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

Case No. ADJ7220223
Regular
Aug 08, 2016

IOAN RUS vs. CALIFORNIA FACILITIES & EQUIPMENT MAINTENANCE COMPANY, INC., STATE COMPENSATION INSURANCE FUND

The Appeals Board affirmed its prior decision, denying a lien claimant further payment. The Board found that current Labor Code section 5307.1, unlike the statute in *Gould v. Workers' Comp. Appeals Bd.*, does not permit rebuttal of the Official Medical Fee Schedule (OMFS). Therefore, the lien claimant cannot recover fees exceeding the OMFS based on their arguments. The Board also stated it cannot rule on the constitutionality of the statute.

Workers' Compensation Appeals BoardOpinion and Decision After ReconsiderationLien ClaimantOfficial Medical Fee Schedule (OMFS)Gould v. Workers' Comp. Appeals Bd.Rebuttal of PresumptionLabor Code § 5307.1Medical-Legal ExpensesConstitutionality of StatuteGreener v. Workers’ Comp. Appeals Bd.
References
Case No. ADJ6585876, ADJ4285015 (POM 0167573)
Regular
Oct 12, 2015

Vicente Jackson vs. Northrop Grumman Corporation, Insurance Company of the State of Pennsylvania

This case concerns Vicente Jackson's cumulative trauma back injury claim against Northrop Grumman and its insurer. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, rescinded prior findings, and remanded the case for further development of the record. The primary issues are whether the applicant's claim was timely filed within the statute of limitations and whether his work activities constituted a new cumulative trauma injury. The WCAB found that Dr. Sanders' reports provided substantial medical evidence for a cumulative trauma injury, but the statute of limitations issue requires further factual development regarding the applicant's knowledge of the injury and the timing of medical treatment.

Workers' Compensation Appeals BoardVICENTE JACKSONNORTHROP GRUMMAN CORPORATIONINSURANCE COMPANY OF THE STATE OF PENNSYLVANIACalifornia Insurance Guarantee AssociationCIGAWCJcumulative trauma injurystatute of limitationsLabor Code section 5412
References
Case No. ADJ9 088743
Regular
Jan 26, 2016

LEO ESTRELLA vs. MILWAUKEE BREWERS, SAN FRANCISCO GIANTS, ACE USA

The Workers' Compensation Appeals Board denied Leo Estrella's petition for reconsideration, upholding the administrative law judge's finding that his cumulative injury claim against the Milwaukee Brewers and San Francisco Giants was time-barred by the one-year statute of limitations. The Board found that applicant knew or should have known of his right to file a claim more than one year prior to filing, precluding application of the five-year "new and further disability" statute. Applicant's contention that the statute of limitations was tolled due to lack of knowledge was rejected, as the evidence indicated he was aware of the industrial causation of his injuries by 2009. One commissioner dissented, arguing the date of injury should be 2013 and that defendants failed to prove applicant's knowledge of his rights or the statute of limitations.

Workers' Compensation Appeals BoardCumulative InjuryStatute of LimitationsLabor Code Section 5405Labor Code Section 5410New and Further DisabilityTollingDate of InjuryIndustrial CausationProfessional Baseball Player
References
Case No. GOL 0099213
Regular
Oct 24, 2007

DEREK VELASQUEZ vs. JOSE VELASQUEZ, STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the applicant sought reconsideration of a decision barring his temporary disability claim under Labor Code Section 4656(c)(1). The applicant conceded the claim was barred but argued the statute was unconstitutional, violating equal protection. The Workers' Compensation Appeals Board denied reconsideration, adopting the Administrative Law Judge's report which stated the Board lacks jurisdiction to determine the constitutionality of statutes.

Workers' Compensation Appeals BoardDerek VelasquezJose VelasquezState Compensation Insurance FundGOL 0099213ReconsiderationAdministrative Law JudgeGreener v. Workers' Comp. Appeals Bd.Industrial InjuryCervical Spine
References
Case No. ADJ8925923
Regular
Feb 23, 2016

TERRY GIBBS vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION PAROLE AND COMMUNITY SERVICES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Terry Gibbs' petition for reconsideration. The Board adopted the Administrative Law Judge's report, which concluded that Labor Code Section 4664(c)(1)(G) legally capped Gibbs' permanent disability award. This cap applied because Gibbs had a prior award for a different injury, and the current renal system injury falls under a category limited by the statute. The Board cannot declare a statute unconstitutional and must follow it until an appellate court rules otherwise.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code section 4664(c)(1)(G)Constitutional protectionsStatute unconstitutionalappellate courtcumulative injuryrenal systemAgreed Medical ExaminerWhole Person Impairment
References
Case No. ADJ10537232, ADJ10537109, ADJ10058212
Regular
Jan 25, 2018

CHARLES CONLEY vs. STATE OF CALIFORNIA DEPARTMENT OF HEALTHCARE SERVICES

The Appeals Board granted reconsideration to further study the applicant's psychiatric and heart injury claims arising from his employment. The WCJ found the claims barred by the statute of limitations and denied a cumulative trauma claim due to lack of medical evidence. The Board rescinded the Findings and Orders, returning the case for further proceedings to address the WCJ's mischaracterization of specific injuries as cumulative trauma and the potential tolling of the statute of limitations. The Board also noted a need for further development of medical evidence on causation for the cumulative trauma claim.

Petition for ReconsiderationFindings and OrdersQualified Medical EvaluatorStatute of LimitationsCumulative TraumaSpecific InjuryIndustrial CausationEstoppelMyocardial InfarctionCoronary Artery Bypass Surgery
References
Case No. ADJ9429450
Regular
Nov 01, 2016

MARTHA SOLTERO vs. DEPARTMENT OF SOCIAL SERVICES / IHSS, YORK SERVICES

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, upholding the administrative law judge's decision. The Board found that the employee's claim was not barred by the statute of limitations because the employer failed to provide legally adequate notice of her rights in a language she understood. Additionally, the Board affirmed that the employee's injury sustained while moving furniture at a client's request arose out of and occurred in the course of her employment. The decision emphasizes the employer's burden to prove statute of limitations defenses and the liberal construction of employment-related injury definitions in favor of the employee.

Workers Compensation Appeals BoardPetition for ReconsiderationLabor Code section 5405Statute of LimitationsIn-home caregiverMoving furnitureClient requestSpanish language noticeUnintelligible translationTolling of statute
References
Case No. LAO 0869924
Regular
Jun 06, 2008

MIRNA SOSA vs. JESI-CARE, INC., STATE COMPENSATION INSURANCE FUND

The applicant's claim for workers' compensation was denied because the evidence did not support her claim of an industrial injury, and the claim was barred by the statute of limitations and post-termination claim rules. The Board found the applicant's testimony regarding reporting the injury to be not credible, citing contradictory medical evidence and employer testimony. Because the applicant did not report the alleged injury within one year of its occurrence, the statute of limitations was not tolled, and the claim also failed as a post-termination claim due to lack of employer notice or medical records indicating injury prior to termination.

Workers' Compensation Appeals Boardapplicant's claimstatute of limitationspost-termination claimcredible testimonyemployer noticemedical recordsdate of injuryindustrial injuryWCJ credibility determination
References
Case No. GRO 024430
Significant
Dec 08, 2004

Myron Abney vs. AERA ENERGY, LIBERTY MUTUAL INSURANCE COMPANY

This en banc decision holds that the revised Labor Code section 5814, operative June 1, 2004, applies to unreasonable delays in compensation payments that occurred prior to its operative date, provided the finding of unreasonable delay is made on or after that date.

SB 899Labor Code Section 5814En Banc DecisionReconsiderationTemporary Disability IndemnityPenaltyUnreasonable DelayOperative DateStatute of LimitationsConclusive Presumption
References
Case No. GRO 024430
En Banc
Dec 08, 2004

Myron Abney vs. Aera Energy, Liberty Mutual Insurance Company

The Appeals Board held that the amended Labor Code section 5814, which changed penalty calculations for unreasonable delay of compensation, applies to delays that occurred before its June 1, 2004 operative date, if the finding of unreasonableness is made on or after that date.

SB 899Labor Code section 5814unreasonable delaypenaltyoperative datetemporary disability indemnityHofmeister v. Workers' Comp. Appeals Bd.prior to operative dateon or after operative dateconclusive presumption
References
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