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

Case No. ADJ9953527
Regular
Dec 15, 2017

NICOLE YARBER vs. MAXIM HEALTHCARE SERVICES, ESIS CHATSWORTH

The Appeals Board granted reconsideration of the WCJ's decision, finding that the medical evidence was insufficient to definitively rule out injury to the applicant's chest, ankles, lower extremities, and thoracic spine. The Board also noted discrepancies in the stipulated amounts for permanent disability advances and temporary disability overpayments. Consequently, these issues, along with permanent disability and attorney fees, are deferred. The case is returned to the trial level for further development of the record, specifically seeking additional opinions from the QME regarding causation for the disputed body parts and clarification on the financial issues.

Petition for ReconsiderationFindings and AwardWorkers' Compensation Administrative Law Judge (WCJ)Permanent DisabilityTemporary Disability IndemnityQualified Medical Evaluator (QME)CausationApportionmentStipulationFurther Development of Record
References
Case No. ADJ1081773
Regular
Dec 27, 2010

LORI GLEASON vs. R.G. III, INCORPORATED, APPLIED RISK SERVICES

This case involves a workers' compensation claim for an alleged industrial injury to the applicant's back, chest, arms, neck, and headaches resulting from an assault by her husband/employer on June 13, 2005. The administrative law judge found no industrial injury, and the applicant sought reconsideration. Medical evaluations, particularly by Dr. Byrne, concluded that the applicant's current disability and need for treatment stemmed from a prior 2001 motor vehicle accident and pre-existing conditions, not the 2005 incident. Ultimately, the Appeals Board denied reconsideration, agreeing that the applicant failed to prove the 2005 incident caused disability or the need for medical treatment.

Workers' Compensation Appeals BoardPetition for ReconsiderationIndustrial InjuryBack InjuryChest InjuryArm InjuryNeck InjuryHeadachesOffice ManagerAssault
References
Case No. ADJ608889 (POM 0271021) ADJ865253 (POM 0271022)
Regular
Mar 27, 2009

BARBARA GARCIA vs. COLEN AND LEE; FREMONT EMPLOYERS INSURANCE COMPANY as administered by EMPLOYERS

The defendant seeks reconsideration of an award finding applicant sustained work-related psyche and chest pain injuries, resulting in 90% permanent disability and need for further medical treatment. Defendant claims clerical, procedural, and evidentiary errors, and inconsistencies with witness testimony. The Board granted reconsideration to review a trial transcript to ensure a just and reasoned decision.

ReconsiderationFirst Amended Findings and AwardCumulative periodPsycheInternal chest painTemporary disabilityPermanent disabilityFurther medical treatmentClerical errorsProcedural errors
References
Case No. ADJ10847877, ADJ10847878
Regular
Mar 21, 2018

Rafael Nieto vs. Coast King Packing, LLC, YORK INSURANCE SERVICES GROUP

This case involves cross-petitions for reconsideration of a Workers' Compensation Administrative Law Judge's (WCJ) award. The Appeals Board denied the employer's petition while granting the applicant's petition. The Board affirmed the original award but amended it, finding the applicant sustained specific injuries to his chest wall, left knee, neck, thoracic spine, lumbar spine, and right elbow arising out of and occurring in the course of employment. The applicant's credibility determination was given great weight due to the WCJ's opportunity to observe the witness.

Petition for ReconsiderationFindings and AwardWorkers' Compensation Appeals BoardAdministrative Law Judgecredibility determinationGarza v. Workmen's Comp. Appeals Bd.AOE/COEcumulative injuryLabor Code 5412Employment Development Department
References
Case No. ADJ1988913
Regular
Aug 31, 2009

MATTHEW CLAPSADDLE vs. CITY OF SAN BUENAVENTURA, CORVEL OXNARD

The Workers' Compensation Appeals Board granted reconsideration to further develop the medical record regarding temporary disability for Matthew Clapsaddle. The Board affirmed the finding of industrial injury to the chest, permanent disability, and need for further medical treatment. However, the issues of temporary disability and the permanent and stationary date were deferred for future determination. This decision corrects an apparent lack of substantial evidence supporting the initial temporary disability findings.

Workers' Compensation Appeals BoardMatthew ClapsaddleCity of San BuenaventuraCorvel Oxnardfirefighter/paramediccumulative injurynon-cardiac chest paintemporary disabilitypermanent disabilityqualified medical evaluator
References
Case No. ADJ10281805
Regular
Oct 05, 2018

JOHN ROSA vs. PERSONNEL STAFFING GROUP, ZURICH AMERICAN INSURANCE

The applicant sought reconsideration of a Compromise and Release agreement approved by the WCJ, which settled his injury claim for $40,000. The applicant argued he did not consent to the settlement, his wages were miscalculated, and his back and knee injuries were unaddressed. The Appeals Board dismissed the petition as premature because no evidence or testimony was presented to support these claims under oath. The Board recommended the WCJ hold a hearing for the applicant to present evidence, after which a new decision can be issued and potentially reconsidered.

Workers' Compensation Appeals BoardPetition for ReconsiderationCompromise and ReleaseAmended Order ApprovingWCJPetition to Set AsidePremature DismissalGood CauseStipulationsDue Process
References
Case No. ADJ7750507
Regular
Mar 02, 2016

AURA GARCIA vs. CENTINELA VALLEY UNIFIED SCHOOL DISTRICT, ALLIANCE OF SCHOOLS FOR COOPERATIVE INSURANCE PROGRAMS

In this workers' compensation case, the Workers' Compensation Appeals Board granted the defendant's petition for reconsideration. The Board affirmed the finding that the applicant sustained an industrial injury but amended the original award. Specifically, the issue of the period of temporary disability indemnity and associated attorney's fees was deferred. The matter was returned to the trial level for further proceedings on these deferred issues.

Workers' Compensation Appeals BoardInstructional AideIndustrial InjuryRight ShoulderBoth KneesNeckLow BackBoth WristsRight RibsChest
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ7427901
Regular
Oct 29, 2013

PABLO GONZALES vs. KVS TRANSPORTATION, INC., SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a finding that Pablo Gonzales sustained a specific industrial injury of Valley Fever on December 29, 2009. The Board found that while medical evidence did not support a specific injury date, the record might support a cumulative injury, occupational disease, or latent injury arising from employment. The case is returned to the WCJ to determine if pleadings should be amended to conform to this proof and to issue a new decision. Issues regarding self-procured medical treatment and medical-legal expenses were improperly addressed and should be limited to issues identified at trial.

Workers Compensation Appeals BoardKVS TransportationSeabright Insurance CompanyPablo GonzalesADJ7427901Findings and AwardReconsiderationIndustrial InjuryDecember 29 2009Chest
References
Case No. ADJ9549789, ADJ10928268
Regular
May 05, 2025

IVAN MIRAMONTES vs. LOS ANGELES METROPOLITAN TRANSIT AUTHORITY

Applicant Ivan Miramontes sought reconsideration of a Joint Findings and Award from January 27, 2025, which found industrial injury to his psyche and specific body parts with assigned permanent disabilities. Applicant raised contentions including defective service, mischaracterization of his primary orthopedic doctor, alleged attorney failure, and reliance on unsubstantial medical evidence, particularly regarding Dr. Faddoul's report. The Appeals Board granted reconsideration solely to admit specified exhibits into evidence to correct a clerical error by the WCJ. The Board otherwise affirmed the WCJ's findings, concluding that the petition was timely filed and the applicant's other contentions lacked merit.

Petition for ReconsiderationJoint Findings and AwardIndustrial InjuryPsycheHipsChestNeckWristShouldersPermanent Disability
References
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