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

Case No. ADJ1358769
Regular
Jan 08, 2013

JOSEPH ODDO vs. MARTIN & LEWIS DRYWALL, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, EXPLORER INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) denied CIGA's petition for reconsideration of the WCJ's findings. The WCJ found that the applicant's injury was a specific injury on April 28, 2000, and not a continuous trauma, and that CIGA failed to meet its burden of proof on this issue. The WCAB gave great weight to the WCJ's credibility findings regarding the applicant's testimony and the lack of substantial evidence supporting a continuous trauma injury during specific coverage periods. Therefore, CIGA's petition for reconsideration was denied.

Workers' Compensation Appeals BoardMartin & Lewis DrywallCalifornia Insurance Guarantee AssociationIntercare Insurance ServicesHIH Insurance CompanyExplorer Insurance CompanyInsurance Company of the WestPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeContinuous Trauma
References
1
Case No. ADJ7632777
Regular
Apr 10, 2012

EFREN MARTINEZ vs. INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

This case involves a petition for reconsideration by the defendant insurer regarding a Workers' Compensation Appeals Board decision. The defendant argued their name was mistyped, the date of injury was incorrect, and the amendment to include a continuous trauma claim was improper. The Board granted reconsideration to correct the insurer's name and amend the date of injury to November 12, 2010, acknowledging these as typographical errors. The Board affirmed the finding of industrial injury and upheld the amendment to reflect a continuous trauma claim, finding the defendant had sufficient notice.

Workers' Compensation Appeals BoardExpress Employment ProfessionalsInsurance Company of the State of PennsylvaniaSedgwick CMSReconsiderationFindings and AwardAdministrative Law JudgeEfren MartinezIndustrial InjuryToolmaker Helper
References
3
Case No. ADJ6693720
Regular
Mar 15, 2010

KERRY NECHODOM vs. CITY OF GROVER BEACH

The Workers' Compensation Appeals Board granted reconsideration to amend the date of injury for Kerry Nechodom's right shoulder injury in case ADJ6693720 from February 3, 2007 - September 10, 2009 to August 12, 2008 - September 10, 2009. This amendment acknowledges a separate cumulative trauma injury due to distinct periods of disability and lack of continuous treatment between injuries. The Board affirmed the original award, finding that the applicant sustained two separate cumulative trauma injuries causing distinct periods of temporary disability. The employer's arguments regarding the cumulative trauma period and Labor Code $\S 4656$ limitations were addressed and resolved by this clarification.

Workers' Compensation Appeals BoardKerry NechodomCity of Grover BeachADJ6693720ADJ5791464ReconsiderationJoint Findings and AwardIndustrial InjuryRight ShoulderCumulative Injury
References
11
Case No. ADJ8680977
Regular
Apr 28, 2014

Albert Johnson vs. Southwest Airlines, ACE USA Insurance

The Workers' Compensation Appeals Board reversed a judge's decision that barred Albert Johnson's cumulative trauma claim due to the statute of limitations. The Board found that the employer's continued provision of medical treatment for Johnson's injuries tolled the one-year statute of limitations under Labor Code section 5405(c). This treatment, provided after an initial specific injury but before the cumulative trauma claim was filed, was deemed to have also addressed the cumulative trauma elements. Therefore, Johnson's claim for cumulative trauma injury ending August 17, 2009, was found to be timely filed.

Cumulative traumaStatute of LimitationsLabor Code section 5405TollingMedical treatmentSpecific injuryRamp agentSouthwest AirlinesWorkers' Compensation Appeals BoardReconsideration
References
1
Case No. ADJ3199594; ADJ522422; ADJ3307814
Regular
Oct 01, 2010

FRANCISCO GOMEZ vs. CONTROL AIR CONDITIONING, STATE COMPENSATION INSURANCE FUND, VIRGINIA SURETY INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of an award for Applicant Francisco Gomez. The Board adopted the Administrative Law Judge's report, which recommended denial. The applicant sustained a continuous trauma injury to his back, hypertension, and diabetes stemming from his employment. While the exact dates and extent of specific injuries remained pending further discovery, the judge found sufficient evidence for a compensable continuous trauma award.

WCABReconsideration DeniedAgreed Medical ExaminerContinuous TraumaIndustrial InjuryCausationCompensable ConsequenceHypertensionDiabetesLaminectomy
References
1
Case No. ADJ 4252592 (VNO 0411668)ADJ 3234790 (VNO 0443319) (MF)
Regular
May 04, 2012

HARRY WINSTON vs. CITY OF LOS ANGELES

This case concerns a petition for reconsideration by the City of Los Angeles challenging the Administrative Law Judge's (ALJ) finding of a single cumulative trauma injury. The applicant stipulated to two separate cumulative trauma periods for various injuries, but subsequent medical opinions from treating physicians concluded there was one continuous cumulative trauma injury spanning the applicant's entire employment. The ALJ amended the stipulations to align with this medical evidence and dismissed one of the applicant's cases as duplicative. Therefore, the ALJ recommends denying the employer's petition for reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationCumulative Trauma InjuryAmended FindingsOpinion on DecisionStipulationsMedical EvaluationQualified Medical EvaluationAgreed Medical EvaluationDate of Injury
References
10
Case No. ADJ7934571
Regular
Dec 03, 2014

NANCY GREYSON vs. TUCALOTA SPRINGS RV PARK, CARL WARREN & COMPANY

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration. The Board adopted the Administrative Law Judge's report, finding the applicant sustained a continuous trauma injury AOE/COE. The defendant's arguments regarding continuous trauma versus specific injury and the AME's findings were rejected. Additionally, the Board ordered defense counsel to comply with WCAB Rule 10550 regarding proper identification of parties, as the defendant's identity was unclear throughout the proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCAB Rule 10550Defense CounselSubstitution of CounselMinutes of HearingApplicant IdentityDefendant IdentityAdministrative Law JudgeInjury AOE/COE
References
1
Case No. ADJ1526910 (LAO 0881311) ADJ1183697 (LAO 0881312)
Regular
Apr 14, 2017

MARGARITA GIUSTRA vs. PRIMARY PROVIDER MANAGEMENT, NATIONAL LIABILITY AND FIRE INSURANCE COMPANY, DELOS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Delos Insurance Company's petition for reconsideration. The Board adopted the arbitrator's report, which found that a prior Compromise and Release agreement between the applicant and Delos Insurance Company only settled a specific injury, not the continuous trauma claim. This decision allowed National Liability and Fire Insurance Company's petition for contribution against Delos Insurance Company for a portion of benefits paid for the continuous trauma injury. The arbitrator also determined that prior conflicting judicial decisions did not bar Delos Insurance Company from being joined in the contribution proceedings.

Workers Compensation Appeals BoardMargarita GiustraPrimary Provider ManagementNational Liability and Fire Insurance CompanyDelos Insurance CompanyADJ1526910ADJ1183697Petition for ReconsiderationArbitrator's ReportCompromise and Release
References
7
Case No. ADJ4290566 (GOL 0091983)
Regular
Aug 06, 2009

CARLOS CABELLOS vs. FOUR SEASONS BILTMORE, TRAVELERS INSURANCE COMPANY, ZURICH COMPANY, LIBERTY MUTUAL INSURANCE COMPANY

This case involves a petition for reconsideration by Zurich Insurance regarding a workers' compensation award. The Board denied Zurich's petition, upholding the Workers' Compensation Judge's (WCJ) finding of new and further injury. The WCJ determined that the applicant sustained cumulative trauma injuries extending through August 3, 2007, based on medical opinions, continued employment activities, and ongoing complaints of pain and treatment. The Board affirmed that medical treatment and evidence of permanent disability justify a cumulative trauma injury finding up to the date the applicant became permanent and stationary.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings and AwardNew and Further InjurySpecific InjuryCumulative TraumaPermanent DisabilityLiability ApportionmentMedical EvidenceSubstantial Medical Evidence
References
1
Case No. ADJ8430146 ADJ7912960 ADJ7914352
Regular
Apr 16, 2019

JULIO BALVANEDA vs. OPTIONS A CHILD CARE AND HUMAN SERVICES, EVEREST NATIONAL INSURANCE COMPANY, SPARTA INSURANCE COMPANY

The Workers' Compensation Appeals Board affirmed a WCJ's award of 95% permanent disability for industrial injuries sustained by Julio Balvaneda while employed as a gardener. The Board clarified that the specific number and dates of cumulative trauma injuries must be re-determined by the WCJ, as the record suggests a single continuous trauma due to ongoing treatment and work activities. The WCJ's finding of combined permanent disability was upheld, particularly concerning intertwined psychiatric and orthopedic impairments, referencing established case law. The matter was returned to the trial level for further proceedings on the cumulative trauma issue.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaApportionmentBensonAustinColtharpCombined Value ChartAgreed Medical EvaluatorPermanent Disability Rating
References
14
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