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

Case No. ADJ383777
Regular
Apr 04, 2011

Roxanna Ortiz vs. ONE SOURCE, ESIS

The Workers' Compensation Appeals Board denied Roxanna Ortiz's petition for reconsideration of a prior findings and order. The initial ruling determined she sustained industrial injury only to her cervical spine as a janitor, not to other body parts or any resulting temporary/permanent disability or need for further medical treatment. Ortiz argued the judge erred by favoring defense medical reports and discrediting her testimony due to minor inconsistencies in her injury description. The Board adopted the WCJ's report, emphasizing deference to credibility determinations and that admissibility of medical reports should have been challenged at trial, not on reconsideration. A dissenting opinion argued the judge overemphasized minor variations in Ortiz's account and that medical evidence did not sufficiently support denial of other injuries or further treatment.

OrtizOne SourceESISWCABFindings and OrderPetition for ReconsiderationWorkers' Compensation Administrative Law Judgeindustrial injurycervical spineright arm
References
Case No. GOL 96757
Regular
Jun 10, 2008

SA YANG LO vs. CUSTOM SENSORS & TECHNOLOGIES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a prior award, upholding the application of the 2005 Permanent Disability Rating Schedule. The Board found that exceptions allowing for the 1997 Schedule did not apply, as the applicant's temporary disability indemnity extended beyond January 1, 2005, and no qualifying pre-2005 reports indicated permanent disability. Furthermore, the Board found the applicant's vocational expert's opinion regarding diminished future earning capacity unpersuasive, thus affirming the initial 9% permanent disability rating.

Workers' Compensation Appeals BoardSA Yang LoCustom Sensors & TechnologiesInc.State Compensation Insurance FundGOL 96757Opinion and Order Denying ReconsiderationFindings and AwardWorkers' Compensation Administrative Law JudgeWCJ
References
Case No. ADJ237483
Regular
Nov 13, 2012

RAYEK J. FAHOUM vs. KAISER FOUNDATION HOSPITAL

The Workers' Compensation Appeals Board denied Rayek J. Fahoum's petition for reconsideration, upholding the findings of the Workers' Compensation Judge. The Judge's report found Fahoum sustained industrial injury to his neck and low back with secondary chronic pain syndrome, awarding 41% permanent disability. This decision relied on the opinions of the Agreed Medical Examiner and Dr. Renee Rinaldi, who concluded Fahoum experienced symptom magnification and that his condition was chronic pain syndrome, not fibromyalgia as claimed by Dr. Allen Salick. The Board extended great weight to the Judge's credibility findings regarding the medical opinions.

Workers' Compensation Appeals BoardReconsideration DeniedAgreed Medical ExaminerSubstantial Medical EvidenceFibromyalgiaChronic Pain SyndromeSymptom MagnificationOrthopedic InjuryLumbosacral StrainCervical Strain
References
Case No. RIV 42174
Regular
Jul 20, 2007

VICTOR LOPEZ vs. DOANE'S PET CARE, ROYAL SUNALLIANCE INSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration to correct a clerical error regarding the temporary disability period. While affirming the finding of industrial injury to the back, leg, and psyche resulting in 86% permanent disability, the Board amended the temporary disability period to commence August 2, 2001, aligning it with the date of injury. The Board specifically noted they would not adopt the WCJ's comment regarding improper fax filing of the petition for reconsideration.

Victim LopezDoane's Pet CareRoyal Sunalliance Insurance Co.RIV 42174Petition for ReconsiderationFindings and Awardindustrial injurybackright legpsyche
References
Case No. ADJ10679914
Regular
Mar 05, 2018

Juan Torres vs. Ganalix Plumbing Repair, Uninsured Employers Benefit Trust Fund

The Workers' Compensation Appeals Board granted reconsideration and reversed the administrative law judge's decision, finding that applicant Juan Torres sustained a back injury arising out of and occurring during the course of employment with Ganalix Plumbing Repair. The Board disagreed with the judge's finding of no injury based solely on applicant's credibility, noting that three defense witnesses corroborated an event occurred, and medical records documented back pain shortly after the fall. The Board also acknowledged applicant's delay in reporting and the employer's lack of workers' compensation insurance, but ultimately found sufficient evidence for a compensable back injury.

WORKERS' COMPENSATION APPEALS BOARDJuan TorresGANALIX PLUMBING REPAIRUNINSURED EMPLOYERS BENEFIT TRUST FUNDFindings and OrderPetition for Reconsiderationadministrative law judgeWCJinjury arising out of and occurring during the course of employmentLabor Code section 5402(b)
References
Case No. ADJ869605
Regular
Nov 19, 2012

MILES GRAY vs. AT&T, permissibly self-insured, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves an applicant who sustained a severe right lower extremity injury, leading to multiple surgeries, significant leg length discrepancy, and fused ankle/foot, requiring constant mobility aids. The Agreed Medical Evaluator (AME) provided opinions on impairment, and vocational experts testified regarding the applicant's ability to return to work. The Workers' Compensation Appeals Board denied reconsideration of the prior award, finding substantial evidence supporting the applicant's unsuitability for rehabilitation. Defendant's supplemental reply did not alter this decision.

Agreed Medical EvaluatorVocational ExpertPetition for ReconsiderationDeniedRight Lower Extremity InjuryMultiple FracturesLeg Length DiscrepancyShoe LiftAnkle FusionGait Derangement
References
Case No. VNO 0428535
Regular
Nov 19, 2007

KATHERINE GRAMMER vs. LOS ANGELES COMMUNITY COLLEGE DISTRICT, LOS ANGELES VALLEY COLLEGE, SOUTHERN CALIFORNIA RISK MANAGEMENT ASSOCIATES

The applicant sustained industrial injuries to her back, neck, right shoulder, and regional pain syndrome, but not fibromyalgia, according to the WCJ's findings. The WCJ awarded temporary partial disability from January 27, 2001, to February 12, 2003, but found zero percent permanent partial disability and no temporary disability indemnity due to increased earnings post-injury. Upon reconsideration, the Appeals Board affirmed the WCJ's decision, adopting the WCJ's reasoning.

GrammerLos Angeles Community College DistrictLos Angeles Valley CollegePetition for ReconsiderationFindings and Awardindustrial injurybackneckshoulderregional pain syndrome
References
Case No. ADJ9176582
Regular
Feb 21, 2020

MARIA MORENO vs. GARROUTTE FARMS, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding applicant sustained industrial injury to her left shoulder, left wrist, left hip, and low back, causing temporary and permanent disability. While the Board denied the defendant's petition regarding the low back injury and temporary disability, it deferred the issue of the permanent disability rating. This deferral includes a potential increase to the whole person impairment for pain, which will be determined at the trial level after further hearing. The Board confirmed an award for additional temporary total disability and further medical treatment.

ADJ9176582Petition for ReconsiderationFindings Award and OrderIndustrial InjuryLeft ShoulderLeft WristLeft HipLow BackTemporary DisabilityPermanent Disability
References
Case No. ADJ6776516
Regular
May 30, 2017

FRANCIS HARGREAVES vs. SOUTHWEST AIRLINES, ACE USA INSURANCE CO.

This case involves an applicant seeking workers' compensation benefits for injuries sustained on the job, including to his back, left shoulder, left wrist, and psyche, as well as complex regional pain syndrome, coronary artery disease, and a sleep disorder. The defendant sought reconsideration of the initial award, arguing that the medical evidence did not support the $90\%$ permanent disability finding. The Appeals Board granted reconsideration, affirming the findings of injury and treatment for Complex Regional Pain Syndrome but reducing the permanent disability to $88\%$ by excluding the sleep disorder impairment due to insufficient objective evidence. The applicant's permanent disability payments were recalculated and ordered to commence from January 21, 2011.

Workers' Compensation Appeals BoardFrancis HargreavesSouthwest AirlinesACE USA Insurance Co.Sedgwick CMSADJ6776516Opinion and Order Granting Petition for ReconsiderationFindings Award and OrderAOE/COEback injury
References
Case No. ADJ1901810 (SAC 0362345) ADJ381755 (SAC 0362346)
Regular
Feb 03, 2010

RONALD WILLIAMS vs. MV TRANSPORTATION, INC.; AMERICAN HOME ASSURANCE, adjusted by BROADSPIRE

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's petition for reconsideration as it was untimely filed and not properly verified. The WCAB also denied the defendant's petition for reconsideration, adopting the reasoning of the Workers' Compensation Judge. The underlying decisions found the applicant sustained an industrial injury to his low back, requiring further treatment but no permanent disability. A separate decision found an industrial injury to his right upper extremity (CRPS) and neck/upper back (myofascial pain syndrome), resulting in 75% permanent disability and entitlement to further medical treatment.

Complex Regional Pain SyndromeMyofascial Pain SyndromeAgreed Medical EvaluatorAMA Guides 5th EditionLabor Code section 4658(d)Permanent Disability IndemnityPetition for ReconsiderationUntimely FilingLack of VerificationJurisdictional Time Limit
References
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