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

Case No. OAK 294681
Regular
Nov 14, 2007

SCOTT SIMPSON vs. GEO OPTIONS, INC., EARTFORD INSURANCE COMPANY

The Workers' Compensation Appeals Board affirmed the WCJ's decision regarding permanent disability apportionment, finding substantial medical evidence supported a 50% apportionment to pre-existing conditions. The Board also upheld the WCJ's finding of unreasonable delay in medical treatment, justifying a penalty against the defendant. A minor clerical error in the award regarding penalty references was corrected.

Workers' Compensation Appeals BoardScott SimpsonGeo Options Inc.Hartford Insurance CompanyOAK 294681Opinion and Decision After Reconsiderationpermanent disabilityapportionmentspondylolisthesisqualified medical examiner
References
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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 57
Regular
Apr 28, 2011

LAURIE TRINIDAD vs. ALBERTSON'S, PSI, Administered by SPECIALTY RISK SERVICES

This case concerns an applicant's claim for temporary disability benefits beyond five years from the date of injury. The Workers' Compensation Appeals Board (WCAB) affirmed the WCJ's decision that it lacked jurisdiction to award these benefits. The WCAB determined that while the applicant experienced new periods of disability after the five-year mark, no petition to reopen or for new and further disability was filed within the statutory period following a prior order awarding temporary disability. The Board distinguished this case from prior decisions where jurisdiction extended beyond five years due to the absence of any prior award or a continuing award that was improperly terminated.

Workers Compensation Appeals BoardLaurie TrinidadAlbertson'sSpecialty Risk ServicesOpinion and Decision After Reconsiderationtemporary disability benefitsjurisdictiongrocery checkerlumbar spinebilateral shoulders
References
Case No. ADJ10021120 ADJ8949346
Regular
Apr 14, 2017

ANTHONY BERNARD EDWARDS (Dec'd), CANDACE EDWARDS (Widow), ASHLEY EDWARDS (Daughter), ANTHONY EDWARDS, JR. (Son) vs. CITY OF LOS ANGELES; LOS ANGELES WORLD AIRPORTS, Permissibly Self-Insured

This case involves a workers' compensation death benefit claim for Anthony Bernard Edwards, who died in the course of his employment. The dependents seek death benefits and burial expenses, which were initially awarded by the WCJ. The employer, City of Los Angeles, sought reconsideration, arguing it should receive credit for a third-party settlement the dependents obtained from Kaiser Permanente. The Board agreed to reconsider the issue of credit, specifically whether Civil Code section 3333.1 bars such credit. The Board ultimately deferred the credit issue, affirming the death benefit award and returning the matter for further proceedings to determine the applicability of Civil Code section 3333.1 and potential employer negligence.

Workers' Compensation Appeals BoardADJ10021120ADJ8949346death benefitsLabor Code section 4702burial expensesCivil Code section 3333.1Medical Injury Compensation Reform ActMICRAthird-party settlement
References
Case No. ADJ11125430
Regular
Sep 30, 2019

Tiffany Merritt vs. CDCR-CALIFORNIA INSTITUTE FOR WOMEN; Legally Uninsured, Adjusted By STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, affirming the WCJ's decision that the applicant did not sustain injury to her psyche arising out of and occurring in the course of employment. The Board found that the applicant's psychological injury was predominantly caused by a lawful, non-discriminatory, good faith personnel action, specifically a transfer to a new department. However, the Board also amended the original order to defer all issues concerning injuries to body parts other than the psyche. These other issues will be returned to the WCJ for further proceedings and decision.

WORKERS' COMPENSATION APPEALS BOARDTIFFANY MERRITTCDCR-CALIFORNIA INSTITUTE FOR WOMENLegally UninsuredSTATE COMPENSATION INSURANCE FUNDADJ11125430Petition for ReconsiderationFindings and OrderWCJHardesty demand
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ9904638, ADJ7352002
Regular
Jul 25, 2017

Carmen Caez vs. California Department of Social Services (IHSS), administered by YORK RISK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board granted reconsideration, amending the prior decision to defer the statute of limitations issue for the applicant's low back and other injuries sustained on November 1, 2008. The Board found the initial determination barring benefits lacked substantial evidence, particularly regarding the timeliness of the claim under Labor Code section 5405. Further development of the record is required to address potential tolling of the statute of limitations due to the employer's failure to provide proper workers' compensation notification. The case is returned for further proceedings to resolve these issues.

ADJ9904638ADJ7352002IHSS caregiverLabor Code sections 35503551statute of limitations tolledclaim formHoneywell v. Workers' Comp. Appeals Bd.denial letterApplication for Adjudication
References
Case No. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
Case No. ADJ4571860
Regular
Oct 16, 2008

FRANK REID vs. COUNTY OF SAN DIEGO

The Appeals Board reversed the trial judge's decision, finding the applicant's skin cancer was not an insidious, progressive disease and thus jurisdiction over permanent disability could not be reserved. They also disallowed apportionment of the applicant's 37 percent permanent disability, as he had no prior awards and was covered by a statutory exception for peace officer injuries. The Board established July 28, 2003, as the permanent and stationary date and corrected the date of injury to July 28, 2003.

Workers' Compensation Appeals BoardFrank ReidCounty of San DiegoCriminal Investigator IVindustrial injuryskin cancerinsidious disease processpermanent and stationarypermanent disabilityapportionment
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
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