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

Case No. ADJ9743499 ADJ10108398
Regular
Oct 01, 2018

JOHN MCGEE vs. CITY OF VACAVILLE

The Workers' Compensation Appeals Board granted defendant City of Vacaville's Petition for Removal, rescinding the prior order that closed discovery and set a trial date. The Board found that closing discovery prematurely would cause significant prejudice to the defendant. This decision stems from the defendant's ongoing, diligent efforts to conduct further discovery, specifically deposing a physician who relocated, while also pursuing global settlement options that included a related civil claim. The case is returned to the trial level for a status conference to determine future proceedings.

Petition for RemovalWCABWCJDiscovery ClosurePrejudiceIrreparable HarmQME PanelDegenerative Disc DiseaseAcromioclavicular ArthritisGlenohumeral Arthritis
References
Case No. ADJ8032740
Regular
Sep 17, 2014

LAURA RAMIREZ vs. LOYOLA MARYMOUNT UNIVERSITY, TRAVELERS

This case involved a custodian injured on the job, causing admitted industrial injury to her knee and lumbar spine. The Administrative Law Judge apportioned 50% of the permanent disability to pre-existing arthritis, a decision the applicant contested. The Workers' Compensation Appeals Board denied reconsideration, finding the apportionment supported by medical evidence indicating the industrial injury and pre-existing arthritis jointly necessitated knee replacement surgery. This aligns with precedent requiring apportionment to all causative factors, including underlying pathology.

ApportionmentPre-existing arthritisIndustrial injuryPermanent disabilityWCJPetition for reconsiderationLabor Code 4663PQMEOrthopaedic surgeonArthroplasty
References
Case No. GRO 0029816, GRO 0029817
Significant

Marlene Escobedo vs. Marshalls, CNA Insurance Co.

The Appeals Board affirmed the WCJ's decision to apportion 50% of the applicant's permanent disability to a preexisting degenerative arthritis, holding that Labor Code section 4663, as amended by SB 899, permits apportionment based on causation from non-industrial factors supported by substantial medical evidence.

SB 899apportionmentcausationpermanent disabilitypreexisting arthritismedical evidencesubstantial evidenceLabor Code section 4663compensable consequenceQME
References
Case No. ADJ9638094
Regular
Apr 04, 2016

ALEJANDRO GONZALEZ CEJA vs. TREASURY WINE ESTATES, SENTRY INSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration, rescinded findings on permanent disability, and returned the case for further proceedings. The Board found the Qualified Medical Evaluator's (PQME) apportionment of 25% permanent disability to pre-existing arthritis lacked substantial evidence. Specifically, the PQME failed to adequately explain the basis and causation for this apportionment, particularly when also stating the job duties likely aggravated and accelerated the condition. The matter was returned to clarify the PQME's apportionment determination before a new decision is issued.

ApportionmentPQMECumulative traumaVineyard workerLeft shoulderLeft elbowPermanent disabilitySubstantial evidencePre-existing conditionAcromioclavicular joint arthritis
References
Case No. WCK 0067792
Regular
Sep 20, 2007

ERNEST J. WILLIAMS vs. PINKERTON SECURITY, ESIS

This case involves an applicant who sustained an industrial injury to his right knee. The defendant sought reconsideration of the original award, arguing the judge erred in denying credit for temporary disability overpayments and in failing to apportion permanent disability to pre-existing arthritis. The Appeals Board granted reconsideration, rescinded the original award, and returned the matter for further proceedings. The Board found that apportionment to prior arthritis, even if it necessitated knee replacement surgery, is required under current law and that the Agreed Medical Evaluator's opinion on apportionment was sufficient.

WCABPinkerton SecurityErnest J. Williamsindustrial injuryright lower extremitypermanent disabilityapportionmenttemporary disability overpaymentAgreed Medical EvaluatorAME
References
Case No. VNO 482752, VNO 482753
Regular
Jul 10, 2007

JESUS SANJORO vs. MOTION PICTURE AND TELEVISION FUND, Permissibly Self-Insured, Adjusted By ROYAL INDEMNITY CO.

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's award of 46% permanent disability. The Board found, consistent with prior precedent in *Steinkamp*, that medical treatment itself is not apportionable, even if non-industrial factors contributed to the need for that treatment. Therefore, the applicant's permanent disability resulting from knee replacement surgery was not subject to apportionment based on the underlying non-industrial arthritis.

Workers' Compensation Appeals BoardSanjoroMotion Picture and Television FundRoyal Indemnity Co.VNO 482752VNO 482753Petition for ReconsiderationFindings Award and OrderSecurity OfficerBilateral Knees
References
Case No. SJO 244847
Regular
Feb 06, 2008

Celestine Lewis vs. COCA-COLA ENTERPRISES, INC.

This case concerns Celestine Lewis's claim against Coca-Cola Enterprises for workers' compensation benefits. The Workers' Compensation Appeals Board (WCAB) denied Lewis's petition for reconsideration of a prior decision regarding the apportionment of her permanent disability. The WCAB adopted the Administrative Law Judge's report, which upheld the apportionment of 30% of Lewis's permanent disability to pre-existing arthritis, consistent with recent legislative changes emphasizing apportionment to causative factors including pathology.

Workers' Compensation Appeals BoardCelestine LewisCoca-Cola EnterprisesInc.Permissibly Self-InsuredPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeDivision of Workers' CompensationJudicial AuthorityOriginal Jurisdiction
References
Case No. ADJ10332854
Regular
Jun 19, 2017

RALPH SWASEY vs. EL DORADO UNION HIGH SCHOOL DISTRICT

This case involves a worker's compensation claim for industrial injury to the left elbow and shoulder. The Appeals Board granted reconsideration, affirming the chosen occupational group but increasing the permanent disability award from 21% to 23%. This increase occurred because the Qualified Medical Evaluator's apportionment of 10% to non-industrial factors was not supported by substantial medical evidence. Specifically, the doctor's reasoning for attributing disability to diabetes and arthritis was conclusory and did not adequately explain how these factors contributed to permanent disability rather than just healing time.

Petition for ReconsiderationOccupational Group Number 390ApportionmentMedical TreatmentPermanent DisabilityQualified Medical EvaluatorSubstantial Medical EvidenceLabor Code 4663Labor Code 4664Industrial Injury
References
Case No. ADJ7006877
Regular
Jul 22, 2014

JANET PARKER vs. COSTCO WHOLESALE, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a defendant's petition to remove an order limiting discovery subpoenas. The defendant sought medical records related to the applicant's spine, left knee, hernia, pain syndrome, arthritis, and obesity, arguing relevance to claimed injuries. The applicant agreed to include left knee records but not other potentially unrelated conditions. The Appeals Board granted the petition, amended the order to include left knee records, and allowed parties twenty days to reach an informal agreement on other records, otherwise returning the matter to the trial level.

Petition for RemovalOrder Limiting Subpoenas Duces TecumSutter Regional Medical FoundationBay Spine Medical Associatesspineleft kneeherniapain syndromearthritisobesity
References
Case No. ADJ10028363, ADJ10028349
Regular
Mar 29, 2018

Timothy Overall vs. City and County of San Francisco

The Workers' Compensation Appeals Board denied the applicant's petitions for reconsideration. The Board affirmed the WCJ's decision to apportion permanent disability between two separate industrial injuries. This decision was based on the principle that separate determinations and awards are required for each injury, unless apportionment is medically impossible. The Agreed Medical Examiner, Dr. Lavorgna, ultimately confirmed his initial apportionment of 50% causation to each injury, despite earlier statements about them being intertwined.

WORKERS' COMPENSATION APPEALS BOARDPetitions for Reconsiderationworkers' compensation administrative law judgepermanent disabilityindustrial injuriesseparate determinationcausally contributingundivided awardAgreed Medical Examiner (AME)orthopedic AME
References
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