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Case Law Database

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

Case No. ADJ8201128
Regular
May 14, 2013

Barry Swartwood vs. UC DAVIS

This case concerns a lien claimant, ARS Legal, seeking payment for medical-legal copy costs incurred in the workers' compensation case of Barry Swartwood v. UC Davis. The Workers' Compensation Appeals Board (WCAB) denied ARS Legal's Petition for Reconsideration, upholding the Administrative Law Judge's (ALJ) finding. The WCAB determined that the costs were not reasonably or necessarily incurred, citing that ARS Legal obtained duplicate records after defendant Sedgwick had already objected to payment for such duplicative services. Furthermore, the records ARS Legal obtained were incomplete compared to those acquired by the defendant.

Workers' Compensation Appeals BoardBarry SwartwoodUC DavisSedgwickADJ8201128Order Denying ReconsiderationLabor Code section 4621(a)medical-legal copy costsStipulations with Request for Awardlien claimant
References
0
Case No. MISSING
Regular Panel Decision
Apr 16, 2003

Mickens v. LaSala

Plaintiffs appealed an order granting summary judgment to defendants in a medical malpractice case. They alleged defendants failed to diagnose their son, Noah, with Down's syndrome in utero, seeking extraordinary expenses for his care. The Supreme Court, Kings County, granted summary judgment, finding plaintiffs had not incurred, and would not necessarily incur, such expenses due to government programs like the Individuals with Disabilities Education Act. The appellate court dismissed the appeal from the order but affirmed the judgment, holding that plaintiffs failed to provide proof of extraordinary financial obligations or expert testimony identifying unmet needs not covered by public expense, reinforcing that damages cannot be based on speculation.

Medical MalpracticeWrongful LifeExtraordinary ExpensesDown SyndromeSummary JudgmentAppellate ReviewParental ClaimGovernment ProgramsIndividuals with Disabilities Education ActCausation
References
6
Case No. MISSING
Regular Panel Decision

In re Ward

The United States Bankruptcy Court for the Northern District of Texas denied a debtor's motion to reconsider an order denying her request to incur new debt for a used car. Debtor Chinique Ward sought to purchase a vehicle with a 20.25% interest rate from Reid’s Auto Connection, a dealership known for targeting bankruptcy debtors, after her original car was repossessed. The court found the proposed financing unreasonable and not in the debtor's best interest, especially given the dealership had provided the car and paid the debtor's attorney fees without prior court approval. The judge ordered the unwinding of the transaction, mandating the return of payments and the car, and highlighted increased scrutiny for future post-petition borrowing requests due to concerns over predatory practices. This decision underscores the court's role as a gatekeeper for chapter 13 debtors' post-confirmation financial activities, particularly regarding significant debt incurrence.

Chapter 13 BankruptcyPost-Petition DebtCar FinancingMotion to Incur DebtReconsideration DenialHigh Interest RatesPredatory LendingAttorney Fee DisclosureUnwinding TransactionDebtor's Rehabilitation
References
10
Case No. ADJ7890528
Regular
Dec 09, 2013

RUBEN CRUZ vs. PACIFIC RIDGE FARMS, ZENITH INSURANCE COMPANY

This case concerns a defendant's petition for reconsideration of a prior decision that allowed a lien for photocopy services. The defendant argued the lien for duplicating already-obtained medical records was improperly allowed. The Appeals Board granted reconsideration, rescinded its prior order, and returned the matter to the trial level. This was because the Board found the photocopy expenses were not reasonably and necessarily incurred when the injury was admitted and the records were duplicative.

Med-Legal Photocopylien claimantPetition for ReconsiderationFindings and Orderrescindedmedical recordsLabor Code Section 4603.2medical-legal costsreimbursementapplicant's injury
References
5
Case No. GOL 0098326
Regular
Jul 23, 2007

DIANE SWEET vs. SANTA MARIA JOINT UNION HIGH SCHOOL DISTRICT

This case involves a lien claimant, Associated Reproduction Services (ARS), seeking reconsideration of a decision that disallowed most of its lien for photocopying services. The Appeals Board denied reconsideration, upholding the administrative law judge's finding that ARS failed to meet its burden of proving the necessity and reasonableness of its charges. The Board affirmed that lien claimants must demonstrate that medical-legal expenses were reasonably, actually, and necessarily incurred to prove or disprove a contested claim, which ARS did not establish here.

Workers' Compensation Appeals BoardDIANE SWEETSANTA MARIA JOINT UNION HIGH SCHOOL DISTRICTAssociated Reproduction ServicesIncARSLien claimantWCJReconsiderationFindings of Fact
References
4
Case No. ADJ10406903
Regular
Jan 11, 2019

LUIS MANUEL MENDEZ SANCHEZ vs. HARTMARK CABINET DESIGN & MANUFACTURING, INC., EVEREST NATIONAL INSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration of an order denying interpreter fees, finding that services for interpreting a Compromise and Release (C&R) may be compensable. The Board clarified that while not explicitly listed in statute, such interpretation could be considered a "similar setting" necessary to ascertain the validity and extent of injury for an applicant with limited English proficiency. The case was returned to the WCJ for further proceedings to determine if the interpreter fees were reasonably, actually, and necessarily incurred under Labor Code section 5811 and AD Rule 9795.3.

Workers' Compensation Appeals BoardPetition for ReconsiderationInterpreter FeesCompromise and ReleaseLabor Code Section 5811AD Rule 9795.3Judicial EconomyWCJPetition for CostsAdministrative Law Judge
References
0
Case No. ADJ7219865
Regular
May 06, 2014

JUVENAL DIAZ vs. CALPAK LANDSCAPE, INC.

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's decision disallowing the lien of New Age Imaging. The Board found the WCJ misapplied the burden of proof by focusing on injury AOE/COE and medical necessity, rather than whether the copy services were "reasonably, actually, and necessarily incurred" as medical-legal expenses for a contested claim. Consequently, the Board rescinded the WCJ's decision, affirmed the disallowance of another lien claimant (True Scan), and returned New Age Imaging's lien to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationMedical-legal expenseContested claimLabor Code section 4620Injury AOE/COESelf-procured servicesBurden of proofRescind
References
0
Case No. ADJ4484509
Regular
Feb 28, 2011

GANCZO CHRISTOV vs. AUCTION AUTO PREP CORPORATION, ZENITH INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to the lien claimant, Vasquez Vocational Experts, Inc., challenging the disallowance of their $2,480.00 lien for vocational expert services. The WCAB found that the original judge erred in determining there was no legal basis for reimbursement, as vocational expert costs are allowable under Labor Code section 5811. The Board held that the services were reasonably and necessarily incurred by the applicant to evaluate diminished future earning capacity, irrespective of whether a formal rating had been issued. The case was returned to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardVocational ExpertLien ClaimReconsiderationFindings and OrderCompromise and ReleasePermanent Disability RatingDiminished Earning CapacityLabor CodeCompensable Services
References
4
Case No. 03-09-00682-CV
Regular Panel Decision
Mar 23, 2011

Austin ISD, Self-Insured v. Charles M. Manbeck

This case originated from a workers' compensation dispute where Austin ISD (AISD), a self-insured governmental entity, sought judicial review of a Division of Workers’ Compensation decision regarding the extent of Charles M. Manbeck's injury. Manbeck, the claimant, counterclaimed for attorneys' fees under Labor Code section 408.221(c). AISD later non-suited its judicial-review claim, and the case proceeded solely on Manbeck's counterclaim for attorneys' fees. The district court awarded Manbeck $36,000 for trial-level fees incurred before AISD's non-suit, $17,415 for fees incurred after the non-suit, and contingent appellate attorneys' fees. On appeal, the court affirmed the award of $36,000 for fees incurred prior to AISD's non-suit but reversed and rendered judgment that Manbeck take nothing on the claims for fees incurred after the non-suit and contingent appellate fees, holding that Labor Code section 408.221(c) does not authorize recovery of 'fees for fees'.

Workers' Compensation ActAttorneys' FeesJudicial ReviewExtent of InjurySelf-Insured EntityLabor Code Section 408.221(c)American RuleFee ShiftingStatutory ConstructionSufficiency of Evidence
References
40
Case No. MISSING
Regular Panel Decision

National Union Fire Insurance Co. v. Burnett

Latricia Burnett, a Wal-Mart sales clerk, sustained a closed head injury after falling at work in 1990. She was initially awarded 401 weeks of workers' compensation benefits by the Texas Workers’ Compensation Commission, which was then challenged by National Union Fire Insurance Company, Wal-Mart's insurance carrier, in county court. The county court awarded Burnett lifetime benefits, finding her depression to be "incurable insanity" and that she suffered a "skull injury" under Article 8306, § 11a of the former Workers’ Compensation Act. National Union appealed this ruling, arguing that depression does not constitute "incurable insanity" and that there was insufficient evidence of a "skull injury." The appellate court reversed the county court's judgment regarding lifetime benefits, concluding there was no evidence Burnett was psychotic or "incurably insane," but affirmed the original award of $156.92 per week for 401 weeks.

Head InjuryDepressionIncurable InsanityStatutory InterpretationLifetime BenefitsTotal IncapacityPermanent IncapacityTexas Appellate LawCausationMedical Testimony
References
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