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

Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ7419350
Regular
Apr 27, 2015

MARLON WHITLEY vs. BELL PLASTICS, THE HARTFORD

The Appeals Board granted reconsideration of the WCJ's attorney fee split, rescinding the original order. The WCJ failed to adequately consider all statutory factors for a reasonable attorney fee, specifically the responsibility assumed, care exercised, and results obtained, relying too heavily on estimated hours. The case is returned to the WCJ for further proceedings, development of the record, and a new decision. This new decision must properly consider all relevant factors mandated by Labor Code section 4906 and WCAB Rule 10775.

Workers' Compensation Appeals BoardPetition for ReconsiderationAttorney's Fee SplitLabor Code section 4906WCAB Rule 10775Findings and OrderSanctionHourly Attorney's FeesGood Faith NegotiationTime Expended
References
Case No. ADJ10456401
Regular
Oct 25, 2016

JUAN RIVAS vs. NORTH AMERICAN TRAILER, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case concerns a Petition for Reconsideration filed by Juan Rivas related to a workers' compensation award. The Workers' Compensation Appeals Board reviewed the petition and the WCJ's report. Adopting the WCJ's reasoning, the Board denied Rivas's petition for reconsideration.

Petition for ReconsiderationDeniedWCJ ReportAdoptedIncorporatedWorkers' Compensation Appeals BoardAward (Assumed)Van Nuys District OfficeADJ10456401North American Trailer
References
Case No. ADJ10443669
Regular
Oct 04, 2017

Donna Carter vs. Rose International Group, OneBeacon Insurance Group

The Appeals Board affirmed the Workers' Compensation Judge's finding that Donna Carter sustained an industrial injury to her right knee and left wrist on May 18, 2016. Despite inconsistencies in the applicant's testimony regarding a slip and fall incident, her account was corroborated by a witness who found her on the floor. Medical records from the day of the incident also supported the applicant's claim, establishing a clear mechanism of injury. The Board found that the common sense nature of a slip and fall does not require expert medical opinion to establish industrial causation for the incident itself.

ADJ10443669Rose International GroupOneBeacon Insurance GroupDonna CarterWorkers' Compensation Appeals BoardOpinion and Decision After Reconsiderationslip and fallindustrial injuryright kneeleft wrist
References
Case No. POM 0231129
Regular
Jun 03, 2008

PEGGY MAYER SPIER vs. BRIDGECREEK RETIREMENT HOME, LIBERTY MUTUAL INSURANCE COMPANY

This case involves a dispute over attorney's fees from a workers' compensation settlement. The WCJ initially divided the remaining $10,500 in fees based solely on the length of representation, awarding $9,450 to the applicant for self-representation and $1,050 to the former attorney. The former attorney sought reconsideration, arguing the WCJ improperly ignored statutory factors like responsibility, care, time, and results obtained. The Appeals Board granted reconsideration and remanded the case for a new fee determination based on all four statutory criteria.

Workers' Compensation Appeals BoardReconsiderationAttorney's FeesCompromise and ReleasePropria PersonaLien ClaimantAgreed Medical ExaminerThoracic Outlet SyndromeLabor Code Section 4906(d)Rule 10775
References
Case No. RDG 115445
Regular
Jun 19, 2008

BRENDA TYNER vs. IHSS and STATE COMPENSATION INSURANCE FUND, KELLEE J. HOPKINS dba ACUTELY RESIDENTIAL CARE

The State Compensation Insurance Fund (SCIF) sought reconsideration of an order approving a stipulation where an uninsured employer assumed 75% of liability. SCIF argued the stipulation lacked consideration as the uninsured employer had no intent to perform. However, SCIF subsequently withdrew its petition for reconsideration during a hearing, leading the Appeals Board to dismiss the petition.

WCABPetition for ReconsiderationStipulationUninsured EmployerState Compensation Insurance FundAcutely Residential CareWorkers' Compensation BenefitsWithdrawalDismissalOrder Approving Stipulation
References
Case No. ADJ8053917
Regular
Dec 31, 2019

WILLIAM CONTRERAS vs. G & M MATTRESS, UNITED STATES FIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the lien claimant's petition for reconsideration. The claimant sought payment for a medical-legal report, arguing it was necessary to prove a psychological injury as a compensable consequence. However, the Board found the report insufficient because the physician assumed an underlying physical injury without evidence and did not prescribe treatment. Therefore, the report was not capable of proving a disputed medical fact essential to the claim.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationMedical-Legal ReportPrimary Treating PhysicianCompensable Consequence InjuryIndustrial InjuryLabor Code Section 4620Reasonable and NecessaryAssignment of Accounts Receivable
References
Case No. ADJ4118785
Regular
Jun 29, 2010

MICHAEL LEWIS vs. REX MOORE ELECTRICAL CONTRACTORS, CHARTIS COSTA MESA

The Appeals Board rescinded a prior award due to a due process violation. The defendant employer was denied an opportunity to rebut the assumed 4.7% annual SAWW increase used to calculate the applicant's attorney's fee. The Board returned the case to the trial level for further proceedings, allowing the defendant to present rebuttal evidence on the SAWW issue. The Board expressed no opinion on the appropriateness of the 4.7% SAWW figure itself.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent Total DisabilityCommutationAttorney's FeeState Average Weekly Wage (SAWW)Disability Evaluation Unit (DEU)Permanent and Stationary (P\&S) dateIndemnity
References
Case No. ADJ2281850
Regular
Dec 01, 2016

LORI L. LAY vs. MERCY HOSPITAL & MEDICAL CENTER

Scripps Health sought removal of an order requiring a "person most knowledgeable" from their hospital to appear at a hearing, arguing Scripps Health was not a party. The Board granted removal due to the undue burden on a non-party witness. However, the Board noted Scripps Health could be a party if they assumed liabilities through a purchase agreement. Ultimately, the Order was amended to require counsel for Scripps Health and Sedgwick CMS to appear and clarify Scripps Health's party status.

Petition for RemovalWCJ OrderPerson Most KnowledgeableUnduly BurdensomeSelf-Insured EntitiesAssumption and Guarantee of LiabilitiesTransfer of OwnershipAdministrative Law JudgeWorkers' Compensation Appeals BoardScripps Health
References
Case No. ADJ1218402 (SAC 0354469)
Regular
Jun 04, 2009

JOHN MUNYER vs. RALEY'S, Permissibly Self-Insured, Adjusted By YORK CLAIMS SERVICE, INC.

The Workers' Compensation Appeals Board granted reconsideration and ordered the defendant to pay lien claimant Boehm & Associates $5,000. This decision stems from a stipulation and order resolving the lien claimant's petition for reconsideration regarding reimbursement for medical treatment. The parties agreed to this settlement amount, which fully satisfies the lien claim, including any claims for interest and penalties. The Board noted a typographical error in the stipulation regarding the beneficiary of the lien, assuming it referred to the UFCW Northern California Benefit Plan.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and AwardCumulative Industrial InjuryMeat CutterOfficial Medical Fee ScheduleLabor Code Section 4903(a)(2)Contract RateStipulation and Order
References
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