZ vs. PARAMOUNT PICTURES, MURPHY AND BEANE

The Workers' Compensation Appeals Board denied Paramount Pictures' petition for reconsideration. The Board upheld the WCJ's finding that the applicant was entitled to a retroactive increase in temporary disability payments based on Labor Code Section 4661.5. The defendant failed to provide evidence to support their proposed method of calculating the earnings rate or to establish prejudice for the applicant's delay in claiming the increase. Therefore, the original award granting the increased benefits remains in effect.

Workers' Compensation Appeals BoardPetition for Reconsideration DeniedTemporary Disability (TTD) RateLabor Code Section 4661.5Labor Code Section 4453Average Weekly EarningsUnion ContractMotion Picture Health and WelfareRetroactive IncreaseCollective Bargaining Agreement
References
Case No. ADJ7405264
Regular
Jun 19, 2012

IVORY PHILLIPS vs. IRWIN INDUSTRIES, INC., ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board sanctioned claims adjuster Richard Bailey $250 for failing to appear at an arbitration hearing. Despite Bailey's contentions about lack of written notice and fear of the arbitrator, the Board found he had actual notice of the verbal order. While the underlying issue was resolved, Bailey should have sought permission for his non-appearance, and his disregard for the arbitrator's order undermined the system's integrity.

Workers' Compensation Appeals BoardSanctionsClaims AdjusterArbitrationWritten ObjectionGood CauseArbitratorVerbal OrderLabor Code Section 5701Independent Medical Examination
References
Case No. ADJ8083206
Regular
Jan 04, 2012

Dwayne McClendon vs. City Wide Electronic Systems, Berkshire Hathaway

The Workers' Compensation Appeals Board denied the defendant's Petition for Removal. Removal is an extraordinary remedy granted only upon a showing of substantial prejudice or irreparable harm, which was not demonstrated here. The Board found that the WCJ's report adequately addressed the defendant's arguments. Specifically, the Board inferred that the applicant's attorney had filed an application in 2008, and the lack of a case number was due to a clerical error, not a lack of jurisdiction.

Petition for RemovalSubstantial PrejudiceIrreparable HarmReconsiderationAdequate RemedyWCJ ReportJurisdictional ArgumentApplication FilingCase NumberClerical Error
References
Case No. ADJ2022332 (ANA 0334821) ADJ947209 (ANA 0334822)
Regular
Feb 27, 2014

JOHN SHEA vs. PROPSERV, INC., CENTRE INSURANCE. COMPANY., CIGA For CALCOMP, In Liquidation

The California Workers' Compensation Appeals Board affirmed the Arbitrator's decision denying CIGA's requests for contribution and reimbursement from Centre Insurance Company. CIGA stipulated to liability for the injury date in 2000, and the Board found that CIGA's subsequent claims of mistake were untimely and lacked good cause to reopen a final award. The Board emphasized the importance of finality in awards and that CIGA failed to timely raise equitable arguments. Therefore, CIGA's appeal for contribution and reimbursement was unsuccessful.

CIGACalCompContributionReimbursementStipulated AwardGood CauseReopenEquitable ArgumentsPrejudgment InterestDate of Injury
References
Case No. ADJ7843125
Regular
Nov 14, 2014

LISA DARBY vs. UNIVERSITY OF CALIFORNIA LOS ANGELES, SEDGWICK CMS

The Appeals Board denied the defendant's Petition for Removal, which sought to reverse a WCJ's order denying disqualification of a QME. The defendant argued the QME failed to timely submit a supplemental report after reviewing surveillance video, a delay stemming from a verbal request during a deposition, not a formal written one. The Board found Administrative Director Rule 38.1(i) inapplicable as it requires a written request. Furthermore, the Board noted a subsequent deposition could resolve the issue or allow the defendant to renew their motion.

Petition for RemovalQualified Medical EvaluatorSupplemental ReportTimelinessDepositionSurveillance VideoAdministrative Director Rule 38.1(i)Verbal RequestMoot IssueRenew Motion
References
Case No. ADJ2904305 (GOL 0095697) ADJ1827151 (GOL 0095698)
Regular
Aug 02, 2010

GUADALUPE CARRILLO vs. SAN ANTONIO VILLAGE HOA, STATE FARM INSURANCE COMPANIES

The Workers' Compensation Appeals Board denied a lien claimant's petition for reconsideration regarding a disallowed lien balance of $9,349.46. The claimant, a doctor, failed to obtain required written authorization for work hardening services billed under CPT Code 97545. Despite a claim of verbal authorization and a general request for multiple modalities, the Board found the lack of specific written authorization for the disputed services to be determinative. Therefore, the administrative law judge's disallowance of the lien balance was upheld.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationCompromise and ReleaseWork hardeningWork conditioningCPT Code 97545Prior authorizationVerbal authorizationWritten authorization
References
Case No. ADJ8103143
Regular
Dec 04, 2015

CHUONG VO vs. ZONARE MEDICAL SYSTEMS, INC., ONE BEACON INSURANCE COMPANY

This case involves a defendant seeking reconsideration of an order enforcing an Independent Medical Review (IMR) determination that authorized applicant's requested cervical surgery. The defendant argued a subsequent conflicting IMR determination, the WCJ's lack of jurisdiction, and an improper physician signature on the initial request voided the original IMR. The Appeals Board denied reconsideration, finding that a later IMR does not negate a prior one, the WCJ had jurisdiction to enforce the IMR, and the defendant waived the physician signature argument by proceeding with utilization review.

Independent Medical ReviewUtilization ReviewPetition for ReconsiderationLabor Code section 4610Labor Code section 4610.5anterior cervical decompression and fusionposterior cervical decompression and fusionmedical necessitywaived argumentsecondary treating physician
References
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