September 2011

Nelson Torres Godinez vs. Valet Detail Service And Auto Restoration; State Farm Insurance Company

is a case in which Nelson Torres Godinez, an employee of Valet Detail Service and Auto Restoration, filed a petition for workers’ compensation after being fired from his job. The petition alleged that he had sustained an injury to his neck and back on a specific date in May 2009, as well as a cumulative trauma injury from August 2008 to October 2009. The Workers’ Compensation Appeals Board denied the petition for reconsideration, finding that there was no credible evidence of an industrial injury and that the medical reports did not support the conclusion that any injury had occurred.

Pamela Smith vs. Hyatt Regency And New Hampshire Insurance Company

is a case between Pamela Smith, the applicant, and Hyatt Regency and New Hampshire Insurance Company, the defendants. The workers’ compensation administrative law judge (WCJ) ordered that the matter required further development of the record, as the medical reports of Paul Kaplan, M.D., did not constitute substantial evidence. The WCJ’s order was not a final order, and the petition for reconsideration was dismissed. The petition for removal was also denied, as the WCJ’s order did not constitute a final order and the petition failed to establish that the order would result in significant prejudice or irreparable harm. The case was returned to the trial level for further development of the record, further proceedings, and a decision by the WCJ.

Harjinder Singh vs. New Legend, Inc.; Aig Claims, Inc.; Uninsured Employers Benefits Trust Fund

In this case, Harjinder Singh filed a petition for reconsideration and removal with the Workers’ Compensation Appeals Board of California. The Board dismissed the petition for reconsideration as it was not a “final” order, and denied the petition for removal as petitioner had not shown that there would be substantial prejudice or irreparable harm if removal was not granted.

Bret Ross vs. Allergan, Inc.; American Home Assurance

(LAO 0785886)In this case, Bret Ross, an employee of Allergan, Inc. and American Home Assurance, sought reconsideration of a decision by a workers’ compensation administrative law judge (WCJ) that all disputes for medical treatment must be submitted to utilization review (UR). The WCJ found that Ross had sustained an industrial injury to his back, left leg, left hip, left ankle, left foot, and psyche, causing 94% permanent disability and a need for further medical treatment. Ross argued that UR for a chronic medical condition was not required and that he was entitled to all medical treatment that was reasonably required to relieve his chronic pain. The Workers’ Compensation Appeals Board granted Ross’ petition for reconsideration

Xuan Phan vs. Codan Medlon, Inc. National Liability And Fire Insurance; Chubb Group

In this case, Xuan Phan sought reconsideration of a Joint Order Approving Compromise and Release, which approved the resolution of her claim for workers’ compensation benefits in exchange for payment of $20,000.00. The Workers’ Compensation Appeals Board dismissed the petition for reconsideration as it was untimely. Even if the petition was not dismissed for being untimely, it would have been denied on the merits.

Martin William Haley, Ii vs. Penske Logistics; Old Republic

This case involves Martin William Haley, II, who was employed as an appliance installer and sustained an industrial injury to his left hip and lower back on June 27, 2007. The Workers’ Compensation Administrative Law Judge found that the injury resulted in temporary disability which became permanent and stationary on August 11, 2008, but that no permanent disability was sustained as a result of the injury. The Judge ordered that the defendants were entitled to credit for payments made after August 11, 2008. Haley filed a petition for reconsideration, but it was dismissed as it was untimely.

Norma Flores vs. Hms Host; Ace Usa Insurance, Administered By Gallagher Services

is a case involving Norma Flores and her workers’ compensation claim against her employer, HMS Host, and their insurance provider, ACE USA Insurance, administered by Gallagher Services. Flores filed a Petition for Reconsideration, alleging that her injury should be presumed compensable due to the defendant’s failure to deny the claim within 90 days, and that the reports of the panel qualified medical examiner (PQME) Timothy Ross M.D. do not constitute substantial medical evidence. The Workers’ Compensation Appeals Board denied the Petition for Reconsideration, finding that the issue of the defendant’s failure to deny the claim within 90 days was waived, and that the reports of the PQME constituted substantial evidence.

Aaron Branscomb vs. County Of Mendocino, Permissibly Self-insured, Administered By York Insurance Services

In this case, Aaron Branscomb, an employee of the County of Mendocino, filed a workers’ compensation claim after he twisted his left knee while working for the County in 2008. The City of Willits, where Branscomb had previously worked, provided medical treatment for his left knee after the 2008 incident based upon a stipulated award of 10% permanent disability and future medical treatment that was approved by the workers’ compensation administrative law judge and entered in a prior case involving a left knee industrial injury incurred by applicant while working for the City in 2002. The City sought an opinion from the prior Panel Qualified Medical Examiner (PQME) regarding its obligation to provide medical treatment for applicant’s left knee after the 2008 incident.

Cynthia Blackledge vs. Bank Of America; Ace American Insurance Company

(LBO 0375311) is a case involving Cynthia Blackledge and Bank of America and ACE American Insurance Company. The Workers’ Compensation Appeals Board denied the Petition for Removal, as the petitioner had not met the standards for removal, which include demonstrating that substantial prejudice or irreparable harm will result if removal is not granted, and that reconsideration will not be an adequate remedy if a final decision adverse to the petitioner ultimately issues. The Board found that the petitioner had not met these standards, and denied the Petition for Removal.

Barbara Edwards vs. Caltrans; State Compensation Insurance Fund

In this case, Barbara Edwards, an employee of Caltrans, sought reconsideration of a workers’ compensation administrative law judge’s (WCJ) decision that she was not entitled to 100 percent permanent disability. The WCJ found that she was in need of future medical care for psyche, cognitive impairment, and headaches, and that she was entitled to a permanent disability award of 88 percent. The WCJ’s decision was based on the opinion of a psychiatric agreed medical evaluator (AME) who apportioned 15 percent of her current difficulties to a pre-existing attention deficit disorder and depression, and 85 percent to the dementia and extreme depression she sustained on an industrial basis. The WCJ granted the petition for reconsideration and rescinded the