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

Case No. ADJ300802 (AHM 0109743) ADJ2310921 (AHM 0115931)
Regular
Nov 21, 2008

CHRISTOPHER SHIELDS vs. LAIDLAW TRANSIT; BROADSPIRE

The Appeals Board granted reconsideration, amending the original award to establish a permanent and stationary date of January 3, 2005, for applicant's abdominal hernia injuries. The Board deferred the issues of permanent disability and attorneys' fees, returning the case to the trial level for re-rating based on hernia/abdominal injuries rather than spinal injuries. The Board affirmed the finding of an industrial inguinal hernia injury, while also noting that the defendant did not provide evidence of unreasonable refusal of medical treatment for the hernias.

HerniaUmbilical herniaInguinal herniaLow back painPermanent and stationary dateTemporary total disabilityMedical treatmentAttorney's feesReconsiderationWorkers' Compensation Appeals Board
References
Case No. ADJ10222181 (MF) ADJ10222198
Regular
Jan 30, 2019

SAM ALBOUDOOR vs. AMJES, INC. dba K&B FREIGHT SYSTEMS

This case concerns claims for hernias and spine injuries sustained by a truck driver. The Workers' Compensation Appeals Board granted reconsideration to review the finding that hernias were work-related, noting the medical evaluator's conflicting opinions on causation. The Board determined further medical development is required on the hernia issue due to contradictory expert testimony. Additionally, the issue of reimbursement for self-procured medical treatment was deferred pending the resolution of the hernia claims.

Workers' Compensation Appeals BoardAMJES INCK&B Freight SystemsSam Alboudoorherniahiatal herniainguinal hernialumbar spinethoracic spinePQME
References
Case No. SDO 0322942
Regular
Jan 31, 2008

ROBERT WEIS vs. VULCAN MATERIALS COMPANY, ZURICH NORTH AMERICA

The applicant claims an admitted industrial spinal injury caused his umbilical hernia, but the WCJ denied benefits for the hernia, finding it nonindustrial. The applicant argues the Qualified Medical Evaluator's opinion supports industrial causation for the hernia, contradicting the defense. The Appeals Board granted reconsideration to obtain a report from the WCJ regarding this contested issue.

Workers' Compensation Appeals BoardVulcan Materials CompanyZurich North AmericaRobert Weisindustrial injuryspineherniaumbilical herniatruck driverqualified medical evaluator
References
Case No. ADJ6548054
Regular
Jul 21, 2010

ROBERT ROTH vs. WABI SABI TEPPAN STEAKHOUSE, AVIZENT

The Workers' Compensation Appeals Board granted reconsideration to applicant Robert Roth. The Board found that Roth's claim is not barred by Labor Code section 3600(a)(10) because his medical records contained evidence of his hernia injury prior to his layoff. This decision overturns the WCJ's prior finding that the claim was barred due to a lack of documented causation in the pre-termination medical records. The case is returned to the trial level for further proceedings on the remaining issues.

Workers' Compensation Appeals BoardLabor Code section 3600(a)(10)Petition for ReconsiderationFindings of Factindustrial injuryherniadiverticulitispsycheabdominal injurypre-existing condition
References
Case No. ADJ10782441 ADJ9193836
Regular
Apr 15, 2019

Stacy Smith vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration to affirm the applicability of Labor Code section 3212 presumptions for hypertension and hernia injuries to an ocean lifeguard. However, the Board amended the decision to defer issues of permanent disability and apportionment. This deferral is due to the apparent conflict between the WCJ's 50% apportionment of hernia disability and the non-attribution clause of Labor Code section 3212. The Board returned these issues to the trial level for further hearing and determination.

Workers' Compensation Appeals BoardLabor Code Section 3212Heart trouble presumptionHernia presumptionFire department memberOcean lifeguardCumulative injuryLumbar spine injuryRight knee injurySkin injury
References
Case No. ADJ9509417
Regular
Apr 05, 2023

ELIZABETH ARBOGAST vs. CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed an award for further medical treatment and attorney fees for an applicant diagnosed with ovarian cancer, hernia, peripheral neuropathy, and colon issues sustained during her employment with the California Highway Patrol. The Board found the applicant's ovarian cancer to be an insidious and progressive disease, warranting a reservation of jurisdiction over permanent disability. This reservation allows for future determination of permanent disability if the condition worsens or recurs.

Workers' Compensation Appeals BoardCalifornia Highway Patrolmedically uninsuredState Compensation Insurance FundAdjudication NumberOpinion and Decision After ReconsiderationFindings and Awardworker's compensation administrative law judgeovarian cancerhernia
References
Case No. ADJ1904323 (GRO 0034275) ADJ3208896 (GRO 0034276) ADJ649343 (GRO 0034277)
Regular
Nov 01, 2010

SARAH SHIPP vs. GOTTSCHALKS, SPECIALTY RISK SERVICES

The Appeals Board granted reconsideration, rescinding the prior award due to the Workers' Compensation Judge's (WCJ) improper reliance on an Agreed Medical Evaluator's (AME) hernia analogy to rate upper extremity impairment. This analogy violated *Almaraz II* by not adhering to the AMA Guides and potentially incorporating pre-2005 rating schedules. The rater also used an incorrect impairment number and occupational adjustment. The case is remanded for further proceedings and a new decision by the WCJ, ensuring the rating is not based on the flawed hernia analogy.

Workers' Compensation Appeals BoardSarah ShippGottschalksSpecialty Risk ServicesJoint Findings and Awardindustrial injuryright shoulderleft shoulderright elbowthumb
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
Case No. ADJ2653887 (SAL 0116844)
Regular
Dec 24, 2008

CARROL BARRIE vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, amending a prior finding to award further medical treatment for admitted industrial hernias. While the original finding denied permanent disability and further treatment, the Board found a stipulation by the parties and the Agreed Medical Evaluator's opinion supported the need for ongoing medical follow-up. The Board affirmed the original finding that the injury did not cause ratable permanent disability based on the AME's report and statutory guidelines.

Workers' Compensation Appeals BoardIndustrial InjuryVentral HerniaUmbilical HerniaRegistered NursePermanent DisabilityFurther Medical TreatmentAgreed Medical EvaluatorAMA GuidesLabor Code Section 5802
References
Case No. ADJ6475661
Regular
May 11, 2015

ALAN COLGROVE vs. SANTA ROSA PRESS DEMOCRAT, TRAVELERS PROPERTY & CASUALTY COMPANY OF AMERICA

The Appeals Board rescinded the WCJ's decision finding a hernia to be a compensable consequence of a back injury, citing insufficient medical evidence. Dr. Klein’s opinion on causation was found to be inconsistent and not substantial evidence. The Board concluded the medical record requires further development to determine if the hernia is causally related to the industrial injury. Therefore, the case is returned to the trial level for further proceedings and a new decision by the WCJ.

COMPENSABLE CONSEQUENCEPETITION TO REOPENMEDICAL RECORD DEVELOPMENTQUALIFIED MEDICAL EVALUATOR (PQME)OPINIONCAUSAL RELATIONSHIPHERNIABACK INJURYSTIPULATIONSSUBSTANTIAL EVIDENCE
References
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