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

Case No. ADJ7425483
Regular
Aug 28, 2019

TERRI CEBALLOS vs. HEMET UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to further study the case of Terri Cebellos versus Hemet Unified School District. The WCAB found the original decision by the Workers' Compensation Judge (WCJ) insufficient regarding psychiatric injury causation. Specifically, the WCAB determined that the WCJ's analysis and the medical evidence presented did not fully address the legal requirements for establishing industrial causation, particularly concerning good faith personnel actions and the Rolda analysis. Consequently, the WCAB rescinded the WCJ's decision and returned the matter to the trial level for further proceedings and a new decision to properly develop the record.

Workers Compensation Appeals BoardReconsiderationPsychiatric injuryHostile work environmentPersonnel actionsGood faithPredominant causeRolda analysisCausationMedical evidence
References
7
Case No. MISSING
Regular Panel Decision

Kurz v. St. Francis Hospital

The defendants moved to preclude plaintiffs' expert testimony on causation or, alternatively, for a pretrial hearing regarding the plaintiff's vision loss. The plaintiff developed visual disturbances shortly after receiving Amiodarone intravenously following cardiac bypass surgery in 2008. Defendants argued a lack of scientific evidence linking short-term Amiodarone use to optic neuropathy, while the plaintiff's expert contended that rapid drug absorption could cause optic disc edema, a known side effect. Furthermore, the plaintiff highlighted medical records where defendant physicians themselves initially attributed the vision loss to the medication. The court, applying the Frye standard, determined that general causation—Amiodarone causing vision loss—is an established medical theory. It further ruled that the specific causation tests from Parker and Cornell, typically applied to toxic tort cases, were not strictly applicable here due to the distinct nature of medical malpractice. Consequently, the court denied the defendants' motion, finding an adequate foundation for the admissibility of the plaintiff's expert testimony, with any disputes regarding specific timing affecting only the weight of the evidence, not its admissibility.

Medical MalpracticeExpert TestimonyCausationAmiodaroneOptic NeuropathyVision LossMotion in LimineFrye StandardParker StandardCornell Standard
References
9
Case No. ADJ10788598
Regular
Jul 19, 2019

Shanai King vs. Food 4 Less

This case involves a claimant alleging a psychiatric injury due to workplace stress. The administrative law judge (WCJ) denied the claim, finding the applicant's testimony not credible and the medical evaluations insufficient. The Appeals Board granted reconsideration, rescinded the WCJ's findings, and returned the case for further proceedings. This decision stems from deficiencies in the medical evaluator's analysis of causation, conflating injury causation with permanent disability causation, and the need to develop the medical record.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrderPsyche InjuryQualified Medical EvaluatorIndustrial CausationPredominant CauseGood Faith Personnel ActionSubstantial EvidenceMedical Opinion
References
7
Case No. ADJ9895504
Regular
Jan 17, 2020

Elmer Umana vs. West Coast Arborists, Inc., Liberty Mutual Insurance Company

This case involves an employer's petition for reconsideration of a workers' compensation award. The employer argued the award was untimely, and that the Qualified Medical Examiner's (QME) reports were inadmissible as they lacked substantial evidence and proper causation analysis. The Appeals Board denied reconsideration, finding that any delay in issuing the award did not invalidate it. The Board also held that the QME's reports were admissible and constituted substantial evidence, as they detailed causation and reasoning for the impairment ratings.

Workers' Compensation Appeals BoardElmer UmanaWest Coast ArboristsInc.Liberty Mutual Insurance CompanyADJ9895504Opinion and Order Denying Petition for ReconsiderationFindings of Fact Award and OrdersAdministrative Law Judge (WCJ)Injury Arising Out of and Occurring in the Course of Employment (AOE/COE)
References
4
Case No. ADJ6500027
Regular
Jun 22, 2009

MARK SCOTT vs. SOUTHERN CALIFORNIA EDISON

The Workers' Compensation Appeals Board granted reconsideration of a finding that applicant Mark Scott sustained an industrial injury to his left knee. The Board found that the medical evidence presented, specifically operative reports, lacked any causation analysis and therefore did not substantially support the finding of industrial injury. Consequently, the case was remanded to the trial level for further development of the medical record concerning causation. The Board also deferred ruling on the statute of limitations defense pending this further development.

Workers' Compensation Appeals BoardSouthern California EdisonMark ScottAOE/COEStatute of LimitationsContinuous TraumaCumulative InjuryLabor Code Section 5405Reynolds v. Workers' Comp. Appeals Bd.Statute of Limitations Tolling
References
23
Case No. MISSING
Regular Panel Decision
Jun 01, 2009

People v. Nunn

This case addresses whether a court's discretion to deem a misdemeanor complaint charging a drug offense as an information, without a field test or laboratory analysis, violates a defendant's due process rights. The court distinguishes People v Kalin and Matter of Jahron S., applying the three-factor test from Mathews v Eldridge. It concludes that the substantial private interest in physical liberty and the risk of erroneous deprivation necessitate a laboratory report or field test in most drug-related cases, imposing minimal burden on the prosecution. Specifically, for defendant Mr. Nunn, the misdemeanor complaint was deemed an information on June 1, 2009, after the certified laboratory analysis was filed.

Due ProcessCriminal ProcedureMisdemeanorControlled SubstanceDrug PossessionMisdemeanor InformationMisdemeanor ComplaintPrima Facie CaseLaboratory AnalysisField Test
References
21
Case No. ADJ8168988
Regular
Oct 23, 2015

JOSE CEJA vs. YORBA LINDA CAR WASH, PENNSYLVANIA MANUFACTURERS INSURANCE GROUP

This case involves applicant Jose Ceja's petition for reconsideration of a Workers' Compensation Appeals Board decision. The Board denied reconsideration, upholding the finding that while Ceja sustained industrial injuries to his spine and knee, he failed to prove industrial causation for neurological, psychiatric, or sleep disorders. The medical evidence presented was deemed insufficient, lacking reasonable medical probability and proper reasoning for causation. Specifically, expert opinions were criticized for speculation, inadequate history, and reliance on applicant's subjective reporting without sufficient medical analysis.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrdersIndustrial InjuryCervical SpineLumbar SpineRight KneeNeurological SystemPsycheSleep Disorder
References
5
Case No. ADJ10223818
Regular
Sep 14, 2018

Irene Malagon vs. Larsen Supply Company, Inc.; Samsung Fire and Marine Insurance Company, Administered by Broadspire

This case involves a workers' compensation applicant claiming injury to her shoulders, neck, and back. The defendant sought reconsideration of the WCJ's finding of industrial causation, arguing the medical evidence was insufficient. The Board affirmed the WCJ's decision, finding the applicant's treating physician's report to be substantial evidence despite some historical inconsistencies. The Board also found the Qualified Medical Evaluator's reports problematic, particularly regarding causation for wrist and hand injuries due to contradictory opinions and insufficient analysis. A dissenting commissioner believed both medical reports had significant flaws, necessitating further evaluation.

AOE/COEProduction workerCumulative injuryMedical opinionSubstantial evidenceTreating physicianQualified Medical Evaluator (QME)CausationReconsiderationCredibility determination
References
0
Case No. ADJ8024294
Regular
Jun 23, 2015

MICHAEL BULLOCK vs. THE REGENTS OF UNIVERSITY OF RIVERSIDE, Permissibly Self-Insured, Administered By SEDGWICK CLAIMS SERVICES

This case involves Michael Bullock's workers' compensation claim against the Regents of the University of Riverside for cumulative trauma, psyche, and sleep disorders. The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the WCJ's finding of no industrial injury. The WCJ found Dr. Alice Martinson's report substantial evidence of no industrial causation, as it considered applicant's showering incident at home and a job analysis indicating less demanding duties. The WCJ also excluded Dr. Thomas Jackson's prior report due to procedural delays and found applicant's primary treating physician's opinion unsubstantial due to a failure to review key medical records and the job analysis.

Petition for ReconsiderationDeniedSubstantial Medical EvidenceWCJPQMEPrimary Treating PhysicianIndustrial CausationAOE/COECumulative TraumaJob Analysis
References
7
Case No. ADJ12471831
Regular
Apr 14, 2025

KATHLEEN ZIPP vs. ST HELENA U.S.D., PSI, NORTH BAY SCHOOLS INSURANCE AUTHORITY

The applicant sought reconsideration of a June 13, 2023, Findings and Order (F&O) which found her psychiatric injury claim barred by the good faith personnel action (GFPA) defense under Labor Code section 3208.3(h). The Workers' Compensation Appeals Board (WCAB) rescinded the F&O, determining that the medical evidence from the Qualified Medical Evaluator (QME), Dr. Kothapalli, was not sufficiently detailed or Rolda-compliant regarding the causation percentages attributed to personnel actions by Ms. Ely and other school district 'players.' The matter was returned to the trial level for further development of the record, including clarification of events and potentially additional medical opinion, to ensure a proper substantial causation analysis.

Labor Code 3208.3Good Faith Personnel ActionPsychiatric InjuryPredominant CauseSubstantial CauseRolda AnalysisActual Events of EmploymentPersonnel ActionsLawful Nondiscriminatory Good FaithMedical Evidence
References
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