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

Case No. ADJ8436467
Regular
Sep 09, 2015

CELEINE MELENDEZ vs. KOHL'S DEPARTMENT STORE, NEW HAMPSHIRE INSURANCE COMPANY

This case concerns an employee seeking workers' compensation for back surgery, specifically an anterior lumbar discectomy and fusion. The employer contested the necessity of the surgery, arguing the administrative law judge erred in approving it. The Appeals Board affirmed the judge's decision, finding the request for authorization was valid as it reflected a change in circumstances. Therefore, the defendant is ordered to provide the authorized surgical treatment.

Workers' Compensation Appeals BoardReconsiderationUtilization ReviewAnterior Lumbar Discectomy and FusionLabor Code section 4610(g)(6)Primary Treating PhysicianIndependent Medical ReviewFindings and OrderLumbar SpineMedical Treatment Authorization
References
0
Case No. 534827
Regular Panel Decision
Dec 15, 2022

In the Matter of the Claim of Kathleen Casacci

The Appellate Division affirmed a Workers' Compensation Board decision that found claimant Kathleen Casacci, a dentist with a permanent partial disability, had no actual or causally-related reduced earnings. Casacci filed a workers' compensation claim in 2015 for work-related repetitive-use injuries, leading to a cervical discectomy and a return to part-time work. While a WCLJ initially found a 30% loss of wage-earning capacity, the Board disagreed on actual reduced earnings, citing inconsistencies in her financial documentation as an S Corporation officer. The court upheld the Board's determination, emphasizing the Board's authority to resolve factual issues based on witness credibility and evidence, particularly regarding the claimant's active role in her dental practice despite reporting reduced personal income.

Workers' CompensationPermanent Partial DisabilityReduced EarningsWage-Earning CapacityOccupational DiseaseCervical DiscectomyCredibilityFinancial DocumentationDental PracticeAppellate Review
References
12
Case No. ADJ7924562
Regular
Sep 19, 2014

RAUL HERNANDEZ vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

The applicant sought reconsideration of a WCJ decision that found an industrial injury to the low back but not the cervical spine or left ankle, with no permanent disability or further medical treatment. The applicant argued the QME's reports were insubstantial and that prior permanent disability was not considered. The Appeals Board granted reconsideration to amend the original award to include injury to the cervical spine, affirming the remainder of the decision. Therefore, the applicant sustained injury to his low back and cervical spine.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryLow Back InjuryCervical Spine InjuryPermanent DisabilityFurther Medical TreatmentPanel Qualified Medical EvaluatorLabor Code Section 4664(b)
References
0
Case No. MISSING
Regular Panel Decision

Claim of Pulos v. Asplundh Tree

Claimant, a tree trimmer, had an existing claim for bilateral carpal tunnel syndrome and later sought to include a cervical spine condition as an occupational disease. A workers' compensation law judge initially disallowed this amendment, but the Workers' Compensation Board reversed, finding the cervical condition was dormant and non-disabling, and that the claimant's work activities aggravated it. The employer appealed this decision. The court affirmed the Board's ruling, concluding there was substantial evidence to support the finding that the claimant's preexisting cervical condition was activated by the distinctive features of his employment.

Occupational DiseaseCervical Spine InjuryCarpal Tunnel SyndromePreexisting ConditionAggravation of InjuryWorkers' Compensation LawJudicial ReviewAppellate DecisionTree TrimmingWork Activities
References
3
Case No. ADJ1337074 (GRO 0034564) ADJ1286218 (GRO 0034565)
Regular
Jun 24, 2009

Dave Gerletti vs. SANTA MARIA AIRPORT DISTRICT, GREGORY BRAGG STOCKTON

The Workers' Compensation Appeals Board denied Dave Gerletti's petition for reconsideration of an award for a cumulative trauma injury to his cervical spine and lungs. The original award found 35% permanent disability, apportioning 50% of the cervical spine disability to non-industrial factors based on a Qualified Medical Evaluator's opinion of degenerative changes. The majority affirmed the WCJ's reliance on this opinion, finding it adequately explained. A dissenting opinion argued the QME's apportionment was speculative and improperly based on age and genetics, recommending an unapportioned award for the cervical spine injury.

Workers' Compensation Appeals Boardcumulative traumacervical spinelungspermanent disabilityapportionmentQualified Medical EvaluatorAgreed Medical Examinerarthritic degenerationnon-industrial factors
References
1
Case No. ADJ7288330
Regular
Oct 03, 2016

GLORIA BENITEZ vs. NEWPORT SUBACUTE HEALTH CARE CENTER, ALASKA NATIONAL INSURANCE COMPANY

The applicant, Gloria Benitez, sought to reopen her workers' compensation claim to include injury to additional body parts beyond her cervical spine and psyche. The original award found injury only to the cervical spine and psyche, with a 19% permanent disability rating for the cervical spine. While the WCJ's initial decision denied injury to additional body parts, the Board granted reconsideration. The Board amended the original findings to defer the issue of injury to the alleged additional body parts, while affirming other aspects of the WCJ's order, including the appointment of a regular physician to evaluate new and further disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderNew and Further DisabilityAgreed Medical ExaminerRegular PhysicianLabor Code Section 5410Petition to ReopenIndustrial InjuryCervical Spine
References
4
Case No. 526688
Regular Panel Decision
Dec 27, 2018

Matter of Bufearon v. City of Rochester Bur. of Empl. Relations

Claimant Kamren Bufearon sustained work-related injuries in a motor vehicle collision on March 4, 2016, for which his workers' compensation claim was established for injuries to his left shoulder, left hip, and lower back. Subsequently, he sought to amend his claim to include a causally-related cervical spine injury, which was initially approved by a Workers' Compensation Law Judge. However, the Workers' Compensation Board reversed this decision, finding that the claimant failed to sufficiently demonstrate a causal relationship between his cervical spine condition and the March 4, 2016 incident. The Appellate Division affirmed the Board's decision, noting that the medical testimony from two physicians contained conflicting findings and equivocal narratives regarding causation. The court concluded that the Board was entitled to reject the physicians' opinions as speculative, particularly since neither physician had reviewed the claimant's prior medical records for a pre-existing cervical spine fusion surgery.

Cervical spine injuryCausal relationshipMedical evidenceSubstantial evidence reviewAppellate DivisionWorkers' Compensation BoardPre-existing conditionCredibility of physiciansBurden of proofMotor vehicle accident
References
13
Case No. SBA 0083738, SBA 0084753
Regular
Dec 04, 2007

MAGDALENA PINEDA vs. INAMED CORPORATION aka MCGHAN MEDICAL, CIGA by CAMBRIDGE INTEGRATED SERVICES, SAFECO

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of a previous award. The applicant had sought reconsideration of findings that she sustained industrial injury to her bilateral upper extremities, neck musculature, shoulders, and upper back, but not to her psyche or cervical spine. The Board adopted the WCJ's report and recommendations, denying the petition and noting a potential clerical error in the award regarding medical treatment for the cervical spine and psyche.

Workers' Compensation Appeals BoardMagdalena PinedaInamed CorporationMcGhan MedicalCIGACambridge Integrated ServicesSafecobilateral upper extremitiesneck musculatureshoulders
References
0
Case No. ADJ7969168; ADJ9330687
Regular
Mar 23, 2016

Mario Alcantar vs. Alfredo Melchor, Zenith Insurance Company

This case involves applicant Mario Alcantar's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision. The WCAB previously rescinded a joint finding and substituted a new one finding applicant sustained a lumbar spine injury but not a cervical spine injury during specified employment periods. Alcantar sought reconsideration to include a cervical spine injury during a different, unspecified period. The WCAB denied the petition, affirming its prior decision and incorporating it by reference.

Petition for ReconsiderationDecision After ReconsiderationJoint Findings of Factcumulative periodlumbar spinecervical spineindustrial injuryarising out of and occurring in the course of employmentWorkers' Compensation Appeals BoardZenith Insurance Company
References
0
Case No. ADJ4283233
Regular
Aug 03, 2009

GARY JOHNSTON vs. BAY PACIFIC PIPELINES, STATE COMPENSATION INSURANCE FUND

This case concerns Gary Johnston's claim for workers' compensation benefits for a cumulative injury to his cervical spine. Initially, the workers' compensation judge denied the claim, finding no industrial injury and citing the statute of limitations. The Appeals Board granted reconsideration, reversed the initial decision, and found that Johnston sustained a cumulative injury that was not time-barred. The Board has now denied the defendant's petition for reconsideration, affirming its prior decision that the applicant's cervical spine injury is compensable.

Workers' Compensation Appeals BoardIndustrial InjuryCervical SpinePipe LayerStatute of LimitationsReconsideration DeniedFindings and OrderOpinion and Order Granting ReconsiderationDecision After ReconsiderationCompensability
References
2
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