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

Case No. ADJ14627934
Regular
Apr 21, 2023

ELSA GARCIA JOFFRE GARCIA (Deceased) vs. U.S. BANK, OLD REPUBLIC

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior finding, remanding the case for further proceedings. The Board determined that the statutory presumption of industrial injury for COVID-19 did not apply as there was insufficient evidence of an "outbreak" at the applicant's workplace. Therefore, the applicant must now prove industrial causation without the benefit of this presumption. This requires substantial medical evidence to establish that the applicant contracted COVID-19 during the course of employment.

COVID-19industrial basispresumptionoutbreakAOE/COEmedical-legal evaluationPQMErebuttalsubstantial evidencedeath claim
References
Case No. MISC. NO. 264
En Banc
Oct 27, 2020

Workers' Compensation Appeals Board vs. State of California

The Appeals Board rescinds its suspension of WCAB Rules 10755, 10756, and 10888, which had previously suspended the dismissal of cases for failure to appear due to the COVID-19 emergency.

Workers' Compensation Appeals BoardCOVID-19State of EmergencyEn BancWCAB RulesSuspensionRescindsDismissalFailure to AppearApplication
References
Case No. ADJ16211996
Regular
Apr 07, 2025

Mauricio Garcia vs. Kern High School District, Self-Insured Schools of California

Defendant sought reconsideration of a Findings and Order by the WCJ which found that the applicant sustained an industrial COVID-19 infection. Defendant contended the presumption of compensability was rebutted and the medical opinions were not substantial evidence. The Workers' Compensation Appeals Board granted the petition for reconsideration to allow for further review of the factual and legal issues. The Board noted its continuing jurisdiction and that this order is not a final decision on the merits.

COVID-19Labor Code section 3212.88presumptionrebuttalsubstantial medical evidencePQMEStewart A. LonkyM.D.Petition for ReconsiderationAOE/COE
References
Case No. ADJ13344359
Regular
Mar 10, 2023

ANGELA DAWSON vs. PATTON STATE HOSPITAL, STATE COMPENSATION INSURANCE FUND

This case involves an applicant claiming a psyche and internal system injury due to COVID-19 infection sustained at work. The WCAB rescinded the prior decision, finding the trial judge erred by disregarding differing medical opinions on causation and by improperly applying a strict latency period calculation. The Board found the medical record undeveloped, necessitating further proceedings to establish a probable date of infection and work-related exposure. The matter was returned to the trial level for further development of evidence and a new decision.

COVID-19industrial causationmedical evidencelatency periodreasonable medical probabilitysubstantial evidenceworkers' compensationvocational rehabscope of employmentworkplace exposure
References
Case No. ADJ14362966
Regular
Feb 18, 2025

JESS PEREZ vs. SOUTHERN CALIFORNIA GAS COMPANY

The Workers' Compensation Appeals Board (WCAB) granted the defendant, Southern California Gas Company's, petition for reconsideration. The WCAB rescinded the November 12, 2024 Findings of Fact and Order, which had determined that applicant Jess Perez sustained an industrial COVID-19 injury. The case was returned to the trial level for further proceedings, as the Board found the WCJ's original decision lacked substantial evidence, noting the Qualified Medical Evaluator's report was limited in scope and did not fully address industrial causation. The Board emphasized the need to fully develop the record on the issue of industrial causation.

COVID-19industrial injuryEnergy TechnicianSouthern California Gas CompanyQualified Medical Evaluator (QME)occupational exposureinjury arising out of and in the course of employment (AOE/COE)Petition for Reconsiderationsubstantial evidencemedical reporting
References
Case No. ADJ13703697
Regular
May 22, 2025

VICTOR ROMERO vs. SANTA BARBARA SMOKEHOUSE, COMPWEST INSURANCE COMPANY

Victor Romero, the applicant, sustained a COVID-19 related injury resulting in pulmonary fibrosis and chronic lung disease. The defendant, Santa Barbara Smokehouse and Compwest Insurance Company, sought reconsideration of a Findings and Award (F&A) which entitled the applicant to temporary disability exceeding 104 weeks. The defendant argued that Dr. Gerald Markovitz's medical report was not substantial evidence and that their due process rights were violated. The Workers' Compensation Appeals Board reviewed the petition and the WCJ's report, affirming that Dr. Markovitz's report constituted substantial medical evidence. Consequently, the Board denied the defendant's Petition for Reconsideration.

AOE/COECOVID-19Pulmonary fibrosisChronic lung diseaseTemporary disabilityLabor Code § 4656Permanent and stationaryMMIPetition for reconsiderationSubstantial medical evidence
References
Case No. ADJ17148489
Regular
Jul 14, 2025

VERONICA SOTO VILLEGAS vs. ORANGE COUNTY PLASTERING COMPANY, INC.; CYPRESS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendants' petition for reconsideration regarding an industrial death claim and the dependency status of a minor stepchild. The Board affirmed the WCJ's finding that the deceased employee contracted COVID-19 at work due to an increased risk from his employment in enclosed spaces with infected co-workers. Furthermore, the Board upheld the finding that the stepchild was a total dependent, emphasizing a liberal interpretation of Labor Code sections 3501 and 4703.5 to include stepchildren within the definition of "child" for death benefits. This decision highlighted the importance of statutory context and legislative intent to protect dependent minors.

Workers' Compensation Appeals BoardReconsiderationLabor CodeCOVID-19Industrial InjuryDeath BenefitsDependencyStepchildIncreased RiskCausation
References
Case No. ADJ13511723
Regular
Mar 29, 2023

SOFIA SEVILLANO vs. STATE OF CALIFORNIA, IHSS, LEGALLY UNINSURED, ADMINISTERED BY YORK RISK SERVICES GROUP, A SEDGWICK COMPANY

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, upholding a prior decision that found COVID-19 related illness to be industrially caused. The Board found the employer failed to rebut the statutory presumption of industrial causation under Labor Code section 3212.86 with sufficient "other evidence." Arguments regarding mask use, lack of proof of employer infection, and alleged roommate illness were deemed insufficient to overcome the presumption.

Labor Code 3212.86presumption of industrial causationCOVID-19 illnessrebuttal burdenaffirmative burden of proofnon-occupational risksclose interpersonal contactSan Antonio Regional Hospitalcredibility determinationsADJ13511723
References
Case No. ADJ15229971
Regular
Mar 17, 2023

GRANT ELLISON vs. CITY OF SAN BUENAVENTURA, ATHENS ADMINISTRATORS

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration of an award to an employee injured by a COVID-19 vaccine. The Board found the injury arose out of and in the course of employment, citing the "dual purpose" rule where the employer strongly encouraged vaccination to reduce employee absences. The Board also applied the "personal convenience" doctrine, stating acts for comfort and convenience while at work are incidental to employment. Therefore, the employee's vaccine injury was deemed work-related, and the employer is liable.

Workers' Compensation Appeals BoardGrant EllisonCity of San BuenaventuraAthens AdministratorsCOVID-19 vaccinationarising out of employmentcourse of employmentdual purpose rulepersonal convenience doctrinework-related injury
References
Case No. ADJ13713694
Regular
May 09, 2025

JOSE ORTEGA vs. CARDENAS MARKETS, LLC; SAFETY NATIONAL CASUALTY CORPORATION

Applicant Jose Ortega claimed a COVID-19 related injury from May 10, 2020, while employed by Cardenas Markets, LLC. The Workers' Compensation Administrative Law Judge (WCJ) initially found the injury compensable under Labor Code section 3212.86. Defendant sought reconsideration, arguing the presumption's repeal and questioning the Qualified Medical Evaluator's evidence and judicial impartiality. The Workers' Compensation Appeals Board granted reconsideration to further review the factual and legal issues, deferring a final decision on the merits of the petition.

COVID-19 presumptionLabor Code section 3212.86Petition for ReconsiderationQualified Medical Evaluator (QME)substantial medical evidencejudicial biasstatutory repealdate of injurycompensabilityrebuttal of presumption
References
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