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

Case No. ADJ3540065
Regular
Apr 21, 2015

GRADLEY MAXHAM vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the award of temporary disability benefits. The applicant, a correctional officer, contracted Guillain Barre Syndrome due to a work-related infection. The Agreed Medical Evaluator, Dr. Pattison, concluded the applicant was temporarily totally disabled from November 10, 2005, to June 12, 2008, a period the defendant contested. The Board found Dr. Pattison's opinion regarding temporary disability remained valid despite requests for further medical evaluations on other issues.

Workers' Compensation Appeals BoardPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeAgreed Medical EvaluatorGuillain Barre SyndromeTemporary Total DisabilityPermanent and Stationary DateFunctional Capacity EvaluationsMedical-Legal ReportsMedical-Legal Opinion
References
Case No. ADJ10537068
Regular
Oct 09, 2020

BYRON GIBBONS vs. CALIFORNIA DEPARTMENT OF FORESTRY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed the finding that the applicant sustained an industrial injury to his respiratory system resulting in Guillain-Barre syndrome. While medical evidence supported the industrial causation of the applicant's condition, the Board deferred the issue of the lien claimant's reimbursement amount. The case is returned to the trial level for further proceedings regarding the lien amount, specifically to litigate whether it should be determined under the Official Medical Fee Schedule with penalties or potentially in excess of it. The original award of $1,085,678.88, a 15% penalty, and interest was rescinded pending this determination.

Guillain-Barre syndromeindustrial injuryAOE/COEreasonable medical probabilitysubstantial medical evidenceoccupational exposureinfectious agentsHVAC systemsewage treatmentofficial medical fee schedule
References
Case No. GRO 0032759, GRO 0032760, GRO 0032761
Regular
Jul 16, 2008

CALIFORNIA MEN'S COLONY vs. Legally Uninsured; STATE COMPENSATION INSURANCE FUND

This case involves an applicant's claim for permanent disability benefits arising from multiple injuries, including specific and cumulative trauma to the left knee and high blood pressure. The original decision apportioned liability for the knee injury per the *Wilkinson* standard, but the Appeals Board rescinded this due to new case law (*Benson*) requiring apportionment based solely on causation. The matter is returned for further proceedings to apply the *Benson* standard and potentially consider other relevant legal decisions.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityApportionmentWilkinsonCumulative TraumaDiminished Earning CapacityLabor Code Section 4660Permanent Disability Rating ScheduleBoughner
References
Case No. ADJ3733087 (SAC 0298774)
Regular
May 28, 2009

Luis Mejia vs. MARQUEZ BROTHERS FOODS, INC., CIGA on behalf of PACIFIC NATIONAL, in liquidation, by its servicing facility, INTERCARE INSURANCE SERVICES

This case involves a worker, Luis Mejia, seeking reconsideration of an earlier denial of his petition by the Workers' Compensation Appeals Board (WCAB). Mejia's current petition attempts to rehash his original arguments and introduce a new case, *Barr v. Workers' Comp. Appeals Bd.* The WCAB dismisses this petition because it is an impermissibly successive filing. The Board states that parties aggrieved by a final decision must seek review from the Court of Appeal, not file further petitions with the WCAB.

Workers' Compensation Appeals BoardReconsiderationDismissalSuccessive PetitionPetition for ReconsiderationWrit of ReviewCourt of AppealOrder Denying ReconsiderationReport and RecommendationDisqualification
References
Case No. ADJ3396302 (WCK 0043860)
Regular
Feb 27, 2014

JOHN ARESCO vs. MARINE WORLD AFRICA USA, TIG SPECIALTY INSURANCE COMPANY

The Workers' Compensation Appeals Board overturned the WCJ's finding that the applicant's psychiatric injury was a result of a sudden and extraordinary employment condition. Therefore, the claim for psychiatric injury is barred by Labor Code section 3208.3(d) due to employment of less than six months. Consequently, the applicant's permanent disability rating was reduced from 47% to 13%, excluding the psychiatric component. The Board found the applicant's injury, regardless of its specific cause (tainted food, trash, or berry), did not constitute an extraordinary employment event.

Labor Code section 3208.3(d)Guillain-Barre syndromepsychiatric injurysudden and extraordinary employment conditioncompensable consequence injurypermanent disabilityMarine World Africa USATIG Specialty Insurance CompanyTristar Risk Managementjanitor/maintenance worker
References
Case No. ADJ3269128 (SAC 0315100)
Regular
Jan 29, 2010

STEFANIE KING vs. SIERRA FAMILY SERVICES, STATE COMPENSATION INSURANCE FUND

This case concerns a defendant's petition for reconsideration of an administrative law judge's (WCJ) order for further medical record development. The Appeals Board dismissed the petition, finding the challenged order was not a "final order" subject to reconsideration. The Board also rescinded the WCJ's subsequent order appointing a physician, as the WCJ lacked authority to issue it while a petition for reconsideration was pending. Removal was granted on the Board's own motion to address the impropriety of the WCJ's order.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Granting RemovalDecision After RemovalAdministrative Law JudgeFinding and OrderCumulative PeriodIndustrial InjuryMononucleosisEpstein-Barr Syndrome
References
Case No. ANA 0326350
Regular
Nov 20, 2007

MONIKA LOUSCHER vs. GARDEN GROVE UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board granted reconsideration on its own motion and reversed its prior dismissal of the defendant's petition. The Board found the defendant's petition was improperly dismissed for lack of verification, as school districts are exempt from this requirement in certain proceedings. Crucially, the Board remanded the case for further proceedings, holding that the utilization review dispute resolution procedures under Labor Code sections 4610 and 4062 must be followed even with a prior award for medical treatment.

Workers' Compensation Appeals BoardGarden Grove Unified School DistrictOpinion and Order Granting ReconsiderationFindings and OrderPetition for ReconsiderationElectric Waveform Lablienutilization reviewACOEM guidelinesLabor Code § 4610
References
Case No. ADJ8361039
Regular
Oct 05, 2018

Ruth Sievers vs. Central Coast Orthopedics, Compwest Insurance Company

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of a finding of $67\%$ permanent disability. The applicant argued for $100\%$ permanent disability and for full reimbursement of vocational expert costs, including reviewing surveillance videos. The majority agreed with the WCJ that the expert's review of videos was not reasonable or necessary, while a dissenting commissioner would have allowed these costs. The Board adopted the WCJ's report and reasoning in denying the petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent Disability RatingVocational ExpertLabor Code Section 5811Surveillance VideosRebuttal EvidenceMedical-Legal CostsIndustrial Injury
References
Case No. ADJ1069838 (OAK 0342751) ADJ780338 (OAK O342750)
Regular
Nov 06, 2017

WANDA AUGUSTINE (Deceased) vs. FEDERAL EXPRESS, SEDGWICK CLAIMS MANAGEMENT SERVICES, THE DIRECTOR OF THE DEPARTMENT OF INDUSTRIAL RELATIONS

The Workers' Compensation Appeals Board rescinded a previous award and held that the Subsequent Injuries Benefits Trust Fund (SIBTF) is not liable for Jeff Malmuth's lien for vocational rehabilitation costs. The Board found that SIBTF was not a party when the costs were incurred and that the lien's recoverability against Federal Express requires further development of the record regarding the dates of injury and body parts involved in the underlying claims. The case is returned to the trial level for new proceedings and a decision on the lien's validity.

SIBTFJeff Malmuthlienvocational rehabilitation expertcostsLabor Code section 5811Barr v. Workers' Comp. Appeals Bd.Costa v. Workers' Comp. Appeals Bd.permanent disability ratingAcme Steel v. Workers' Comp. Appeals Bd. (Borman)
References
Case No. ADJ4659248 (MON 0335156)
Regular
May 19, 2011

Joseph Nollet vs. STATE OF CALIFORNIA DEPARTMENTOF CORRECTIONS, Legally Uninsured and Adjusted by STATE COMPENSATION INSURANCE FUND

This case involves a dispute over reimbursement for an applicant's expert witness fees in a workers' compensation claim. The defendant sought reconsideration of an order awarding these fees. The Appeals Board granted reconsideration and rescinded the award because the applicant failed to establish the expert's qualifications or present their report or testimony into evidence. The Board found that without this foundational proof, the administrative law judge could not properly exercise discretion regarding the reasonableness and necessity of the costs.

WCABJoseph NolletDepartment of CorrectionsState Compensation Insurance FundADJ4659248ReconsiderationExpert CostsLabor Code Section 5811Diminished Future Earning CapacityDFEC
References
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