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

Case No. ADJ6736602 (MF); ADJ6736601; ADJ6736597; ADJ8013380

Regular

Sep 06, 2012

SABRINA TAANING vs. EAST BAY MUNICIPALITY UTILITY DISTRICT, Permissibly Self-Insured; Adjusted By ATHENS ADMINISTRATORS

The Workers' Compensation Appeals Board (WCAB) denied the applicant's petition for reconsideration. The applicant, a surveyor, claimed she contracted Lyme disease from tick bites sustained during employment with East Bay Municipal Utility District. The WCAB found that the applicant did not sustain injury arising out of and in the course of employment. The WCAB specifically adopted the reasoning of the Workers' Compensation Administrative Law Judge (WCJ), which found the medical report of Dr. Thomas Allems to be substantial evidence supporting this conclusion. The WCAB also admonished the applicant's attorney for failing to comply with rules requiring fair and accurate representation of the evidence in the petition.

Lyme diseaseAOE/COEPetition for ReconsiderationWCJ reportsubstantial evidencetick bitesBorrelia burgdorferiWestern blotPCR testingdiagnostic criteria

References

Case No. ADJ8787215

Regular

Jan 10, 2014

FILIBERTO MARTINEZ vs. VORTEX WHIRLPOOL SYSTEMS, INC.; CYPRESS INSURANCE COMPANY, c/o BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The Workers' Compensation Appeals Board denied Filberto Martinez's petition for reconsideration. Martinez sought reimbursement for self-procured medical treatment outside the defendant's Medical Provider Network (MPN), claiming the defendant failed to provide adequate care. The Board found that the defendant provided timely MPN notice and initial medical treatment. Martinez's claim that the treatment was ineffective or a misdiagnosis did not justify self-procurement, as he failed to utilize available internal MPN dispute resolution processes.

Workers' Compensation Appeals BoardPetition for ReconsiderationMedical Provider Network (MPN)Labor Code section 4616.3Self-procured medical treatmentExpedited HearingLabor Code section 4600Medical utilization treatment scheduleIndependent Medical Review (IMR)Findings and Order

References

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SABRINA TAANING vs. EAST BAY MUNICIPALITY UTILITY DISTRICT, Permissibly Self-Insured; Adjusted By ATHENS ADMINISTRATORS

Lyme diseaseAOE/COEPetition for ReconsiderationWCJ reportsubstantial evidencetick bitesBorrelia burgdorferiWestern blotPCR testingdiagnostic criteria

FILIBERTO MARTINEZ vs. VORTEX WHIRLPOOL SYSTEMS, INC.; CYPRESS INSURANCE COMPANY, c/o BERKSHIRE HATHAWAY HOMESTATE COMPANIES