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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ7332241
Regular
Jun 30, 2011

Jesus Hernandez vs. JCB CLARK ENTERPRISES INC, U.S. FIRE AND GUARANTY

Here's a summary for a lawyer: The Workers' Compensation Appeals Board denied Jesus Hernandez's petition for reconsideration, affirming the WCJ's decision that he failed to meet his burden of proof for a cumulative trauma injury ending March 17, 2007. The applicant argued that prior injuries and a doctor's report supported his claim for a longer period, but the Board found his arguments unpersuasive. A dissenting commissioner believed the case should be returned for further proceedings on orthopedic cumulative trauma claims due to disputed employment periods and available evidence.

Cumulative TraumaPetition for ReconsiderationFindings and AwardWorkers' Compensation Administrative Law Judge (WCJ)Burden of ProofIndustrial Cumulative TraumaPast Industrial InjuryMedical EvidenceSubstantial Medical EvidenceFaulty History
References
Case No. ADJ3864552 (LAO 0788138)
Regular
Jan 03, 2011

ANTONIETA GUERRERO vs. WELLPOINT HEALTH NETWORK, INC., ZURICH LOS ANGELES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For FREMONT In Liquidation

The Workers' Compensation Appeals Board granted reconsideration of a prior award due to insufficient analysis by the WCJ regarding the date(s) of cumulative trauma. The Board found the WCJ's decision lacked specific reference to evidence, particularly on whether multiple or a single period of cumulative trauma applied. The matter was returned to the trial level for further proceedings, a new decision, and adequate analysis of all contentions, including permanent disability and apportionment.

Cumulative traumaOveruse syndromeFibromyalgiaPsyche injuryPermanent total disabilityApportionmentAttorney feesFindings and AwardReconsiderationWCJ
References
Case No. ADJ7050517
Regular
Jun 16, 2010

Gary Tull vs. YOUNGS MARKET, Permissibly Self-Insured Administered By CANNON COCHRAN MANAGEMENT SERVICES

This case concerns an applicant claiming cumulative trauma injury to his right knee. The WCJ denied the claim, finding the Panel QME's report insufficient to establish cumulative trauma. The Appeals Board granted reconsideration, noting the PQME found an injury and work-related causation but incorrectly characterized it as a specific injury on a particular date. The Board remanded the case to develop the medical record, specifically directing a supplemental report from the PQME on the cumulative trauma aspect of the claim.

Cumulative traumaPanel Qualified Medical EvaluatorPQMEIndustrial injuryRight kneeFindings and OrderReconsiderationTake nothing orderSubstantial medical evidenceBurden of proof
References
Case No. ADJ120949 (LBO 0345949)
Regular
Mar 28, 2011

RON CURTIS vs. C.J. SEGERSTROM & SONS, AMERICAN CLAIMS MANAGEMENT FOR EVEREST NATIONAL INSURANCE, AMERICAN SAFETY CASUALTY COMPANY

This case concerns American Safety Casualty Company's petition for reconsideration of an arbitrator's decision regarding contribution. The arbitrator found that Everest National Insurance Company timely instituted contribution proceedings based on a subsequent Compromise and Release Agreement that redefined the cumulative trauma injury dates. American argued that a prior, rescinded award determining earlier injury dates should control, but the Board affirmed the arbitrator's conclusion that the rescission rendered the prior finding void. The Board clarified that this decision only addresses the timeliness of contribution proceedings, not final liability, allowing for further litigation.

Workers' Compensation Appeals BoardCumulative Trauma ClaimContribution ProceedingsArbitrator's Findings and AwardCompromise and Release AgreementDate of Cumulative Trauma InjuryLabor Code Section 5500.5Rescinded Findings and AwardStatus Quo AntePetition for Reconsideration
References
Case No. ADJ9172692
Regular
Feb 25, 2016

TIMOTHY FRYE vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION, Legally Uninsured; STATE COMPENSATION INSURANCE FUND

This case involves a correctional lieutenant who claimed a cumulative industrial injury to his heart, knees, hip, cardiovascular system, and hypertension. The defendant sought reconsideration, arguing for separate injury periods for orthopedic and internal conditions. The Board denied the petition, upholding the finding of a single cumulative trauma period ending on the applicant's last day of employment. The Board found no evidence that the applicant knew his disability was work-related prior to consulting an attorney, thus establishing the date of injury as post-employment.

Cumulative traumaDate of injuryIndustrial injuryCardiovascular systemHypertensionOrthopedic claimInternal claimPetition for reconsiderationFindings of Fact and AwardsWCJ
References
Case No. ADJ11029299 ADJ10664592
Regular
May 03, 2018

KATHLEEN CAMPER vs. VAL VERDE UNIFIED SCHOOL DISTRICT, PSI, administered by KEENAN \u0026 ASSOCIATES

The Workers' Compensation Appeals Board granted reconsideration, finding the applicant's initial timely filed claim for cumulative trauma injury should be amended to conform to proof of a specific back injury on May 5, 2016. The Board rescinded the judge's order finding the applicant took nothing and instead ordered the dismissal of the defendant's later-filed specific injury claim. The case is returned to the trial level for further proceedings on the amended claim.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderAdministrative Law JudgeCustodianCumulative TraumaSpecific InjuryApplication for Adjudication of ClaimDue ProcessQualified Medical Examiner
References
Case No. ADJ7785251
Regular
Nov 14, 2014

Jon Brothers vs. STATE OF CALIFORNIA, DEPARTMENT OF FORESTRY AND FIRE PROTECTION, COASTAL/NORTH REGION; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to clarify that the applicant's cumulative trauma orthopedic injury claim is still under development. The Board agreed with the WCJ that the defense's medical expert, Dr. Baldwin, failed to provide substantial medical evidence due to a misunderstanding of cumulative trauma principles. Dr. Baldwin improperly required documented prior specific injuries to opine on cumulative trauma, thereby failing to adequately assess the applicant's extensive work history. Therefore, the case is affirmed except for the amendment of a finding of fact to reflect that the orthopedic injury claim is contested and requires further medical evaluation.

Cumulative traumaQualified Medical EvaluatorIndependent Medical Evaluatorsubstantial medical evidenceorthopedic injurybinaural hearing losscardiovascular systemBattalion Chiefretired annuitantorthopedic cumulative trauma
References
Case No. ADJ6550186
Regular
Mar 18, 2013

KELVIN EDWARDS vs. DALLAS COWBOYS, TRAVELERS INDEMNITY COMPANY AND ITS CASUALTY AFFILIATES AND SUBSIDIARIES, SAN FRANCISCO 49ERS, NATIONAL UNION FIRE INSURANCE COMPANY, CHARTIS CLAIMS, INC.

This case involves a cumulative trauma injury claim by former professional football player Kelvin Edwards. The Workers' Compensation Appeals Board (Appeals Board) affirmed the finding of a single cumulative trauma injury to multiple body parts, rejecting the defendant's argument for apportionment to different employers and dates of injury. The Appeals Board also reversed the award of a Labor Code section 5814 penalty against the San Francisco 49ers, finding their delay in paying benefits was not unreasonable. The applicant's entitlement to permanent disability and future medical treatment, as initially awarded, remains in place.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaPermanent DisabilityLabor Code Section 5500.5Injurious ExposureApportionmentLabor Code Section 5814PenaltyUnreasonable Delay
References
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