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

Case No. ADJ1171761 (RDG 0076230) ADJ3401110 (RDG 0077725)
Regular
Dec 10, 2012

HAROLD HOUSTON vs. CITY OF REDDING

The Workers' Compensation Appeals Board granted the City of Redding's petition for reconsideration regarding a prior award of medical mileage reimbursement to Harold Houston. While affirming the award of medical mileage, the Board amended the Findings of Fact to clarify that no past interest is due. Interest on the medical mileage will only accrue from the date the amount becomes determined and payable, as per Labor Code section 5800. The case was returned to the trial level for further proceedings to determine the specific amount owed.

Workers' Compensation Appeals BoardCity of ReddingHarold HoustonPetition for ReconsiderationFindings Award and OrderCompromise & Releasemedical mileagefuture medical treatmentLabor Code section 5800accrued interest
References
Case No. ADJ1323942
Regular
Jan 25, 2010

JANN WASHINGTON vs. DAVIS COMPANIES, FIREMAN'S FUND

The Workers' Compensation Appeals Board granted reconsideration to address the applicant's medical mileage reimbursement. The Board amended the prior award to allow reimbursement for travel between the applicant's Nevada residence and her California treating physician. The employer failed to prove that equally effective treatment was available closer to the applicant's residence, thus their objection to the extended mileage was denied. The specific amount of reimbursement is to be determined by the parties, with jurisdiction reserved for dispute resolution.

Workers' Compensation Appeals BoardIndustrial InjuryUpper ExtremitiesMedical TreatmentMedical MileageReconsiderationResidenceGeographic AreaTreating PhysicianEmployer Burden
References
Case No. ADJ9522703
Regular
Jul 04, 2018

MAYRA MENDOZA vs. SAFEWAY, INC., ALBERTSONS HOLDINGS

This case concerns whether applicant's medical mileage and self-procured medical expenses were included in a prior Compromise and Release (C&R) agreement. The applicant sought reconsideration of the WCJ's finding that these expenses were resolved by the C&R. The Appeals Board affirmed the WCJ's decision, finding that the plain language of the C&R explicitly included medical mileage and self-procured medical treatment as resolved issues within the settlement amount. Therefore, the applicant's subsequent claims for these expenses were denied.

Workers' Compensation Appeals BoardReconsiderationCompromise and ReleaseWCJLabor Code section 5813medical mileageout-of-pocket medical expensesself-procured medical treatmentindustrial injurychecker/stocker
References
Case No. ADJ4522362
Regular
Sep 26, 2008

CELESTE LILJEBLAD-THOMAS vs. BARONE'S RESTAURANT, STATE COMPENSATION INSURANCE FUND

The WCAB reversed the Supplemental Findings and Award granting reconsideration to the defendant, State Compensation Insurance Fund. The WCJ lacked jurisdiction to award temporary disability more than five years after the injury date.

WORKERS' COMPENSATION APPEALS BOARDCeleste Liljeblad-ThomasBarone's RestaurantState Compensation Insurance FundSupplemental Findings and Awardtemporary disability indemnityactual earnings25% penaltiesfurther medical treatmentreimbursement for mileage
References
Case No. SFO 432276
Regular
Dec 31, 2007

JANICE HOLMES vs. NEXT LEVEL COMMUNICATIONS, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration because it was untimely and improperly filed. The defendant's arguments regarding the WCJ's assessment of penalties for delayed medical treatment and mileage payments were not considered on their merits due to the procedural defect. The Board emphasized that failure to file a petition within the statutory 20-day period (plus mailing time) deprives the Board of jurisdiction.

Workers' Compensation Appeals BoardPetition for Reconsiderationuntimely filingdismissaljurisdictionstatutory time perioddelayed paymentmedical treatmentpenaltyutilization review
References
Case No. ADJ9360366, ADJ9360331, ADJ10274829
Regular
Mar 11, 2019

KELLIANN VICKORY vs. MIDTOWN CREPERIE & CAFÉ, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the petition for reconsideration and dismissed the petition for removal. The WCJ's findings on employment, injury AOE/COE, and mileage reimbursement were deemed final and properly before the Board. However, the challenged issue, concerning the need for further record development, was an interlocutory discovery dispute. Removal was denied because the petitioner failed to demonstrate substantial prejudice or irreparable harm, and reconsideration was deemed an adequate remedy.

Petition for RemovalPetition for ReconsiderationInterlocutory OrderDiscovery DisputeSubstantial PrejudiceIrreparable HarmExtraordinary RemedyAppeals BoardWCJ AnalysisAOE/COE
References
Case No. ADJ6760596
Regular
May 23, 2018

SAMUEL ESPINOZA vs. EXCEL STAFFING SERVICES, ACE AMERICAN INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to amend a prior decision regarding applicant Samuel Espinoza's work injury. The Board increased Espinoza's lumbar spine Whole Person Impairment (WPI) from 29% to 45%, based on the agreed medical examiner's alternative rating which was deemed more accurate. Consequently, Espinoza's permanent disability rating was increased from 43% to 57%. The Board also deferred the issue of mileage reimbursement.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardWhole Person Impairmentlumbar spineagreed medical examinerAMA Guidespermanent disabilitysexual dysfunctionurological issues
References
Case No. ADJ9099900
Regular
May 04, 2015

JESSEKA BETTS vs. YMCA OF THE EAST VALLEY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, affirming a prior award. The applicant, a YMCA site director, sustained injuries in a car accident while en route to a work-related meeting. The Board found that the "required vehicle exception" to the going and coming rule applied, as the applicant was required to use her personal vehicle for her job duties, for which she was reimbursed mileage. Therefore, her injuries were deemed to have arisen out of and in the course of employment.

Workers' Compensation Appeals Boardgoing and coming defenserequired vehicle exceptionmaterial deviationwork-related meetingmileage reimbursementsplit shiftssite directorcar insurancelicensing inspection
References
Case No. ADJ2570253
Regular
Oct 18, 2012

SHIRLEY KING vs. COUNTY OF LOS ANGELES CHILDREN AND FAMILY SERVICES

The Workers' Compensation Appeals Board denied Shirley King's Petition for Reconsideration regarding her medical mileage claim. The Board adopted the Administrative Law Judge's (WCJ) findings, which found the applicant lacked credibility due to apparent willful dishonesty about her residence. However, the Board returned the case to the trial level for the WCJ to consider the employer's request for sanctions under Labor Code section 5813. The WCJ will address sanctions because the alleged misconduct occurred during proceedings before them.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJLabor Code section 5813sanctionswillful dishonestycredibilityAgreed Medical ExaminerStipulations with Request for Awardpermanent partial disability
References
Case No. ADJ1210556 (AGO 0018589)
Regular
Oct 10, 2008

EDWIN MILLER vs. KEEBLER COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's petition for removal and granted reconsideration of the WCJ's prior decisions regarding medical mileage and penalties. The Board found the WCJ failed to properly consider statutory factors in determining a "reasonable geographic area" for the applicant's medical treatment. Consequently, the WCAB rescinded the WCJ's decisions and returned the case to the trial level for further proceedings and a new decision addressing all outstanding issues, including the definition of a reasonable geographic area for treatment.

WCABPetition for RemovalPetition for ReconsiderationMedical MileageReasonable Geographic AreaLabor Code Section 4600Administrative Director Rule 9780(h)WCJBoltonRamirez
References
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