Penalty for Failure to Authorize Plasma Decompression Disc Surgery: Cal. Comp. Cases May Advanced Postings (4/30/2013)

Penalty for Failure to Authorize Plasma Decompression Disc Surgery: Cal. Comp. Cases May Advanced Postings (4/30/2013)

Here’s the second batch of advanced postings for the May 2013 issue of Cal. Comp. Cases.
Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries.
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Turlock City Tow Services, Westport Insurance Corporation, administered by Southland Claims Services, Petitioners v. Workers' Compensation Appeals Board, George Viverios, Respondents, 2013 Cal. Wrk. Comp. LEXIS 63 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 63 (Lexis Advance)
Medical Treatment—Utilization Review—Penalties for Unreasonable Delay—WCAB affirmed WCJ’s award of 15 percent penalty under Labor Code § 5814 and reasonable attorney’s fees under Labor Code § 5814.5 for defendant’s failure to provide plasma decompression disc surgery pursuant to applicant’s medical treatment award for industrial injuries to his left lower extremity, spine, back, and left hip, when applicant’s treating physician issued report on 2/11/2009 requesting authorization to perform plasma decompression disc surgery, defendant failed to authorize procedure even after WCAB found that defendant was liable to provide surgery based on defendant’s failure to adhere to spinal surgery second opinion procedure in Labor Code § 4062(b) and Cervantes v. El Aguila Food Products, Inc. (2009) 74 Cal. Comp. Cases 1336 (Appeals Board en banc opinion), and WCAB held that…
Baltazar Blackwood, Petitioner v. Workers' Compensation Appeals Board, Timec/Welltec, Zurich North America, Respondents, 2013 Cal. Wrk. Comp. LEXIS 55 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 55 (Lexis Advance)
Injury AOE/COE—Presumption of Compensability—WCAB held that presumption of compensability of Labor Code § 5402(b) did not apply to claim of industrial injury from 1/15/2002 through 7/20/2007 because applicant general laborer/safety attendant did not satisfy burden of proving that claim form was filed with employer, and, alternatively, WCAB held that…
Concentra Managed Care, c/o Travelers Property Casualty Company of America, Petitioner v. Workers' Compensation Appeals Board, California Insurance Guarantee Association, on behalf of Atlantic Mutual Insurance Company, in liquidation, (Susan Virdier), Respondents, 2013 Cal. Wrk. Comp. LEXIS 56 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 56 (Lexis Advance)
California Insurance Guarantee Association—Covered Claims—Other Insurance—WCAB held that employer’s insurance with petitioner Travelers constituted “other insurance” within meaning of Insurance Code § 1063.1(c)(9) such that WCAB ordered Travelers to administer applicant’s medical treatment award for cumulative trauma industrial injury and relieved California Insurance Guarantee Association of liability for administering same award, when WCAB found that…
County of Los Angeles, PSI, Acclamation Insurance Management Services, Petitioners v. Workers' Compensation Appeals Board, Myrna Medina, Respondents, 2013 Cal. Wrk. Comp. LEXIS 57 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 57 (Lexis Advance)
Injury AOE/COE—WCAB held that applicant eligibility worker sustained injury AOE/COE to her neck and right shoulder, elbow, wrist, and hand, based on…
Due Process—WCAB held that defendant waived issue of violation of its due process rights by not raising issue at trial, and that, alternatively, even if issue was timely raised, there was no violation of defendant’s due process rights, when…
Sara Gamez, Petitioner v. Workers' Compensation Appeals Board, Action Awnings, Inc., State Compensation Insurance Fund, Respondents, 2013 Cal. Wrk. Comp. LEXIS 58 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 58 (Lexis Advance)
Petitions for Writ for Review—Final Orders—Court of Appeal denied without prejudice to refile petition for writ of review of non-final decision in which WCAB rescinded WCJ’s decision, issued new decision on some issues, and remanded for…
Roberto Manzo, Petitioner v. Workers' Compensation Appeals Board, McCarthy Building Companies, Chartis, administered by Gallagher Bassett, Respondents, 2013 Cal. Wrk. Comp. LEXIS 59 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 59 (Lexis Advance)
Discrimination—Labor Code § 132a—WCAB held that employer did not discriminate against applicant carpenter in violation of Labor Code § 132a by 4/11/2008 lay off, when WCAB found that…
Peggy Miller, Petitioner v. Workers' Compensation Appeals Board, State of California/Department of Mental Health, State Compensation Insurance Fund, adjusting agent, Respondents, 2013 Cal. Wrk. Comp. LEXIS 60 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 60 (Lexis Advance)
Petitions for Writ for Review—Final Orders—Court of Appeal denied petition for writ of review because petition was appealing non-final WCAB order, citing Labor Code § 5950 and Maranian v. W.C.A.B. (2000) 81 Cal. App. 4th 1068, 97 Cal. Rptr. 2d 418, 65 Cal. Comp. Cases 650, when WCAB ordered …
Robert Reed, Petitioner v. Workers' Compensation Appeals Board, Warner Bros. Entertainment, Inc., PSI, Respondents, 2013 Cal. Wrk. Comp. LEXIS 61 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 61 (Lexis Advance)
Injury AOE/COE—WCAB held that applicant laborer sustained injury AOE/COE on 1/20/2006 and 3/21/2007 to his left knee but not to his back, right knee, or in form of sleep disorder, based on opinions from orthopedic agreed medical evaluator in reports and deposition testimony, when WCAB found that…
Sylvia Thomas, Petitioner v. Workers' Compensation Appeals Board, State of California/Department of Parks and Recreation, legally uninsured, adjusted by State Compensation Insurance Fund, Respondents, 2013 Cal. Wrk. Comp. LEXIS 62 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 62 (Lexis Advance)
Statute of Limitations—WCAB held that applicant financial examiner’s claim for injury AOE/COE to left ankle on 7/12/89 was barred under Labor Code § 5404 because applicant did not…
Injury AOE/COE—Benefits—WCAB held that applicant sustained admitted injury AOE/COE on 8/12/93 to her right knee and left ankle and awarded one-half percent permanent disability for…
Injury AOE/COE—Benefits—WCAB held that applicant sustained admitted injury AOE/COE on 4/11/94 to her back, neck, right knee, and in form of… 

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