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

Case No. ADJ11329391, ADJ13022586
Regular
Dec 11, 2020

Richard Mancha vs. California Department of Forestry and Fire Prevention, STATE COMPENSATION INSURANCE FUND

This case involves a firefighter, Richard Mancha, who claimed injury to his heart, memory, and cognitive abilities. Both the applicant and the defendant Department of Forestry and Fire Prevention appealed an earlier award. After reconsideration, the parties reached a Compromise and Release agreement for $150,000, which the Board found adequate and in the applicant's best interest. The Board rescinded the prior Findings and Award and approved the settlement.

Workers' Compensation Appeals BoardRichard ManchaCalifornia Department of Forestry and Fire PreventionLegally UninsuredState Compensation Insurance FundADJ11329391ADJ13022586Opinion and Decision After Reconsiderationapparatus/engineer fire fighterheart trouble presumption
References
Case No. ADJ198338 (OXN 0146100)
Regular
Mar 26, 2010

RICHARD GARLAND vs. COUNTY SANITATION DISTRICT OF LOS ANGELES, ADMINSURE DIAMOND BAR

This case involves five separate workers' compensation awards for Richard Garland against the County Sanitation District of Los Angeles. The defendant seeks reconsideration of the administrative law judge's refusal to allow credit for an alleged overpayment of permanent disability advances made in one case against the indemnity awarded in other consolidated cases. The Appeals Board granted reconsideration, rescinded the prior decisions, and returned the matters for further proceedings. The Board found that the judge erred in disallowing the credit and directed development of the record on payment details and proper calculation/explanation of attorney's fees.

Workers' Compensation Appeals BoardRichard GarlandCounty Sanitation DistrictAdminsureTreatment Plant OperatorPermanent Disability IndemnityPermanent Disability AdvancesOverpayment CreditAttorney's FeesReconsideration
References
Case No. ADJ3080847 (LBO 0340948), ADJ4148428 (LBO 0344716)
Regular
Dec 02, 2013

RICHARD SELLERS vs. ROCKVIEW FARMS, ARROWOOD INDEMNITY COMPANY, Administered by SEGWICK CMS

The Workers' Compensation Appeals Board affirmed a prior award granting Richard Sellers temporary disability indemnity for his bilateral knee and low back injuries sustained in 2001. The defendant challenged nearly three and a half years of this award, arguing the applicant reached permanent and stationary status earlier based on an Agreed Medical Examiner's (AME) opinion. However, the Board found the treating physician's opinion, supported by the successful surgical outcome, constituted substantial evidence of ongoing temporary disability. The Board was not bound by the AME's opinion, especially given discrepancies in findings and the eventual authorization of surgery that resolved the applicant's symptoms.

ADJ3080847ADJ4148428Rockview FarmsArrowood Indemnity CompanySegwick CMSRichard SellersPetition for reconsiderationFindings and Awardtemporary disabilitypermanent disability
References
Case No. ADJ7911474
Regular
Jan 22, 2019

KIA SPREWELL vs. STATE OF CALIFORNIA, RICHARD J. DONOVAN CORRECTIONAL FACILITY

This case involved Kia Sprewell's workers' compensation claim against the Richard J. Donovan Correctional Facility for injuries sustained as an office assistant. The defendant sought reconsideration of the initial award, primarily contesting the commutation method for attorney fees and the substantiality of the neurologist's medical opinions. The Workers' Compensation Appeals Board granted reconsideration in part, affirming the award of permanent disability but amending the attorney fees to be commuted from the side of the life pension award. The Board found the neurologist's opinions on apportionment and rating of various injuries, including headaches and spinal issues, to be substantial medical evidence.

Workers Compensation Appeals BoardKia SprewellRichard J. Donovan Correctional FacilityState Compensation Insurance FundPetition for ReconsiderationFindings and AwardPermanent DisabilityApportionmentLife PensionAttorney Fees
References
Case No. ADJ6871732
Regular
Oct 26, 2019

TAMORA WHITFIELD vs. ONLINE CAR STEREO, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to review a judge's award for Dr. Richards' services. While finding Dr. Sobol was the primary treating physician and referred applicant for lab tests, the Board determined the record lacked sufficient evidence to prove the reasonableness and necessity of Dr. Richards' specific treatments. Consequently, the original award was rescinded, and the case was remanded for further proceedings to develop the record regarding the exact services provided by the lien claimant.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and AwardLumbosacral spine injuryDr. RichardsOfficial Medical Fee Schedule (OMFS)Labor Code Section 4622Treatment lienReasonableness of chargesPrimary treating physician
References
Case No. ADJ4700532
Regular
Nov 23, 2009

RICHARD DENNY vs. PINKERTON; ACE

Reconsideration granted; WCJ decision affirmed except for rescission of paragraphs (a) and (b) of the Award in favor of Boxer Law Firm and amendments to Findings 6, 7, 10, 11 and paragraphs (a) and (b) of the Award in favor of applicant.

Workers' Compensation Appeals BoardRichard DennyPinkertonACEFindings and AwardVocational Rehabilitation Maintenance AllowanceVRMATemporary DisabilityTDLabor Code section 5814
References
Case No. ADJ4203019 (STK 0122552)
Regular
Nov 01, 2012

TEENA WIGGINS vs. TREAT'S GENERAL STORE, GROCERS INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed Teena Wiggins' Petition for Reconsideration in case ADJ4203019. The dismissal was based on the petition not being timely filed, as per the WCJ's report which the WCAB adopted. Had the petition been timely, it would have been denied on the merits. The WCAB also advised Ms. Wiggins to contact the Information and Assistance Office for guidance on her options.

Petition for ReconsiderationTimely-filedReport and RecommendationWorkers' Compensation Appeals BoardAdministrative Law JudgeDismissing PetitionDeny on the meritsInformation and Assistance OfficeStockton District OfficeApplicant
References
Case No. VNO 513573
Regular
Apr 23, 2008

RICHARD FISCHINGER vs. RALPHS GROCERY COMPANY

The Workers' Compensation Appeals Board granted reconsideration, finding no evidence that the defendant failed to provide necessary medical treatment for the applicant's admitted industrial lung injury. The WCAB amended the findings to state that the defendant rendered all necessary medical treatment and deferred determination of Dr. Weingarten's lien claim. The award for further medical treatment was removed, and the issue of self-procured treatment was also reversed due to lack of supporting evidence.

Ralphs Grocery CompanySedgwick Claims Management ServicesRichard Fischingerpermanent disabilitylung injuryhypertensiondiabetesself-procured medical treatmentWCJFindings and Award
References
Case No. ADJ2035014 (POM 0295544)
Regular
Mar 06, 2014

RICHARD VAZQUEZ vs. EPIC FIRE PROTECTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and amended its prior decision concerning Richard Vazquez's claim against Epic Fire Protection and State Compensation Insurance Fund. The amended decision affirms the original ruling but modifies the findings regarding temporary disability. Specifically, applicant Richard Vazquez is found to be totally temporarily disabled from March 28, 2007, to the present, subject to the 240-week limitation under Labor Code section 4656. The rate of this disability, along with further earnings development, remains pending before the Board.

Workers' Compensation Appeals BoardPetition for ReconsiderationDecision After ReconsiderationTotally Temporarily DisabledLabor Code Section 4656240 LimitationFindings and AwardState Compensation Insurance FundApplicantDefendant
References
Case No. ADJ1923190
Regular
Jul 19, 2010

Richard Martinez vs. SIFLING BROTHERS, ZENITH INSURANCE COMPANY

Lien claimants, Dr. Silver and Dr. Bresler, sought payment for medical services exceeding the Official Medical Fee Schedule (OMFS). They argued their services warranted higher fees due to "extraordinary circumstances" and defendant's alleged improper billing practices. The Workers' Compensation Appeals Board denied their petitions for reconsideration, finding they failed to meet the burden of proof. The board held that lien claimants must demonstrate extraordinary circumstances justifying fees above the OMFS and present evidence of their usual and customary fees.

Workers' Compensation Appeals BoardRichard MartinezSifling BrothersZenith Insurance CompanyDavid BreslerDavid SilverSupplemental Findings and AwardOfficial Medical Fee ScheduleLien ClaimantsReconsideration
References
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