04/03/2024
Category: Profile
04/01/2024
applicant the burden of proof shifts to the employer to show good cause for the
6
delay. Ramirez v. WCAB 1970 35 CCC 383; Waters v. WCAB 2000 65 CCC
484; Kamel v. West Cliff Medical 2001 66 CCC 1521 appeals board en banc.
The employer must provide a satisfactory explanation of reasonable delay
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in Ramirez v. Workers Comp. Appeals Bd. Ramirez 2017 10 Cal.App.5th 205 223 82
Cal.Comp.Cases 327 other than timeliness any deficiency in UR is reviewed by independent
medical review and not by the WCAB. Defects in UR are not tendered directly to the WCAB.
Rather UR decisions are
Category: Panel
04/01/2024
WORKERS COMPENSATION APPEALS BOARD
STATE OF CALIFORNIA
YOLANDA RAMIREZ Applicant
vs.
SWAT FAME INC.; ZURICH AMERICAN INSURANCE COMPANY Defendants
Adjudication Number ADJ12901263
Pomona District Office
OPINION AND DECISION
AFTER RECONSIDERATION
We previously granted reconsideration in order
Category: Panel
03/18/2024
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03/01/2024
THE ABOVE DATE ON THE PERSONS LISTED BELOW AT
THEIR ADDRESSES SHOWN ON THE CURRENT OFFICIAL ADDRESS RECORD.
TAMMY MCLEMORE
THE RAMIREZ FIRM
COUNTY COUNSEL SAN BERNARDINO
LNpm
I certify that I affixed the official seal of
the Workers Compensation Appeals
Board to this original decision on this
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selected Michael Tooke M.D. to act as the Qualified Medical Evaluator
QME. The parties have also obtained vocational expert reporting from P. Steve Ramirez for the
applicant and Scott Simon for the defendant.
On September 12 2023 the parties proceeded to trial and framed issues in relevant part
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the WCJs finding in ADJ12131247 that
applicant did not sustain industrial injury to his lumbar spine on October 15 2018. Upon reconsideration however
the Appeals Board is not limited to consideration of the issues defined by the parties. See Ramirez v. Workers' Comp.
Appeals Bd. 2017 10 Cal
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the following
Meals are remuneration if the employee is provided with meals in exchange for
services and the meals are an economic advantage to applicant. For example in
Watson v. Workers Comp. Appeals Bd. Ramirez 1980 45 Cal.Comp.Cases 50
writ den. the value of meals were included in
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02/01/2024
treatments during discussions surrounding settlement of the home
modification issue.
In this regard we observe that Ramirez v. Workers' Comp. Appeals Bd. 1970 10
Cal.App.3d 227 35 Cal.Comp.Cases 383 states
Upon notice or knowledge of a claimed industrial injury an employer has both the
right and duty
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