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Cases pending on appellate grants

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Cases pending on appellate grants

Gaona, R B271987 ADJ7170139 Writ issued 7/18/2016

-- Whether the Board correctly (1) dismissed reconsideration and denied removal of defendant’s motion to strike a psychiatric AME’s report based on an ex parte communication by applicant’s attorney, when applicant caused to be served on the psyche AME, without prior notice to defendant, a pain management specialist’s report that previously had been requested by the AME but ignored by defendant; and (2) found that defendant waived its objection to the communication by its subsequent agreement to serve the orthopedic AME with the pain specialist’s report and the psyche AME report.

Romo, P. A147582 ADJ8778127 Writ issued 7/8/2016

-- Whether the Board correctly found that a firefighter who last worked for a fire protection district in 1991 was an active volunteer within the meaning of Labor Code sections 3212.1 and 3361, and that the firefighter was entitled to the industrial cancer presumption of section 3212.1 where he was not diagnosed until 2011 and where he “last worked in specified capacity” for other fire departments from 2002 to the present.

Gage, R. C081618 ADJ8010054 Writ issued 5/19/2016

-- Whether the Board correctly concluded that disability retirement advances to peace officers under Labor Code § 4850.4 do not constitute “compensation” within the meaning of Labor Code § 3207 and thus, are not subject to penalty for delay in payment under Labor Code § 5814.

Sylves, P. E065688 ADJ9538021 Writ issued 4/27/2016

-- Whether the Board correctly concluded that a former peace officer’s claim of cumulative injury to various body parts was not barred by the Statute of Limitations and was subject to the Labor Code § 3213.2 presumption of low back injury, notwithstanding the peace officer’s post-retirement employment as a police officer for a federally-recognized Native American tribe.

Baker, J. C080895 ADJ8111772 Writ issued 4/8/2016

-- Whether the Board correctly concluded that the time periods in Labor Code § 4610.6(d) are directory and not mandatory, and if they are mandatory, whether an untimely IMR determination  removes the dispute from the Labor Code § 4610.5 IMR appeals process and allows it to be determined by the WCAB under Labor Code § 4604.

Ortega, H. B269619 ADJ9708932 Writ issued 3/17/2016

-- Whether the Board correctly concluded that applicant’s claim of injury in 2007 is barred by the one-year statute of limitation of Labor Code section 5405, where applicant did not introduce into evidence an Application for Adjudication of Claim date-stamped July 1, 2010, and where applicant had full notice of his workers’ compensation rights no later than December 2010 but did not file an Amended Application until November 2014.

Margaris, D. B269038 ADJ9397913 Writ issued 3/11/2016

-- Whether the Board correctly concluded that the Lab. Code § 4610.6(d) requirement that the Independent Medical Review (IMR) organization “make its determination in writing…within 30 days of the receipt of the request for review and supporting documentation” is mandatory, and whether the Board correctly concluded that it had authority to determine the reasonableness and necessity of the medical treatment at issue because the IMR organization’s determination was not made within the 30-day deadline.

Hernandez, A. B268700 ADJ1646469 Writ issued 2/26/2016

-- Whether the Board correctly concluded that a California Highway Patrol officer who in 2013 obtained an award of temporary disability indemnity at $881.56 per week for five months in 2011 was paid in conformity with Labor Code section 4800.5, in that he was provided a leave of absence without loss of salary for that period, and whether the Board correctly denied the officer’s claims that he had not been paid in full and that the Highway Patrol violated Labor Code sections 3751 and 3752 by using the officer’s annual leave to satisfy workers’ compensation benefits.

Kwok, N. B268231 ADJ8464986 Writ issued 2/5/2016

-- Whether the Board correctly concluded that the claim of an injured employee, who is in a vegetative state due to a restaurant accident that occurred in 2005, is not barred by the Statute of Limitations or by laches where the claim was not served upon the employer’s insurer until 2012, and whether the case should be remanded to an arbitrator (through the WCAB) to determine under Labor Code section 5275(a) whether there is coverage by the employer’s insurer and whether laches relieves the insurer of liability.

Zuniga, S. A143290 ADJ2563341 Writ issued 2/3/2016

-- Whether the Board correctly concluded that Labor Code 4610.6(f), which provides in part that “the independent medical review organization shall keep the names of the reviewers confidential in all communications with entities or individuals outside the independent medical review organization,” does not deny due process to an injured employee who seeks to obtain medical treatment under Labor Code 4600.

Dreher, M. A146538 ADJ7050835 Writ issued 12/10/2015

-- Whether the Board correctly found that a claimed psychiatric injury resulting from a slip-and-fall injury sustained by an applicant who was employed by his employer for less than six months is not barred by Labor Code section 3208.3(d)’s provision that no compensation shall be paid for a psychiatric injury related to a claim against an employer unless the employee has been employed by that employer for at least six months, unless the psychiatric injury is caused by a sudden and extraordinary employment condition.

Rodas, C. B266633 ADJ8899793 Writ issued 11/12/2015

-- Whether the Board correctly found that the death of a dishwasher who had a history of tuberculosis and was found dead from pulmonary hemorrhaging near a trash can and dumpster in his employer-restaurant’s parking lot, did not arise out of and occur in the course of employment.

Lopez, R. S227995
B263869
ADJ7167333 Supreme Court granted, transferred to
Court of Appeal 9/30/15, writ issued 10/28/15

-- -- Whether the Board erred in concluding that the California Insurance Guarantee Association is bound by a pre-liquidation stipulation between its bankrupt insurer and a solvent insurer re: contribution.

Southard, S. C079912 ADJ218782 Writ issued 10/2/2015

-- Whether the Board correctly concluded that the time periods in Labor Code section 4610.6(d) are mandatory, and that if an IMR determination is not timely issued, the treatment dispute is not covered by Labor Code section 4610.5 and may be determined by the WCAB under Labor Code section 4604.

Ramirez, D. C078440 ADJ6821103 Writ issued 5/13/2015

-- Whether the Utilization Review (UR) and Independent Medical Review (IMR) process that resulted in denial of acupuncture treatments for a lower extremity injury under existing award violates the workers' compensation provisions of the California Constitution (Art. XIV, § 4) and applicant's right to due process under the California and U.S. Constitutions.

Rice, C. C078706 ADJ8701916 Writ issued 4/30/2015

-- Whether the Board erred in rejecting the apportionment opinion of the panel Qualified Medical Evaluator, who found that 49% of the injured police officer’s neck disability was caused by genetic predisposition to degenerative disc disease, as demonstrated by his father’s medical history.

Stevens, F. A143043 ADJ1526353 Writ issued 12/3/2014

-- Whether Independent Medical Review under Lab. Code §§ 4610.5 & 4610.6, as instituted by the Legislature through Senate Bill 863, violates the injured employee's right to due process and the workers' compensation and separation of powers clauses of the California Constitution.

July 2016