October, 2012 - CompFox

Armando Enriquez vs. Big Lots Stores, Inc., Zurich Insurance Company

Leave a Comment / California, Pomona / By Ashish

Big Lots Stores, Inc., Zurich Insurance Company Armando Enriquez WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAARMANDO ENRIQUEZ, Applicant,vs.BIG LOTS STORES, INC., ZURICH INSURANCE COMPANY, Defendants.Case No. ADJ1982267 (POM 0288693)OPINION AND ORDER GRANTING PETITION FOR RECONSIDERATION AND DECISION AFTER RECONSIDERATION Defendant seeks reconsideration of the August 12, 2011 Findings And Award And Order of Commutation of the …

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LISA SIMMONS vs. STATE OF CALIFORNIA, DEPARTMENT MENTAL HEALTH, Legally Uninsured; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES, Adjusting Agency

Leave a Comment / California, Long Beach / By Ashish

is a case involving Lisa Simmons, an applicant, and the State of California, Department of Mental Health, Legally Uninsured; State Compensation Insurance Fund/State Contract Services, Adjusting Agency, defendants. The case involves a petition for reconsideration and/or removal from the Findings and Award, issued August 1, 2012, in which a workers’ compensation administrative law judge (WCJ) appointed an Independent Medical Examiner (IME) to evaluate applicant. The WCJ found the medical record was not sufficient to determine applicant’s need for home health care, nursing services, maid and cleaning services, and whether defendant appropriately terminated these services, as an element of her 2006 award of further medical treatment for her 2002 industrial injury. The WCJ indicated that the

KATRINA SENTIERI vs. PET SMART, Permissibly Self-Insured Retention Policy, Thereafter, ACE AMERICAN INSURANCE COMPANY Administered By SEDGWICK CLAIMS MANAGEMENT SERVICES

Leave a Comment / California, Salinas / By Ashish

In this case, Katrina Sentieri filed a petition for reconsideration against Pet Smart, Permissibly Self-Insured Retention Policy, Thereafter, ACE American Insurance Company Administered By Sedgwick Claims Management Services. The Workers’ Compensation Appeals Board dismissed the petition for reconsideration and denied removal. The Board determined that the petition was not a “final” order and did not determine any substantive right of the parties. The Board also determined that removal was not granted because Sentieri had not shown that there would be substantial prejudice or irreparable harm if removal was not granted.

ROCIO SALINAS vs. TUTOR & SALIBA; INTERCARE

Leave a Comment / California, Oakland / By Ashish

In the case of Rocio Salinas vs. Tutor & Saliba; Intercare, the Workers’ Compensation Appeals Board granted reconsideration of the decision of July 31, 2012, and rescinded the decision, returning the matter to the trial level for further proceedings and decision by the WCJ. This is not a final decision on the merits of any issues raised.

ROSE ROCKFORD vs. LONG BEACH UNIFIED SCHOOL DISTRICT; YORK RIVERSIDE

Leave a Comment / California, Long Beach / By Ashish

is a case in which Rose Rockford, an employee of the Long Beach Unified School District, sought reconsideration of an Opinion and Order Granting Reconsideration and Decision After Reconsideration, issued August 13, 2012. The original decision found that Rockford had sustained 27% permanent disability as a result of an injury to her lumbar and thoracic spine while employed by the school district. The reconsideration amended the permanent disability award based upon the substantial medical evidence by the panel Qualified Medical Evaluator, Dr. Mizuguchi, to award applicant 19% permanent disability. Rockford contested the Decision After Reconsideration, and requested that the matter be returned to Dr. Mizuguchi so that he may explain

ESAU FATU LEOTA PANAPA, Deceased JULIA PANAPA vs. COUNTY OF VENTURA PROBATION AGENCY; Legally Uninsured, Administered By CORVEL

Leave a Comment / California, Oxnard / By Ashish

This case involves a petition for reconsideration and removal filed by Julia Panapa against the County of Ventura Probation Agency, which is legally uninsured and administered by Corvel. The petition for reconsideration was dismissed as it was not a “final” order, decision, or award. The petition for removal was denied as Julia Panapa did not show that there would be substantial prejudice or irreparable harm if removal was not granted or that reconsideration would be an inadequate remedy if a final decision adverse to petitioner ultimately issued.

NICOLE NELSON vs. COUNTY OF SOLANO, Permissibly Self-Insured And Adjusted By INTERCARE HOLDINGS INSURANCE SERVICES

Leave a Comment / California, Sacramento / By Ashish

In this case, Nicole Nelson, a former social worker, claimed to have sustained an industrial injury to her psyche while employed from February 23, 2010, through February 23, 2011. The injury was denied by the County of Solano, Permissibly Self-Insured and Adjusted by Intercare Holdings Insurance Services. Nelson was evaluated by James O’Dowd, Psy.D., as panel QME pursuant to Labor Code section 4062.1. The County of Solano filed a Petition for Removal, requesting that the Appeals Board reverse the Order dated August 30, 2012, wherein the workers’ compensation administrative law judge (WCJ) denied defendant’s request for a replacement panel of qualified medical evaluators (QMEs).

PETE MINOR vs. BP AMERICA, INC., Permissibly Self-insured, Administered By EMPLOYERS SELF-INSURANCE SERVICE

Leave a Comment / California, San Jose / By Ashish

This case involves a worker’s compensation claim by Pete Minor against BP America, Inc., who is permissibly self-insured and administered by Employers Self-Insurance Service. The Workers’ Compensation Appeals Board denied the defendant’s petition for reconsideration of the August 6, 2012 Findings, Award and Orders, which found that Minor sustained an industrial injury to his shoulders while employed as a production delivery driver from September 12, 2010 through September 12, 2011. The WCJ awarded temporary disability indemnity, attorneys’ fees, and further medical treatment and ordered reimbursement for self-procured medical treatment, with the amount to be adjusted by the parties. The WCJ also found that defendant unreasonably delayed and refused payment of benefits and medical treatment,

PATRICIA BEAN vs. COUNTY OF SAN BERNARDINO, Permissibly Self-Insured

Leave a Comment / California, San Bernardino / By Ashish

This case involves a dispute between Patricia Bean, the applicant, and the County of San Bernardino, the defendant, over the validity of four medical liens. The parties had previously settled Bean’s underlying claim, which included industrial injuries to her right knee, right ankle, and lumbar spine. The defendant sought reconsideration of the July 30, 2012 Findings and Order issued by the workers’ compensation administrative law judge (WCJ). The WCJ found that Khalid Ahmed, M.D., was the primary treating doctor and allowed the liens of Mamutz Ali, M.D., in the amount of $1,814.48 and the lien of ASAP Family Therapy in the amount of $1,895.29 and dis

NOE VASQUEZ vs. IN AND OUT REMOVAL; CALIFORNIA INSURANCE COMPANY, ADJUSTED BY APPLIED RISK SERVICES

Leave a Comment / California, Los Angeles / By Ashish

, ADJ7452514

This case involves a lien claimant, Integrative Industrial, seeking reconsideration of a Joint Findings and Orders (F&O) issued by a workers’ compensation administrative law judge (WCJ) on July 25, 2012. The F&O found that the lien claimant did not meet its burden to show that applicant Noe Vasquez was employed by defendant In and Out Removal on the day of applicant’s claimed specific injury of April 15, 2010 or that his claimed specific and cumulative trauma injuries arose out of or in the course of his employment. The WCJ issued a Report and Recommendation recommending denial of the petition, which was adopted by the Workers’ Compensation Appeals Board. The petition was denied due

October 2012