December 2009

Kevin Morales, vs. Ralphs Grocery Co.; Sedgwick Claims Management Services,

RALPHS GROCERY CO.; SEDGWICK CLAIMS MANAGEMENT SERVICES, KEVIN MORALES, WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAKEVIN MORALES, Applicant,vs.RALPHS GROCERY CO.; SEDGWICK CLAIMS MANAGEMENT SERVICES, Defendant(s).Case No. ADJ2778117 (RIV 0032584)OPINION AND ORDER GRANTING PETITION FOR RECONSIDERATION AND DECISION AFTER RECONSIDERATION            Defendant seeks reconsideration of the October 8, 2009, Findings and Award, wherein the workers’ compensation administrative law judge …

Kevin Morales, vs. Ralphs Grocery Co.; Sedgwick Claims Management Services, Read More »

Robert Thein, vs. Pacific Gas & Electric Company,

In this case, Robert Thein, an employee of Pacific Gas & Electric Company, sought reconsideration of a workers’ compensation administrative law judge’s Joint Findings and Award of October 13, 2009, wherein it was found that while employed as a communication tech, Thein did not sustain industrial injury to his psyche on December 21, 1988, during a cumulative period ending on January 24, 1995, or on January 24, 1995. The WCJ also found that the defendant had overpaid temporary disability in the amount of $26,608.03 ($13,304.01 in SFO 384777 and $13,304.02 in SFO 384779) and was entitled to a credit towards its permanent disability indemnity liability

Nick Navarro, vs. State Of California, Department Of Corrections, Legally Uninsured, Adjusted By State Compensation Insurance Fund,

This case involves a dispute between Nick Navarro, an applicant, and the State of California, Department of Corrections, Legally Uninsured, Adjusted By State Compensation Insurance Fund, the defendant. Navarro’s attorney sought reconsideration of a Joint Findings and Award issued by a workers’ compensation administrative law judge (WCJ) on October 22, 2009, wherein the WCJ found that there was no indemnity payable from which an award of attorney’s fees could be made. The WCJ also found, based on the parties’ stipulations, that Navarro, while employed as a correctional officer, sustained industrial injury to his right knee, causing six broken periods of temporary disability for which he received industrial disability leave (IDL) in lieu of temporary

Salvador Lozano, vs. Juice Harvest And Employers Direct Insurance Company

(SBR 0341928) is a case between Salvador Lozano, the applicant, and Juice Harvest and Employers Direct Insurance Company, the defendants. The lien claimant, Priority First Professional Services, filed a petition for reconsideration or removal of the order taking the case off calendar when it came on for trial. The Workers’ Compensation Administrative Law Judge determined that the medical record was not adequately developed on the reasonableness and efficacy of compound creams that PFPS provided to the applicant, and ordered the case off calendar and directed the parties to submit the issue to the Agreed Medical Evaluator for further opinion. The Workers’ Compensation Appeals Board dismissed the petition for reconsideration and denied the petition for removal, finding that the WC

Dee Ann White, vs. New York Life Insurance Co.; Federal Insurance Company Adjusted By Chubb Services,

This case involves a dispute between the applicant, Dee Ann White, and the defendants, New York Life Insurance Co. and Federal Insurance Company adjusted by Chubb Services, regarding the applicant’s industrial injury on October 24, 2007 to her right wrist and left knee. The Workers’ Compensation Appeals Board granted the defendant’s petition for reconsideration and rescinded the October 1, 2009 Findings, Award and Order, returning the matter to the WCJ for further proceedings and a new decision. The Board found that the defendant should be allowed to present additional evidence regarding payments made pursuant to an Unum Insurance Company policy, and that the WCJ should consider whether the arrangement violates the prohibition on employee contributions to the cost of compensation found in Labor Code section 3751.

Miles Wallace, vs. Bellagio & Back Door Board Shop; Cna Claimplus For Valley Forge (portland),

In this case, Miles Wallace, an employee of Bellagio & Back Door Board Shop, sought reconsideration of a workers’ compensation administrative law judge’s (WCJ) October 19, 2009 Findings and Award. The WCJ found that Wallace had incurred an industrial injury to his pelvis and bilateral hips while employed by the defendant, causing 20% permanent disability without apportionment, and a need for future medical treatment. Wallace contended that his permanent disability was erroneously calculated by considering his work restrictions instead of factors of disability and that an incorrect occupational variant was used by the rater from the Disability Evaluation Unit (DEU). The WCJ granted reconsideration and rescinded the October 19, 2009 decision, returning the case to the trial level

George Villarreal, vs. Amerisource Bergen Drug Company, Permissibly Self-insured,

(MON 0308877)This case is about George Villarreal’s workers’ compensation claim against Amerisource Bergen Drug Company. The Workers’ Compensation Appeals Board denied the petition for reconsideration/removal and dismissed the petition for removal filed by Unitech Diagnostics, the lien claimant. The WCJ had previously found that Villarreal sustained an industrial injury to his knee, but not to his shoulder or wrist, and that Unitech Diagnostics was not entitled to reimbursement for the MRI of the shoulder. The WCJ also issued a Notice of Intention that if Unitech Diagnostics continued to impede the speedy resolution of its liens, then costs and sanctions would be imposed. The WCAB denied reconsideration and dismissed the

Josephine Stoffel, vs. Albertsons, Inc.; Permissibly Self-insured, Administered By Specialty Risk Services,

In this case, Josephine Stoffel, an applicant, sought reconsideration of the Findings of Fact issued by a workers’ compensation administrative law judge (WCJ) on October 1, 2009, in which the WCJ found that the defendant’s request for a new panel QME was denied and that the defendant was allowed to select its own QME. The WCJ’s decision was unclear and the evidence he relied on was not identified, so the Workers’ Compensation Appeals Board granted the Petition for Reconsideration and rescinded the WCJ’s decision, returning the matter to the hearing level for further proceedings and a decision by the WCJ consistent with the decision.

Moises Medina, vs. Continental Processing; California Insurance Guarantee Association For Paula Insurance, In 1li Liquidation, By Intercare,

In this case, Moises Medina was injured while employed as a vegetable processor by Continental Processing. The workers’ compensation administrative law judge found that the lien claim of Work Injury Network Medical Group, Inc. had been assigned to ZA Management, Inc., and for that reason Insurance Code section 1063.1(c)(9)(b) precluded liability of the California Insurance Guarantee Association for the lien. The Workers’ Compensation Appeals Board granted reconsideration and rescinded the decision, returning the case to the trial level for development of the record to determine if the lien had been assigned.

Alfredo Lomeli, vs. Environmental Service Products, Inc.; And State Compensation Insurance Fund,

In this case, Environmental Service Products, Inc. and the State Compensation Insurance Fund were defendants in a workers’ compensation case brought by Alfredo Lomeli. The Workers’ Compensation Appeals Board denied the defendant’s petition for reconsideration of the Opinion and Order Granting Reconsideration and Decision After Reconsideration of October 20, 2009, which found that the injury caused 82% permanent disability, entitling the applicant to permanent disability indemnity totaling $122,935, plus thereafter a weekly life pension of $85.04.