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

Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ7555409
Regular
Mar 04, 2014

JESUS ESCANUELA vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the defendant's Petition for Reconsideration and dismissed the applicant's untimely petition. The WCAB found that the Agreed Medical Examiner's (AME) opinion regarding psychiatric permanent disability was not supported by substantial evidence, as it did not properly address causation under the current PDRS. Consequently, the case is remanded to the trial level for further development of the record concerning psychiatric permanent disability. The WCAB deferred the issue of permanent disability and attorney's fees pending this further development.

Workers' Compensation Appeals BoardJesus EscanuelaCalifornia Department of Correctionslegally uninsuredState Compensation Insurance FundADJ7555409Fresno District OfficeOpinion and OrderPetition for ReconsiderationFindings and Award
References
Case No. ADJ4225526 (GOL 0092072)
Regular
Apr 20, 2017

JESUS ARROYO vs. JOHN CRAVENS PLASTERING, STATE COMPENSATION INSURANCE FUND

This case involves Jesus Arroyo's petition for reconsideration of a Workers' Compensation Appeals Board decision. The Board denied reconsideration, adopting the reasoning of the workers' compensation administrative law judge. Medical evidence from Dr. Markovitz established that Arroyo suffered a total and permanent disability resulting from industrial injuries, including an aortic aneurysm repair and subsequent strokes. The Board found Dr. Markovitz's opinions constituted substantial medical evidence, despite conflicting defense opinions, and affirmed that all necessary medical care and permanent disability were industrially caused.

Workers' Compensation Appeals BoardJesus ArroyoJohn Cravens PlasteringState Compensation Insurance FundPetition for ReconsiderationAgreed Medical ExaminerGerald Markovitzechocardiogramaortic root dilationexpanding aortic aneurysm
References
Case No. ADJ2010797 (SAC 0296371)
Regular
Oct 06, 2008

GURNAIL SINGH vs. BARRETT BUSINESS SERVICES, INC.

The Board granted reconsideration of the WCJ's award finding industrial injury to multiple body parts, resulting in 71% permanent disability. The Board rescinded the award and returned the matter for further proceedings to correct an erroneous disability rating for atrophy and to recalculate indemnity considering prior payments and credits. Other contentions raised by the defendant were not reached due to the rescission of the award.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationFindings Award and OrderPermissibly Self-Insuredindustrial injurywelderpermanent disabilityPDIlife pensionLabor Code section 4658
References
Case No. ADJ6786593 MF
Regular
Oct 01, 2013

CEICEL MOUSSA, CEICEL MOUSSA ANDRAMOS vs. NBC UNIVERSAL MEDIA, LLC, AMERICAN HOME ASSURANCE COMPANY

The Appeals Board denied defendant's petition for reconsideration of the WCJ's award. The WCJ found applicant sustained industrial injuries to bilateral knees, low back, and psyche in 2002 and 2007-2008, resulting in temporary disability, 71% permanent disability, and future medical treatment. The Board affirmed the WCJ's findings and reasoning, including the need for further proceedings to clarify earnings stipulated at trial.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Order AwardIndustrial InjuryBilateral KneesLow BackPsycheSales ClerkTemporary DisabilityPermanent Disability
References
Case No. GOL 0099340
Regular
May 27, 2008

SARAH FRYE RICE (SARAH RICE-SIŞCO) vs. VONS GROCERY COMPANY

The Workers' Compensation Appeals Board granted reconsideration, rescinding the prior decision. The Board found that Vons Grocery Company was only entitled to credit for $3,485.71 in permanent disability advances as specified in the approved Compromise and Release, not the greater amount unilaterally taken. Consequently, Vons must pay the applicant the full balance of $20,274.29, and the case is returned for further proceedings on penalties and attorney fees.

WORKERS' COMPENSATION APPEALS BOARDSARAH FRYE RICEVONS GROCERY COMPANYGOL 0099340OPINION AND ORDER GRANTING RECONSIDERATIONFINDINGS AND ORDERPERMANENT DISABILITYCOMPROMISE AND RELEASELABOR CODE SECTION 5814ORDER APPROVING COMPROMISE AND RELEASE
References
Case No. ADJ12305682
Regular
Apr 14, 2023

DAVID REED vs. CSR MANAGEMENT SERVICES, STATE COMPENSATION INSURANCE FUND

This case involves CSR Management Services and their insurer seeking reconsideration of a $71\%$ permanent disability award for David Reed. The defendants argued that the qualified medical evaluator, Dr. Brophy, did not sufficiently explain the applicant's scarring impairment. The Workers' Compensation Appeals Board denied the petition, finding Dr. Brophy adequately explained the scarring impairments as Class 1 under the AMA Guides. The Board noted that defendants could have sought further clarification from the evaluator.

CSR Management ServicesState Compensation Insurance FundADJ12305682Petition for ReconsiderationAmended Findings of FactAward and Orderconstruction laborerindustrial injuryupper extremitiesback
References
Case No. ADJ9358203
Regular
Nov 26, 2018

OCTAVIO LEMUS vs. HASA, INC.; COMMERCE & INDUSTRY INSURANCE COMPANY; administered by AIG PROPERTY CASUALTY; INSURANCE COMPANY OF THE WEST

Defendants seek reconsideration of a WCJ's award finding 71% permanent disability for applicant Octavio Lemus, arguing the judge erred by not apportioning disability and by failing to address non-industrial factors identified by a QME. The Appeals Board granted reconsideration, agreeing the record on apportionment was undeveloped and that the EDD lien and other defendant contentions require further consideration. The case is returned to the trial level for further proceedings and a new decision addressing all raised issues, including apportionment.

Workers Compensation Appeals BoardReconsiderationPermanent DisabilityApportionmentCumulative TraumaQualified Medical EvaluatorTemporary DisabilityLife PensionEmployment Development DepartmentLiens
References
Case No. ADJ2493898 (EUR 0033234)
Regular
Jun 28, 2013

KATHY MATHENEY vs. REGIS CORPORATION, LIBERTY MUTUAL INSURANCE COMPANY

This case involves an applicant seeking reconsideration of a Workers' Compensation Appeals Board decision regarding her industrial injury as a cosmetologist. The Board denied the defendant's petition for reconsideration while granting the applicant's petition. The original award of 71% permanent disability, with a life pension, was affirmed and amended to clarify the credit for advances at $3,368.40 and to include "upper back" as an injured body part. The defendant's arguments regarding apportionment and the sufficiency of medical evidence were rejected.

Workers Compensation Appeals BoardRegis CorporationLiberty Mutual Insurance CompanyPetition for ReconsiderationFindings and AwardIndustrial InjuryCervical SpineRadiculopathyShoulder SymptomsRight Upper Extremity
References
Case No. ADJ8203843
Regular
Aug 15, 2016

GARY KUBECK vs. CALETTI JUNGSTEN CONSTRUCTION, AMERICAN ZURICH INSURANCE COMPANY

In this workers' compensation case, the defendant sought reconsideration of the original finding that the applicant sustained $71\%$ permanent disability, arguing the judge improperly rejected the Agreed Medical Evaluator's (AME) apportionment opinion on psychiatric injury. The Board granted reconsideration, amending the award to include $35\%$ non-industrial apportionment to the applicant's psychiatric disability. This resulted in a revised permanent disability award of $68\%$. The Board found the AME's opinion on apportionment constituted substantial medical evidence and was not unpersuasive.

ApportionmentAgreed Medical Evaluator (AME)Psychiatric InjuryPermanent DisabilityFindings and AwardPetition for ReconsiderationIndustrial InjuryNon-industrial ApportionmentCausationSubstantial Medical Evidence
References
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