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

Case No. ADJ11423609
Regular
Sep 12, 2022

DANIEL SERVIN vs. CERRITOS LEXUS, ACE AMERICAN INSURANCE

This case concerns a defendant's petition for reconsideration of an order authorizing left shoulder surgery. The defendant argued a prior utilization review denial should prevent subsequent authorizations, citing Labor Code section 4610(k). However, the applicant's physician resubmitted the request with additional supporting documentation, triggering a new utilization review. This subsequent review certified the surgery as medically necessary, resolving the medical dispute. The Board denied reconsideration, holding that the defendant voluntarily submitted the resubmitted request, making the February 2, 2022 certification final and precluding further utilization review.

Utilization ReviewFindings and OrderPetition for ReconsiderationMedical NecessityReverse Total Shoulder ArthroplastyRequest for AuthorizationNon-certificationCertificationLabor Code Section 4610Resubmission
References
4
Case No. ADJ8122128, ADJ8142736
Regular
Aug 08, 2012

Henrietta McCarthy vs. Michelman & Robinson LLP, Travelers Property & Casualty Company

The Workers' Compensation Appeals Board dismissed Dr. Greenzang's Petition for Reconsideration of the Joint Findings and Orders. The Board found the petition procedurally defective, as it was not filed from a final order, the lien claimant was not aggrieved, and proper service on adverse parties was not effectuated. Additionally, Dr. Greenzang violated a rule by resubmitting documents already in the adjudication file. Consequently, his petition was dismissed.

Workers' Compensation Appeals BoardQualified Medical EvaluatorPetition for ReconsiderationJoint Findings and OrdersCumulative TraumaPsyche InjuryMedical RecordsPersonnel RecordsService of ProcessAggrieved Party
References
4
Case No. ADJ10821696
Regular
Apr 17, 2018

PATRICIA MENDOZA vs. WESTERN OILFIELDS SUPPLY CO., INC. dba RAIN FOR RENT

This Workers' Compensation Appeals Board matter is dismissed because the defendant withdrew its Petition for Reconsideration after a settlement agreement was reached. The parties had already submitted a Compromise and Release, and an order approving it was issued prematurely by the District Office while the reconsideration petition was pending. Consequently, the District Office lacked jurisdiction to issue the approval order at that time. The parties can resubmit the settlement agreement for a new approval order once the case returns to the trial level.

Workers' Compensation Appeals BoardPetition for ReconsiderationRemovalCompromise and ReleaseOrder ApprovingJurisdictionTrial LevelWCJPermissibly Self-insuredESIS
References
1
Case No. ADJ1525428
Regular
Aug 20, 2013

Raymond Barrios vs. Irwin Industries, Inc., California Insurance Guarantee Association, For California Compensation Insurance Company, In Liquidation, Mobil Corporation, Petroleum Casualty Company

The Workers' Compensation Appeals Board (WCAB) vacated an arbitrator's findings due to an incomplete arbitration file, lacking essential evidence and documentation. The WCAB found the arbitrator failed to comply with regulations requiring minutes of hearing, stipulations, and a summary of evidence. Consequently, the WCAB rescinded the arbitrator's decision and returned the case to the trial level for further proceedings. The prior order compelling arbitration was also vacated, allowing parties to resubmit to arbitration if desired.

WCABCIGAarbitrationreconsiderationarbitration fileminutes of hearingsummary of evidencedocumentary evidencetestimonial evidencestipulated facts
References
1
Case No. ADJ3839297 (GOL 00100930)
Regular
May 31, 2009

Edith Barrett vs. PACIFICA GRADUATE INSTITUTE, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Appeals Board denied defendant's petition for removal, finding it premature. The defendant sought to reinstate an earlier decision denying permanent disability benefits, arguing the WCJ's subsequent rescission of that order would cause irreparable harm through increased litigation costs. However, the WCJ's rescission was a proper procedural step following the applicant's petition for reconsideration, and the case was subsequently resubmitted. Therefore, removal was inappropriate as the defendant's alleged harm was speculative and not yet realized.

Petition for removalRescission of orderFindings and awardPermanent disabilityFurther discoveryIrreparable harmLitigation expensesWCJ report and recommendationTrial briefDue process
References
2
Case No. ADJ3992440 (SBR 0339508)
Regular
Nov 23, 2011

LOUIE M. GONZALES vs. MOBILE MINI, LIBERTY MUTUAL INSURANCE COMPANY

The Appeals Board dismissed the defendant's petition for reconsideration because the WCJ's Minute Order was not a final order, as it did not dispose of substantive rights. Additionally, the Board denied the defendant's petition for removal, finding no evidence of significant prejudice or irreparable harm as required for such an extraordinary remedy. The WCJ had previously denied the defendant's petition to dismiss for lack of prosecution without prejudice, allowing it to be resubmitted in one year. The defendant sought reconsideration based on alleged new circumstances regarding the applicant's parole violation.

Petition for ReconsiderationPetition for RemovalPetition to Dismiss for Lack of ProsecutionIncarcerated ApplicantParole ViolationIncompetent while incarceratedFinal OrderSubstantive Rights and LiabilitiesSignificant PrejudiceIrreparable Harm
References
5
Case No. ADJ9900384 ADJ10047409
Regular
Apr 07, 2016

SARA LOPEZ vs. AIRPORT CENTURY INN, PACIFIC COMPENSATION INSURANCE COMPANY

This case involves a defendant's petition for reconsideration of an approved Compromise and Release (OACR) in a workers' compensation claim. The defendant sought to vacate the OACR due to a claimed mutual mistake regarding the applicant's Social Security benefits. Notably, the applicant also requested the OACR be vacated for the same reason. The Appeals Board granted reconsideration, finding its discretion broader than that of the WCJ when reviewing an OACR via a petition for reconsideration. The Board vacated the OACR, allowing the parties to resolve the issue of Medicare Set Aside and resubmit their settlement.

Petition for ReconsiderationCompromise and ReleaseOrder Approving Compromise and ReleaseMutual Mistake of FactVacated OrderGood CauseAppeals Board DiscretionLabor Code SectionsMedicare Set AsideHousekeeper
References
3
Case No. ADJ7188251; ADJ7188272
Regular
Mar 08, 2013

Raymond Mark vs. City of Los Angeles

This case involves a petition by applicant Raymond Mark to resubmit or remove two workers' compensation cases, alleging the City of Los Angeles refused to fund an arbitrator. The Appeals Board dismissed the petition for three reasons: no arbitrator decision existed for review, the underlying claims were previously dismissed giving the Board no jurisdiction, and the Board lacks jurisdiction over disputes concerning the administration of the Alternative Dispute Resolution Agreement itself. The Board concluded that the applicant's recourse for funding disputes lies in collective bargaining, arbitration, or petitioning the Administrative Director to decertify the agreement.

Petition for ResubmissionADR CasesL.C. § 3201.7ADR ARB IVCity of Los AngelesFunding ArbitratorOpinion and Order Granting ReconsiderationDecision After ReconsiderationOrder of DismissalJurisdiction
References
0
Case No. MISSING
Regular Panel Decision
Apr 30, 2004

People v. Dalton

The defendant appealed a judgment from Chenango County Court following her conviction on multiple counts of sexual misconduct, rape, use of a child in a sexual performance, incest, criminal solicitation, and endangering the welfare of a child involving her three children. The appellate court found that the criminal solicitation charges should have been dismissed due to a statutory exemption and that several counts (rape, incest, use of a child in a sexual performance, and criminal solicitation) were duplicitous, requiring their dismissal with leave for the People to resubmit nonduplicitous charges. However, the court affirmed the lower court's decisions regarding the denial of a juror for cause, access to confidential counseling records, proper impeachment of a witness, and the refusal to charge the jury on accomplice testimony. The imposed maximum sentence for the remaining convictions (course of sexual conduct against a child and endangering the welfare of a child) was upheld.

Criminal LawSexual AbuseChild EndangermentIncestRapeCriminal SolicitationDuplicitous IndictmentAccomplice TestimonyAppellate ProcedureEvidence
References
30
Case No. MISSING
Regular Panel Decision
Aug 18, 1995

Transport Workers Union of America v. New York City Transit Authority

The New York City Transit Authority (TA) appealed an order from the Supreme Court, Kings County, which confirmed two arbitration awards dated July 8, 1993, and January 22, 1994, and denied the TA's cross-petition to vacate the latter. The initial award reinstated an employee following a disciplinary grievance, and a supplemental award granted the employee back pay. The TA argued that the Tripartite Arbitration Board exceeded its authority by issuing the supplemental award without adhering to statutory procedures for modifying original awards (CPLR 7509, 7511[c]). The Appellate Division modified the Supreme Court's order, vacating the confirmation of the January 22, 1994, award and remitting the case for a hearing. This hearing is necessary to determine if the TA had agreed to resubmit the matter, acquiesced in its submission, and was given an opportunity to be heard, which would impact the validity of the supplemental award.

Arbitration AwardCPLR 7510CPLR 7509CPLR 7511Supplemental AwardVacatur of AwardEmployee Disciplinary GrievanceBack PayModification of AwardJurisdiction of Arbitrator
References
1
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