WCPanelIQ
PanelMed-legalLienGranted in Part

Sernas Gomez, Ernesto

ERNESTO SERNAS GOMEZ, Applicant vs. NEIGHBORHOOD ITALIAN CAFE, INC.; MIDCENTURY INSURANCE, administered by FARMERS INSURANCE, Defendants

ADJ number
ADJ15017749
Decision date
Sep 24, 2025
District office
Van Nuys
WCJ
—
Claim administrator
Farmers Insurance (administering Midcentury Insurance)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: multiple body parts (cumulative trauma)

LC §5909LC §5900LC §5813LC §5704CCR §10786CCR §10945CCR §10803CCR §10421CCR §9789.14

Summary

Cost petitioner Physical Rehabilitation Services, Inc. filed a Petition to Resolve a Non-IBR Medical-Legal Dispute seeking payment for reports prepared by Dr. Arbi Mirzaians in connection with applicant's denied cumulative trauma claim, which had resolved by compromise and release. At trial, defendant failed to file its exhibits in EAMS and declined the WCJ's offer of relief conditioned on paying cost petitioner's appearance costs, electing to proceed without evidence; the WCJ awarded payment for three of five reports. The Board granted reconsideration and affirmed, rejecting defendant's request for relief under CCP 473(b) (no affidavit of fault or explanation of neglect) and its Labor Code 5704 rebuttal-evidence argument. However, the Board amended the award to allow a credit for payments defendant made to cost petitioner after the petition was filed but before trial, finding cost petitioner's representative had an affirmative duty to disclose those payments to avoid unjust enrichment through double recovery. The Board also admonished defendant for improperly attaching non-record exhibits to its petition and deferred the sanctions issue to the WCJ.

Issues

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Holding

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Analysis

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Applicant takeaway

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Defense takeaway

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Provider takeaway

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