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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. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ7730913, ADJ8640698, ADJ8233287, ADJ7881756, ADJ8438104, ADJ7467140, ADJ7467243, ADJ9068351, ADJ9081983
Regular
Dec 02, 2016

HOLLIS COPELAND, JR. vs. DENVER NUGGETS, PINNACOL ASSURANCE

This case involved multiple consolidated workers' compensation claims where the Board initially denied reconsideration of an order dismissing Pinnacol Assurance for lack of personal jurisdiction. The Appeals Board is now granting reconsideration on its own motion to correct clerical errors in its prior opinion. Specifically, the Board failed to list all nine adjudication file numbers and did not serve all affected applicants. The decision after reconsideration affirms the original denial of reconsideration but amends the opinion to include all case numbers.

Appeals BoardGranting ReconsiderationOn MotionDecision After ReconsiderationClerical ErrorsPersonal JurisdictionPinnacol AssuranceConsolidated CasesAdjudication File NumbersAffirm Opinion
References
Case No. ADJ6548746
Regular
Jun 30, 2015

TYRONE TUCKER vs. YOSEMITE WATER, U.S. FIDELITY & GUARANTEE COMPANY

The applicant sought reconsideration of a workers' compensation award. The Board granted reconsideration to address the applicant's claims regarding hearing loss and an overlooked 15% increase in permanent disability payments. While the Board affirmed the denial of the hearing loss claim due to insufficient evidence, it amended the award to include the 15% increase under Labor Code section 4658(d)(2), finding its omission by the trial judge to be inadvertent.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationFindings of Fact and Awardnew and further injurypermanent disabilitytemporary disabilityLabor Code section 3202hearing losstinnitusneurological injury
References
Case No. SFO 0495098
Regular
Jan 14, 2008

SALVADOR GARCIA vs. ABLE BUILDING MAINTENANCE, ZURICH NORTH AMERICA INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and amended the original award, reducing the applicant's permanent disability rating from 29% to 17%. This decision was based on the persuasive opinion of one medical evaluator who found minimal neck complaints, deeming a prior report stale and lacking substantial evidence regarding neck impairment. Consequently, the applicant's permanent disability indemnity was reduced to $15,023.64.

Salvador GarciaAble Building MaintenanceZurich North America Insurance CompanySFO 0495098Opinion and Order Granting ReconsiderationFindings and Awardindustrial injuryshouldersneckjanitor
References
Case No. ADJ7948651
Regular
May 09, 2016

Barbara Tom vs. CITY OF OAKLAND, JT2 INTEGRATED

This case involves a petition for reconsideration by the defendant, City of Oakland, following an award of permanent disability to applicant Barbara Tom. The defendant argued the Workers' Compensation Judge (WCJ) erred by not deferring to the Agreed Medical Evaluator's (AME) opinion and by not developing the record with the AME. The WCAB denied reconsideration, adopting the WCJ's report which found the AME's opinion deficient. The WCJ's report detailed how the primary treating physician's report was more persuasive and thoroughly reasoned, supporting the WCJ's findings over the AME's.

Workers' Compensation Appeals BoardPetition for ReconsiderationAgreed Medical Evaluator (AME)Primary Treating Physician (PTP)AMA GuidesPermanent Disability RatingCarpal Tunnel SyndromeSubstantial EvidenceWCJ OpinionMedical Opinion Deference
References
Case No. ADJ10007434
Regular
Sep 23, 2016

RUSSELL RASMUSSEN vs. CITY OF PETALUMA, REDWOOD EMPIRE MUNICIPAL INSURANCE FUND

This case concerns a firefighter's claim for a carotid pseudoaneurysm, which the original judge found work-related based on a QME's opinion. The employer sought reconsideration, arguing the QME's opinion lacked substantial evidence as it was speculative and not based on a history of trauma. The Board granted reconsideration, finding the QME's opinion impermissibly speculative. Ultimately, the Board amended the award to exclude the pseudoaneurysm as an industrial injury, reducing the permanent disability award.

Workers' Compensation Appeals BoardCity of PetalumaRussell RasmussenIndustrial cumulative traumaCardiac palpitationsCarotid pseudoaneurysmBattalion ChiefQualified Medical EvaluatorSubstantial medical evidencePetition for Reconsideration
References
Case No. ADJ1577836
Regular
May 04, 2009

JESUS GAVINO-REMIGIO vs. STRATUS SERVICES GROUP, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant injured when stepping on a metal hook, sustaining an admitted industrial injury to his right foot. The applicant sought reconsideration after the Workers' Compensation Judge (WCJ) denied findings that the injury also affected his internal systems (diabetes), eyes, and psyche, along with associated disability. The Board denied reconsideration, finding the defendant's medical expert's opinion on non-industrial diabetes causation to be substantial evidence, while deeming the applicant's medical experts' opinions insufficient. A dissenting commissioner argued the applicant's medical evidence sufficiently supported industrial causation for diabetes aggravation, warranting reconsideration.

Workers' Compensation Appeals Boardindustrial injuryright footinternal systemseyespsychediabetes mellituspermanent disabilitytemporary disabilityGerald Markovitz M.D.
References
Case No. ADJ9916195
Regular
Apr 28, 2023

FAUSTINO AGUILAR ARIAS vs. AGR CONTRACTING, STAR INSURANCE COMPANY, MEADOWBROOK INSURANCE GROUP

The Appeals Board affirmed the denial of the applicant's cumulative trauma injury claim, finding the WCJ properly relied on Dr. Bhatia's medical opinion which contradicted the applicant's expert. The Board also determined the statute of limitations issue was moot as to the cumulative trauma claim because no injury was found. However, the Board amended the decision to defer the issue of a specific injury, as this claim potentially involves different body parts and requires further WCJ determination. The case is returned to the trial level for proceedings on the specific injury claim.

Workers' Compensation Appeals BoardReconsiderationFindings of FactCumulative TraumaSpecific InjuryStatute of LimitationsBurden of ProofMedical OpinionPanel Qualified Medical EvaluatorPQME
References
Case No. VNO 0386181
Regular
Apr 05, 2007

SUSAN PASCALE vs. BLUE CROSS/WELLPOINT DENTAL, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION on behalf of FREMONT INDEMNITY

This case concerns applicant Susan Pascale's claim for workers' compensation benefits due to industrial injuries resulting in fibromyalgia and other conditions. The WCJ awarded 80% permanent disability, apportioning 20% to applicant's pre-existing personality traits based on medical opinions. The Appeals Board affirmed this decision, finding the apportionment was supported by substantial medical evidence of causation, as allowed by recent statutory changes.

Workers' Compensation Appeals BoardSusan PascaleBlue Cross/Wellpoint DentalCalifornia Insurance Guarantee AssociationFremont IndemnityVNO 0386181Opinion and Decision After ReconsiderationApplicantDefendantWCJ
References
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