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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 The Workers' Compensation Appeals Board (WCAB) rescinded the prior award, holding that the conclusive presumption does not apply to stepchildren absent legal adoption.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
3
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
2
Case No. ADJ6761550, ADJ6761551
Regular
Dec 14, 2010

JUAN SANCHEZ vs. CITY OF SANTA CLARA, Permissibly Self-Insured, Adjusted By CAMBRIDGE, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board affirmed a prior decision finding applicant Juan Sanchez totally and permanently disabled. This disability stemmed from a combination of industrial injuries, including a stroke, which qualified for a conclusive presumption of total disability under Labor Code section 4662(d). The defendant City of Santa Clara had argued for apportionment of this disability based on prior awards and the distinct nature of the current injuries. However, the Board found that the conclusive presumption of total disability under section 4662 precluded apportionment. The concurring opinion agreed with the outcome but differed on the strict interpretation of unapportionability, asserting that apportionment might be possible in other section 4662 cases if properly proven.

Workers' Compensation Appeals BoardSubsequent Injuries Benefits Trust FundCity of Santa Clarapermanent total disabilityLabor Code section 4662incurable mental incapacitystrokecumulative injuryspecific injuryapportionment
References
6
Case No. MISSING
Regular Panel Decision

Cortijo v. Ilfin Corp.

A decedent, employed as a building superintendent, was found dead from a 12-gauge shotgun wound on his employer's premises during working hours. The Workers' Compensation Board determined that the unexplained death, occurring on the employer's property and during working hours, raised a presumption of compensability under section 21 of the Workers' Compensation Law. This presumption led to the conclusion that the death arose out of and in the course of employment, justifying an award of death benefits to the claimant. The Board found that police testimony regarding the decedent's prior illegal activities was insufficient to rebut this statutory presumption. The appellate court affirmed the Board's decisions, finding them supported by substantial evidence.

Workers' CompensationDeath BenefitsPresumption of CompensabilityUnexplained DeathEmployment InjuryOn-Premises DeathStatutory PresumptionRebuttal of PresumptionSubstantial EvidenceAppellate Review
References
0
Case No. MISSING
Regular Panel Decision

Claim of Richman v. NYS Unified Court System

This case concerns an appeal regarding a Workers' Compensation Board decision. The claimant suffered an unwitnessed injury at work, leading to a presumption of compensability under Workers' Compensation Law § 21 (1). The employer attempted to overcome this presumption with an expert's opinion suggesting the ruptured aneurysm was unrelated to employment. However, the Board found the expert's testimony not credible, particularly due to evasiveness regarding the role of work-induced stress and high blood pressure in the aneurysm's rupture. The Appellate Division affirmed the Board's conclusion, finding no basis to disturb the finding that the employer failed to present sufficient evidence to rebut the presumption of compensability.

Workers' CompensationAneurysmWork StressPresumption of CompensabilityExpert CredibilityUnwitnessed InjuryBlood PressureMedical OpinionBoard DecisionAppellate Review
References
4
Case No. ADJ7031117
Regular
Feb 27, 2013

JAMIE XELOWSKI, JENNIFER CAMPBELL vs. CITY AND COUNTY OF SAN FRANCISCO, COMMUNITY HEALTH NETWORK

This case concerns dependent benefits for the adult daughter of a deceased employee. The applicant argued that a Social Security Administration (SSA) Notice of Award conclusively presumed her dependency for death benefits under Labor Code section 3501(a). The Appeals Board reversed the WCJ's decision, finding the SSA's disability determination constitutes an administrative finding by a trier of fact that the applicant was incapacitated from earning. This finding, occurring prior to the mother's death, satisfies the statutory requirement for conclusive presumption of dependency.

Workers' Compensation Appeals BoardDependent benefitsLabor Code section 3501(a)Conclusive presumption of dependencyTrier of factSocial Security AdministrationIncapacitated from earningAdult daughterMotor vehicle accidentIndustrial injury
References
18
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
8
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
1
Case No. ADJ6990407
Regular
Nov 02, 2011

DANIEL CHESNUT vs. MANTECA POLICE DEPARTMENT, MUNICIPAL POOLING WALNUT CREEK

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The applicant, a police officer, sought to establish that his testicular cancer was presumptively industrial under Labor Code section 3212.1. However, the Agreed Medical Evaluator concluded that the cancer's manifestation fell outside the established ten-year minimum latency period for solid tumors, thus rebutting the statutory presumption. The Board found this conclusion to be substantial evidence, particularly as the applicant's cancer was not characterized by extreme aggressiveness or massive exposure doses that might shorten latency.

Workers' Compensation Appeals BoardDaniel ChesnutManteca Police DepartmentMunicipal Pooling Walnut CreekADJ6990407Petition for ReconsiderationLabor Code section 3212.1testicular cancerinjurious exposurepolice officer
References
7
Case No. MISSING
Regular Panel Decision

Claim of McClain v. Buffalo News

The case involves an appeal from a Workers’ Compensation Board decision regarding a district manager’s death in a company van fire. Despite being on vacation, evidence showed the decedent performed work-related tasks, leading the Board to apply the presumption of compensability under Workers’ Compensation Law § 21. The employer and its carrier appealed, arguing the death did not occur in the course of employment. The Appellate Division affirmed the Board’s decision, finding substantial evidence supported the conclusion that the decedent was acting within the scope of his employment at the time of his death, thus upholding the applicability of the Section 21 presumption.

Workers' CompensationAccidental DeathCourse of EmploymentPresumption of CompensabilityUnwitnessed IncidentBusiness TravelVacation WorkAppellate ReviewCausal RelationshipEmployer Liability
References
5
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