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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. LAO 0848876
Regular
Dec 27, 2007

MARIA MURILLO vs. HI POINT/NORCO RANCH, REPUBLIC INSURANCE by CRAWFORD AND COMPANY

The Workers' Compensation Appeals Board (WCAB) determined that a diskectomy is not an amputation under Labor Code section 4656(c)(2)(C), limiting temporary disability to 104 weeks. The WCAB affirmed the finding that temporary disability should have been paid from October 6, 2006, to November 24, 2006, but reversed the decision to extend benefits beyond the statutory 104-week limit due to a delay in authorizing surgery. Therefore, the applicant is entitled to additional temporary disability indemnity only for the specified period, with the last payment due November 24, 2006.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardMachine operatorIndustrial injuryBilateral shouldersBack injuryTemporary disability indemnityLabor Code section 4656Amputation
References
Case No. ADJ10649068
Regular
Dec 08, 2017

PATRICK TERRY (Dec'd), WENDY TERRY (Widow) vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

This case involves a widow's claim for death benefits after her husband died from an injury that contributed to his death. The Workers' Compensation Appeals Board denied reconsideration, upholding the administrative law judge's finding that the claim was barred by Labor Code section 5406(b). This statute prohibits death benefit claims filed more than 240 weeks from the "date of injury." The Board clarified that for a specific injury, the date of injury is fixed and cannot be extended to the date of death, even if death is a consequence of that injury. Therefore, the widow's claim was dismissed because it was filed beyond the 240-week statutory limit.

Labor Code ยง 5406(b)death benefits240-week limitationdate of injuryspecific injurycompensable consequencestatute of limitationsPetition for ReconsiderationWorkers' Compensation Appeals BoardFindings and Award
References
Case No. ADJ9895453
Regular
Aug 21, 2017

SIR WALTERS (Dec'd), AMORN WALTERS (Widow) vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded an earlier award. The WCAB found that the death certificate alone was insufficient substantial medical evidence to establish the cause of the decedent's death, specifically concerning whether it was due to an industrial injury, a blood-borne infectious disease, or MRSA. Therefore, the case was returned to the trial level for further proceedings and development of the record. The issue of the applicable statute of limitations remains deferred pending this further evidence.

Valley FeverCoccidioidomycosisCocci meningitisMRSACorrectional officerDeath benefitsStatute of limitations240-week limitation420-week limitationLabor Code 3212.8
References
Case No. LAO 0854553
Regular
Oct 01, 2007

DANIEL A. LONG vs. RYANS EXPRESS MOTORCOACH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration, upholding the finding that the applicant's temporary disability payments for a right shoulder injury terminated on February 28, 2007. The Board ruled that the surgical removal of a distal clavicle spur does not constitute an "amputation" under Labor Code Section 4656(c)(2), which requires severance of an external body part. Therefore, the applicant is not entitled to extended temporary disability benefits beyond the statutory 104-week limit.

Distal clavicleAmputation exceptionSection 4656(c)(2)Temporary disability termination104-week limitation240-week limitationRight shoulder surgeryRotator cuff tearJacob Tauber M.D.Hawkins v. Amberwood Products
References
Case No. SRO 0135735
Regular
Nov 06, 2007

ROBERT ANUSEWICZ vs. JOINT INDUSTRY BOARD OF PLUMBING, dba KONOCTI HARBOR INN AND RESORT, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's entitlement to temporary disability indemnity beyond the standard 104-week limit. The Appeals Board rescinded the prior award, ruling that the applicant's hip and knee replacement surgeries did not constitute "amputations" as defined by Labor Code section 4656(c)(2)(C). Therefore, the applicant is limited to 104 weeks of temporary disability indemnity from the commencement of payments, precluding indemnity beyond January 31, 2007.

Workers' Compensation Appeals BoardRobert AnusewiczJoint Industry Board of PlumbingKonocti Harbor Inn and ResortState Compensation Insurance FundSRO 0135735Opinion and Decision After Reconsiderationtemporary disability indemnityindustrial injuryleft knee
References
Case No. ADJ7432904
Regular
Sep 24, 2012

NEDA MOTAVAKEL vs. FANTASTIC SAM'S, TOWER SELECT INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, STAR INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, ENDURANCE WORKERS' COMPENSATION, SOUTHERN INSURANCE CO., FIRSTCOMP OMAHA

This case involves an appeal by Star and Tower Insurance Companies regarding a workers' compensation award. The primary issue is the applicant's average weekly earnings, specifically the inclusion of tip income, which was not adequately substantiated by documentary evidence. The Appeals Board found the initial decision lacked substantial evidence regarding earnings and rescinded the award. The matter is remanded for further proceedings to properly develop the evidentiary record on earnings and insurance coverage dates before a new decision is issued.

Workers' Compensation Appeals BoardNeda MotavakelFantastic Sam'sTower Select Insurance CompanyStar Insurance CompanyIllinois Midwest Insurance AgencyLLEndurance Workers' CompensationSouthern Insurance CompanyFirstComp Omaha
References
Case No. ADJ3722656 (BAK 0145213)
Regular
Jul 24, 2014

WILLIAM CASTO vs. GENE WATSON CONSTRUCTION, COMMERCE & INDUSTRY INSURANCE COMPANY BY CHARTIS

This case concerns an applicant suffering severe burns who sought further temporary disability (TD) indemnity after the initial award expired. The Appeals Board overturned the WCJ's 104-week TD cap, finding the 240-week cap for severe burns applicable, extending TD entitlement to August 6, 2007. The Board also adopted the WCJ's calculation of the third-party credit but clarified its application based on the established total civil damages and defendant's comparative negligence. Consequently, the award was amended to reflect the extended TD period and the 240-week statutory cap.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary Disability IndemnityPermanent and StationaryLabor Code Section 4656104-week cap240-week capSevere BurnsSubstantial EvidenceMedical Opinion
References
Case No. ADJ2212690 (RIV 048643)
Regular
Mar 20, 2009

JAMIE WOLDEN (deceased), PATRICIA WOLDEN, individually and as guardian ad litem for DAVID EYLER and ANITA WOLDEN vs. BRIGHT DEVELOPMENT, STATE COMPENSATION INSURANCE FUND

This case involves a widow seeking death benefits for her husband, who died from a multi-drug intoxication more than 240 weeks after his industrial injury. The Workers' Compensation Appeals Board denied reconsideration, upholding the administrative law judge's finding that the death benefit claim was untimely. The Board relied on *Massey v. Workers' Comp. Appeals Bd.*, holding that the 240-week period from the date of injury is a prerequisite for death benefits, which had expired before the decedent's death. Therefore, no death benefit claim could arise, and the applicant's claim was properly disallowed.

Death benefitsLabor Code section 5406(c)240-week limitationdate of injurydate of deathindustrial injurypermanent disabilitymedical treatmentprescription drugsmulti-drug intoxication
References
Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ7383066
Regular
Apr 18, 2012

FRANK LOCKETT, Deceased SARAH LOCKETT, Widow vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board denied reconsideration of the decision barring the widow's death benefits claim. The Board adopted the Administrative Law Judge's report, which found the claim untimely under Labor Code Section 5406. This was because the deceased employee had previously stipulated to an injury date, and his death occurred more than 240 weeks after that date. The applicant's petition for reconsideration failed to provide specific record references as required by WCAB Rule 10842(b).

Labor Code Section 5406Death ClaimStatute of LimitationsIntervivos Determination240-Week RuleCumulative TraumaCardiovascular InjuryPulmonary EmbolismDependent's RightsLatent Disease
References
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