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

Case No. ADJ834041
Regular
Jan 24, 2011

DAWN DEANS vs. PALMDALE WATER DISTRICT; Permissibly Self-Insured, Administered by ACWA/JPIA

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding 13% permanent disability for the applicant's right elbow and wrist injury. Defendant argued the award was not supported by substantial medical evidence. The Board found the Qualified Medical Evaluator's (PQME) report deficient due to inadequate grip strength testing, misinterpretation of AMA Guides on grip strength differences, and failure to explain why grip loss was the primary rating factor. Consequently, the prior award was rescinded, and the case was returned to the trial level for further medical development and a new decision.

Workers' Compensation Appeals BoardPalmdale Water DistrictPermissibly Self-InsuredACWA/JPIAFindings and AwardPermanent Disability RatingSubstantial Medical EvidenceQualified Medical EvaluatorAMA GuidesGrip Strength
References
11
Case No. ADJ2 186466 (LAO 0872140) ADJ1902141 (LAO 0877542)
Regular
Dec 08, 2015

AMADO URIAS vs. VALLEY COUNTY WATER DISTRICT, ACWA JOINT POWERS INSURANCE AGENCY

The applicant, Amado Urias, sought reconsideration of a Workers' Compensation Appeals Board decision regarding claims for back, internal system, and psychological injuries. The Board agreed to amend the temporary disability end date to May 3, 2007, as stipulated by both parties. However, the Board rescinded findings on permanent disability and attorney fees, remanding the issue of apportionment of the applicant's hypertension impairment back to the trial level for further development of the record. The WCJ's reasoning on vocational expert opinions and psychiatric apportionment was adopted, but Dr. Stewart's apportionment of hypertensive impairment was rejected for failing to meet California's causation-based standard.

Workers' Compensation Appeals BoardAmado UriasValley County Water DistrictACWA Joint Powers Insurance AgencyOpinion and Decision After ReconsiderationAmended Joint Findings Award and Ordervocational expertdiminished future earnings capacityapportionmentpsychiatric disability
References
3
Case No. ADJ6805367
Regular
Feb 07, 2011

DANIEL JACOBS vs. WESTERN MUNICIPAL WATER DISTRICT, ACWA JOINT POWERS INSURANCE AUTHORITY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, affirming the finding that Daniel Jacobs sustained an industrial injury from Disseminated Coccidiomycosis. The Board found substantial evidence supported the original award, based on applicant's credible testimony regarding ongoing excavation and his extensive outdoor work at the 13-acre plant. The Board relied on the expert opinion of Dr. Sweeney, who stated with "very high medical probability" that the applicant's illness was work-related due to prolonged exposure to airborne fungus from disturbed soil. This employment exposed the applicant to a greater risk than the general public, thus meeting the legal standard for industrial causation.

Valley FeverCoccidiomycosisIndustrial InjuryCumulative TraumaExposureMedical ProbabilitySubstantial EvidenceWork SiteExcavationWastewater Reclamation Facility
References
7
Case No. ADJ1337418 (GOL 0091701) ADJ850408 (GOL 0091702)
Regular
May 26, 2009

DAWAYNE MOGENSEN vs. SANTA YNEZ RIVER WATER DISTRICT, ACWA/JOINT POWERS INSURANCE AUTHORITY

This case concerns an applicant's claim for reimbursement for an orthopedic bed following a stipulated award for future medical treatment for industrial neck and back injuries. The applicant's treating physician supported the need for the bed for pain relief and improved sleep. However, the Agreed Medical Evaluator (AME) opined that there was no evidence-based research to support the medical necessity of such a bed, which the majority decision followed. The dissenting opinion argues the AME's opinion was not substantial evidence as it was based on a legally incorrect premise that beds are never compensable, and that the treating physician's recommendation, coupled with the absence of a negative guideline, should have been sufficient.

Workers' Compensation Appeals BoardDawayne MogensenSanta Ynez River Water DistrictACWA/Joint Powers Insurance AuthorityADJ1337418ADJ850408Petition for ReconsiderationFuture Medical TreatmentOrthopedic BedDr. Richard Kahmann
References
10
Case No. ADJ8499859
Regular
Sep 21, 2015

LEOBARDO HERNANDEZ vs. CITY OF SANTA PAULA, JPIA, Administered by YORK RISK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board denied the defendant's Petition for Removal. Removal is an extraordinary remedy, and the Board found no substantial prejudice or irreparable harm if removal was denied. The defendant's due diligence in obtaining a vocational expert report was deferred to the trial judge, who would also consider admitting the report. The Board concluded reconsideration would be an adequate remedy should an adverse decision issue later.

Petition for RemovalWorkers' Compensation Appeals BoardDenial of RemovalSubstantial PrejudiceIrreparable HarmReconsiderationDue DiligenceVocational Expert ReportMandatory Settlement ConferenceDeclaration of Readiness to Proceed
References
4
Case No. MISSING
Regular Panel Decision

Polite v. Casella

Plaintiff Roseann Polite filed a complaint in May 1995, alleging federal and state causes of action against Daniel Casella, Harvey Singer, Lynn Smith, Broome County Department of Social Services (DSS), and Broome County, stemming from the termination of her parental rights. Claims against Singer and Casella were previously dismissed. Defendants Smith, DSS, and Broome County moved to dismiss the remaining complaint in its entirety. The Court dismissed several counts based on federal statutes (FA-ACWA and Social Security Act) for lacking a private cause of action, and other counts for failing to state a claim against the specific defendants. However, the Court determined that the plaintiff adequately stated a claim under 42 U.S.C. § 1983 for a Fourteenth Amendment due process violation against Smith, DSS, and Broome County. Consequently, the defendants' motion to dismiss the complaint in its entirety was denied, and the court retained jurisdiction over the plaintiff's state law claims.

Parental RightsDue ProcessFourteenth AmendmentSection 1983Motion to DismissSubject Matter JurisdictionFailure to State a ClaimDeliberate IndifferenceFoster CareChild Welfare
References
11
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