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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ2529270 (MON0205624)
Regular
Dec 17, 2010

ZOI FOVOS vs. LOS ANGELES UNIFIED SCHOOL DISTRICT permissibly self insured c/o SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a prior decision that found an award was paid timely without penalties. Applicant contended the defendant failed to include interest with the award payment, entitling them to penalties and attorney fees. The Board found the WCJ's decision failed to address the timeliness of interest payment and the applicability of penalties under Labor Code sections 5814 and 5814.5. The case is returned to the WCJ for further proceedings and a new decision regarding potential penalties and attorney fees for the delayed interest payment.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings of FactAwardPenaltyAttorney's FeeInterest on AwardLabor Code Section 4650Labor Code Section 5814Labor Code Section 5814.5
References
Case No. ADJ4320293 (PAS0014831)
Regular
Nov 03, 2011

LAWRENCE WEITZER vs. LAW OFFICES OF LAWRENCE WEITZER, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and amended a prior order, primarily to delete a penalty award. The Board affirmed that the defendant incorrectly paid an attorney's fee installment to a trust instead of the applicant's attorney. Consequently, the defendant must pay the outstanding attorney fee, plus interest, and interest on funds repaid by the trust. The penalty was removed because the applicant was deceased, as such penalties are payable to the applicant.

SCIFattorney's fee paymentWeitzer Trustinterest on awardLabor Code section 5814 penaltyunreasonable delaygood faith legal basisCompromise and Releaseapplicant deceasedpenalty paid to applicant
References
Case No. ADJ1367543 (POM 0286181)
Regular
May 11, 2012

XJU BIN CAO vs. WO HIN INTERNATIONAL, INC., BERKSHIRE HATHAWAY

The Appeals Board rescinded the WCJ's decision, finding that the November 3, 2010 Stipulation and Order was an enforceable contract despite the parties' differing interpretations of unstated interest and penalty clauses. The Board ruled the lien claimant is entitled to interest under Labor Code section 5800 on the $17,000 payment from the agreement date to payment. However, no penalty was awarded as the defendant's delay in payment was not deemed unreasonable.

Workers' Compensation Appeals BoardReconsiderationStipulation and OrderMeeting of the MindsLabor Code Section 5800Lien ClaimantInterestPenaltiesLabor Code Section 5814Unreasonable Delay
References
Case No. ADJ9487589
Regular
Feb 25, 2020

DONNA KNIGHT (DECEASED) vs. MARISAN GROUP, SENTINEL INSURANCE COMPANY, THE HARTFORD

This case concerns the deceased worker's estate's claim for penalties and attorney's fees related to delayed death benefit payments. The Appeals Board affirmed the Workers' Compensation Judge's decision, finding the defendant was entitled to a credit for an overpayment. The majority ruled that the penalty under Labor Code section 4650(d) did not apply because payments were made before the award became final for appellate purposes. A dissenting commissioner argued for the application of penalties and attorney's fees due to the defendant's failure to pay accrued interest.

Labor Code section 4650(d)Death benefitsPenaltyAttorney's feesCreditInterestReconsiderationFinality of awardEquitable creditUnilateral mistake of law
References
Case No. ADJ1314529 (LBO 0331102), ADJ2710937 (LBO 0337681), ADJ3736545 (LBO 0334960), ADJ4463186 (LBO 0363045)
Regular
Jan 25, 2018

BELIA FLORES vs. THE KROGER COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a dispute over lien claimant Dr. Elena Konstat's reimbursement for medical-legal expenses. The Court of Appeal remanded the case, directing the Board to address issues of penalties and interest. The Board affirms its prior decision awarding $4,900 for Dr. Konstat's medical-legal evaluations but defers the penalties and interest issue to the trial level. Further proceedings will occur at the trial level regarding penalties and interest.

Workers Compensation Appeals BoardRemittiturLien ClaimantPetition for Writ of ReviewPenaltiesInterestMedical-Legal CostsAgreed Bill ReviewerOfficial Medical Fee ScheduleLabor Code 4622
References
Case No. ADJ7968765
Regular
Mar 22, 2018

DONALD BECHTEL vs. AMZAC ENTERPRISES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and amended a prior order, finding that lien claimant Med-Legal Photocopy is entitled to penalties and interest under Labor Code section 4622(a). The original order had allowed the lien but denied penalties and interest. The Board found that the employer did not dispute receiving the services or invoices, making them liable for the statutory additions. The parties are directed to adjust the penalty and interest amount, with jurisdiction reserved to the WCJ if they cannot agree.

Workers Compensation Appeals BoardLien ClaimantPetition for ReconsiderationLabor Code Section 4622PenaltiesInterestDuplicative ServicesReasonablenessNecessityCopy Service Fee Schedule
References
Case No. ADJ9614737 ADJ9613068
Regular
Oct 30, 2018

NORA MAY RAMIREZ-CORTES vs. MARQUEZ BROTHERS ENTERPRISE, INC., TRAVELERS INSURANCE COMPANY

This case involves a defendant's petition for reconsideration of an administrative law judge's (WCJ) order assessing penalties for late payment of a workers' compensation award. The defendant argued that confusion over the applicant's name justified the delay, but the Board found the four-month delay after the initial inquiry unreasonable. The Board adopted the WCJ's report, denying reconsideration and upholding the penalty, interest, and attorney's fees. The Board found no evidence the defendant took reasonable steps to resolve the payment issue after May 9, 2017.

Workers' Compensation Appeals BoardFindings and OrdersCompromise and ReleaseLabor Code section 5814Penalty assessmentInterestAttorney's feesPetition for ReconsiderationWCJ Report and RecommendationGood faith
References
Case No. ADJ126279 (OAK 0305558)
Regular
Dec 20, 2011

STEPHEN CLAY vs. LOWE'S HIW, INC., AIG INSURANCE COMPANY

The Workers' Compensation Appeals Board reconsidered a WCJ's decision denying St. Francis Memorial Hospital's lien claim entirely. The Board, agreeing with the WCJ's recommendation, rescinded the original order. St. Francis Memorial Hospital's lien is now allowed in the amount of $8,379.22, excluding amounts already paid. However, the lien claimant's request for interest and penalties was denied due to timely and reasonable payment on the hospital bill.

St. Francis Memorial Hospitallien claimantpetition for reconsiderationWCJ's Findings and Orderstipulated Awardindustrial injurypermanent disabilityfurther medical treatmentpenaltiesinterest
References
Case No. ADJ186123 (AHM 0101334)
Regular
Jun 22, 2009

JERRY NARANJO vs. SOUTHERN CALIFORNIA EDISON, PSI SOUTHERN CAL EDISON ROSEMEAD

This case concerns a dispute over a workers' compensation lien for medical treatment. The Appeals Board granted reconsideration, finding the employer liable for a 10% penalty and interest for failing to properly contest a medical billing. Although the employer overpaid the base facility fee, this overpayment will be credited against the penalty and interest owed. The Board clarified that the employer did not adequately notify the lien claimant of contested billing items, thus triggering statutory penalties.

Labor Code section 4603.2Petition for ReconsiderationFindings and Awardlien claimantfacility feedate of servicepenaltyinterestcivil judgment rateindustrial injury
References
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