Borja, Pablo

Applicant Pablo Borja filed a cumulative trauma claim (lumbar spine, both knees, eyes) against American Integrated Services, insured by Starr Indemnity (administered by Gallagher Bassett). The dispute arose on a lien filed by Joyce Altman Interpreters and turned on whether the CT claim was timely denied, whether the FMR medical report constituted substantial medical evidence of AOE/COE, and whether defendant's continued denial warranted sanctions. The WCJ found the claim was not timely denied (denial issued May 13, 2022, well beyond 90 days from service of the claim form on July 27, 2021), triggering the presumption of compensability under Labor Code section 5402, which defendant failed to rebut with any contrary evidence; the WCJ further found injury AOE/COE was independently supported by substantial medical evidence and that defendant's meritless denial constituted bad-faith conduct sanctionable under section 5813. The Appeals Board adopted and incorporated the WCJ's report and denied reconsideration, also addressing the timeliness of its own action under the amended Labor Code section 5909.