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

Case No. ADJ422252 (SBR 0302367)
Regular
Apr 12, 2017

ELAINE HACKER vs. COUNTY OF SAN BERNARDINO-PUBLIC HEALTH DEPARTMENT

The Appeals Board granted the defendant's petition for removal, reversing the WCJ's decision that rescinded an Independent Medical Review (IMR) determination. The Appeals Board found that a family practice physician reviewing treatment for chronic pain was not plainly erroneous, nor did it exceed the Administrative Director's powers. Consequently, the July 8, 2016 IMR determination is now considered final and binding. Additionally, the WCJ's proposed monetary sanctions against defense counsel were rescinded due to the lack of a prior ruling on the defense's procedural arguments.

Workers' Compensation Appeals BoardPetition for RemovalFindings and OrderLabor Code 4610.6(h)Independent Medical ReviewAdministrative DirectorUtilization ReviewPlainly Erroneous FindingChronic Pain SpecialistNotice of Intention to Impose Monetary Sanctions
References
Case No. ADJ 9194457, ADJ9194450, ADJ8835968, ADJ8835949, ADJ8835510, ADJ1 0126921
Regular
Jul 04, 2000

CHARLES OKPALA vs. NORTHROP GRUMMAN CORPORATION, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA, AIG CLAIMS, THE BOEING COMPANY, ACE AMERICAN INSURANCE, SEDGWICK

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board adopted the Workers' Compensation Judge's report, which found the applicant not credible. The judge determined the applicant was not incapacitated when he entered into a Compromise and Release agreement and thus it would be approved. The Board gave great weight to the judge's credibility determination based on observing the witness.

COMPROMISE AND RELEASEWITHDRAWALINCAPACITYCREDIBILITY DETERMINATIONPETITION FOR RECONSIDERATIONDUE DILIGENCEUNDUE INFLUENCEDURESSMEDICAL EVIDENCEEMPLOYMENT DEVELOPMENT DEPARTMENT
References
Case No. ADJ9693295, ADJ9797058
Regular
Nov 09, 2017

TONY THANG PHUNG vs. METIS TPS LLC, INSURANCE COMPANY OF THE WEST

The Appeals Board dismissed the Petition for Removal, ruling that reconsideration was the proper remedy. The Board denied the Petition for Reconsideration, adopting the WCJ's findings and credibility determinations. The WCJ found the applicant sustained injury arising out of and occurring in the course of employment (AOE/COE). Great weight was given to the WCJ's credibility determinations due to the opportunity to observe witness demeanor.

Workers' Compensation Appeals BoardPetition for RemovalPetition for ReconsiderationAOE/COEWCJ credibility determinationfinal orderthreshold issueadequate remedyRymer v. HaglerSafeway Stores
References
Case No. ADJ9166524
Regular
Feb 24, 2015

MICHAEL GORBEA vs. LIMBACH COMPANY, LP, ARCH INSURANCE, GALLAGHER BASSETT SERVICES

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration. The Board adopted and incorporated the WCJ's report, giving great weight to the WCJ's credibility determinations due to observing the witnesses' demeanor. The WCJ found the applicant's testimony regarding the alleged injury was not credible and was rebutted by defense witnesses. Furthermore, the WCJ determined the post-termination defense was applicable as the applicant's notice of injury was not timely or contemporaneous with his layoff.

AOE/COEPetition for ReconsiderationWCJ credibility determinationpost-termination defenseDover v. Fresh Start Bakeriescontemporaneous notification exceptionpreponderance of the evidenceindustrial clinic diagnosislumbar sprainmuscle spasm
References
Case No. ADJ8182022
Regular
May 23, 2013

RAMON MALDONADO vs. G. SIMOES DAIRY, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Ramon Maldonado's petition for reconsideration, upholding the original findings and award. The Board adopted the judge's report, which found Maldonado's testimony regarding his work injury not credible. The judge determined that the defense witnesses' testimony was more persuasive, and the applicant failed to meet his burden of proof to show an injury arising out of and in the course of employment. The Board gave great weight to the judge's credibility determinations.

WORKERS' COMPENSATION APPEALS BOARDRECONSIDERATIONDENIEDWCJ REPORTCREDIBILITY FINDINGGARZA V. WORKERS' COMP. APPEALS BD.PETITION FOR RECONSIDERATIONNO INJURY ARISING OUT OF AND IN THE COURSE OF EMPLOYMENTAPPLICANT'S TESTIMONYDEFENSE WITNESSES
References
Case No. ADJ12616197
Regular
Jan 12, 2022

VANESSA FATZER (Deceased) KATRINA S. HAGEN, Director of Department of Industrial Relations, administrator for Death Without Dependents Unit JOEL STAPLETON III vs. KELLY-MOORE PAINT COMPANY INC., ACE AMERICAN INSURANCE COMPANY, administered by ESIS, INC.

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior finding, and returned the case to the WCJ for further proceedings. The Board found that the original decision, which determined Mr. Stapleton was a partial dependent of the deceased, was not supported by substantial evidence. Specifically, the WCJ's credibility assessment of Mr. Stapleton and his father was insufficient as their testimony was solely from deposition transcripts and they were not called as witnesses at trial. The Board emphasized that deposition testimony alone is insufficient to establish credibility for a dependency determination.

Death Without Dependents UnitPartial DependentLabor Code Section 4706.5Dependency DeterminationCredibility of WitnessesDeposition TestimonySubstantial EvidenceFurther ProceedingsReconsiderationRescission
References
Case No. ADJ10161297
Regular
Nov 17, 2017

LUIS CHAVEZ vs. SYSCO, AMERICAN ZURICH INSURANCE COMPANY, GALLAGHER BASSETT

The Workers' Compensation Appeals Board (WCAB) denied the applicant's petition for reconsideration, upholding the administrative law judge's (WCJ) findings. The WCJ found the applicant not to be a credible witness, largely due to discrepancies between his reported limitations and observed activities in subrosa video evidence. Consequently, the WCJ determined that the applicant failed to prove his injury arose out of and occurred in the course of his employment (AOE/COE). The WCAB gave great weight to the WCJ's credibility determination, finding no substantial evidence to warrant overturning it.

WCABPetition for ReconsiderationCredibility DeterminationSubrosa VideoAOE/COERange of MotionAMA GuidelinesSubstantial Medical EvidenceCausationModified Work
References
Case No. ADJ92-42068
Regular
Mar 02, 2018

FRANCINE MORALES vs. LOTION AND LACE, INC., WILLIAMSBURG NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the Petition for Reconsideration. The Board adopted the Workers' Compensation Administrative Law Judge's (WCJ) report, which found the applicant lacked credibility due to inconsistencies in her testimony and medical histories. The WCJ determined the applicant failed to prove her injury arose out of and occurred in the course of employment (AOE-COE) due to unsubstantiated medical evidence and her job duties not being physically arduous as claimed. The Board gave great weight to the WCJ's credibility determinations, finding no substantial evidence to warrant rejection.

WCABPetition for ReconsiderationWCJcredibility determinationsubstantial evidenceAOE-COELC 4062medical reportscumulative injuryorthopedic
References
Case No. ADJ48 1388
Regular
May 12, 2016

SURYA CORREA vs. CITY OF PASADENA

The Workers' Compensation Appeals Board denied reconsideration of a Findings and Award, upholding the determination that applicant Surya Correa sustained a psychiatric injury arising from her employment with the City of Pasadena. The Board gave significant weight to the administrative law judge's credibility determinations, finding no substantial evidence to warrant overturning them. The judge's report, which the Board adopted, addressed the applicant's credibility issues, including undisclosed accidents and misrepresentations, but still found the psychiatric injury to be a compensable consequence of the industrial orthopedic injury. Applicant's separate petition for reconsideration regarding prejudgment interest on temporary disability was also denied as that issue had been deferred and not yet decided.

Workers' Compensation Appeals BoardReconsiderationPsychiatric InjuryCredibility DeterminationsAgreed Medical EvaluatorSub Rosa FilmsCumulative TraumaMajor Depressive DisorderPain DisorderApportionment
References
Case No. ADJ10843290
Regular
Aug 21, 2018

MANUEL SOLIS vs. DECORE-ATIVE SPECIALTIES, SECURITY NATIONAL INSURANCE COMPANY, AMTRUST NORTH AMERICA

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board adopted the WCJ's report, which found that while an injury occurred, the claim was barred by the statute of limitations. This decision was based on the WCJ's credibility determinations, which found the applicant's testimony regarding reporting the injury to his employer to be not credible. The Board gave great weight to the WCJ's observations of witness demeanor, finding no substantial evidence to warrant overturning these credibility findings.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ Credibility DeterminationsStatute of LimitationsLachesTimely Reporting of InjuryMachine OperatorRight Shoulder InjuryRight Arm InjurySpecific Injury
References
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