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

Case No. ADJ9099563
Regular
Sep 25, 2017

LAWRENCE TURNER vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's petition for reconsideration. This action was taken because no final order, decision, or award had been issued by the WCAB, and therefore, the applicant was not legally aggrieved. The WCAB found that the case was still in a preliminary stage, with a dispute regarding eligibility for the Alternative Dispute Resolution (ADR) program pending. Consequently, the petition was dismissed as premature.

Petition for ReconsiderationFinal OrderAggrieved ApplicantWorkers' Compensation Appeals BoardAdministrative Law JudgeLabor Code Section 5900Labor Code Section 5902Labor Code Section 5903Substantive RightLiability Determination
References
Case No. ADJ7188251; ADJ7188272
Regular
Mar 08, 2013

Raymond Mark vs. City of Los Angeles

This case involves a petition by applicant Raymond Mark to resubmit or remove two workers' compensation cases, alleging the City of Los Angeles refused to fund an arbitrator. The Appeals Board dismissed the petition for three reasons: no arbitrator decision existed for review, the underlying claims were previously dismissed giving the Board no jurisdiction, and the Board lacks jurisdiction over disputes concerning the administration of the Alternative Dispute Resolution Agreement itself. The Board concluded that the applicant's recourse for funding disputes lies in collective bargaining, arbitration, or petitioning the Administrative Director to decertify the agreement.

Petition for ResubmissionADR CasesL.C. § 3201.7ADR ARB IVCity of Los AngelesFunding ArbitratorOpinion and Order Granting ReconsiderationDecision After ReconsiderationOrder of DismissalJurisdiction
References
Case No. ADJ2373559 (OAK 0280633)
Regular
Dec 29, 2008

LYNN JONES vs. INTERNEWS NETWORK, STATE COMPENSATION INSURANCE FUND

The WCAB granted reconsideration, rescinded the prior award, and returned the case to the trial level to allow parties to complete the dispute resolution process regarding medical treatment denials. The Board found that after utilization review denied treatment, the parties failed to follow the required procedures under Labor Code sections 4610 and 4062 to resolve the dispute. Therefore, a new decision is to be made after the proper dispute resolution process is completed.

Workers' Compensation Appeals BoardUtilization ReviewMedical Treatment DisputeLabor Code Section 4610Labor Code Section 4062Qualified Medical ExaminerGym MembershipPhysical TherapyIndustrial InjuryTreating Physician
References
Case No. ADJ8202286; ADJ8202308
Regular
Jul 23, 2013

BRADLEY WHEELER vs. COUTS HEATING & COOLING, INC., ZURICH AMERICAN INSURANCE CO.

The Appeals Board dismissed Zurich's unverified Petition for Removal due to procedural defects and its misrepresentation of the record. The Board also removed the cases to itself on its own motion and issued a notice of intention to impose sanctions on Zurich for frivolous actions. The Board directed the WCJ to hold a priority hearing to determine if Seabright should be joined as a party and to resolve issues regarding alternative dispute resolution provisions.

Workers' Compensation Appeals BoardPetition for RemovalDismissedSanctionsLabor Code Section 3201.7Alternative Dispute ResolutionWCIRBSocial Security EarningsPetition for DismissalOff Calendar
References
Case No. ADJ7086267
Regular
Feb 14, 2013

Branden Robinson vs. Circulating Air, SEABRIGHT INSURANCE COMPANY

This case concerns Branden Robinson's attempt to recover vocational expert fees through an Alternative Dispute Resolution (ADR) process. The Ombudsman found the reimbursement request improperly raised due to insufficient documentation and service. The Workers' Compensation Appeals Board dismissed reconsideration, as no final determination was made, and denied removal. Applicant was advised to properly initiate proceedings with the Ombudsman by providing sufficient specificity regarding the claim.

Workers' Compensation Appeals BoardBranden RobinsonCirculating AirSeabright Insurance CompanyOmbudsmanVocational ExpertReimbursementAlternative Dispute ResolutionSheet Metal Workers International AssociationLabor Management Safety Oversight Committee
References
Case No. ADJ8969518
Regular
Mar 30, 2015

EDUARDO FLORES RAMOS vs. LETNER ROOFING CO.; GALLAGHER BASSETT

The Workers' Compensation Appeals Board (WCAB) dismissed Eduardo Flores Ramos's petition for reconsideration because it was untimely filed. The petition was filed on January 11, 2015, which was more than 25 days after the WCJ's December 11, 2014 decision. The WCAB emphasized that the deadline for filing a petition for reconsideration is jurisdictional and proof of mailing is insufficient. The WCAB noted that the applicant may pursue their claim through alternative dispute resolution under a Union Collective Bargaining Agreement.

Petition for ReconsiderationUntimely FilingJurisdictional LimitWCABWCJ ReportLabor CodeCalifornia Code of RegulationsAlternative Dispute ResolutionCollective Bargaining AgreementUnion Agreement
References
Case No. ADJ6751296
Regular
May 16, 2012

RYAN MCDONALD vs. IRWIN INDUSTRIES

The Workers' Compensation Appeals Board denied reconsideration of a decision involving Ryan McDonald and Irwin Industries. The Board upheld sanctions against applicant's attorney for compounding errors and improperly attaching excess documents. The Board clarified that Serious and Willful Misconduct claims under Labor Code section 4553, and all other claims, must first be arbitrated under the Alternative Dispute Resolution process. Only after an arbitration decision can a petition for reconsideration be filed with the Appeals Board.

Workers' Compensation Appeals BoardIrwin IndustriesPermissibly Self-InsuredOpinion and Order Denying ReconsiderationWorkers' Compensation Administrative Law JudgeWCJPetition for ReconsiderationSanctionsApplicant's AttorneyCompounding Errors
References
Case No. ADJ6634260
Regular
Aug 02, 2010

MELCHOR ELIZARRARAS vs. MIKE BUBALO CONSTRUCTION COMPANY, SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior finding that the parties were not subject to an Alternative Dispute Resolution (ADR) process. The Board found the original decision was based on unclear issues and the record may support a valid ADR process applicable to the applicant's injury. The case is returned to the trial level for further proceedings and a new decision on whether the applicant's injury is covered by a valid ADR system under Labor Code §3201.5.

Labor Code §3201.5Alternative Dispute ResolutionADR systemcollective bargaining agreementSouthern California District Council of LaborersMike Bubalo Construction CompanySeabright Insurance Companyindustrial injurylow back injuryright shoulder injury
References
Case No. ADJ6663169
Regular
Jan 27, 2010

RICHARD SHILTS (Deceased), KAAREN GUEST (Widow) vs. BRUNTON ENTERPRISES, INC., SEABRIGHT INSURANCE CO.

This case concerns whether a union's "carve-out" agreement, allowing for alternative dispute resolution under Labor Code § 3201.5, applies to dependent death benefits. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, reversing a prior finding. The WCAB held that "carve-out" agreements, by their plain language, apply only to "employees" and not to dependents' death benefit claims. Because dependents' rights to death benefits are independent of the deceased employee's claim and constitutionally mandated, the WCAB found these claims fall under its exclusive jurisdiction.

carve-out agreementLabor Code section 3201.5death benefitsdependents' claimalternative dispute resolutionWCAB jurisdictioncollective bargaining agreementindustrial injurywidowinsurer
References
Case No. ADJ9660632
Regular
Feb 17, 2017

FRANCISCO SANCHEZ vs. MERCHANTS BUILDING MAINTENANCE dba GUARD SYSTEMS, INC., CLAIMQUEST, INC.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior Minute Order that dismissed the applicant's case. The WCJ had found the WCAB lacked jurisdiction due to an alternative dispute resolution (ADR) agreement and directed parties to present the jurisdiction issue to an arbitrator. However, the WCAB found the WCJ's dismissal order lacked reasoning and evidence, failing to comply with legal requirements for a decision. The case is returned to the trial level for further proceedings and a new decision, to determine jurisdiction and whether the applicant's case should be reopened before the WCAB.

Workers' Compensation Appeals BoardPetition for ReconsiderationAlternative Dispute ResolutionJurisdictionDismissalMinute OrderDeclaration of Readiness to ProceedPetition for DismissalLabor CodeThreshold Issues
References
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