March, 2014 - CompFox

Clevette Thomas vs. Wellpoint Inc Zurich North America

Leave a Comment / California, Los Angeles / By Ashish

is a case in which lien claimant, Mirzaians Chiropractic, Inc., sought reconsideration of the Findings and Orders, issued January 2, 2014, in which a workers’ compensation administrative law judge (WCJ) denied reimbursement to lien claimant for its services. The WCJ found lien claimant failed to meet its burden of proof to establish that the functional capacity examination (FCE) it provided for applicant Clevette Thomas was requested by applicant’s primary treating physician, that the services rendered were reasonable or necessary, and that its charges were reasonable. After review of the record, the Workers’ Compensation Appeals Board granted reconsideration, rescinded the Findings and Orders and ordered that lien claimant be reimbursed for its services

Maria Perez vs. Ts Staffing Lumbermen’s Underwriting Alliance

Leave a Comment / California, Oxnard / By Ashish

This case involves a dispute between lien claimant, Santana, Lopez & Associates, LLC (Santana), and defendants, TS Staffing and Lumbermen’s Underwriting Alliance, regarding the reimbursement of interpreter services provided by Santana for medical appointments and hearings. The Workers’ Compensation Appeals Board granted defendant’s petition for reconsideration and rescinded the January 7, 2014 Findings and Orders, finding that Santana is not entitled to any further payment on its lien.

Jesus Rios vs. Bryan Jones Dba The K Group Tokio Marine Unisured Employers Benefits Trust Fund

Leave a Comment / California, Los Angeles / By Ashish

BRYAN JONES dba THE K GROUP TOKIO MARINE UNISURED EMPLOYERS BENEFITS TRUST FUND JESUS RIOS WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAJESUS RIOS, Applicant,vs.BRYAN JONES dba THE K GROUP; TOKIOMARINE; UNISURED EMPLOYERSBENEFITS TRUST FUND, Defendants.Case No. ADJ1471935 (LAO 0872244)OPINION AND DECISION AFTER RECONSIDERATION On February 4, 2014, we granted reconsideration in this matter to provide an opportunity to further …

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ANTHONY PEARSALL vs. CITY OF VALLEJO Permissibly Self-Administered By YORK INSURANCE SERVICES GROUP

Leave a Comment / California, Santa Ana / By Ashish

CITY OF VALLEJO Permissibly Self-Administered by YORK INSURANCE SERVICES GROUP ANTHONY PEARSALL WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAANTHONY PEARSALL, Applicant,vs.CITY OF VALLEJO, Permissibly Self-Administered by YORK INSURANCESERVICES GROUP, Defendants.Case No. ADJ7689119(Santa Rosa District Office)ORDER DENYINGPETITION FORRECONSIDERATION We have considered the allegations of the Petition for Reconsideration and the contents of the report of the workers’ compensation …

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CYNTHIA MOLINA vs. NORDSTROM INC Permissibly Self-insured

Leave a Comment / California, Santa Ana / By Ashish

NORDSTROM INC permissibly self-insured CYNTHIA MOLINA WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIACYNTHIA MOLINA, Applicant,vs.NORDSTROM, INC., permissibly self-insured, Defendants.Case No. ADJ6552646(Santa Ana District Office)OPINION AND DECISION AFTER RECONSIDERATION We earlier granted applicant’s petition for reconsideration of the April 2, 2012 Findings And Order of the workers’ compensation administrative law judge (WCJ), who found in pertinent part, as follows:[justify] “The …

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Connie Lozano vs. Trino Packing And Cooking Inc Zenith Insurance Company

Leave a Comment / Bakersfield, California / By Ashish

In this case, Connie Lozano filed a Petition for Reconsideration against Trino Packing and Cooking, Inc. and Zenith Insurance Company. The Workers’ Compensation Appeals Board reviewed the allegations and contents of the Report and Recommendation on Petition for Reconsideration of the workers’ compensation administrative law judge and dismissed the petition due to it being unverified and failing to state grounds for reconsideration.

Richard Herrera vs. City Of Fullerton Permissibly Self-insured Administered By Adminsure

Leave a Comment / California, Santa Ana / By Ashish

In this case, the City of Fullerton was permissibly self-insured and administered by Adminsure. Richard Herrera, the applicant, filed a petition for reconsideration with the Workers’ Compensation Appeals Board. After reviewing the record, the Board granted reconsideration, amended the decision of the workers’ compensation administrative law judge, and affirmed the decision of January 2, 2014. The findings of fact numbers 2, 6, and 7 were amended, and the orders were amended to allow the lien of the California Law Enforcement Association. The issue of attorney’s fees was deferred.

Kristian Von Ritzhoff vs. Ogden Entertainment Food Services American International Group Inc Administered By Broadspire

Leave a Comment / California, Van Nuys / By Ashish

(MON 0212034)ADJ1776170 (MON 0224335)ADJ1414058 (MON 0246016)This case involves Kristian Von Ritzhoff’s petition for reconsideration of the February 12, 2014 Opinion and Order Granting Reconsideration and Decision After Reconsideration. The Appeals Board dismissed the petition because Von Ritzhoff was not aggrieved by the February 12, 2014 decision and had not been granted the relief he had sought in his Petition for Reconsideration of the October 13, 2013 decision.

Arcelia Torres vs. Ralphs Sedgwick Cms

Leave a Comment / California, San Francisco / By Ashish

RALPHS SEDGWICK CMS ARCELIA TORRES WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAARCELIA TORRES, Applicant,vs.RALPHS; SEDGWICK CMS, Defendants.Case No. ADJ7834761(Goleta District Office)ORDER DENYINGPETITION FOR REMOVAL We have considered the allegations of the Petition for Removal and the contents of the Report of the workers’ compensation administrative law judge (WCJ) with respect thereto. Based on our review of the …

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Ivan Sanchez vs. Native Foods California California Restaurant Mutual Benefit Corporation Administered By American Claims Management

Leave a Comment / Anaheim, California / By Ashish

This case involves a Petition for Removal filed by Ivan Sanchez against Native Foods California and California Restaurant Mutual Benefit Corporation, administered by American Claims Management. The Petition for Removal was denied by the Workers’ Compensation Appeals Board due to the fact that it was not verified as required by WCAB Rule 10843(b). The WCAB also noted that the Division of Workers’ Compensation must act within its budgetary constraints and that the WCAB has the authority to calendar a hearing at a different district office, without changing venue, when judicial or space resources are limited. The WCAB also noted that CourtCall is available in most of the hearing rooms at the Oxnard district office of the WCAB and encouraged the use of CourtCall for applicants who may have difficulty traveling to

March 2014