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

Case No. ADJ8939849
Regular
Jan 04, 2016

GEORGE KIMMEL vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation claim for hearing loss. The applicant, a former correctional officer, alleged injury from a 1978 bomb blast and cumulative trauma from noise exposure throughout his career. The Workers' Compensation Appeals Board (WCAB) rescinded the initial award finding a cumulative trauma injury with a 2014 date of injury. The WCAB determined the case involves potential specific and cumulative injuries, requiring further development of the record regarding the date of injury, last injurious exposure, and the exact nature of the injuries. The matter was returned to the trial level for these further proceedings.

Cumulative traumaStatute of limitationsLachesDate of injurySpecific injuryTinnitusHearing lossQualified Medical ExaminerImprovised explosive deviceMatch bomb
References
3
Case No. ADJ410642 (FRE 0218111)
Regular
Jul 21, 2009

PATRICK SLENDERS vs. JOSEPH GALLO FARMS, STATE COMPENSATION INSURANCE FUND, ALASKA NATIONAL INSURANCE COMPANY

This case concerns whether Patrick Slenders sustained a cumulative industrial injury to his right knee between July 14, 2002, and February 21, 2003, while employed by Joseph Gallo Farms. The defendant insurers, State Compensation Insurance Fund (SCIF) and Alaska National Insurance Company, sought reconsideration of a prior decision finding such an injury occurred. They argued the primary treating physician's opinion was not substantial evidence and did not meet the legal definition of cumulative trauma. The Appeals Board affirmed the finding, holding that the physician's opinion, detailing progressive deterioration of the knee due to work use, constituted substantial evidence of a compensable cumulative trauma injury.

Workers' Compensation Appeals BoardPatrick SlendersJoseph Gallo FarmsState Compensation Insurance FundAlaska National Insurance CompanyReconsiderationIndustrial InjuryRight KneeCumulative TraumaDr. David E. Taylor
References
1
Case No. ADJ1312501, ADJ4641701
Regular
May 03, 2011

Walter Harrison vs. ROLLING HILLS COUNTRY CLUB, CNA INSURANCE COMPANY, GENERAL INSURANCE COMPANY OF AMERICA, FIRST NATIONAL INSURANCE COMPANY OF AMERICA, CALIFORNIA INDEMNITY INSURANCE COMPANY, GALLAGHER BASSETT SERVICES, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant with a prior specific injury to his right knee and claims of cumulative trauma to the knee, low back, and coccidioidomycosis. The Workers' Compensation Appeals Board granted reconsideration and rescinded the original award. The Board found no substantial medical evidence linking the applicant's coccidioidomycosis to cumulative trauma, requiring the matter to return to the trial level. Further proceedings are needed to determine the actual nature of the cumulative trauma injury, its date, and relevant liability.

CoccidioidomycosisCumulative traumaDate of injurySpecific injuryMedical evidenceAgreed Medical Examiner (AME)Permanent disabilityReconsiderationFindings and AwardLabor Code section 5500.5
References
0
Case No. MON 0271251 MON 0271252 MON 0271253
Regular
Jan 09, 2008

CONSUELO AMADOR vs. JIMWAY, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INDEMNITY INSURANCE COMPANY, in liquidation, by CAMBRIDGE INTEGRATED SERVICES, STATE COMPENSATION INSURANCE FUND

This case concerns liability for an applicant's cumulative trauma injury where both Fremont Indemnity (represented by CIGA) and the State Compensation Insurance Fund (SCIF) provided coverage. The Workers' Compensation Appeals Board reversed an arbitrator's decision, finding that SCIF, as a solvent insurer jointly and severally liable for the injury, constitutes "other insurance." Therefore, under Insurance Code section 1063.1(c)(9), CIGA is not liable for the applicant's cumulative trauma injury.

CIGAFremont IndemnitySCIFcumulative traumajoint and several liabilitycovered claimother insuranceInsolvencyLabor Code section 5500.5Insurance Code section 1063.1(c)(9)
References
12
Case No. ADJ7785251
Regular
Nov 14, 2014

Jon Brothers vs. STATE OF CALIFORNIA, DEPARTMENT OF FORESTRY AND FIRE PROTECTION, COASTAL/NORTH REGION; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to clarify that the applicant's cumulative trauma orthopedic injury claim is still under development. The Board agreed with the WCJ that the defense's medical expert, Dr. Baldwin, failed to provide substantial medical evidence due to a misunderstanding of cumulative trauma principles. Dr. Baldwin improperly required documented prior specific injuries to opine on cumulative trauma, thereby failing to adequately assess the applicant's extensive work history. Therefore, the case is affirmed except for the amendment of a finding of fact to reflect that the orthopedic injury claim is contested and requires further medical evaluation.

Cumulative traumaQualified Medical EvaluatorIndependent Medical Evaluatorsubstantial medical evidenceorthopedic injurybinaural hearing losscardiovascular systemBattalion Chiefretired annuitantorthopedic cumulative trauma
References
1
Case No. ADJ4416816 (AHM 0140718); ADJ3554653 (AHM 014719)
Regular
Sep 22, 2010

MARK ROGERS vs. ALL ABOUT FLOORS, INC., PREFERRED EMPLOYERS INSURANCE COMPANY and STATE COMPENSATION INSURANCE FUND; BARRETT BUSINESS SERVICES A.K.A WESTERN FLOORING INSTALLATIONS, PSI

This case involves Mark Rogers' claim for workers' compensation benefits for back injuries sustained while employed by All About Floors, Inc. and Barrett Business Services. The applicant alleged cumulative trauma injury, but medical evidence from Dr. Einbund was inconsistent. Despite Dr. Einbund's initial uncertainty and later inability to state with reasonable medical certainty that a cumulative trauma injury occurred, the Workers' Compensation Appeals Board (WCAB) denied reconsideration. The WCAB adopted the WCJ's report, which found the applicant's testimony credible and supported by medical reports, thus deeming the medical opinion substantial evidence to uphold the findings of fact.

WCABReconsideration DeniedPetition for ReconsiderationCumulative Trauma InjuryMedical EvidenceCausation of InjuryDeposition TestimonyApplicant TestimonyJob DutiesSubstantial Medical Evidence
References
0
Case No. ADJ2719991 (VNO 0485134) ADJ1334047 (VNO 0428744)
Regular
Aug 20, 2009

Catalina Barajas vs. WELLPOINT HEALTH NETWORK, INC., ZURICH LOS ANGELES

This case involves an applicant who initially sustained a cumulative trauma injury to her upper extremities during a period covered by one insurer. After returning to work with modified duties, she experienced a recurrence and worsening of symptoms, necessitating further treatment and surgery, which the Board now recognizes as a separate cumulative trauma injury. The Workers' Compensation Appeals Board granted reconsideration, reversing the prior finding of a single cumulative trauma injury. The Board held that distinct periods of compensable temporary or permanent disability, as established by medical evidence and treatment, demarcate separate cumulative trauma injuries, aligning with the *Rodarte* precedent. Consequently, the applicant was found to have sustained two separate cumulative trauma injuries, each attributed to different insurance coverage periods.

cumulative traumaanti-merger doctrineLabor Code sections 3208.25303Rodartecompensable temporary disabilitypermanent disabilitywage lossmodified workbilateral upper extremities
References
3
Case No. ADJ3280434 (MF) ADJ6953178
Regular
Dec 07, 2012

WILLIAM RICHARDSON vs. CHECKMATE TRANSPORT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for CASCADE NATIONAL INSURANCE, in liquidation, TONY'S SONS MOVING & STORAGE, STATE COMPENSATION INSURANCE FUND

This case concerns applicant William Richardson's claim for permanent disability due to specific and cumulative industrial injuries. The Workers' Compensation Appeals Board (WCAB) affirmed the finding of total permanent disability stemming from a specific injury in 2004. The WCAB clarified that the presumption of total permanent disability does not preclude apportionment, but found that the applicant's current total permanent disability was solely caused by the specific injury, not the cumulative trauma. Therefore, apportionment to the cumulative injury was denied, and the claim for cumulative trauma was dismissed.

Workers Compensation Appeals BoardCIGASCIFReconsiderationJoint FindingsAwardOrderAdministrative Law JudgeSpecific Industrial InjuryCumulative Trauma
References
2
Case No. ADJ7894308, ADJ7661229, ADJ9465603
Regular
Jun 12, 2015

ASSADOUR ASSADOURIAN vs. ARI G. MINASSIAN SCHOOL, CHURCH MUTUAL INSURANCE COMPANY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to further develop the medical record regarding applicant's claims for cumulative trauma and specific industrial injuries. The Board found the existing medical evidence insufficient to determine whether the applicant sustained one or multiple cumulative trauma injuries, or a combination of cumulative and specific injuries. Consequently, the Board rescinded the prior determinations and remanded the cases for a new evaluation by an Agreed Medical Examiner or a physician appointed by the judge.

cumulative traumacardiovascular systemsleep and sexual dysfunctionpsychiatric injuryschool principalLabor Code section 5412Labor Code section 5500.5duplicative claimspecific industrial injuryangioplasty
References
12
Case No. ADJ2570637 (SDO 0241398) ADJ3916811 (SDO 0342504)
Regular
Aug 24, 2009

CAROL ANN MCDONNELL, CAROL ANN PONCE vs. VAN CAN COMPANY, ZENITH INSURANCE COMPANY, STATE COMPENSATION INSURANCE FUND

Zenith Insurance Company sought reconsideration of an arbitration decision that denied its contribution claim against State Compensation Insurance Fund. Zenith argued the arbitrator erred by not finding cumulative injuries and that subsequent employment aggravated the applicant's permanent disabilities. The arbitrator recommended reconsideration, acknowledging evidence of cumulative trauma but finding the initial analysis inadequate regarding dates and causation percentages. The Appeals Board granted Zenith's petition, rescinded the original decision, and remanded the case for further proceedings on the cumulative trauma issue to determine liability sharing between insurers.

Cumulative traumaContribution claimZenith Insurance CompanyState Compensation Insurance FundWorkers' Compensation Appeals BoardPetition for ReconsiderationArbitration DecisionFindings and OrderIndustrial injuryMedical evidence
References
0
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