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

Case No. 2018 NY Slip Op 02556 [160 AD3d 502]
Regular Panel Decision
Apr 12, 2018

Florists' Mut. Ins. Co., Inc. v. Behman Hambelton, LLP

The Appellate Division, First Department, affirmed the Supreme Court's order which dismissed a legal malpractice complaint filed by Florists' Mutual Insurance Company against Behman Hambelton, LLP, as time-barred. The plaintiff's argument that it needed to appeal the underlying action before pursuing a malpractice claim was rejected because the Workers' Compensation Board appeal was deemed unlikely to succeed. The court noted that the Board's decision was issued on October 29, 2013, providing nearly two years for the plaintiff to file the malpractice action, which had accrued in September 2012. The decision to dismiss the claim was unanimous.

Legal MalpracticeStatute of LimitationsWorkers' Compensation BoardAppellate ReviewAffirmed DecisionInsurance LawLaw Firm LiabilityTime-Barred Claim
References
1
Case No. ADJ1686177, ADJ1816809, ADJ1785567
Regular
Jun 17, 2011

LOURDES BUENROSTRO vs. PEGGY BRADLEY, ANTHONY ALBISO ENTERPRISES, INCL. dba FLOWERS BY PEGGY, MARIO DEL FANTE FLORIST FLORISTS MUTUAL INSURANCE COMPANY, EMPLOYERS ELITE INSURANCE COMPANY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case consolidates multiple workers' compensation claims involving the applicant, Lourdes Buenrostro, and various employers and insurance carriers. The Workers' Compensation Appeals Board (WCAB) addressed disputes concerning industrial injury findings, penalties for unreasonable delays in benefit payments, and the apportionment of liability. The WCAB affirmed some WCJ findings, corrected awards, and deferred issues like certain penalties and attorney fees for further proceedings. Ultimately, the WCAB clarified liability and ordered Florists Mutual Insurance Company to administer benefits and liens for two of the claims.

WCABLabor Code section 5814illegally uninsuredpenaltyattorney feestemporary disabilitypermanent disabilitycumulative traumajoint and several liabilityapportionment
References
1
Case No. MISSING
Regular Panel Decision

Brown v. Grandview Florist

A claimant, injured in 1978 en route to her car from work, filed a Workers' Compensation claim in 1980. The claim faced initial controversion and a later defense of untimely filing. The Hearing Officer denied the claim, but the Workers' Compensation Board reversed this, finding an employment-related accident and excusing the late notice due to the employer's prompt actual knowledge. On appeal, the employer and carrier contested the notice and filing requirements. The court affirmed the Board's decision, upholding the finding of timely actual notice and ruling that the untimely filing issue was not properly before it, as it was not raised at the Board level.

untimely filinglate noticeactual noticeprejudiceWorkers' Compensation Boardjudicial reviewscope of appealstatutory limitsaccident in course of employmentemployer knowledge
References
4
Case No. ADJ4260365 (MON 0358119) ADJ4240008 (MON 0358120)
Regular
Nov 21, 2014

BLAS ALVARADO vs. ED ELLIS PLANT, THE FLORISTS' MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board affirmed the dismissal of liens for Orthogear, Comprehensive Outpatient Surgery Center, and California Urgent Care Centers. These lien claimants failed to demonstrate good cause after receiving notice of intention to dismiss their liens following their non-appearance at a continued lien conference. The Board found that these claimants were responsible for informing themselves of the conference's continuation after signing in on the original date. However, the Board rescinded the dismissal of Technical Surgery Support's lien due to a lack of evidence that it ever filed a lien.

Workers' Compensation Appeals BoardReconsiderationLien ClaimantDismissalNotice of IntentionGood CauseStipulated AwardPermanent DisabilityMedical TreatmentLien Conference
References
1
Case No. ADJ8899778; ADJ8899779
Regular
Jul 08, 2016

ENRIQUE ALVAREZ vs. A TO Z WHOLESALE FLORAL SUPPLY, HORTICA FLORIST MUTUAL INSURANCE

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's petition for reconsideration because it was filed against an interlocutory order, not a final decision that determined substantive rights or liabilities. The WCAB also denied the petition for removal, finding no showing of substantial prejudice or irreparable harm that would warrant such an extraordinary remedy. The WCJ's report, incorporated by reference, detailed why these petitions were deemed improper under relevant California Labor Code sections and regulations.

Petition for ReconsiderationPetition for RemovalFinal OrderInterlocutory OrderThreshold IssueSubstantive RightLiabilityExtraordinary RemedySubstantial PrejudiceIrreparable Harm
References
6
Case No. ADJ2335133 (GOL 0097375)
Regular
Jun 24, 2010

ARMANDO TINAJERO vs. B & H FLOWERS, INC., FLORISTS MUTUAL INSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration to address unclear factual and legal issues regarding lien claimant Dr. Duell's $\$13,230.68$ medical treatment lien. The Board rescinded the prior decision disallowing the lien due to lack of clarity on authorized treatment, whether Dr. Duell's requests aligned with the defendant's utilization review denials, and the applicability of certain Labor Code sections. The case is remanded for further proceedings to clarify the treatment authorization, the physician's role, and the reasonableness of the treatment provided.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings and OrderDisallowed LienMedical TreatmentCompromise and ReleaseLabor Code section 139.3Utilization ReviewPrimary Treating Physician
References
1
Case No. ADJ7849715, ADJ7851060
Regular
Mar 13, 2018

AURELIO DAVILA GARCIA vs. T-Y NURSERY; FLORISTS' MUTUAL INSURANCE CO.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to review the administrative law judge's (WCJ) findings regarding permanent disability ratings and the statute of limitations defense. The WCAB found the WCJ's decision lacked substantial evidence and proper explanation, failing to cite specific evidence for its conclusions on disability and referencing non-existent testimony. Additionally, the WCAB directed the WCJ to further analyze the statute of limitations defense in light of the employer's submitted letter and the lack of a claim form. The matter is returned to the trial level for further proceedings consistent with the WCAB's decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderCumulative InjurySpecific InjuryPermanent DisabilityStatute of LimitationsLabor Code section 5405Arising out of and in the course of employment (AOE/COE)Disability Evaluation Unit
References
0
Case No. ADJ1557376 (RIV 0052354) ADJ3175359 (RIV 0053956)
Regular
Oct 20, 2008

RENEE WORLEY vs. NORCO DAISY KART FLORIST, EMPLOYERS COMPENSATION INSURANCE COMPANY

This case consolidated two workers' compensation claims for Renée Worley. The Board affirmed the original findings that she sustained no permanent disability and required no further treatment for her right hand, while awarding 14% permanent disability and further medical treatment for her bilateral upper extremities and low back for a separate injury period. The applicant's petition for reconsideration, arguing for a different disability rating schedule and additional treatment for her hand, was denied.

Workers' Compensation Appeals BoardRenee WorleyNorco Daisy Kart FloristEmployers Compensation Insurance CompanyADJ1557376RIV 0052354ADJ3175359RIV 0053956ReconsiderationFindings and Award
References
0
Case No. ADJ7849715 ADJ7851060
Regular
Feb 01, 2019

, Applicant, , AURELIO DAVILA GARCIA vs. T-Y NURSERY, FLORISTS' MUTUAL INSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration and will defer issues regarding the applicant's entitlement to an adjusted permanent disability indemnity rate and temporary total disability indemnity. The Board affirmed the Finding of Fact that the applicant sustained a 53% permanent disability award. These deferred issues, along with applicant's attorney fee, are returned to the trial level for further proceedings and decision by the administrative law judge.

ADJ7849715ADJ7851060Petition for ReconsiderationFindings and Orderpermanent disability indemnity rateLabor Code section 4658(d)(2)temporary total disability indemnityWCJAppeals BoardBontempo v. Workers' Comp. Appeals Bd.
References
1
Case No. ADJ865705 (GOL 0098805)
Regular
Nov 16, 2009

ILDELISA VARGAS vs. NATURE'S WEST, FLORIST MUTUAL INSURANCE COMPANY (HORTICA INSURANCE COMPANY)

The Appeals Board grants reconsideration, rescinds the WCJ's August 26, 2009 decision, and returns the matter to the trial level for further proceedings due to inadequate findings and lack of a clear explanation of the reasons for the decision.

WORKERS' COMPENSATION APPEALS BOARDFindings and AwardPetition for Reconsiderationtemporary total disabilityindustrial injuryright wristright armright handright shoulderleft arm
References
3
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