Air Ambulance En Banc Decision Denied Writ of Review: Cal. Comp. Cases September Advanced Postings (9/11/2013)

Air Ambulance En Banc Decision Denied Writ of Review: Cal. Comp. Cases September Advanced Postings (9/11/2013)

The following are advanced postings for the September 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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Zenith Insurance Company, insurer for Couto Dairy, Petitioner v. Workers' Compensation Appeals Board, Luis Enriquez (Dec'd), Respondents, 2013 Cal. Wrk. Comp. LEXIS 138 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 138 (Lexis Advance)

Air Ambulance—Preemption of State Regulation—Official Medical Fee Schedule—WCAB en banc, rescinding WCJ’s decision, held that (1) neither California Constitution Art. III, § 3.5, nor Labor Code § 5307.1 prevents WCAB from finding preemption of 8 Cal. Code Reg. § 9789.70, which contains official medical fee schedule for air ambulance services, (2) federal airline deregulation act of 1978 preempts that regulation if lien claimant for air ambulance services is …

Aramark Uniform Services, Ace American Insurance Company, adjusted by Sedgwick, Petitioners v. Workers' Compensation Appeals Board, Joshua Grossman, Respondents, 2013 Cal. Wrk. Comp. LEXIS 134 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 134 (Lexis Advance)

Medical Provider Networks—Liability for Self-Procured Treatment—WCAB affirmed its prior decision [see Grossman v. Aramark Uniform Service, 2013 Cal. Wrk. Comp. P.D. LEXIS 1], holding that lien claimant was entitled to reimbursement on its lien for medical treatment self-procured by applicant outside defendant’s Medical Provider Network, when WCAB found that (1) defendant’s assertion that it “substantially complied” with Medical Provider Network notice requirements, and that its failure to properly notify applicant that it was transferring his care into defendant’s Medical Provider Network should be excused because its intention to transfer applicant’s care into Medical Provider Network was “glaringly obvious” did not rebut evidence that…

Athens Services, Arch Insurance, administered by Sedgwick CMS, Petitioners v. Workers' Compensation Appeals Board, Ramon Mora, Respondents, 2013 Cal. Wrk. Comp. LEXIS 135 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 135 (Lexis Advance)

Injury AOE/COE—Post-Termination Defense—WCAB held that applicant truck driver sustained specific injury AOE/COE on 10/18/2010 to his left shoulder, back, and psyche from motor vehicle accident, and defendant did not meet burden of proving Labor Code § 3600(a)(10) post-termination defense, when WCAB found that…

Rene Garcia, Petitioner v. Workers' Compensation Appeals Board, City of Anaheim, PSI, Respondents, 2013 Cal. Wrk. Comp. LEXIS 136 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 136 (Lexis Advance)

Permanent Disability—Rating—AMA Guides—WCAB rescinded WCJ’s finding that applicant/firefighter incurred 81 percent permanent disability as result of cumulative trauma injuries to his low back and both knees, when WCAB found that supplemental report and deposition testimony of applicant’s primary treating physician, on which WCJ relied to determine extent of applicant’s permanent disability, did not justify departure from strict application of AMA Guides, because…

United States Fire Insurance Company, insurer for Pelican Products, Inc., Petitioner v. Workers' Compensation Appeals Board, Rosa Palafox, Respondents, 2013 Cal. Wrk. Comp. LEXIS 137 (lexis.com), 2013 Cal. Wrk. Comp. LEXIS 137 (Lexis Advance)

Petitions for Reconsideration—Final Orders—WCAB dismissed defendant’s petition for reconsideration because it was not taken from final order of WCAB, as required by Labor Code § 5900, and WCAB, noting that defense counsel was repeatedly warned not to …

Petitions for Reconsideration—Final Orders—WCAB dismissed defendant’s petition for reconsideration of WCJ’s decision to proceed with trial, as noticed, while defendant’s petition for reconsideration was pending about…