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

Case No. ADJ6843683
Regular
Dec 03, 2019

ELIZABETH FUERTE vs. B&H EDUCATION INC., ZENITH INSURANCE COMPANY, ICW GROUP

The Workers' Compensation Appeals Board (WCAB) rescinded a prior award, returning the case to the trial level for further proceedings. The WCAB clarified that lien claimants bear the burden of proving their copy services were reasonable, actual, and necessary, as clarified by the en banc decision in *Colamonico*. The Board also noted that services performed after the applicant settled her claim may require further justification. Finally, the WCAB indicated that if the lien claimant meets its initial burden, penalties and interest under Labor Code section 4622 may apply, as the defendant did not submit an Explanation of Review (EOR).

Lien claimantWCJReconsiderationFindings and AwardLabor Code section 4622PenaltyInterestCopy servicesCompromise and ReleaseColamonico
References
1
Case No. ADJ9734069
Regular
Jul 19, 2018

DARLENE MORALES vs. STATE COMPENSATION INSURANCE FUND; Permissibly Self-Insured, adjusted by AIMS

The Workers' Compensation Appeals Board (WCAB) rescinded a prior decision finding applicant's claim barred by the statute of limitations due to the WCJ improperly placing the burden of proof on the applicant. The WCAB determined that the defendant bears the burden of proving the statute of limitations defense. Further development of the record is necessary to establish when the applicant had both knowledge and disability, as there is no clear medical advice in the record indicating her conditions were work-related. The case is returned to the trial level for further proceedings and a new decision.

Cumulative traumaStatute of limitationsBurden of proofDate of injuryKnowledge of injuryMedical adviceApportionmentCausationQualified Medical EvaluatorReconsideration
References
5
Case No. ADJ9584373
Regular
Apr 23, 2018

FRITCHJOFF GILBERTSON vs. BIG 5 CORPORATION, CORVEL CORPORATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration, finding the WCJ erred in placing the burden of proof on the lien claimant. The WCAB granted removal on its own motion, rescinded the WCJ's findings, and returned the case to the trial level. The Board concluded that a declaration made under penalty of perjury is prima facie evidence, and the defendant failed to meet its burden of proving the declaration false. Therefore, the case requires further proceedings to address other lien claim issues.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationPetition for RemovalFindings and NoticeLabor Code Section 4903.05(c)DeclarationIndependent Bill Review (IBR)Medical Provider Network (MPN)WCJ
References
8
Case No. ADJ2942517 (LBO 0343924) ADJ141977 (LBO 0343923)
Regular
Aug 30, 2010

ANTHONY R. LANE vs. MULTIFOODS DISTRIBUTION GROUP, LIBERTY MUTUAL INSURANCE COMPANY

This case involves a lien claimant seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that disallowed a significant portion of their bill for outpatient surgical services. The WCAB denied the petition, affirming the administrative law judge's finding that the lien claimant failed to meet its burden of proving the reasonableness of its charges. The Appeals Board found the lien claimant's billing itself was facially unreasonable and that the defendant's expert provided persuasive testimony supporting the paid amount. The decision reiterates that lien claimants bear the burden of proving the reasonableness of their fees, not the defendant.

Workers Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and OrderAdministrative Law JudgeOutpatient ServicesCompromise and ReleaseIndustrial InjuryTruck Driver/UnloaderBill Review
References
4
Case No. ADJ 9547788, ADJ 9771745, ADJ 9805683
Regular
Mar 24, 2016

MARTIN TORTOLEDO vs. BARRETT BUSINESS SERVICES, INC.

The Workers' Compensation Appeals Board (WCAB) dismissed the Petition for Reconsideration filed by Martin Tortoledo. The dismissal was based on the petitioner's failure to comply with WCAB Rule 10842(b), which requires specific citations to the record to support evidentiary statements. The WCAB emphasized that this rule mirrors appellate court requirements and that litigants cannot shift the burden of searching the record to the Board. Had the petition not been dismissed procedurally, the WCAB would have denied it on the merits as per the WCJ's report.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationWCJ reportWCAB Rule 10842(b)specific references to the recordappellate proceedingswaiver of pointburden of discoveryADM_CASE_NO_ADJ9547788ADM_CASE_NO_ADJ9771745
References
6
Case No. STK 0187467
Regular
Sep 26, 2007

HASINA SINGH vs. MARINA VILLAGE WEST, ZENITH INSURANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a WCJ's decision, affirming the disallowance of a lien claimant's claim for medical-legal costs due to insufficient proof. However, the WCAB reversed the WCJ's imposition of sanctions against the lien claimant, finding that the defendant failed to meet its burden of proof to demonstrate the claimant's non-compliance with WCAB rules regarding availability for settlement discussions. The WCAB rescinded the sanctions order, finding the lien claimant's petition on that issue meritorious.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings and OrdersMedical-Legal CostsBad Faith ActionsSanctions OrderCompromise and ReleaseWCAB RulesMandatory Settlement Conference
References
0
Case No. ESRP 99030 (WCAB Case No. ADJ3304426 [RIV 0019356])
Regular
Jun 13, 2017

JIMMIE WISE vs. EASTSIDE RESERVOIR PROJECT/AWZ, ITT HARTFORD, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of its prior dismissal of the defendant's petition. The WCAB acknowledged an arithmetical error in calculating the timeliness of an arbitrator's order modifying the original findings and award. The arbitrator's order was timely, thus the WCAB affirmed this aspect and returned the case to the arbitrator for further proceedings. However, the dismissal of the defendant's petition for failure to properly serve the arbitrator was affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardFurther Medical TreatmentSurgeryAlternative Dispute Resolution AgreementMediator's OrderRule 10850Rule 10859Arithmetical Error
References
2
Case No. ADJ821366 (OAK 0323506) ADJ7173636
Regular
Jun 01, 2010

ANTHONY REYNOLDS vs. COCA-COLA BOTTLING COMPANY, Permissibly Self-Insured

Defendant Coca-Cola Bottling Company sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision regarding applicant Anthony Reynolds' industrial injuries. The WCAB granted reconsideration and rescinded the original decision, returning the matter for further proceedings. This action was primarily to address the defendant's contention that the WCJ erred in determining apportionment of permanent disability under Labor Code section 4664. The WCAB clarified that the defendant bears the burden of proving the extent of overlap between a prior permanent disability award and the current injury. The WCAB also instructed the WCJ to correct a clerical error regarding the defendant's self-insured status.

Labor Code section 4664ApportionmentWhole Person ImpairmentPermissibly Self-InsuredCumulative TraumaSpecific InjuryPanel Qualified Medical ExaminerOld Rating ScheduleNew Rating ScheduleBurden of Proof
References
4
Case No. ADJ1927786
Regular
Dec 21, 2012

LUIS CISNEROS vs. GCL CORPORATION, INC., LIBERTY MUTUAL INSURANCE COMPANY

This case involves a lien claimant, Joyce Altman Interpreters, Inc., seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision. The applicant sustained an industrial injury to his left knee and back, and his claim was settled via compromise and release. The WCAB denied reconsideration, affirming the administrative law judge's award for the lien claimant's services. While the lien claimant argued the awarded rate was too low and excluded preparation, travel, and waiting time, the WCAB found their submitted evidence insufficient to prove a higher reasonable market rate. The WCAB concluded the awarded rate was reasonable and the lien claimant failed to meet their burden of proof.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings Award and OrderCompromise and ReleaseInterpreting ServicesReasonable Market RateBurden of ProofPreponderance of the EvidenceClear and Convincing Evidence
References
3
Case No. ADJ928027
Regular
Feb 03, 2016

DAVID TRINH vs. TZENG LONG USA, INC., BERKSHIRE HATHAWAY

This case involves the suspension of Mike Traw's privilege to appear before the Workers' Compensation Appeals Board (WCAB) under Labor Code Section 4907. The WCAB issued a Notice of Intention to suspend due to non-payment of sanctions and failure to respond. While Professional Lien Services, Inc. (PLS) sought extensions, neither Traw nor PLS provided a substantive response. Consequently, Traw's appearance privilege is suspended for ninety days due to his failure to comply with the WCAB's orders. Further action against PLS may occur if ordered sanctions remain unpaid.

Labor Code Section 4907Decision After RemovalNotice of IntentionSuspension of PrivilegeProfessional Lien ServicesMike TrawAppeals Board En BancSanction OrderInterference with Judicial ProcessWCAB
References
0
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