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Case Law Database

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

Case No. SAC 289086
Regular
Jun 09, 2008

SCOTT PACHECO vs. GRAND FLOOR DESIGNS, LIBERTY MUTUAL/GOLDEN EAGLE INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding industrial injury, including Crohn's disease, to the applicant. The Board rescinded the award and returned the case to the trial level due to a lack of substantial medical evidence regarding the Crohn's disease claim. Further proceedings, potentially including the appointment of an independent medical evaluator, are required to properly develop the medical record on this issue.

Workers Compensation Appeals BoardScott PachecoGrand Floor DesignsLiberty MutualGolden Eagle Insurance Companyindustrial injuryCrohn's diseasepsyche injurypermanent disabilityWCJ
References
Case No. ADJ9184413
Regular
Oct 27, 2020

JEFFREY SPRINGER vs. RJ DONOVAN CORRECTIONAL FACILITY, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation claim by Jeffrey Springer against RJ Donovan Correctional Facility. The Applicant sustained injuries resulting in industrially caused hypertension, hypertensive kidney disease, and hypertensive heart disease. The primary dispute centered on how to combine a prior 28% permanent disability rating for kidney disease with a new 49% rating for heart disease. The defendant argued these were part of a single cardiovascular system and sought to subtract the prior award's monetary value from the new rating. The WCJ found the injuries to the kidney and heart were distinct, justifying combining them, and awarded 63% permanent disability after deducting the prior award's value. The Appeals Board denied the defendant's petition for reconsideration, adopting the WCJ's reasoning.

Workers Compensation Appeals BoardRJ Donovan Correctional FacilityLegally UninsuredState Compensation Insurance FundPetition for ReconsiderationPermanent DisabilityHypertensionHypertensive Kidney DiseaseHypertensive Heart DiseaseHypertensive Cardiovascular Disease
References
Case No. ADJ10256108, ADJ10255968, ADJ10256212, ADJ10256223, ADJ10489875
Regular
Sep 23, 2022

JOSEPH RYAN vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Appeals Board affirmed the finding of permanent and total disability for the applicant, Joseph Ryan, stemming from industrial injuries sustained while employed as a correctional captain. However, the Board remanded the matter for further proceedings to specifically address apportionment of the permanent disability under Labor Code section 4663, considering the Agreed Medical Evaluator's opinion on pre-existing spinal disease. The Board found that the applicant's specific and cumulative trauma injuries to his spine resulted in intertwined disabilities, justifying a combined award, but that Dr. Hasday's apportionment findings require further development and determination at the trial level.

Workers' Compensation Appeals BoardJoseph RyanCalifornia Department of CorrectionsLegally UninsuredState Compensation Insurance FundADJ10256108ADJ10255968ADJ10256212ADJ10256223ADJ10489875
References
Case No. ADJ7242853
Regular
Dec 04, 2012

DANNY SABAG vs. MITRANI USA CORP c/o CPEHR, CASTLEPOINTE NATIONAL INSURANCE CO by TOWER GROUP

This case concerns applicant Danny Sabag's claim for workers' compensation benefits for cumulative trauma injury to his back, neck, right shoulder, psyche, jaw, and digestive system. The defendant contested the finding of industrial injury, particularly regarding the aggravation of pre-existing Crohn's disease by work stress. The Appeals Board found the current medical record insufficient to support injury to the psyche, jaw, and digestive system. Therefore, the matter is returned to the trial level for further medical development on these specific body parts, while upholding the finding of orthopedic injury.

Workers' Compensation Appeals BoardReconsiderationCumulative Trauma InjuryCrohn's DiseaseAggravationMedical EvidenceQualified Medical Evaluator (QME)Agreed Medical Examiner (AME)Psychiatric InjuryLabor Code Section 3208.3
References
Case No. ADJ8906863
Regular
Feb 17, 2023

YURI MARKEVITCH vs. HITACID GLOBAL STORAGE TECHNOLOGY, TOKIO MARINE and FIRE INSURANCE COMPANY LTD, BROADSPIRE

The Workers' Compensation Appeals Board denied reconsideration of a Legionnaires' disease claim. The applicant contracted the disease during a business trip abroad, which was deemed to have arisen out of and in the course of employment. The Board found the applicant was exposed to a special risk due to travel, distinguishing this case from prior precedents involving non-infectious diseases. Therefore, the Board upheld the compensability of the applicant's injury.

AOE/COELaTourette v. Workers' Comp. Appeals Bd.course of employmentarise out of employmentcommercial traveler ruleinfectious diseasespecial exposurerisk of communitymedical expert opinionLegionella Pneumonia
References
Case No. ADJ1036120 (SDO 0330367)
Regular
Jul 08, 2013

JESSE SUMABAT vs. CALIFORNIA HIGHWAY PATROL

This case concerns whether the applicant's valley fever is an "insidious, progressive disease" for which jurisdiction over permanent disability can be reserved. The WCAB granted reconsideration, rescinded the initial award, and returned the matter to the trial level. This is because the medical evidence regarding the progressive nature of the applicant's condition was contradictory and required further development. The Board emphasized that the determination of a progressive disease must be supported by substantial medical evidence stating medical probability.

Valley FeverCoccidioidomycosisProgressive DiseaseInsidious DiseasePermanent DisabilityJurisdiction ReservationJackson DoctrineGeneral Foundry ServiceRuffin CaseMedical Probability
References
Case No. ADJ6836868
Regular
Feb 03, 2012

STEPHEN SEAVELLO vs. COUNTY OF SAN DIEGO

This case concerns a deputy sheriff diagnosed with skin cancer, with a presumption that it arose from his employment. The Workers' Compensation Appeals Board reversed the administrative law judge's finding that the skin cancer was an "insidious disease process" and the subsequent reservation of jurisdiction over permanent disability. The Board determined that the applicant's condition was found to be permanent and stationary, and not a progressive insidious disease, thus precluding jurisdiction beyond the statutory five-year limit for amendments. Consequently, the original award of 4% permanent disability and need for future medical treatment was reinstated, but without the reservation of jurisdiction.

Workers' Compensation Appeals BoardStephen SeavelloCounty of San DiegoSkin CancerDeputy SheriffPermanent DisabilityFuture Medical TreatmentInsidious Disease ProcessReservation of JurisdictionLabor Code Section 5804
References
Case No. ADJ6854571
Regular
Oct 08, 2018

TED HIRSCHBERGER vs. STOCKWELL HARRIS WOOLVERTON AND MUEHL, STATE COMPENSATION INSURANCE FUND

Here's a summary of the case for a lawyer, in max four sentences: The Appeals Board granted reconsideration, overturning the WCJ's apportionment of permanent disability. The Board found that the applicant's industrial psyche injury aggravated Parkinson's disease, causing brain injury and permanent mental incapacity. This condition conclusively presumes total permanent disability under Labor Code section 4662(a)(4), precluding apportionment. Therefore, the applicant is found totally permanently disabled without apportionment.

WCABPetition for ReconsiderationFindings And AwardIndustrial InjuryPsycheParkinson's DiseasePermanent DisabilityApportionmentLabor Code Section 4662(a)(4)Conclusive Presumption
References
Case No. ADJ388201
Regular
Nov 12, 2010

RONALD WECHSLER vs. STATE OF CALIFORNIA, DEPARTMENT OF PARKS AND RECREATION, legally uninsured and adjusted by STATE COMPENSATION INSURANCE FUND

Defendant sought reconsideration of a prior WCAB decision that allowed applicant to reopen his case for increased permanent disability due to industrial hypertensive disease and resulting end-organ damage. Defendant argued that end-organ damage occurring outside the five-year limit from the date of injury barred recovery for new and further disability. The WCAB denied reconsideration, reaffirming that the parties' stipulation of injury to the cardiovascular system, including "hypertension and end organ damage," was binding and encompassed the current claim. The case is returned to the WCJ for determination of the extent of the applicant's increased permanent disability.

Petition to ReopenNew and Further DisabilityReconsideration DeniedPermanent DisabilityHypertensive DiseaseCardiovascular DiseaseEnd Organ DamageStipulated AwardDate of InjuryWCJ Decision
References
Case No. SAC 286368
Regular
Jan 25, 2008

DALE OLIVER vs. BRIAN WILLIAMS CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

This case involves an applicant seeking approval for disc replacement surgery for a work-related back injury. The defendant argued the surgery is experimental per ACOEM guidelines, thus not covered. The Board denied reconsideration, finding the applicant's physician rebutted the presumption of experimental status. The Board determined the surgery is no longer experimental, citing FDA approval, and is reasonably required for the applicant's specific condition, supported by expert medical opinion.

Workers' Compensation Appeals BoardBrian Williams ConstructionState Compensation Insurance Fundindustrial injuryright anklefootelbowshoulderskneesleft lower extremity
References
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