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

Case No. ADJ8789952
Regular
Nov 16, 2017

LISA STROTHER vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

This case involves Lisa Strother's claim for psychiatric injury due to cumulative trauma as a correctional officer. The Appeals Board granted reconsideration because the Agreed Medical Evaluator's (AME) report lacked specificity regarding the actual employment events causing the psyche injury and failed to properly apportion permanent disability. The Board found the AME's opinion on causation was not adequately detailed to determine if work events were the predominant cause. Therefore, the matter was returned to the trial level for further development of the record on these critical issues.

Workers' Compensation Appeals BoardLisa StrotherState of California Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8789952Fresno District OfficePetition for ReconsiderationFindings of Fact and AwardCorrectional Officer
References
Case No. ADJ9549773
Regular
Nov 13, 2015

EDWARD BAUTISTA vs. ARLON GRAPHICS, TRAVELERS

The Appeals Board dismissed the applicant's petition for reconsideration or removal, finding the WCJ's order was not a final determination. The WCJ correctly ordered the applicant to first discuss his anxiety symptoms and need for psychological referral with his primary treating orthopedist. Applicant is not entitled to a second opinion from a psychologist until the primary treating physician has diagnosed the anxiety or determined a referral is unnecessary. Commissioner Sweeney dissented, believing the applicant had an absolute right to an MPN second opinion for his psychiatric condition without first obtaining a referral from his orthopedist.

ADJ9549773Arlon GraphicsTravelersPetition for ReconsiderationPetition for RemovalWorkers' Compensation Appeals BoardWCJLabor Code Section 4616.3Labor Code Section 4616.4Administrative Director Rules
References
Case No. STK 0204737
Regular
May 13, 2008

EDUARDO MACHADO vs. GALLO GLASS COMPANY

The Workers' Compensation Appeals Board denied Gallo Glass Company's petition for reconsideration, upholding a prior award finding applicant sustained industrial injury to his face, right shoulder, and related issues like sleeping problems, anxiety, and vision. While temporary disability was awarded for a specific period, permanent disability was deferred pending further evaluation, and future medical care was deemed necessary. The majority adopted the WCJ's report, finding sufficient evidence to link the anxiety, sleeping, and vision issues to the head injury, despite the defendant's arguments to the contrary.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact Award and OrderIndustrial InjuryJanitorTemporary DisabilityFuture Medical CarePermanent DisabilitySleeping ProblemsAnxiety
References
Case No. ADJ4080665
Regular
Apr 24, 2012

LAO-35 XYZZX vs. ANTHONY INTERNATIONAL, INC., TRAVELERS INSURANCE COMPANY

This case involves an applicant claiming cumulative trauma injury resulting in stress, depression, and anxiety due to workplace issues at Anthony International, Inc. The applicant alleged unwarranted criticism, witnessing drug use, and general stress. Defense witnesses, including a former supervisor and coworker, credibly refuted the applicant's allegations and attributed his problems to new management and his own impatience. The Workers' Compensation Appeals Board denied reconsideration, upholding the WCJ's finding of no credible evidence supporting the applicant's claim.

WCABLAOAnthony InternationalTravelers InsuranceADJ4080665Petition for ReconsiderationTake Nothing OrderCumulative TraumaStressDepression
References
Case No. ADJ1047594 (VNO 0549852)
Regular
Dec 22, 2016

Diane De Los Reyes vs. Mediscan, Zurich American Insurance Company

In this case, the applicant, Diane De Los Reyes, sought reimbursement for self-procured medical treatment related to her work-induced Reactive Airway Disease and Anxiety Disorder. The Appeals Board found that some of the applicant's self-procured treatment was likely industrial and reversed the WCJ's finding that all such treatment was non-industrial. The Board therefore rescinded the original order and returned the matter to the WCJ for further proceedings to determine the extent of reimbursable self-procured medical treatment and associated penalties. The applicant's entitlement to reimbursement for medical mileage and penalties thereon was affirmed.

Workers' Compensation Appeals BoardReconsiderationAgreed Medical EvaluatorReactive Airway DiseaseAnxiety DisorderSelf-procured Medical TreatmentReimbursementPenaltiesMedical MileageLabor Code ยง 4600(a)
References
Case No. LAO 801322
Regular
May 23, 2008

O.C. MARSHALL (Deceased) JENNIFER MARSHALL (Widow) vs. ARCO/BRITISH PETROLEUM; ESIS

This case concerns a widow's appeal of a denial of workers' compensation benefits for her husband's death. The Administrative Law Judge (ALJ) denied benefits, finding the death was due to natural causes and not his employment as a pipe fitter for Arco/British Petroleum. The Workers' Compensation Appeals Board affirmed the denial, finding the applicant's medical expert's opinion lacked substantial evidence due to an inaccurate history and incomplete analysis of the decedent's medical records and family history.

Workers Compensation Appeals BoardApplicantDefendantPetition for ReconsiderationFindings of Fact and OrdersAdministrative Law JudgeQualified Medical EvaluatorQMEatherosclerotic diseasehypertension
References
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. ADJ8794924
Regular
Nov 12, 2013

PHILLIP POSTON vs. CALTRANS, STATE COMPENSATION INSURANCE FUND

This case involves a Caltrans road maintenance worker who claimed psychological injury due to alleged workplace harassment. The applicant's claim was denied by the Workers' Compensation Appeals Board (WCAB). The applicant sought reconsideration, arguing the denial was erroneous. The WCAB denied the petition, adopting the WCJ's report which found the applicant failed to prove a compensable injury. The WCJ concluded the matter stemmed from an employment dispute rather than a medical condition, and the applicant did not meet the burden of proof.

Petition for ReconsiderationWCJ ReportDenialCaltransState Compensation Insurance FundPhillip PostonADJ8794924workers' compensationinjurypsyche
References
Case No. ADJ9584702
Regular
May 03, 2019

ROBERTO RUIZ PEREZ vs. DEL RIO WEST PALLETT, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ULLICO CASUALTY COMPANY, INTERCARE INSURANCE SERVICES

The Workers' Compensation Appeals Board granted reconsideration to modify a prior award. The Board found that the applicant was only entitled to two weeks of temporary total disability for his admitted industrial injury to the left hand, based on medical opinions. The Board specifically rejected the applicant's claim for psychological injury and any extended temporary disability beyond the initial two-week period. Therefore, the prior award of temporary total disability from July 2, 2012, to September 11, 2014, was amended to reflect the limited two-week period.

CIGAUllico Casualty CompanyliquidationPetition for ReconsiderationTemporary Total DisabilityLabor Code section 4656(c)(1)Qualified Medical Evaluatorchronic regional pain syndromeanxietyinsomnia
References
Case No. ADJ7560161
Regular
Feb 16, 2017

Julie Cagle vs. Bank of America, ACE AMERICAN INSURANCE COMPANY

This case involves Julie Cagle's workers' compensation claim against Bank of America for admitted industrial injuries to her psyche and abdomen. The Appeals Board reconsidered a prior award, increasing the applicant's permanent disability rating. The key dispute centered on the proper rating for internal injuries under the AMA Guides, with the applicant arguing for a higher WPI rating based on a Class 3 classification. The Board ultimately determined the applicant's internal system impairment warranted a 25% WPI, leading to a total of 49% permanent disability. The award was also clarified to allow the defendant credit for permanent disability advances already paid.

Workers' Compensation Appeals BoardJulie CagleBank of AmericaAce American Insurance CompanyCorvelPetition for ReconsiderationFindings of Fact and AwardInternal Systems InjuryPsyche InjuryPermanent Disability
References
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