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

Case No. ADJ9309704

Regular

Oct 25, 2018

BRANDON WASHINGTON vs. LOS ANGELES COUNTY DEPARTMENT OF PUBLIC WORKS

The Workers' Compensation Appeals Board granted Reshealth Medical Group's Petition for Reconsideration. The Board found that the defendant failed to meet its burden of proof that Eric Schames controlled Reshealth Medical Group, which is required to stay Reshealth Medical's lien under Labor Code Section 4615. Evidence presented showed Reshealth Medical and Reshealth Diagnostics are separate entities, and Dr. Zain Vally, not Mr. Schames, was identified as an officer of Reshealth Medical. Therefore, the WCJ's Findings and Award were rescinded, and the case was returned to the trial level for further proceedings.

Labor Code section 4615lien claimantPetition for ReconsiderationDIR listEAMS notationFranchise Tax BoardReshealth Medical GroupReshealth DiagnosticsEric Schamesofficer or director

References

Case No. ADJ7779326

Regular

Nov 26, 2012

MICHAEL MOSER vs. VALLI CONSTRUCTION, OLD REPUBLIC GENERAL INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and found that the defendant's initial petition for reconsideration was timely filed, rescinding the prior order of dismissal. The Board affirmed the WCJ's original findings that the applicant is entitled to temporary disability benefits from March 1, 2012, and continuing. This ruling was based on the determination that the applicant's second spinal surgery constituted a bona fide medical emergency, exempting it from the usual pre-authorization and second opinion requirements. Therefore, the defendant's petition for reconsideration was ultimately denied.

WCABReconsiderationFindings and AwardTemporary Disability IndemnitySpinal SurgeryUtilization ReviewSecond OpinionBona Fide Medical EmergencyLabor Code Section 4062(b)AD Rule 9788.01(l)(4)

References

Case No. ADJ7932966

Regular

Oct 26, 2018

JUAN CARLOS ROMERO vs. EVOLUTION FRESH, TECHNOLOGY INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of an award of permanent total disability. The Board found that the applicant's vocational expert's report lacked substantial evidence, as it improperly increased work restrictions and relied on external sources without connecting them to the medical record. Consequently, the Board rescinded the original award and returned the case to the judge for a new decision. This new decision must be based on the medical opinions of Drs. Berman, Justice, and Vally-Mahomed, which constitute substantial evidence.

Workers' Compensation Appeals BoardPermanent Total DisabilityVocational ExpertSubstantial EvidencePermanent Disability Rating ScheduleAgreed Medical ExaminerQualified Medical ExaminerWhole Person ImpairmentMajor Depressive DisorderGlobal Assessment of Functioning Scale

References

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BRANDON WASHINGTON vs. LOS ANGELES COUNTY DEPARTMENT OF PUBLIC WORKS

Labor Code section 4615lien claimantPetition for ReconsiderationDIR listEAMS notationFranchise Tax BoardReshealth Medical GroupReshealth DiagnosticsEric Schamesofficer or director

MICHAEL MOSER vs. VALLI CONSTRUCTION, OLD REPUBLIC GENERAL INSURANCE

WCABReconsiderationFindings and AwardTemporary Disability IndemnitySpinal SurgeryUtilization ReviewSecond OpinionBona Fide Medical EmergencyLabor Code Section 4062(b)AD Rule 9788.01(l)(4)

JUAN CARLOS ROMERO vs. EVOLUTION FRESH, TECHNOLOGY INSURANCE COMPANY