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

Case No. ADJ7288330
Regular
Oct 03, 2016

GLORIA BENITEZ vs. NEWPORT SUBACUTE HEALTH CARE CENTER, ALASKA NATIONAL INSURANCE COMPANY

The applicant, Gloria Benitez, sought to reopen her workers' compensation claim to include injury to additional body parts beyond her cervical spine and psyche. The original award found injury only to the cervical spine and psyche, with a 19% permanent disability rating for the cervical spine. While the WCJ's initial decision denied injury to additional body parts, the Board granted reconsideration. The Board amended the original findings to defer the issue of injury to the alleged additional body parts, while affirming other aspects of the WCJ's order, including the appointment of a regular physician to evaluate new and further disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderNew and Further DisabilityAgreed Medical ExaminerRegular PhysicianLabor Code Section 5410Petition to ReopenIndustrial InjuryCervical Spine
References
4
Case No. ADJ7924562
Regular
Sep 19, 2014

RAUL HERNANDEZ vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

The applicant sought reconsideration of a WCJ decision that found an industrial injury to the low back but not the cervical spine or left ankle, with no permanent disability or further medical treatment. The applicant argued the QME's reports were insubstantial and that prior permanent disability was not considered. The Appeals Board granted reconsideration to amend the original award to include injury to the cervical spine, affirming the remainder of the decision. Therefore, the applicant sustained injury to his low back and cervical spine.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryLow Back InjuryCervical Spine InjuryPermanent DisabilityFurther Medical TreatmentPanel Qualified Medical EvaluatorLabor Code Section 4664(b)
References
0
Case No. 526688
Regular Panel Decision
Dec 27, 2018

Matter of Bufearon v. City of Rochester Bur. of Empl. Relations

Claimant Kamren Bufearon sustained work-related injuries in a motor vehicle collision on March 4, 2016, for which his workers' compensation claim was established for injuries to his left shoulder, left hip, and lower back. Subsequently, he sought to amend his claim to include a causally-related cervical spine injury, which was initially approved by a Workers' Compensation Law Judge. However, the Workers' Compensation Board reversed this decision, finding that the claimant failed to sufficiently demonstrate a causal relationship between his cervical spine condition and the March 4, 2016 incident. The Appellate Division affirmed the Board's decision, noting that the medical testimony from two physicians contained conflicting findings and equivocal narratives regarding causation. The court concluded that the Board was entitled to reject the physicians' opinions as speculative, particularly since neither physician had reviewed the claimant's prior medical records for a pre-existing cervical spine fusion surgery.

Cervical spine injuryCausal relationshipMedical evidenceSubstantial evidence reviewAppellate DivisionWorkers' Compensation BoardPre-existing conditionCredibility of physiciansBurden of proofMotor vehicle accident
References
13
Case No. ADJ7969168; ADJ9330687
Regular
Mar 23, 2016

Mario Alcantar vs. Alfredo Melchor, Zenith Insurance Company

This case involves applicant Mario Alcantar's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision. The WCAB previously rescinded a joint finding and substituted a new one finding applicant sustained a lumbar spine injury but not a cervical spine injury during specified employment periods. Alcantar sought reconsideration to include a cervical spine injury during a different, unspecified period. The WCAB denied the petition, affirming its prior decision and incorporating it by reference.

Petition for ReconsiderationDecision After ReconsiderationJoint Findings of Factcumulative periodlumbar spinecervical spineindustrial injuryarising out of and occurring in the course of employmentWorkers' Compensation Appeals BoardZenith Insurance Company
References
0
Case No. MISSING
Regular Panel Decision

Malburg v. Keller

Plaintiff commenced a personal injury action following a motor vehicle accident. The defendant moved for summary judgment, arguing the plaintiff did not sustain a serious injury under Insurance Law § 5102 (d), and the Supreme Court granted this motion, dismissing the amended complaint. On appeal, the court modified the order by denying the motion in part. It reinstated the amended complaint concerning the significant limitation of use category of serious injury for the plaintiff's cervical spine injury. This modification was based on an independent medical examination report establishing a triable issue of fact.

Personal InjuryMotor Vehicle AccidentSummary JudgmentSerious InjuryInsurance LawCervical Spine InjuryRange of MotionIndependent Medical ExaminationAppellate ReviewWorkers' Compensation
References
1
Case No. ADJ1337074 (GRO 0034564) ADJ1286218 (GRO 0034565)
Regular
Jun 24, 2009

Dave Gerletti vs. SANTA MARIA AIRPORT DISTRICT, GREGORY BRAGG STOCKTON

The Workers' Compensation Appeals Board denied Dave Gerletti's petition for reconsideration of an award for a cumulative trauma injury to his cervical spine and lungs. The original award found 35% permanent disability, apportioning 50% of the cervical spine disability to non-industrial factors based on a Qualified Medical Evaluator's opinion of degenerative changes. The majority affirmed the WCJ's reliance on this opinion, finding it adequately explained. A dissenting opinion argued the QME's apportionment was speculative and improperly based on age and genetics, recommending an unapportioned award for the cervical spine injury.

Workers' Compensation Appeals Boardcumulative traumacervical spinelungspermanent disabilityapportionmentQualified Medical EvaluatorAgreed Medical Examinerarthritic degenerationnon-industrial factors
References
1
Case No. ADJ9762954
Regular
Aug 16, 2019

CHRISTOPHER PAPPAS vs. COUNTY OF SANTA BARBARA, CORVEL CORPORATION

This case concerns a workers' compensation applicant claiming a cumulative injury to his cervical spine. The Appeals Board denied reconsideration of its prior decision, which had apportioned 48% of the applicant's current 80% permanent disability to a prior cervical spine injury. The Board found the defendant met its burden of proving overlap between the prior and subsequent injuries, thus reducing the disability award for the current injury. The applicant's argument that he should receive the dollar value difference between the two awards was also rejected, with the Board applying the established Fuentes Formula A for calculating benefits in multiple injury cases.

Workers Compensation Appeals BoardPetition for ReconsiderationCumulative InjuryCervical SpinePermanent DisabilityApportionmentLabor Code Section 4664(b)KoppingAgreed Medical EvaluatorAlmaraz/Guzman
References
11
Case No. ADJ4283233
Regular
Aug 03, 2009

GARY JOHNSTON vs. BAY PACIFIC PIPELINES, STATE COMPENSATION INSURANCE FUND

This case concerns Gary Johnston's claim for workers' compensation benefits for a cumulative injury to his cervical spine. Initially, the workers' compensation judge denied the claim, finding no industrial injury and citing the statute of limitations. The Appeals Board granted reconsideration, reversed the initial decision, and found that Johnston sustained a cumulative injury that was not time-barred. The Board has now denied the defendant's petition for reconsideration, affirming its prior decision that the applicant's cervical spine injury is compensable.

Workers' Compensation Appeals BoardIndustrial InjuryCervical SpinePipe LayerStatute of LimitationsReconsideration DeniedFindings and OrderOpinion and Order Granting ReconsiderationDecision After ReconsiderationCompensability
References
2
Case No. ADJ8429146 ADJ8429148
Regular
Dec 11, 2018

STEPHANIE L. TRUEX vs. ALLEGENT GROUP CERTIFIED ACCOUNTANTS, STATE FARM CALIFORNIA, WC CLAIMS

The Appeals Board affirmed a decision that the applicant did not sustain an injury arising out of and occurring in the course of employment on January 15, 2010. In a separate case, the Board affirmed findings regarding cumulative injury to the applicant's wrists but amended the decision to defer the issue of injury to the cervical spine and shoulders pending further proceedings. This amendment is due to the finding that the basis for injury to the cervical spine and shoulders was not substantial evidence. The matter is returned to the WCJ for further development of the record, including an examination by a court-appointed physician.

Workers' Compensation Appeals BoardReconsiderationFindings and OrdersInjury AOE/COESubstantial EvidenceQualified Medical ExaminerRegular PhysicianCervical SpineShouldersWrists
References
7
Case No. ADJ1211037
Regular
May 10, 2010

ANGELICA DAYRIT vs. WALGREENS

The Workers' Compensation Appeals Board granted Walgreens' petition for reconsideration, overturning the prior award for cervical, lumbar spine, and psyche injuries. The Board found the applicant failed to provide sufficient evidence and testimony to establish industrial injury to her cervical and lumbar spine. However, the Board affirmed the finding of a psyche injury, acknowledging that hearsay evidence from a physician's report could support this claim. The case is remanded for further proceedings to determine temporary disability, permanent disability, and attorney's fees based solely on the psyche injury.

Workers' Compensation Appeals BoardSenior Pharmacy TechnicianCumulative TraumaOrthopedic ComponentsPsychiatric ComponentsMandatory Settlement ConferenceApplicant Failure to AppearNotice to AppearDue ProcessSubstantial Evidence
References
7
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