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DGC’s Robert Diaz de Leon (Ontario) Prevails Against Applicant and CIGA, Saves Client Over $100,000

Faced with a CT injury claim based on an orthopedic AME report and CIGA’S attempt to shift liability to his legally uninsured client, Robert Diaz de Leon went to trial on the issues of injury AOE/COE as to the applicant and “other insurance” as to CIGA.  At stake was significant exposure: to the applicant for a minimum of 28% permanent disability ($26,212) after multiple shoulder surgeries and continuing/future medical treatment; to CIGA for reimbursement of at least $66,881; and to various lien claimants, including EDD, whose lien was about $12,012.00.

Robert was armed with a PQME report by an orthopedist who found no injury caused by the applicant’s concurrent part-time employment with the client, the applicant’s testimony (from CIGA’s two depositions and the deposition taken by Robert) to the effect that she did not have any injury or problems from her job duties with the client, and legal arguments supporting the position that the client was not “other insurance” for CIGA’s purposes.  The WCJ found that the PQME report was better reasoned and more persuasive than the AME’s report (the applicant and CIGA were the parties to the AME in the three specific injury claims against the other employer).  This medical evidence and the applicant’s trial testimony, which was consistent with her deposition testimony, led to the WCJ’s finding that no CT injury resulted from the applicant’s employment with the client.

A “take nothing” was issued. In addition, the WCJ agreed with Robert’s legal argument that the client did not qualify as “other insurance” and found that the legally uninsured employer was not “other insurance” under Insurance Code sec. 1063.1(c)(9).  Therefore, CIGA was not entitled to shift liability to, or obtain reimbursement from, the client.

Neither the applicant nor CIGA filed a petition for reconsideration.

You can read redacted versions of the Amended Minutes of Hearing and Summary of Evidence and Findings of Fact and Opinion on Decision below.

 

Amended Minutes of Hearing and Summary of Evidence:  Click here

Findings of Fact and Opinion on Decision:  Click here

 

Media Contacts:
Company Name:  Dietz, Gilmor & Chazen, APC
Full Name:  David Jankosky, DGC Client Services (818-654-9911, Ex. 1231)
Email Address:  djankosky@dgcattorneys.com

2019-09-26T12:51:19+00:00 September 25th, 2019|News Articles|

DGC’s Jonathan Freeman (Managing Attorney, San Francisco Office) Obtains Take Nothing from Oakland WCAB

On May 29, 2019, DGC attorney Jonathan Freeman obtained a take-nothing decision from the Oakland WCAB.

The claimed injury was filed as a cumulative trauma by an applicant at a tire store, who claimed that he suffered a knee and back injury.  Defendant had no medicals to support the claim and immediately referred the case to DGC because they suspected the motive for the claim was that a co-worker (the applicant’s cousin) at the insured had recently received a substantial settlement for a workers’ compensation case.  The applicant failed to attend a scheduled MPN appointment to assess his medical condition during the delay period.  After deposition of the applicant revealed that he had never missed any time from work and continued to be employed by the insured in a full-duty capacity, Jonathan Freeman recommended denial based on the lack of a date of injury under Labor Code Sections 5412 and 5500.5(a).

The PQME evaluated the applicant and provided 0% impairment under DRE I, but did state that the applicant’s back problems were due to a combination of repetitive work and degenerative issues.  Applicant demanded stipulations at 0% PD with a lifetime medical award, which defendants refused on the grounds that without compensable permanent disability or compensable temporary disability there could be no date of injury under Labor Code 5412, and without a last day worked there could not be a “last date” upon which the employee was harmfully exposed under Labor Code 5500.5(a).   Jonathan next pushed the case to hearing with a DOR and obtained favorable stipulations when setting the case for trial, including the fact that the case rated 0% and that applicant had missed no time from work.

The matter was submitted for trial on May 29, 2019.  The WCJ ordered that the applicant take nothing.  The decision has not been appealed and is therefore final.

You can read a redacted version of the WCJ’s Findings, Order, and Opinion on Decision below.

 

WCJ’s Findings and Order and Opinion on Decision:  Click here

 

Media Contact:
David Jankosky, Director of Client Services, DGC Attorneys
djankosky@dgcattorneys.com / (818) 654-9911, Ex. 1231

2019-09-25T11:57:50+00:00 August 12th, 2019|News Articles|

Dietz, Gilmor & Chazen Announces Ryan Greer as New Firm Partner

Dietz, Gilmor & Chazen, APC, is proud to announce the promotion of Ryan Greer to firm Partner.

San Diego, CA – 07/17/2019 – Dietz, Gilmor & Chazen, APC, a California statewide law firm practicing exclusively in workers’ compensation defense, subrogation, asbestos, Labor Code §132a, and serious and willful misconduct claims, promotes Ryan Greer, Esq. to Partner.

Ryan Greer, Managing Attorney (Orange County) will continue his leadership as Partner providing outstanding legal representation from our new office in Orange County.

“Our firm is pleased to share this news and recognize Ryan Greer as an exceptional attorney.  Our clients will also be pleased with this announcement,” said Bill Dietz, speaking on behalf of fellow firm Principals Mark Gilmor and Avery Chazen.

About Dietz, Gilmor & Chazen, APC

DGC was established in 1997 and has now grown to eight California Offices, with 42 attorneys, providing defense for insurance carriers, brokers, third-party administrators, private and public employers, and large self-insured groups.  The firm’s guiding principles are based on providing exceptional customer service and legal representation.  DGC provides the expertise needed to reduce claim costs and achieve prompt case resolution.  Please visit the firm’s website for more information at https://dgcattorneys.com

Media Contacts:                                                                                                                      

Company Name: Dietz, Gilmor & Chazen, APC
Full Name: David Jankosky, DGC Client Services (213-278-1513)
Email Address: djankosky@dgcattorneys.com

2019-07-13T08:06:22+00:00 July 17th, 2019|News Articles|

DGC Managing Attorney Jonathan Freeman (San Francisco) Assists In Fraud Conviction with $5,145.65 in Restitution Ordered

On May 8, 2019, having committed insurance fraud by lying about prior injuries and medical treatment to a PQME, an applicant pled no contest in the County of Sonoma to one count of insurance fraud under Insurance Code 1871.4(a)(1).

The applicant had claimed a neck and right shoulder injury via cumulative trauma through October 2015. Prior to the case being referred to DGC, the applicant was evaluated by a PQME. In that evaluation, the applicant falsely stated she had never had prior injuries to her right shoulder or neck and had never been involved in a motor vehicle accident. Based on that history, the PQME issued a report finding PD, with no non-industrial apportionment. Defendants began paying PDAs consistent with the rating. The case was then referred to DGC for finalization of stipulations at 15% PD.

However, when reviewing the file materials provided by the client, it became clear that the applicant had grossly misrepresented her medical and litigation history. She had been involved in a MVA resulting in neck pain in 2003. She had also filed a workers’ compensation claim for her right shoulder in 2006 while working for a different employer and had received substantial medical treatment. The medical records also showed that she had been involved in a MVA about 4 months prior to the industrial injury resulting in a whiplash injury to her neck. The applicant continued treating for the neck injury from the MVA until the day after her alleged work injury, at which time she commenced telling her workers’ compensation evaluators that she did not have prior injuries or symptoms. DGC’s Jonathan Freeman recommended a supplemental report to address apportionment before proceeding with stipulations, and recommended the filing of an FD-1.

After Jonathan cleared a cover letter and provided the PQME with these records, he reduced the rating by finding non-industrial apportionment to all body parts. Defendant by that time had a substantial PD overpayment due to the applicant’s material misrepresentations, and this formed the damages of the fraud case which was filed by the DA’s office in the County of Sonoma.

The applicant stipulated to restitution in the amount of $5,145.65, was sentenced to 75 days in jail with the option of entering a work release program, and was put on probation for 36 months.

You can read the redacted Minute Orders below.

 

Minute Orders – Superior Court of California, County of Sonoma:  Click here

 

Media Contact:
David Jankosky, Director of Client Services, DGC Attorneys
djankosky@dgcattorneys.com / (818) 654-9911, Ex. 1231

2019-09-25T11:58:59+00:00 July 10th, 2019|News Articles|
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