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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ1245384 (VNO 0361404)
Regular
Jul 27, 2009

Lenard E. Taylor vs. WELLPOINT HEALTH NETWORKS, INC., CIGA

The Workers' Compensation Appeals Board (WCAB) affirmed a finding that Lenard Taylor sustained a cumulative trauma injury to multiple conditions, including psychological impairment, resulting in 100% permanent disability. While the WCAB agreed with the original judge's findings regarding the injury and benefits, it rescinded a $2,500 sanction imposed on the defendant. The Board determined that the sanction under Labor Code §5813 was improperly applied to penalize delays in benefit payments, as that section is intended to address litigation abuses, not payment delays.

Workers Compensation Appeals BoardReconsiderationCumulative Trauma InjuryAggravation of DiabetesAggravation of HypertensionAggravation of Cardiovascular DiseaseAggravation of GERDAggravation of EyesPsychological ImpairmentMajor Depressive Episode
References
Case No. ADJ671568 (VNO 0519723)
Regular
Jun 05, 2009

KAREN REFF vs. UNION OF AMERICAN HEBREW CONGREGATION, MEADOWBROOK INSURANCE COMPANY, GALLAGHER BASSETT

This case involves an applicant claiming her industrial pneumonia aggravated a pre-existing common variable immunodeficiency (CVID), necessitating ongoing immunoglobulin treatment. The defendant disputes that the pneumonia aggravated the CVID or that the treatment is causally related to the industrial injury. The Agreed Medical Evaluator could not definitively opine on CVID aggravation without reviewing later medical records. Consequently, the Appeals Board granted reconsideration, rescinded the prior award, and returned the case for further medical development and a new decision.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardIndustrial InjuryPneumoniaCommon Variable Immunodeficiency (CVID)Immunoglobulin Replacement TreatmentsAggravationAgreed Medical Evaluator (AME)Further Development of Record
References
Case No. ADJ3300067
Regular
Feb 01, 2010

AL DAVENPORT vs. CORCORAN UNIFIED SCHOOL DISTRICT, JT2 INTEGRATED PLEASANTON

The Workers' Compensation Appeals Board denied the applicant's reconsideration of an amended award. The applicant sought permanent disability benefits for a cardiovascular condition, arguing the industrial incident caused permanent disability, not just temporary aggravation. The Board found that the agreed medical examiner's opinion, which attributed the applicant's permanent cardiovascular disability to non-industrial risk factors, constituted substantial evidence. Therefore, the WCJ's finding of temporary aggravation with no permanent disability was upheld.

Workers Compensation Appeals BoardAmended Findings and Awardindustrial injurypsychecardiovascular systemtemporary aggravationpermanent disabilityreconsiderationAgreed Medical Examiner (AME)Escobedo v. Marshalls
References
Case No. ADJ11496459
Regular
Dec 11, 2019

ALEXANDER VAZQUEZ vs. UNIVERSITY OF SOUTHERN CALIFORNIA

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding that the applicant sustained an industrial injury to his right shoulder. The Board agreed that lifting a vacuum cleaner at work aggravated a pre-existing shoulder condition, satisfying the AOE/COE requirement. They affirmed the administrative law judge's reliance on the qualified medical examiner's report, despite minor discrepancies in the applicant's description of the lifting activity. The decision clarifies that industrial aggravation of a pre-existing condition constitutes a compensable injury.

AOE/COEFindings and AwardPetition for ReconsiderationQualified Medical Examiner (QME)apportionmentindustrial aggravationpre-existing conditionsubstantial evidencemechanism of injuryWCJ
References
Case No. SAL 103035
Regular
Jul 20, 2007

CARLOS CONTRERAS vs. NATURAL SELECTION FOODS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a decision apportioning 30% of the applicant's permanent disability to a pre-existing, non-industrial condition. The applicant's injury aggravated this DISH syndrome, and the Board found the Agreed Medical Examiner's opinion supporting apportionment constituted substantial evidence. The Board also rejected the applicant's argument that the judge improperly relied on an unadmitted report, as the relevant information was summarized within an admitted medical report.

DISH SyndromeDisseminated Idiopathic Skeletal HyperostosisspondylosisApportionmentSB 899Labor Code Section 4663Agreed Medical Examinerpermanent disabilitynon-industrial conditionaggravation
References
Case No. ADJ9226143 ADJ9640587
Regular
Dec 02, 2020

RAUL MARTINEZ GARCIA vs. THE SUN VALLEY GROUP, INC., ZENITH INSURANCE AND TRAVELERS

The Workers' Compensation Appeals Board granted reconsideration to further study the factual and legal issues. While the WCJ found an industrial aggravation of the applicant's arthritis due to cumulative trauma, there was insufficient evidence to determine which specific body parts were injured. The Board rescinded the initial Findings and Order, remanding the case to the trial level for further proceedings to develop the medical record and clarify the extent of the industrial injury. The existing medical opinions were deemed deficient, necessitating further investigation.

AOE/COEcumulative traumaaggravationgouty arthritissecondary osteoarthritisrheumatology consultationspecific injuryFindings and OrderPetition for ReconsiderationReport and Recommendation
References
Case No. ADJ6854571
Regular
Oct 08, 2018

TED HIRSCHBERGER vs. STOCKWELL HARRIS WOOLVERTON AND MUEHL, STATE COMPENSATION INSURANCE FUND

Here's a summary of the case for a lawyer, in max four sentences: The Appeals Board granted reconsideration, overturning the WCJ's apportionment of permanent disability. The Board found that the applicant's industrial psyche injury aggravated Parkinson's disease, causing brain injury and permanent mental incapacity. This condition conclusively presumes total permanent disability under Labor Code section 4662(a)(4), precluding apportionment. Therefore, the applicant is found totally permanently disabled without apportionment.

WCABPetition for ReconsiderationFindings And AwardIndustrial InjuryPsycheParkinson's DiseasePermanent DisabilityApportionmentLabor Code Section 4662(a)(4)Conclusive Presumption
References
Case No. ADJ7234303
Regular
Nov 26, 2012

KENNETH ALBERS vs. SOUTHERN CALIFORNIA EDISON

This Workers' Compensation Appeals Board decision denies Southern California Edison's petition for reconsideration. The Board affirmed the finding that applicant Kenneth Albers sustained an industrial injury to his lumbar spine and lower extremities requiring future medical treatment. The Board found the applicant's employment was a sufficient contributing cause to his injury, even if it aggravated a pre-existing condition. The Board also noted concerns regarding a Qualified Medical Evaluator's understanding of workers' compensation law.

Workers' Compensation Appeals BoardSouthern California Edisonindustrial injurylumbar spinelower extremitiesfuture medical treatmentjob analysisPanel Qualified Medical Evaluator (PQME)Labor Code section 3600arising out of and in the course of employment
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
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