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

Case No. ADJ823138 (OXN 0142604)
Regular
Oct 25, 2010

CHERYL PEET vs. COUNTY OF VENTURA, Permissibly SelfInsured, Administered By CORVEL CORPORATION

The Workers' Compensation Appeals Board is reconsidering a prior decision that found a deputy probation officer sustained industrial injuries resulting in 78% permanent disability. The defendant sought reconsideration, arguing the Qualified Medical Examiner's (QME) opinion, which formed the basis of the award, was ambiguous and unsubstantiated. The Board agrees that the QME's assessment of 60% whole person impairment is not adequately supported by the record, particularly in light of the applicant's own testimony regarding her daily activities. Therefore, the case is returned to the trial level for further evidence development and a new decision, with consideration for cost of living adjustments if a life pension is awarded.

Workers Compensation Appeals BoardCheryl PeetCounty of VenturaCORVEL CORPORATIONADJ823138OXN 0142604Opinion and Decision After Reconsiderationdeputy probation officerindustrial injuryright upper extremity
References
Case No. ADJ8731635
Regular
Apr 02, 2019

Daissy Contreras vs. CRESTWOOD BEHAVIORAL HEALTH, UNION FIRE INSURANCE COMPANY

The Appeals Board granted reconsideration and rescinded the prior award, finding the medical record inadequate to determine applicant's claim of Complex Regional Pain Syndrome (CRPS). While some physicians noted symptoms consistent with CRPS, the Agreed Medical Examiner (AME) found no objective evidence. The Board ordered the matter returned to the trial level for further development of the medical record by appointing a pain management specialist. This new evaluation will aim to diagnose the applicant's right upper extremity condition and determine its industrial causation.

Complex Regional Pain SyndromeCRPSskin injuryrashcumulative traumaAgreed Medical ExaminerAMEskin conditionright upper extremitypain management specialist
References
Case No. ADJ9176746, ADJ10288149
Regular
Jan 05, 2018

ANA MARIA ROCHA vs. GREEN VALLEY CHRISTIAN CENTER, CHURCH MUTUAL INSURANCE COMPANY

This case involves Ana Maria Rocha's petition for reconsideration of a Workers' Compensation Appeals Board decision. The Board denied reconsideration, adopting the Administrative Law Judge's report. The applicant's primary contentions involved a separate psychological injury, her CRPS classification, apportionment of disability, and future medical treatment for her neck and back. The Judge found no separate psychological injury, that medical opinions on CRPS classification were for physicians, that apportionment was supported by substantial evidence regarding pre-existing conditions, and that further medical treatment was not warranted for her neck and back.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedAdministrative Law JudgePsychological InjuryPermanent DisabilityApportionmentCRPSWhole Person ImpairmentAMA Guides
References
Case No. ADJ363747 (RDG 0125429)
Regular
May 05, 2009

CAROLYN BETTIS vs. SISKIYOU DEVELOPMENT CO. INC., STATE COMPENSATION INSURANCE FUND

The WCAB granted reconsideration, rescinded the July 15, 2009 Findings and Award, and returned the matter for a new decision consistent with Dr. Horner's medical opinion which found that the applicant's CRPS was not industrially caused.

Complex Regional Pain SyndromeCRPSindustrial causationsubstantial evidencequalified medical evaluatorpermanent and stationary datetemporary disabilitywhole person impairmentmedical opinionburden of proof
References
Case No. ADJ8376717
Regular
Apr 12, 2019

SOOHYUN KIM vs. VALENTINO, Permissibly Self-Insured, Administered By GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board (WCAB) affirmed the finding of industrial injury for Complex Regional Pain Syndrome (CRPS) but rescinded the finding of chronic pain. The WCAB also rescinded the finding of permanent and total disability, finding the medical evidence supported a scheduled disability rating between 64-81%. The vocational expert's opinion was deemed insufficient to rebut the scheduled rating or establish permanent total disability. The case was returned to the trial level for further proceedings and a new permanent disability finding based on the medical reports.

Complex Regional Pain SyndromeCRPSIndustrial InjuryPermanent and Total DisabilityReconsiderationVocational ExpertMedical EvidencePermanent Disability RatingAMA GuidesLabor Code
References
Case No. ADJ7721810
Regular
Feb 08, 2016

MAUREEN HIKIDA vs. COSTCO WHOLESALE

This case involves an applicant seeking reconsideration of a $90\%$ permanent disability award for an industrial injury. The applicant argues for $100\%$ permanent disability without apportionment, while the defendant maintains the original award. The Appeals Board rescinded the original decision and remanded the case for further proceedings on permanent disability, specifically ordering the WCJ to consider the applicant's psychiatric injury's contribution to her current disability, in addition to the previously considered CRPS. A dissenting commissioner argued that the applicant's total permanent disability resulted solely from treatment for the industrial injury, thus precluding apportionment.

Complex Regional Pain SyndromeCRPSapportionmentpermanent disabilitypsyche injuryvocational evidenceAgreed Medical EvaluatorAMEcarpal tunnelcognitive impairment
References
Case No. ADJ9854290
Regular
Apr 10, 2017

MARY VIEIRA vs. PASO ROBLES TANK, INCORPORATED., OLD REPUBLIC GENERAL INSURANCE CORPORATION, GALLAGHER BASSETT SERVICES

This case involves defendant's petition for reconsideration of a finding of total permanent disability due to an admitted industrial right ankle injury complicated by Complex Regional Pain Syndrome (CRPS). Defendant argues the Qualified Medical Evaluator's (QME) report lacks substantial evidence due to failure to review prior injury records and for not using DRE ratings. The Appeals Board granted reconsideration to admit a supplemental QME report that reviewed the prior injury records and did not alter the QME's opinions. The Board intends to admit this supplemental report unless good cause is shown within 15 days.

Complex Regional Pain SyndromeCRPSQualified Medical EvaluatorQMEsubstantial evidenceDRE ratingsAMA Guidessupplemental reportPetition for ReconsiderationFindings and Award
References
Case No. ADJ12180865
Regular
Dec 01, 2022

FRANCELIA DIAZ vs. MEDTRONIC, INC., ACE AMERICAN INSURANCE COMPANY

The Appeals Board granted reconsideration and rescinded the WCJ's order for an additional pain management QME panel. The Board found the applicant did not demonstrate good cause for the panel, as the current orthopedic QME's reports sufficiently addressed the applicant's diagnoses, including CRPS. The Board substituted new findings acknowledging the applicant's AOE/COE injuries but denying the request for a pain management QME panel.

Workers' Compensation Appeals BoardMedtronicInc.Ace American Insurance CompanyAdjudication Number ADJ12180865Petition for ReconsiderationAmended Opinion on DecisionFindings of Fact and OrderInjury AOE/COEQuality Control Inspector
References
Case No. ADJ7673925
Regular
Jul 02, 2015

MICHELLE ROEHRIG vs. CHILD DEVELOPMENT, INC., UNITED STATES FIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to address the defendant's challenges to the previous award. The Board found the existing medical evidence insufficient to support the awarded permanent disability rating and injury in the form of a sleep disorder. Consequently, these issues, along with attorney fees, are deferred for further development of the record at the trial level. The decision emphasizes the need for a formal sleep study and admonishes defense counsel for procedural and citation deficiencies.

Complex Regional Pain SyndromeCRPSAlmaraz-Guzmanagreed medical examinerAMEqualified medical examinerPQMEAMA Guides5th Editionsleep disorder
References
Case No. ADJ9961038
Regular
Nov 12, 2025

DEBORAH JANKOWSKI vs. TVI, INC.; ZURICH AMERICAN INSURANCE COMPANY

Defendant petitioned for reconsideration of the August 19, 2024 Findings of Fact, Award and Order, which found applicant Deborah Jankowski 100% permanently totally disabled. Petitioner contended errors regarding the permanent disability award, lack of established schedule rating, and reliance on treating physicians over Agreed Medical Evaluators. After an interim order granting the petition and a subsequent status conference, the parties agreed to resolve the matter by Compromise and Release. Consequently, the Workers' Compensation Appeals Board rescinded the August 19, 2024 decision and returned the case to the district office to consider the proposed settlement.

AOE/COECRPSAgreed Medical Evaluatorsvocational rehabilitationpermanent total disabilitypermanent disabilitycompromise and releaseFindings of FactAward and Orderrescinded
References
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