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

Case No. AHM 0093643
Regular
Nov 07, 2007

RUBEN DE LA TORRE vs. ST. JUDE HOSPITAL; Permissibly Self-Insured

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration, upholding the Administrative Law Judge's (ALJ) finding that the applicant was not credible and did not sustain an injury arising out of and in the course of employment (AOE/COE). The ALJ's report, which the Board adopted, emphasized the applicant's lack of credibility, failure to disclose pre-existing conditions, and the credibility of defense witnesses and medical evidence. The Board gave great weight to the ALJ's credibility findings.

Petition for ReconsiderationWCJ ReportApplicant CredibilityInjury AOE/COEPermissibly Self-InsuredWorkers' Compensation Appeals BoardGarza v. Workmen's Comp. Appeals Bd.Pro PerFindings & OrderMedical Evidence
References
Case No. SAL 0113062
Regular
Jan 02, 2008

, Maria LOURDES TAPIA, vs. REGENT ASSISTED LIVING, ALASKA NATIONAL INSURANCE

The Workers' Compensation Appeals Board denied reconsideration of a decision upholding a 24-visit limit for chiropractic treatment per industrial injury. The applicant argued that the statutory cap conflicted with the liberal construction mandate of Labor Code section 3202, but the Board found no ambiguity in the clear language of Labor Code section 4604.5(d)(1). The Board further clarified that the provision allowing employers to authorize additional visits in writing (LC 4604.5(d)(2)) did not remove the cap, nor did it render chiropractors meaningless within the workers' compensation system.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code Section 4604.5(d)(1)chiropractic visitsoccupational therapyphysical therapyLiberal constructionLabor Code Section 3202employer authorizationFindings & Order
References
Case No. ADJ7811907
Regular
Jul 10, 2017

KYLE PIKE vs. COUNTY OF SAN DIEGO

The Workers' Compensation Appeals Board denied the County of San Diego's petition for reconsideration, affirming an award of temporary disability and salary continuation benefits to Kyle Pike. Despite the benefits extending beyond five years from the injury date, the Board found applicant's temporary disability commenced within that period and was limited to 104 weeks. This decision aligns with a judicial interpretation that allows such awards when a timely petition to reopen is filed and benefits begin within the statutory five-year window. The dissenting opinion argued that Labor Code section 4656(c)(2) strictly prohibits temporary disability payments beyond five years from the injury date for injuries after January 1, 2008.

Labor Code section 4850temporary disability benefitsPetition to ReopenLabor Code section 4656(c)(2)five-year limitation104 weeksDeputy Sheriff Detentiondate of injurycontinuing jurisdictionnew and further disability
References
Case No. ADJ8501790
Regular
Jul 29, 2015

Kelly Chase vs. St. Louis Blues Hockey Club, Federal Insurance Company

The Workers' Compensation Appeals Board (WCAB) reversed a prior finding of industrial injury for a professional hockey player against the St. Louis Blues. The WCAB found insufficient connection to California for jurisdiction, citing the player's limited games in the state compared to his overall career. This decision followed the precedent set in *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)*, which requires a legitimate and substantial connection to the state for jurisdiction. The WCAB concluded that 21 games out of 485 did not meet this standard for a cumulative injury claim.

WCABSt. Louis Blues Hockey ClubFederal Insurance CompanyADJ8501790Opinion and Decision After Reconsiderationcumulative industrial injuryprofessional hockey playersubject matter jurisdictionstatute of limitationssubstantial medical evidence
References
Case No. ADJ8552834
Regular
Aug 24, 2015

JOHN SKORUPAN vs. NEW YORK GIANTS, ACE USA INSURANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to clarify its jurisdiction over applicant John Skorupan's cumulative industrial injury claim against the New York Giants. The WCAB affirmed the administrative law judge's (ALJ) finding that while the WCAB has personal jurisdiction, California lacks a legitimate and substantial interest to exercise jurisdiction over the claim, citing the *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)* precedent. This decision hinges on the applicant's minimal California contacts (5 games out of 141 played) not establishing a sufficient connection for due process. Commissioner Sweeney dissented, arguing that the applicant's more than de minimis exposure in California and the state's public policy of protecting injured workers should support jurisdiction.

Workers' Compensation Appeals Boardcumulative industrial injuryprofessional athleteoutside linebackerspecial teamsFederal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)de minimis California contactsconstitutional due processPetition for ReconsiderationWCJ
References
Case No. ADJ1577836
Regular
May 04, 2009

JESUS GAVINO-REMIGIO vs. STRATUS SERVICES GROUP, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant injured when stepping on a metal hook, sustaining an admitted industrial injury to his right foot. The applicant sought reconsideration after the Workers' Compensation Judge (WCJ) denied findings that the injury also affected his internal systems (diabetes), eyes, and psyche, along with associated disability. The Board denied reconsideration, finding the defendant's medical expert's opinion on non-industrial diabetes causation to be substantial evidence, while deeming the applicant's medical experts' opinions insufficient. A dissenting commissioner argued the applicant's medical evidence sufficiently supported industrial causation for diabetes aggravation, warranting reconsideration.

Workers' Compensation Appeals Boardindustrial injuryright footinternal systemseyespsychediabetes mellituspermanent disabilitytemporary disabilityGerald Markovitz M.D.
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. ADJ9350015
Regular
Feb 24, 2017

LAURA SIERRA vs. RUIZ CONTRACTING, STAR INSURANCE COMPANY, Administered by MEADOWBROOKS INSURANCE GROUP, ICW

The Workers' Compensation Appeals Board denied Star Insurance Company's petition for reconsideration. The Board found that Star Insurance failed to meet its burden of proof by a preponderance of the evidence to establish entitlement to contribution. Furthermore, the petition did not adequately explain why new medical evidence was unavailable prior to the close of discovery. Therefore, the petition was denied.

Petition for ReconsiderationArbitrator's ReportBurden of ProofAffirmative of the IssuePreponderance of the EvidenceSubstantial EvidenceMedical OpinionReasonable Medical ProbabilityInadequate Medical HistoriesCumulative Trauma
References
Case No. ADJ10721346 ADJ10568270
Regular
Nov 30, 2018

GERALDINE PEREYRA vs. SAGE HUMPHRIES, D.D.S., STATE FARM INSURANCE

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The applicant alleged injury from carrying a sterilization machine, but the administrative law judge found her testimony not credible, particularly after hearing conflicting testimony from Dr. Do. The Board deferred to the judge's credibility determination due to his opportunity to observe the witnesses. Therefore, the applicant failed to prove her injury arose out of and in the course of employment.

WCABPetition for ReconsiderationFindings and OrderADJ10721346ADJ10568270injury arising out of and in the course of employmentcredibilityQualified Medical ExaminerAgreed Medical Evaluatorsterilization machine
References
Case No. ADJ7224294; ADJ6597177
Regular
Dec 31, 2012

GIOVANNI MENDOZA vs. COBY ELECTRONICS CORP., CHUBB INSURANCE

The Workers' Compensation Appeals Board denied Dr. Nachman Brautbar's petition for reconsideration regarding the disallowance of his lien. The Board affirmed the finding that Dr. Brautbar failed to meet his evidentiary burden to prove the reasonableness and necessity of his services, and that he was not the applicant's treating physician. The Board clarified that lien claimants, like defendants, must prove their case by a preponderance of the evidence, and reliance on outdated case law like *Keifer* is misplaced due to legislative amendments. Furthermore, Dr. Brautbar's failure to appear at conferences and present evidence on raised issues, coupled with procedural errors in his petition, supported the denial.

Lien claimantPetition for ReconsiderationJoint Findings and OrdersWCJindustrial injurypsychelower extremityinternalherniacervical spine
References
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