November, 2017 - CompFox

Thomas Martinez vs. Ralphs Grocery Company, Permissibly Self-insured; Administered By Sedgwick Claims Management Services,

Leave a Comment / California, Marina del Rey / By Ashish

In this case, Ralphs Grocery Company petitioned for reconsideration of the Findings and Orders issued by the workers’ compensation administrative law judge (WCJ) which allowed the lien claim of the Motion Picture Health Fund (MPHF) for medical treatment expense in the amount of $51,400.37 plus penalties and interest. After the parties participated in voluntary mediation through a commissioners’ settlement conference, they agreed to resolve all issues concerning MPHF’s lien in consideration of the payment of $29,500.00 by defendant. As part of this negotiation, the parties agreed that the underlying decision would be rescinded and the lien settlement agreement was approved by the Workers’ Compensation Appeals Board.

Juan Rodriguez, vs. Nestle Usa; Ace American Insurance Company, Administered By Sedgwick Claims Management Services, Inc.,

Leave a Comment / California, Van Nuys / By Ashish

This case involves a petition for reconsideration and removal filed by Juan Rodriguez against Nestle USA and Ace American Insurance Company, administered by Sedgwick Claims Management Services, Inc. The Workers’ Compensation Appeals Board dismissed the petition to the extent it sought reconsideration and denied it to the extent it sought removal. The Board found that the decision of the workers’ compensation administrative law judge was not a “final” order and that the petitioner had not demonstrated that substantial prejudice or irreparable harm would result if removal was denied.

Jose Manuel Mora, vs. Los Angeles Unified School District, Permissibly Self-insured, Administered By York Risk Management,

Leave a Comment / California, Marina del Rey / By Ashish

In this case, Jose Manuel Mora filed a petition for reconsideration and removal with the Workers’ Compensation Appeals Board. The Board dismissed the petition to the extent it sought reconsideration and denied it to the extent it sought removal. The Board found that the decision did not determine any substantive right or liability and did not determine a threshold issue, and thus was not a “final” decision. The Board also found that the petitioner did not demonstrate that substantial prejudice or irreparable harm would result if removal was denied, and that reconsideration would be an adequate remedy if a final decision adverse to the petitioner ultimately issued.

Vivian Lowry, vs. Whitefield Medical Laboratories, Inc.; National Liability And Fire Insurance By Berkshire Hathaway Homestate Companies; Illinois Midwest Insurance Agency, On Behalf Of Pennsylvania Manufacturers’ Association Insurance Company,

Leave a Comment / California, Los Angeles / By Ashish

ADJ7518440This case involves a petition for reconsideration or removal in the alternative by Vivian Lowry against Whitefield Medical Laboratories, Inc., National Liability and Fire Insurance by Berkshire Hathaway Homestate Companies, and Illinois Midwest Insurance Agency on behalf of Pennsylvania Manufacturers’ Association Insurance Company. The Workers’ Compensation Appeals Board dismissed the petition to the extent it sought reconsideration and denied it to the extent it sought removal, as the decision did not determine any substantive right or liability and did not determine a threshold issue. Removal was denied as the petitioner did not demonstrate that substantial prejudice or irreparable harm would result if removal was not granted, and that reconsideration would not be an adequate remedy if a final decision adverse to the petitioner ultimately issued.

Maria Sosa, vs. Cintas Corporation; Travelers Property And Casualty Insurance Company Of America, Administered By Sedgwick,

Leave a Comment / California, Santa Ana / By Ashish

This case is about Cintas Corporation and Travelers Property and Casualty Insurance Company of America, administered by Sedgwick, and Maria Sosa. Maria Sosa claimed injury to her neck, right shoulder, and bilateral wrists from November 5, 2015 through December 9, 2016 while employed as a folder for Cintas Corporation. The parties agreed to utilize Lawrence Feiwell, M.D., as an agreed medical evaluator, who concluded that Maria Sosa would have been able to perform her usual and customary duties had she not been terminated for cause. The Workers’ Compensation Appeals Board granted reconsideration, rescinded the Findings and Award and Order, and returned the matter to the WCJ for further proceedings.

Claudia Parra, vs. Covidien; New Hampshire Insurance Company; Esis,

Leave a Comment / Anaheim, California / By Ashish

This case involves a lien claimant, Med-Legal Photocopy, who is seeking reconsideration of a decision by a workers’ compensation administrative law judge (WCJ) that found that the applicant, Claudia Parra, did not sustain an injury arising out of and in the course of employment. The WCJ also found that Med-Legal copied records at the request of applicant’s attorney and that defendant has no liability for Med-Legal’s lien because the subpoenas issued to obtain those records were improper, duplicative, and not signed by a sitting workers’ compensation judge. The Workers’ Compensation Appeals Board granted reconsideration, rescinded the Findings and Order, and returned the matter to the trial level for further proceedings and a new decision

Diane Carol Moreno, vs. Vitro, Formerly Ppg Industries, Inc.; Century Insurance Group, Administered By York Risk Services Group, Inc.,

Leave a Comment / California, Fresno / By Ashish

(FRE 0221296)ADJ4067986 (FRE 0234030)ADJ6864975(Fresno District Office)This case is about Diane Carol Moreno, a forklift driver loader/unloader, who sustained industrial injury to her left shoulder, upper extremities, and psyche while employed by Vitro, formerly PPG Industries, Inc. The Workers’ Compensation Appeals Board granted the Petition for Reconsideration and Decision After Reconsideration, amended the September 18, 2017 Joint Findings of Fact & Award, and otherwise affirmed the WCJ’s findings that the medical reporting of Dr. Jacks and Dr. Newton constituted substantial medical evidence. The WCJ found industrial injury to applicant’s upper

Barbara Garza, vs. Barbosa Cabinets, Inc.; Applied Risk,

Leave a Comment / California, Stockton / By Ashish

In this case, Barbara Garza filed a Petition for Removal from the Workers’ Compensation Administrative Law Judge’s September 6, 2017 Pretrial Conference Statement Order addressing discovery. The parties resolved the dispute and agreed that the Petition for Removal was moot and withdrawn, so the Petition for Removal was dismissed by the Workers’ Compensation Appeals Board.

Noemi Gamez, vs. Knotts Berry Farm; Ace American Insurance Company, Administered By Sedgwick Claims Management,

Leave a Comment / California, Los Angeles / By Ashish

Noemi Gamez was appealing a decision by the Workers’ Compensation Appeals Board regarding venue in her case against Knotts Berry Farm and Ace American Insurance Company, administered by Sedgwick Claims Management. The Board dismissed the petition to the extent it sought reconsideration and denied it to the extent it sought removal, as the decision did not determine any substantive right or liability and did not determine a threshold issue. The Board also admonished defense attorney Matthew Boyer for filing a petition for reconsideration on an alternative basis from an order that was not final.

Lorenzo Enriquez, vs. House Foods America; Tokio Marine Management,

Leave a Comment / Anaheim, California / By Ashish

In this case, the Workers’ Compensation Appeals Board considered the allegations of the Petition for Reconsideration or in the Alternative Removal from Findings of Fact and the contents of the report and the opinion on decision of the workers’ compensation administrative law judge (WCJ). The Board dismissed the Petition for Removal and denied the Petition for Reconsideration, noting that a “final” order has been defined as one that either “determines any substantive right or liability of those involved in the case” or determines a “threshold” issue that is fundamental to the claim for benefits. The WCJ found that the applicant sustained injury arising out of and occurring in the course of employment (AOE/COE), which is a threshold

November 2017