April 2018

Donald Yeager vs. Calportland Company; Mitsui Sumitomo Insurance Usa, Inc., Administered By Sedgwick Claims Management Services, Inc.

In this case, Donald Yeager, an employee of Calportland Company, filed three applications for adjudication of claim alleging that he suffered injury to his pulmonary system, cardiovascular system, esophagus, auditory system and kidneys from March 19, 1977 to March 26, 2009; to his back on August 13, 2008; and, to his upper extremities, back and psyche on October 12, 2009. The parties submitted a pre-trial conference statement dated February 16, 2017 in which applicant identified as an issue for trial, “whether applicant is entitled to replace Dr. Omar Syed Tirmizi as pulmonary QME.” A trial was conducted by WCJ Pollak on April 17, 2017. During the proceeding, applicant was

Ramonda Walker vs. Petrochem Insulation, Inc.; Ace American Insurance Company

In this case, Ramonda Walker filed a claim for workers’ compensation benefits due to an injury sustained while working outside of California. The Workers’ Compensation Appeals Board denied the petition for reconsideration, finding that the contract of hire was made in Georgia, not California, and thus the Board did not have jurisdiction over the claim. The Board noted that the payment of California taxes and the factors that demonstrate employment as opposed to independent contractor status were not sufficient to establish jurisdiction.

Tamara Steinhoff vs. Delta Dental; Liberty Mutual Insurance Company

In this case, Tamara Steinhoff was seeking reconsideration of a decision by the Workers’ Compensation Appeals Board that she had been fully paid all the benefits owed to her under the Stipulations resolving her cases. The Board found that the parties had not intended to consolidate the awards, and that the defendant had not paid the $26,979.00 due under the Award in Case No. ADJ9616784. The Board granted the Petition for Reconsideration and ordered the defendant to pay the applicant the $26,979.00 due under the Award in Case No. ADJ9616784.

Sharon Padron vs. Frito Lay, Permissibly Self-insured, Adjusted By Sedgwick Claims Management Services

In this case, Sharon Padron sought reconsideration of a February 9, 2018 Findings and Award (F&A) from the Workers’ Compensation Appeals Board. The F&A found that Padron was entitled to temporary disability indemnity benefits from April 19, 2011 to October 29, 2012, but not before April 19, 2011. Padron argued that she was entitled to temporary disability indemnity benefits from July 15, 2005 to October 19, 2012. The Workers’ Compensation Appeals Board granted Padron’s Petition for Reconsideration, amending the February 9, 2018 F&A to award Padron temporary disability indemnity benefits from July 15, 2005 to October 19, 2012.

Donna Ives vs. Dr Myers Distributing Company; Preferred Employers Insurance Company

In this case, Donna Ives, an employee of Dr. Myers Distributing Company, filed an application for adjudication of claim alleging that on December 7, 2015, she sustained industrial injury to her head, brain, eye, and nervous system. The employer accepted injury to the head. The parties stipulated that there was no chiropractic neurologist in the medical provider network. The Workers’ Compensation Appeals Board rescinded the February 15, 2018 Findings of Fact and returned the matter to the trial level for further proceedings to develop the record and a new decision by the WCJ, as the defendant failed to properly refer the matter to medical utilization review and medical utilization review was not timely sought.

Elizabeth Huynh vs. Bristol Myers Squibb Company; National Union Fire Insurance Company Of Pittsburgh, Pa, Administered By Aig

In this case, the Workers’ Compensation Appeals Board denied the Petition for Removal filed by Elizabeth Huynh against Bristol Myers Squibb Company and National Union Fire Insurance Company of Pittsburgh, PA, administered by AIG. The Board found that Huynh did not demonstrate how or why she would be substantially prejudiced or irreparably harmed if removal was denied, and that reconsideration would be an adequate remedy if a final decision adverse to the petitioner ultimately issued.

Sergio Huizar vs. Palm Springs Volkswagen; Employers Compensation Insurance Company

In this case, Sergio Huizar, an auto detailer for Palm Springs Volkswagen, filed a workers’ compensation claim after sustaining an injury to his knee and back. Edward Haronian, M.D., the primary treating physician, filed a Notice and Request for Allowance of Lien. The parties proceeded to a lien trial to determine whether the Workers’ Compensation Appeals Board had jurisdiction over the lien dispute. The WCAB found that an express agreement fixing the amounts to be paid for medical, surgical, or hospital treatment had been made between the lien claimant and the defendant, Employers Compensation Insurance Company, and thus the WCAB lacked jurisdiction. The Petition for Reconsideration was denied.

Patricia Castro vs. Stockton Unified School District, Permissibly Self-insured, Adjusted By York Risk Services Group

Stockton Unified School District, Permissibly Self-Insured, adjusted by York Risk Services Group Patricia Castro WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAPATRICIA CASTRO, Applicant,vs.STOCKTON UNIFIED SCHOOL DISTRICT, Permissibly Self-Insured, adjusted by YORK RISK SERVICES GROUP, Defendants.Case No. ADJ10231800 (Stockton District Office)OPINION AND ORDER GRANTING PETITION FOR RECONSIDERATION AND DECISION AFTER RECONSIDERATION            Applicant Patricia Castro seeks reconsideration of the …

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Israel Zirate vs. Yum Yum Donut Shop, Inc. And Benchmark Insurance Company Administered By Illinois Midwest Insurance Agency, Llc

is a case between Yum Yum Donut Shop, Inc. and Benchmark Insurance Company administered by Illinois Midwest Insurance Agency, LLC and lien claimant Garfield Health Center Medical Group, Inc. The case involves a worker’s compensation claim for injuries sustained by Israel Zirate while employed as a baker. The Workers’ Compensation Appeals Board granted lien claimant’s Petition for Reconsideration and admitted into evidence the Medical Provider Networks Approved by DWC document as Defendant’s Exhibit K. The Board affirmed the Joint Findings and Award issued by the workers’ compensation administrative law judge.

Timothy Watson vs. Martinez Steel Corporation; Starr Indemnity And Liability Insurance Company; York Risk Services Group

In this case, Timothy Watson filed a Petition for Reconsideration against Martinez Steel Corporation, Starr Indemnity and Liability Insurance Company, and York Risk Services Group. The Petition for Reconsideration was unverified and was dismissed. The Workers’ Compensation Appeals Board noted that Watson had received only $21,250 of the settlement proceeds and should have been paid $25,000 according to the Order Approving Compromise and Release. The Board ordered that the difference ($3,750) should be paid to Watson forthwith to avoid penalties. The Board also noted that William Carlisle remained Watson’s attorney of record and that Watson had not complied with Appeals Board Rule 10778. The Petition for Reconsideration was dismissed