January, 2015 - CompFox

Juan Prado vs. Original 22, Inc.; Employers compensation Insurance Company,

Leave a Comment / California, Oakland / By Ashish

This case involves a dispute between Juan Prado and Original 22, Inc. and Employers Compensation Insurance Company. Prado sought reconsideration of a November 12, 2014 Award issued by a workers’ compensation administrative law judge (WCJ) approving the parties’ Stipulations with Request for Award. The WCJ issued a Report and Recommendation on Petition for Reconsideration (Report) recommending that the Workers’ Compensation Appeals Board deny reconsideration. However, the Report only contained Case No. ADJ833911 0 in the caption. The Board granted reconsideration, rescinded the November 12, 2014 Award, and returned the matter to the trial level for further proceedings and decision by the WCJ consistent with the opinion.

Pope Powell, vs. City And County Of San Francisco, Permissibly Self-insured,

Leave a Comment / California, Oakland / By Ashish

is a case in which the City and County of San Francisco, Permissibly Self-Insured, is the defendant and Pope Powell is the applicant. The First District Court of Appeal (Div. 5) issued a remittitur to the Workers’ Compensation Appeals Board, which concluded that in determining the appropriate occupational group to rate an injured employee’s permanent disability, the relevant inquiry should look to the physical activities required to perform the injured employee’s duties. The Board granted reconsideration of its February 18, 2014 Opinion and Order Granting Petition for Reconsideration and Decision After Reconsideration, and reinstated and affirmed it, but with an amendment of Finding 5 to conform to the Court’s decision. The case was returned to the WC

Jose Morfin, vs. White Memorial Medical Center, Permissibly Self-insured,

Leave a Comment / California, Los Angeles / By Ashish

In this case, White Memorial Medical Center sought removal of the case to the Workers’ Compensation Appeals Board to contest the December 18, 2014 minute order of the workers’ compensation administrative law judge’s (WCJ) documenting the parties’ stipulation to utilize two Agreed Medical Evaluators (AMEs). The WCJ denied the petition for removal and the case was removed to the Appeals Board on their own motion to address concerns about the conduct of defendant and its attorneys. The Appeals Board issued a Notice of Intention to impose sanctions jointly and severally against defendant, Mr. Truong and Manning & Kass, for filing a petition with false statements of material fact and for asserting a position that had no valid basis in fact or law and was indisput

Victor Moran, vs. J.b. Hunt Transportation Services; Liberty Mutual Insurance Company,

Leave a Comment / California, Pomona / By Ashish

: In this case, Victor Moran was injured while employed as a truck driver on September 9, 2011. The Workers’ Compensation Appeals Board granted the Petition for Reconsideration to amend the ending date of temporary disability to May 9, 2013, and also to delete the finding of injury to applicant’s bilateral knees. The Board found that there was no substantial evidence that applicant sustained an injury to either of his knees as a result of the September 9, 2011 injury.

Mitchell Meredith, vs. Jh Askins Insurance Company; State Compensation Insurance Fund,

Leave a Comment / California, Santa Rosa / By Ashish

is a case in which Mitchell Meredith, the applicant, sought reconsideration of a December 2, 2014 Findings and Award, wherein the workers’ compensation administrative law judge (WCJ) found that applicant sustained an admitted injury arising out of and in the course of employment to both shoulders and upper extremities, but suffered no compensable temporary disability for the period April 22, 2014 to the present and continuing. The Workers’ Compensation Appeals Board granted the Petition for Reconsideration and returned the matter to the trial level for the WCJ to take the actions outlined in his report. The Board also noted that the WCJ’s decision that applicant is not entitled to temporary disability is a final order subject to reconsideration.

June Martin, vs. Cottage Health Systems, Permissibly Self-insured, Administered By Sedgwick Cms,

Leave a Comment / California, Oxnard / By Ashish

In this case, the Workers’ Compensation Appeals Board granted reconsideration of a February 3, 2014 Findings and Award issued by a workers’ compensation administrative law judge and rescinded the WCJ’s decision, finding that the applicant did not sustain an injury arising out of and occurring in the course of her employment. The Board also issued a Notice of Intention to impose a sanction of $500.00 against defendant’s attorney and the law firm of Tobin Lucks, LLP on account of their failure to comply with the Workers’ Compensation Appeals Board’s Rules of Practice and Procedure. After considering the defendant’s attorney’s response, the Board accepted the apology and explanation that the violations were the result of inadvertence and mistake and decided not to impose

Carolynholman, vs. Los Angeles Unified School District, P S-1, A B Sedgwick Claims Management Services,

Leave a Comment / California, Los Angeles / By Ashish

(LAO 0786271)This case involves a dispute between lien claimants Darrell H. Burstein, M.D. and The Prescription Center, and Los Angeles Unified School District, P S-1, A B Sedgwick Claims Management Services, regarding the reimbursement of medical services provided to the applicant, Carolyn Holman. The Workers’ Compensation Appeals Board affirmed the decision of the WCJ ordering that both Dr. Burstein and The Prescription Center take nothing for their respective liens. The Board found that there was no evidence that Dr. Burstein was ever the applicant’s requested or treating physician, and that there was no reliable evidence as to the reasonableness or necessity of the services provided by The Prescription Center.

Michael Gibson, vs. Orange County Transit Authority, Permissibly Self-insured,

Leave a Comment / California, Santa Ana / By Ashish

ORANGE COUNTY TRANSIT AUTHORITY, permissibly self-insured, MICHAEL GIBSON, WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAMICHAEL GIBSON, Applicant,vs.ORANGE COUNTY TRANSIT AUTHORITY,permissibly self-insured, Defendant.Case No. ADJ8897698(Santa Ana District Office)OPINION AND DECISION AFTERRECONSIDERATION We previously granted applicant’s petition for reconsideration of the August 27, 2014 Findings And Order of the workers’ compensation administrative law judge (WCJ) who denied applicant’s Labor …

Michael Gibson, vs. Orange County Transit Authority, Permissibly Self-insured, Read More »

Aristeo Martinez vs. La Casa Anaheim Resort, Insured By Cypress Insurance Company, Administered By Berkshire Hathaway Homestate Companies

Leave a Comment / Anaheim, California / By Ashish

This case involves La Casa Anaheim Resort, which is insured by Cypress Insurance Company and administered by Berkshire Hathaway Homestate Companies. Lien claimant, Physical Rehabilitation Services, sought reconsideration of the Findings and Orders issued by a workers’ compensation administrative law judge (WCJ) which disallowed its lien due to its failure to meet its burden of proof to establish the reasonableness and necessity of the Functional Capacity Evaluation and report it provided. The WCJ further issued a notice of intention to impose a sanction of $1,000.00, plus fees and costs, jointly and severally, against lien claimant and its representative A V Management and Collections, absent a showing of good cause or reasonable excuse to the contrary

Richard Orr vs. State Of California, Department Of Corrections, Pelican Bay State Prison, Legally Uninsured, Adjusted By State Compensation Insurance Fund

Leave a Comment / California, Eureka / By Ashish

, The State of California, Department of Corrections, Pelican Bay State Prison, Legally Uninsured, Adjusted By State Compensation Insurance Fund, Richard Orr, appealed to the Workers’ Compensation Appeals Board to reconsider the November 4, 2014 Joint Findings and Award and Order. The Board granted the reconsideration and amended the Joint Findings and Award and Order to correct the clerical error in the rate of temporary disability indemnity benefits and the period of entitlement to temporary disability indemnity benefits. The Board affirmed the WCJ’s decision otherwise.

January 2015