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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ383777
Regular
Apr 04, 2011

Roxanna Ortiz vs. ONE SOURCE, ESIS

The Workers' Compensation Appeals Board denied Roxanna Ortiz's petition for reconsideration of a prior findings and order. The initial ruling determined she sustained industrial injury only to her cervical spine as a janitor, not to other body parts or any resulting temporary/permanent disability or need for further medical treatment. Ortiz argued the judge erred by favoring defense medical reports and discrediting her testimony due to minor inconsistencies in her injury description. The Board adopted the WCJ's report, emphasizing deference to credibility determinations and that admissibility of medical reports should have been challenged at trial, not on reconsideration. A dissenting opinion argued the judge overemphasized minor variations in Ortiz's account and that medical evidence did not sufficiently support denial of other injuries or further treatment.

OrtizOne SourceESISWCABFindings and OrderPetition for ReconsiderationWorkers' Compensation Administrative Law Judgeindustrial injurycervical spineright arm
References
Case No. GOL 96757
Regular
Jun 10, 2008

SA YANG LO vs. CUSTOM SENSORS & TECHNOLOGIES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a prior award, upholding the application of the 2005 Permanent Disability Rating Schedule. The Board found that exceptions allowing for the 1997 Schedule did not apply, as the applicant's temporary disability indemnity extended beyond January 1, 2005, and no qualifying pre-2005 reports indicated permanent disability. Furthermore, the Board found the applicant's vocational expert's opinion regarding diminished future earning capacity unpersuasive, thus affirming the initial 9% permanent disability rating.

Workers' Compensation Appeals BoardSA Yang LoCustom Sensors & TechnologiesInc.State Compensation Insurance FundGOL 96757Opinion and Order Denying ReconsiderationFindings and AwardWorkers' Compensation Administrative Law JudgeWCJ
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. ADJ757155
Regular
Mar 21, 2013

FRANK KEY vs. TORRANCE MEMORIAL MEDICAL CENTER, MATRIX ABSENCE MANAGEMENT, INC.

The Workers' Compensation Appeals Board denied the Defendant's Petition for Reconsideration. The Defendant argued that the applicant's condition had improved post-surgery, necessitating reevaluation by medical and vocational experts. However, the Board upheld the WCJ's finding that the applicant's testimony was credible and that his chronic pain and unemployability were well-established. The Board agreed with the WCJ that further evaluations were unnecessary as pain management was ongoing and did not alter the applicant's permanent total disability status.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeCredibilityGarza v. Workers' Comp. Appeals Bd.PhlebotomistLumbar spineCervical spineLeft lower extremityPsyche
References
Case No. ADJ237483
Regular
Nov 13, 2012

RAYEK J. FAHOUM vs. KAISER FOUNDATION HOSPITAL

The Workers' Compensation Appeals Board denied Rayek J. Fahoum's petition for reconsideration, upholding the findings of the Workers' Compensation Judge. The Judge's report found Fahoum sustained industrial injury to his neck and low back with secondary chronic pain syndrome, awarding 41% permanent disability. This decision relied on the opinions of the Agreed Medical Examiner and Dr. Renee Rinaldi, who concluded Fahoum experienced symptom magnification and that his condition was chronic pain syndrome, not fibromyalgia as claimed by Dr. Allen Salick. The Board extended great weight to the Judge's credibility findings regarding the medical opinions.

Workers' Compensation Appeals BoardReconsideration DeniedAgreed Medical ExaminerSubstantial Medical EvidenceFibromyalgiaChronic Pain SyndromeSymptom MagnificationOrthopedic InjuryLumbosacral StrainCervical Strain
References
Case No. ADJ3931400 (MON 0218725) ADJ4561489 (MON 0257189)
Regular
Nov 07, 2008

ELLEAN SLAUGHTER vs. CENTINELA HOSPITAL MEDICAL CENTER/TENET HEALTHCARE CORPORATION

This case involves a petition to reopen a worker's compensation claim where the applicant's permanent disability increased from 77.5% to 100% due to chronic pain syndrome. The defendant argued for apportionment to non-industrial conditions like multiple sclerosis and chronic fatigue syndrome. The Appeals Board granted reconsideration, rescinded the original award, and remanded the case for a new permanent disability rating, specifically requiring apportionment of the increased disability to the applicant's non-industrial conditions as per *Vargas v. Atascadero State Hospital*.

ReconsiderationPermanent DisabilityApportionmentNew and Further DisabilityChronic Pain SyndromeMultiple SclerosisChronic Fatigue SyndromeAgreed Medical ExaminersSB 899Vargas v. Atascadero State Hospital
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. ADJ6933293
Regular
Aug 05, 2015

Norma Salazar vs. Fresno County In-Home Support Services, York Insurance Service Group

The Workers' Compensation Appeals Board (WCAB) granted the applicant's request for an additional Qualified Medical Evaluator (QME) in pain management after reconsideration. The WCAB found good cause due to concerns raised by prior medical evaluators regarding the applicant's significant pain issues, extensive narcotic use, and the need for ongoing pain management strategies. Although the initial petition was procedurally flawed, the WCAB elected to address the merits and reversed the WCJ's denial.

Workers' Compensation Appeals BoardNorma SalazarFresno County In-Home Support ServicesYork Insurance Service GroupPetition for ReconsiderationQualified Medical EvaluatorPain ManagementLumbar Spine InjuryPsyche InjurySleep Disturbance
References
Case No. ADJ1088522 (RIV 0015524)
Regular
Jan 03, 2013

SAMANTHA VAN DUINHOVEN vs. SPA HOTEL & CASINO, CALIFORNIA CASUALTY, Administered by GAB ROBINS NORTH AMERICA

This case involved an applicant who claimed industrial injury to her neck, back, left shoulder, psyche, and associated chronic pain syndrome, resulting in a finding of permanent total disability. The defendant sought reconsideration, arguing the medical evidence did not support injury to the low back or a diagnosis of chronic pain syndrome. The Appeals Board reversed the findings on the low back and chronic pain syndrome, finding no substantial evidence to support them. Consequently, the applicant's permanent disability award was amended to 70%, based on ratings for her neck, left shoulder, and psyche.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent Total DisabilityChronic Pain SyndromeAgreed Medical EvaluatorQualified Medical EvaluatorMedical Record ReviewIndustrial InjuryPermanent Disability Indemnity
References
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