California Workers’ Compensation Case Law

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Cameron Pierce, vs. Pamarco Pacific, Inc.; The Hartford,

In this case, the Workers’ Compensation Appeals Board dismissed the Petition for Reconsideration filed by Sherman Oaks Hospital and Health Center of the Findings of Fact and Order issued on May 24, 2007, as it was not timely filed. The WCJ found that applicant’s inpatient hospital stay was at lien claimant’s facility as a result of the back surgery and was not self-procured medical treatment and ordered that lien claimant was not entitled to additional payment from defendant.

Maria Figuero vs. Help Net, Inc. And State Compensation Insurance Fund

(LBO 0326931)Help Net, Inc. and State Compensation Insurance Fund v. Maria Figueroa is a case in which lien claimant Michael A. Wooten, D.C. sought reconsideration of the Findings and Order issued by the workers’ compensation administrative law judge (WCJ) on February 21, 2016, wherein the WCJ found in pertinent part that the services Wooten provided did not constitute reasonable medical treatment pursuant to the medical treatment utilization schedule (MTUS) guidelines and ordered that Wooten’s lien was disallowed. The Workers’ Compensation Appeals Board granted the Petition for Reconsideration and rescinded the F&O, returning the matter to the WCJ for further proceedings consistent

Rosa Gamez vs. Full Steam Staffing And Esis

In this case, Rosa Gamez filed a petition for reconsideration and removal with the Workers’ Compensation Appeals Board against Full Steam Staffing and ESIS. 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 petition was not a “final” order, decision, or award and that removal was an extraordinary remedy rarely exercised by the Board. The Board also found that 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.

Michael Jimenez vs. Sp Plus Security Services; Zurich American Insurance Company

This case is about Michael Jimenez, who was denied workers’ compensation benefits by the Workers’ Compensation Appeals Board. The defendant, SP Plus Security Services and Zurich American Insurance Company, sought reconsideration of the decision, but the petition was dismissed as it was untimely. The Board also admonished the defendant’s attorney for filing a meritless petition and for her apparent lack of familiarity with the Appeals Board’s Rules of Practice and Procedure.

Gustavo Chairez Murillo vs. Smart & Final Stores; Sedgwick

SMART & FINAL STORES; SEDGWICKIn this case, the Workers’ Compensation Appeals Board granted the Petition for Removal filed by Gustavo Chairez Murillo, rescinding the Order Compelling Medical Examination dated April 24, 2014, and returning the matters to the trial level for further proceedings. The Board expressed no opinion on the merits of the underlying issues.

Theresa Merenkov vs. Oracle Usa, Inc.; Safety National Casualty Company, Administered By Matrix Absence Management, Inc.

This case involves Theresa Merenkov, an employee of Oracle USA, Inc., who sustained an industrial injury on December 8, 2012, to multiple body parts causing 50% permanent disability and a need for future medical treatment. The defendant, Safety National Casualty Company, administered by Matrix Absence Management, Inc., sought reconsideration of the July 31, 2014 Findings and Award, arguing that the finding of permanent disability was excessive and not correctly rated. The Workers’ Compensation Appeals Board denied the Petition for Reconsideration, finding that the Panel Qualified Medical Evaluator assigned correct whole person impairments and that the WCJ reasonably relied on the findings of the medical evaluator.

ANGEL AVILA vs. PHILIPPS SERVICES CORPORATION; CIGA, By Its Servicing Facility, SEDGWICK CMS, For RELIANCE INSURANCE COMPANY, In Liquidation

In this case, Angel Avila filed a workers’ compensation claim for injuries sustained while employed by Phillips Services Corporation, insured by Reliance Insurance Company, in liquidation, by CIGA, through its servicing facility, Sedgwick CMS. Several medical facilities filed liens for goods/services allegedly provided to Avila. The Workers’ Compensation Appeals Board granted reconsideration of the July 22, 2014 Orders Dismissing Lien Claims and issued a Notice of Intention to affirm the WCJ’s Orders unless lien claimants demonstrate good cause why the Orders should not be affirmed. The Board also ordered defendant to file a pleading responding to any pleading filed by lien claimants.

JORGE PRECIADO vs. ALAMILLO REBAR, INC.; OLD REPUBLIC GENERAL INSURANCE

is a case in which the defendant, Alamillo Rebar, Inc., sought reconsideration of a workers’ compensation administrative law judge’s (WCJ) Findings of Fact, Order and Award of July 17, 2014. The WCJ found that the applicant, Jorge Preciado, was entitled to temporary disability indemnity corresponding to the period October 12, 2012 to the present and continuing, subject to the limitations of Labor Code section 4656(c), and less credit to defendant for days worked and wages earned by applicant. The defendant argued that the WCJ erred in finding applicant entitled to temporary disability indemnity, arguing that the reporting of qualified medical evaluator pain management specialist Jerome A. Robson, M.D., did not

Anoush Massihi vs. Occidental College; Seabright Insurance Company

OCCIDENTAL COLLEGE; SEABRIGHT INSURANCE COMPANY ANOUSH MASSIHI WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAANOUSH MASSIHI, Applicant,vs.OCCIDENTAL COLLEGE; SEABRIGHT INSURANCE COMPANY, Defendants.Case No. ADJ8171717(Los Angeles District Office)ORDER

Norma Hernandez vs. Kragen Auto Parts; Zurich North America Insurance Company

In this case, Norma Hernandez filed a Petition for Removal against Kragen Auto Parts and Zurich North America Insurance Company. The Petition was withdrawn and the Workers’ Compensation Appeals Board dismissed the Petition for Removal. Service was made on the parties listed on the current official address record.

Joshua Hinson vs. City Of Fullerton; Adminsure Diamond Bar

In this case, the Workers’ Compensation Appeals Board denied the Petition for Reconsideration filed by Joshua Hinson against the City of Fullerton and Adminsure Diamond Bar. The Board adopted and incorporated the report of the workers’ compensation administrative law judge and denied the Petition for Reconsideration. The order was dated and filed at San Francisco, California on November 17, 2010 and service was made by mail on the same date.

Stephino Brown vs. First Transit/first Group; Broadspire, Sedgwick, Adjusted By Gallagher Bassett

In this case, Stephino Brown, an applicant, filed a Petition for Reconsideration, Petition for Removal, and Petition for Disqualification against First Transit/First Group; Broadspire, Sedgwick, Adjusted by Gallagher Bassett. The Workers’ Compensation Appeals Board dismissed the Petition for Reconsideration, denied the Petition for Removal, and dismissed the Petition for Disqualification. The Board found that the Order by which the applicant claimed to be aggrieved was not a “final order” within the meaning of Labor Code section 5902, and that no proceedings had been assigned to the PWCJ or any other WCJ.

CLAUDIA ANDRADE vs. SOUTHERN CALIFORNIA EDISON; Permissibly Self-Insured

is a case involving Claudia Andrade and Southern California Edison, a permissibly self-insured company. On July 2, 2014, Arsineh Arakel, attorney for lien claimant Physical Rehabilitation Services, filed a Petition to disqualify the workers’ compensation administrative law judge (WCJ) Glass. The Labor Code section 5311 provides that a WCJ may be disqualified per Code of Civil Procedure section 641 which lists seven grounds for disqualification. The Petition was granted on the ground that the WCJ may have expressed or formed an opinion on the merits of the action, and the case was returned to the Presiding Judge for assignment to a different WCJ.

LERHONE WILLIAMS vs. CALIFORNIA DEPARTMENT OF SOCIAL SERVICES, IN-HOME SUPPORTIVE SERVICES; Permissibly Self-insured, Administered By YORK RISK SERVICES GROUP, INC.

This case involves Lerhone Williams, who filed a Petition for Reconsideration against the California Department of Social Services, In-Home Supportive Services, which is permissibly self-insured and administered by York Risk Services Group, Inc. The Petition for Reconsideration was denied by the Workers’ Compensation Appeals Board, as they found no lawful grounds to grant reconsideration. The Board found that while there may have been inaccuracies in the medical record, they were not convinced that they materially affected the outcome of the case. Furthermore, the Board found that not all of the applicant’s assertions were correct. The Board accepted and considered the supplemental letter and documents submitted by the applicant, but they did not change the decision.

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