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

Case No. ADJ9767947
Regular
Jan 18, 2017

GILBERT PEREZ vs. ABC SHEET METAL, LIBERTY MUTUAL INSURANCE

This case involves an applicant who sustained industrial injury to his left knee and abdomen. The trial judge initially found injury to these parts but also found no injury to back, psyche, lower extremities, and stress, which the applicant appealed. The appellate court annulled the denial of reconsideration, finding the trial judge improperly ruled on body parts not fully at issue. The Appeals Board rescinded the negative finding, deferred the issue of additional injured body parts, and remanded for further proceedings to determine if injury to other parts occurred.

WCABindustrial injurywelderleft kneeabdomenbackpsychelower extremitiesstressCourt of Appeal
References
Case No. ADJ8533165
Regular
Mar 08, 2016

Margarito Trujillo vs. Cardenas Markets, Inc.

This case involves a worker claiming industrial injury to multiple body parts. The WCJ initially found injury only to the abdomen but applicant argued other claimed injuries were not addressed. The Appeals Board granted reconsideration to clarify the issues. They are rescinding the WCJ's decision and deferring the determination of injured body parts and the nature/extent of injury for further proceedings at the trial level.

Workers' Compensation Appeals BoardReconsiderationFindings of FactInjury AOE/COELabor Code section 5402Presumption of CompensabilityMandatory Settlement ConferencePre-Trial Conference StatementParts of Body InjuredNature and Extent of Injury
References
Case No. ADJ2297894 (POM 0278528), ADJ3191942 (POM 0292415), ADJ128178 (POM 0292417)
Regular
Dec 02, 2013

MARTIN ADAME vs. ANHEUSER-BUSCH, INC., ACE USA INSURANCE, FOOTHILL BEVERAGE COMPANY, EVEREST NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to address contested findings regarding applicant Martin Adame's industrial injuries. The Board rescinded decisions in two cases (ADJ2297894 and ADJ3191942) concerning injuries to applicant's wrists, neck, and upper back. These cases are returned to the trial level for further development of the record and new decisions. The decision in a third case (ADJ128178), concerning a right wrist injury, was affirmed as no issues were raised.

Workers' Compensation Appeals BoardReconsiderationIndustrial InjuryTruck DriverCumulative PeriodTemporary Disability IndemnityFurther Medical TreatmentPetitions for ReconsiderationAdministrative Law JudgeFindings and Award
References
Case No. ANA 0329574
Regular
Sep 21, 2007

Martina Gonzalez, Ocegueda vs. ST. JOHN KNITS, ARGONAUT INSURANCE COMPANY

The Appeals Board granted reconsideration and overturned the WCJ's decision, finding the WCJ erred in calculating average weekly earnings and relying on an incomplete medical report for apportionment. The case is returned to the trial level to recalculate average weekly earnings and revisit permanent disability and apportionment issues, considering recent legislative changes regarding pre-existing conditions. The Appeals Board noted that the prior medical report failed to address the applicant's spondylolisthesis and that apportionment rules have changed, eliminating the "old rules" regarding pathology.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardIndustrial InjuryLow BackAbdomenRight LegPsycheTotal Permanent DisabilityApportionment
References
Case No. ADJ9478710
Regular
Apr 28, 2015

Hanna Kefetew vs. Neiman Marcus, Liberty Mutual Insurance Company

This case involves applicant Hannah Kefetew's petition for removal of a WCJ's order setting a trial for her workers' compensation claim. The petition was denied because the applicant failed to demonstrate substantial prejudice or irreparable harm. The Appeals Board also noted issues with proper attorney representation and service of documents. Reconsideration is deemed an adequate remedy if a final decision is adverse to the applicant.

Petition for RemovalWCJThreshold IssueInjury arising out of and occurring in the course of employmentCumulative PeriodAbdomenPsycheSubstantial PrejudiceIrreparable HarmIncomplete Discovery
References
Case No. STK 0199856
Regular
Aug 08, 2008

GARY WINSLOW vs. EAST/WEST STAFFING, GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board granted reconsideration and rescinded the dismissal of the applicant's case for lack of prosecution. The Board found the petition for reconsideration timely filed and determined that the applicant may have been denied due process due to a mistaken belief that he could not pursue his claim after moving out of state. The case is remanded for further proceedings and a new decision by the WCJ.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissal for Lack of ProsecutionNotice of Intention to DismissDue ProcessIndustrial InjuryFurniture MoverAbdomenGroinHernia
References
Case No. ADJ1245747 (BAK 0140714)
Regular
Jul 14, 2009

BALDEMAR SANCHEZ vs. KINLEY CONSTRUCTION, AIG COSTA MESA

The applicant sought reconsideration of a WCJ's finding that the employer's actions did not constitute serious and willful misconduct, thus denying additional benefits under Labor Code § 4553. The applicant had previously settled his industrial injury claim for $60,000, but the settlement explicitly excluded the serious and willful misconduct claim. The Appeals Board denied the petition for reconsideration, adopting the WCJ's reasoning that the employer's conduct, while negligent, did not rise to the level of serious and willful misconduct. The Board also noted the applicant's petition violated procedural rules regarding spacing, cautioning counsel for future compliance.

Serious and Willful MisconductLabor Code § 4553Petition for ReconsiderationFindings of Fact & AwardCompromise & ReleaseIndustrial InjuryPelvis InjuryHip InjuryAbdomen InjuryBilateral Knees Injury
References
Case No. ADJ1128183 (AHM 0122447)
Regular
Apr 19, 2010

MANUEL SOLIS vs. THE QUILTING HOUSE, AMERICAN COMMERCIAL CLAIMS ADMINISTRATION FOR EVEREST NATIONAL INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to overturn a prior ruling that awarded over $32,000 to Psychological Assessment Services (PAS) for applicant Manuel Solis's treatment. The Board found that PAS failed to meet its burden of proof by demonstrating that the extensive psychotherapy services provided were reasonably necessary to cure or relieve the applicant's industrial injury. While affirming the finding of psyche injury, the Board concluded that PAS was entitled to no further reimbursement due to inadequate evidence supporting the necessity and reasonableness of the prolonged treatment.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderIndustrial InjuryBack InjuryShoulder InjuryPsyche InjuryAbdomen InjuryHerniaPsychological Assessment Services
References
Case No. ADJ852225
Regular
Jan 29, 2016

ROSA JIMENEZ FLORES vs. BERKELEY BOWL PRODUCE, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior order dismissing Rosa Jimenez Flores' case. The dismissal occurred because she failed to appear for a trial hearing. However, it appears she was not properly served with the dismissal order, as indicated by a returned mail notice. Therefore, the Board found her petition for reconsideration to be timely and returned the case to the trial level for further proceedings to ensure due process.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder of DismissalNotice of Intention to DismissIndustrial InjuryBack InjuryAbdomen InjurySushi MakerCook AssistantDenial of Due Process
References
Case No. ADJ2470784 (MON 0352485)
Regular
Dec 28, 2009

CELSO ALVAREZ vs. TUFF SHED, ZURICH INSURANCE

The WCAB granted reconsideration and reversed the WCJ's finding that the applicant sustained an industrial injury to his abdomen in the form of a hernia. The Board found insufficient substantial evidence to support the WCJ's decision.

Industrial injuryAbdominal herniaLeft knee injuryTemporary disabilityMedical treatmentSelf-procured treatmentMedical legal costsSubstantial medical evidenceAdministrative law judgeWorkers' Compensation Appeals Board
References
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