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

Case No. SFO 0499272
Regular
Jul 07, 2008

Helen Miller vs. Green Gulch Farm and Zen Center, EVEREST NATIONAL INSURANCE

The Workers' Compensation Appeals Board affirmed the administrative law judge's finding that Helen Miller was an employee of Green Gulch Farm and Zen Center and sustained an industrial injury to her left ankle. The Board found Miller was not a volunteer due to the extensive benefits received and the employer's control, and her jogging injury during a lunch break was a reasonable expectancy of employment, not barred by Labor Code section 3600(a)(9). Therefore, her injury arose out of and occurred in the course of her employment.

Workers' Compensation Appeals BoardHelen MillerGreen Gulch Farm and Zen CenterEverest National InsuranceGallagher BassettSFO 0499272Opinion and Decision After ReconsiderationLabor Code Section 3351Labor Code Section 3352(i)Employee definition
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. 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. ADJ8501790
Regular
Jul 29, 2015

Kelly Chase vs. St. Louis Blues Hockey Club, Federal Insurance Company

The Workers' Compensation Appeals Board (WCAB) reversed a prior finding of industrial injury for a professional hockey player against the St. Louis Blues. The WCAB found insufficient connection to California for jurisdiction, citing the player's limited games in the state compared to his overall career. This decision followed the precedent set in *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)*, which requires a legitimate and substantial connection to the state for jurisdiction. The WCAB concluded that 21 games out of 485 did not meet this standard for a cumulative injury claim.

WCABSt. Louis Blues Hockey ClubFederal Insurance CompanyADJ8501790Opinion and Decision After Reconsiderationcumulative industrial injuryprofessional hockey playersubject matter jurisdictionstatute of limitationssubstantial medical evidence
References
Case No. GOL 0088273
Regular
Aug 18, 2008

ROBERT SIEBURG vs. RONALD WOLFE & ASSOCIATES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the original award, and returned the case for further development of the record. The Board found the findings of the administrative law judge regarding $97\%$ permanent disability and apportionment were not supported by substantial medical evidence. Specifically, the opinion of Dr. Kahmann was deemed deficient due to internal inconsistencies, lack of explanation for apportionment, and undefined work restrictions. The Board also found Dr. Basham's report did not meet the standard for substantial medical evidence regarding cognitive dysfunction.

WORKERS' COMPENSATION APPEALS BOARDROBERT SIEBURGRONALD WOLFE & ASSOCIATESSTATE COMPENSATION INSURANCE FUNDGOL 0088273OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONFindings and AwardWCJmaintenance person
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. ADJ8829857 ADJ8829856
Regular
Apr 18, 2016

DULCE ESPINOZA vs. JENCO PRODUCTIONS, INC., FIRST NATIONAL INSURANCE COMPANY OF AMERICA

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration because the appealed finding, deferring development of the record on psychiatric injury, was not a final order. The Board then treated the petition as one for removal, granted it, and rescinded the deferral. Ultimately, the Board found that the applicant failed to prove industrial injury to her psyche, citing a lack of objective evidence and inconsistencies in her reporting, as well as a conflicted medical opinion.

WORKERS' COMPENSATION APPEALS BOARDDULCE ESPINOZAJENCO PRODUCTIONSINC.FIRST NATIONAL INSURANCE COMPANY OF AMERICAADJ8829857ADJ8829856Petition for ReconsiderationPetition for RemovalDecision After Removal
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. 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. 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
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