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

Case No. ADJ1940516 (GOL 0101910)
Regular
Apr 29, 2011

TONY COSTANTINO (Deceased), ELLIE COSTANTINO (Widow), CIERA MILLENDER (Dependent) vs. SANTA BARBARA SCHOOL DISTRICT

This case concerns whether a stepdaughter is entitled to the conclusive presumption of total dependency for workers' compensation death benefits under Labor Code section 3501. The Workers' Compensation Appeals Board (WCAB) rescinded the prior award, holding that the conclusive presumption does not apply to stepchildren absent legal adoption. The Board found insufficient evidence regarding the stepdaughter's actual dependency and returned the matter for further proceedings to develop the record on this issue. The WCAB clarified that while stepchildren can be dependents, the specific statutory presumption of total dependency is limited to "children" under the law.

Workers' Compensation Appeals BoardIndustrial InjuryDeath BenefitsDependencyLabor Code Section 3501Conclusive PresumptionStepchildPartial DependentReconsiderationWCJ
References
Case No. ADJ9373269, ADJ9373270
Regular
Dec 12, 2017

SOCORRO SALAZAR vs. MV TRANSPORTATION, ACE AMERICAN INSURANCE

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the WCJ's finding that the applicant failed to prove her injury was presumptively compensable under Labor Code section 5402. The Board clarified that the 90-day presumption period begins when an employee files a claim form, not when the employer receives notice of injury. The Board affirmed that a claim form, not an Application for Adjudication of Claim, is the legally mandated method for initiating a workers' compensation claim. Therefore, the applicant did not meet her burden of proof for presumptive compensability.

WCABPetition for ReconsiderationLabor Code section 5402presumption of compensabilityclaim formdenial of liabilityApplication for Adjudication of Claimrebuttable presumptionfraudulent attemptsstatutory references
References
Case No. ADJ8621726
Regular
Jul 18, 2019

LEONARD DE LA ROSA vs. KLOECKNER TRAVELERS COMPANY OF AMERICA, USA PROPERTY AMERICA, HOLDINGS; CASUALTY

This case involves a defendant challenging a permanent total disability award for an applicant who sustained a neurological injury. The defendant argued the QME's revised opinion on causation and disability was not substantial evidence, and that Labor Code section 4662(a)(4)'s conclusive presumption of total disability violates apportionment requirements. The Board denied reconsideration, affirming the WCJ's findings. They found the QME's reporting constituted substantial evidence, and importantly, that the conclusive presumption under LC 4662(a)(4) overrides apportionment requirements.

Workers' Compensation Appeals BoardPermanent Total DisabilityLabor Code section 4662(a)(4)Permanent Mental IncapacityQualified Medical EvaluatorNeurological InjuryNeurodegenerative DisorderApportionmentLabor Code section 4663Medical Evidence
References
Case No. ADJ7949972
Regular
Nov 07, 2013

DANIEL BIGELOW vs. CITY OF PASO ROBLES

This Workers' Compensation Appeals Board decision reverses a prior ruling and finds applicant's colon cancer industrially caused. The employer failed to rebut the Labor Code section 3212.1 presumption of industrial causation for peace officers exposed to carcinogens. The Appeals Board determined the defendant's medical expert did not sufficiently prove the cancer was "not reasonably linked" to the applicant's workplace exposure. Therefore, the presumption stands, and the case is returned for further proceedings.

Labor Code section 3212.1cancer presumptionpeace officeractive law enforcementindustrial injurycolon cancercarcinogen exposurerebuttable presumptionprimary site of cancerlatency period
References
Case No. SDO 244774
Significant
Dec 11, 2003

Walter Faust vs. City of San Diego

The Appeals Board held that under the amended Labor Code section 3212.1, a firefighter only needs to show exposure to a known carcinogen to establish a presumption of industrial cancer, shifting the burden to the defendant to prove no reasonable link.

Labor Code section 3212.1cumulative industrial injuryfirefightercancerpresumptionrebutting presumptionqualified medical evaluatorcarcinogencadmiumplating company fire
References
Case No. ADJ9312112
Regular
Apr 17, 2017

CUONG PHAN vs. CITY OF SANTA CLARA

In this case, the Workers' Compensation Appeals Board denied the defendant City of Santa Clara's petition for reconsideration. The Board upheld a prior finding that applicant Cuong Phan sustained industrial injuries to his lower back, resulting in 29% permanent disability. The key issue was the application of the "duty belt presumption" under Labor Code section 3213.2, which presumes lower back impairments in long-term peace officers required to wear duty belts arise from employment. The Board found the presumption applicable and not rebutted, deeming it a legislative intent to protect officers with these specific conditions.

Duty belt presumptionLabor Code section 3213.2police officerlower back impairmentpeace officerpermanent disabilityjoint findings and awardpetition for reconsiderationBenson apportionmentLabor Code section 4663(e)
References
Case No. ADJ9870999
Regular
Feb 13, 2017

ROBIN SMITH vs. CITY OF SUNNYVALE

This case involves a firefighter claiming breast cancer arose from employment exposure to carcinogens, triggering a statutory presumption of industrial causation under Labor Code section 3212.1. The employer sought to rebut this presumption by arguing a medical examiner found no studies linking applicant's specific exposures to breast cancer. However, the Appeals Board denied reconsideration, affirming that the employer failed to prove there is *no reasonable link* between workplace carcinogen exposure and the applicant's cancer, a higher bar than simply the absence of direct scientific studies. The Board reiterated that an employer must affirmatively demonstrate a lack of reasonable connection, not just highlight a lack of studies supporting causation.

Labor Code section 3212.1presumption of industrial causationpublic safety officerfirefightercarcinogen exposurebreast cancerdisputable presumptioncontroverted evidencereasonable linkburden of proof
References
Case No. ADJ7449576
Regular
May 11, 2016

MANNY WINNINGHAM vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS

This case concerns an applicant seeking total permanent disability benefits based on a brain injury. The applicant argued for conclusive total disability under Labor Code section 4662(a)(4) due to permanent mental incapacity. The Board affirmed the WCJ's finding that while the applicant suffered serious psychiatric impairments leading to overall total disability, the specific cognitive impairments did not meet the threshold for the *conclusive* presumption of total disability under section 4662(a)(4). Therefore, apportionment was still applicable, and the previous award of $84\%$ permanent disability was upheld.

Permanent total disabilityLabor Code section 4662(a)(4)Conclusive presumptionApportionmentBrain injuryPermanent mental incapacityGlobal Assessment of Functioning ScaleCognitive impairmentPsychiatric impairmentCorrectional officer
References
Case No. ADJ2046824
Regular
Jun 24, 2013

OSCAR CARTER vs. COUNTY OF FRESNO

The Appeals Board granted reconsideration to further develop the record regarding the applicant's 100% permanent total disability finding. While the heart trouble presumption for correctional officers was correctly applied, the medical evidence did not sufficiently establish "incurable mental incapacity" as required by Labor Code section 4662(d) for a conclusive presumption of total disability. The Board rescinded the original award and returned the case to the trial level for supplemental medical reporting on the applicant's mental capacity and consideration of formal rating instructions to ensure substantial justice.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardLabor Code section 4850Permanent Total DisabilitySubstantial Medical EvidenceLabor Code section 3212.2Heart Trouble PresumptionCorrectional OfficersRebuttal of Presumption
References
Case No. ADJ11254123
Regular
Oct 28, 2019

SAMANTHA HANSEN vs. ALERE HEALTH SYSTEMS, INC., THE HARTFORD INSURANCE GROUP

This case concerns a workers' compensation claim for a neck and spine injury. The applicant's attorney provided proof of service for the claim form on the defendant employer on March 16, 2018, and later sent a copy to the defendant insurance carrier. The defendant denied the claim on April 29, 2019, and argued that the claim should not be presumed compensable as the applicant did not prove receipt of the claim form. The Board upheld the WCJ's decision, finding that the proof of service created a presumption of receipt that the defendant failed to rebut. Therefore, the applicant's claim is presumed compensable under Labor Code Section 5402 as the defendant did not reject liability within 90 days.

Workers' Compensation Appeals BoardLabor Code Section 5402Presumption of CompensabilityReconsiderationFindings of Fact and OrdersPetition for ReconsiderationRN Case ManagerCumulative InjuryProof of ServiceClaim Form
References
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