California Workers’ Compensation Case Law

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RAFAEL TELLEZ vs. FIESTA MEXICAN MARKET, LLP; SPRINGFIELD INSURANCE COMPANY

In this case, Rafael Tellez was injured while working as a baker for Fiesta Mexican Market, LLP. He received a lump sum payment of $50,000 for his injuries. A third-party lien claimant, California Physician’s Network, sought to recover $104,578.90 for transportation services it claimed to provide Tellez in taking him to and from appointments with his physicians. The workers’ compensation administrative law judge allowed the lien of CPN, in the amount of $24,920.00, along with interest and penalties. The defendants sought reconsideration of the decision, arguing that the lien claimant did not meet its burden of proving that the transportation it provided was reasonable medical treatment, that the claimed transportation was outside of

Ronald Sousa, vs. United Airlines; Gallagher Bassett, Inc.,

In this case, Ronald Sousa, an aircraft mechanic, was found to have sustained industrial injuries to his right knee on February 13, 1997, his right knee on September 14, 1999, and his left shoulder on October 25, 2002. The Workers’ Compensation Appeals Board granted reconsideration of a workers’ compensation administrative law judge’s (“WCJ”) Findings and Order of October 21, 2008, wherein the WCJ affirmed the April 25, 2008 Determination of the Division of Workers’ Compensation Rehabilitation Unit (“RU”) which found that retroactive vocational rehabilitation maintenance allowance (“VRMA”) was due from the permanent and stationary date of 8/25/04. The defendant argued that there was no medical opinion expressing that applicant was

Mario Chavez-pineda, vs. Cor-o-van/employers Leasing Co., St. Paul/travelers Insurance,

This case involves a worker’s compensation dispute between Mario Chavez-Pineda, the applicant, and Cor-O-Van/Employers Leasing Co. and St. Paul/Travelers Insurance, the defendants. The applicant sustained an industrial injury to his back, right lower extremity, and right knee on June 22, 2005, while employed as a mover. The defendants sought to terminate their liability for continuing temporary disability, citing the opinion of a panel Qualified Medical Evaluator (QME) that the applicant was permanent and stationary. The Workers’ Compensation Appeals Board granted reconsideration to amend the findings of fact with regard to the defendant’s liability for temporary disability, rescind the award of interim attorney fees, and return the matter for

Michael Coyer, vs. County Of San Bernardino, permissibly Self-insured,

This case is about Michael Coyer, a firefighter employed by the County of San Bernardino, who claimed to have sustained an industrial injury to his back and spinal cord while on paid administrative leave. After trial, the Workers’ Compensation Appeals Board granted the defendant’s petition for reconsideration and ultimately found that Coyer did not sustain an injury arising out of and in the course of his employment. The Board found that Coyer’s attempt to protect his roof was a personal undertaking, unrelated to his responsibilities as a firefighter, and thus his injury did not arise out of his employment.

JOEY M. COSTA, vs. HARDY DIAGNOSTIC And STATE COMPENSATION INSURANCE FUND,

This case involves a dispute between Joey M. Costa, the applicant, and Hardy Diagnostic and State Compensation Insurance Fund, the defendant, over the reimbursement of costs for the testimony and report of a vocational rehabilitation expert. The Appeals Board granted reconsideration in order to further study the factual and legal issues and ultimately reversed the WCJ’s decision, allowing the costs of the expert’s testimony and report.

Yvette Whitmer vs. Hi Shear Corporation; Zurich North America; Golden State Foods; Liberty Mutual; Santa Barbara Applied Research,

; ADJ6736155; ADJ7147776. In this case, Yvette Whitmer sought reconsideration of the September 28, 2010 Opinion and Order Granting Reconsideration and Decision After Reconsideration, which granted reconsideration and reversed the July 7, 2010 Findings of Fact issued by the workers’ compensation administrative law judge. The court denied the petition for reconsideration, finding that Whitmer’s claims were non-compensable, post-termination claims pursuant to Labor Code section 3600(aX10).

Kenneth Grom vs. Shasta Wood Products; And State Compensation Insurance Fund

In this case, Kenneth Grom was awarded medical treatment in the form of testosterone cream therapy to counteract the decrease in his testosterone levels due to his opiate medications. The defendant, Shasta Wood Products, argued that the treatment was not necessary to cure and relieve him from the effects of his industrial injury. The Workers’ Compensation Appeals Board held that the treatment was reasonable and necessary to cure and/or relieve him from the effects of his industrial injury, and affirmed the WCJ’s determination.

CORNELIO CAMPOS vs. GOURMETS FRESH PASTA; GALLAGHER BASSETT, INC.

GOURMETS FRESH PASTA; GALLAGHER BASSETT, INC. CORNELIO CAMPOS WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIACORNELIO CAMPOS, Applicantvs.GOURMETS FRESH PASTA; GALLAGHER BASSETT, INC., DefendantCase No. ADJ7873223(Marina del Rey District Office) ORDER DENYING PETITION FOR RECONSIDERATIONThis case involves a worker’s compensation claim filed by Cornelio Campos against Gourmets Fresh Pasta and Gallagher Bassett, Inc. The worker’s compensation administrative law judge (WCJ) recommended that the Petition for Rec

KELLI MCCOO vs. GORDON BIRCH; CALIFORNIA INSURANCE GUARANTEE ASSOCIATION BY ITS SERVICING FACILITY, BROADSPIRE FOR CAL COMP/SUPERIOR NATIONAL INSURANCE COMPANY, IN LIQUIDATION

In this case, Kelli McCoo was the applicant and Gordon Birch and the California Insurance Guarantee Association by its servicing facility, Broadspire for Cal Comp/Superior National Insurance Company, in Liquidation were the defendants. Khosrow Tabaddor, M.D. (lien claimant) sought reconsideration of the Findings and Order (F&O) issued in this case by the workers’ compensation administrative law judge (WCJ) on December 1, 2010. The WCJ found that there was an assignment of lien claimant’s lien to lien representative WSG & Associates (WSG) and that under Insurance Code section 1063.1, subdivision (c) (9) (b), defendant

ROBERTO HERNANDEZ vs. MILL VALLEY SCHOOL DISTRICT, Permissibly Self-insured; SUBSEQUENT INJURIES BENEFITS TRUST FUND

and ADJ2646453 (SRO0133845) is a case in which the Mill Valley School District, a permissibly self-insured entity, and the Subsequent Injuries Benefits Trust Fund (SIBTF) are defendants. The Workers’ Compensation Appeals Board granted the SIBTF’s petition for reconsideration and issued a notice of intention to receive two documents into evidence. The WCJ found that the applicant, Roberto Hernandez, had incurred industrial injuries to his right knee and psyche on July 12, 2004, and to his lumbar spine and psyche on October 12, 2004, while employed as a maintenance worker by Mill Valley, causing 8% and 95% permanent disability, respectively. The WCJ also found that Hernandez was

SYLVIA BOYD vs. SBC/PACIFIC BELL, Permissibly Self-Insured

and ADJ2026118 (AHM0091649) Sylvia Boyd filed a petition for reconsideration against SBC/Pacific Bell, Permissibly Self-Insured. The petition was withdrawn by the petitioner and the case was dismissed by the Workers’ Compensation Appeals Board of California on November 14, 2012.

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