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

Case No. ADJ1279352
Regular
Nov 18, 2010

WARREN BARNA vs. PACIFIC TUBE, ST. PAUL TRAVELERS, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of an award finding them liable for an applicant's psychiatric injury. The applicant had previously settled orthopedic claims and a cumulative trauma claim. The Appeals Board granted reconsideration to amend the original decision, adding specific findings required by Labor Code section 4751 regarding the applicant's pre-existing psychiatric disability and the compensable industrial psychiatric injury. The Board affirmed the original finding of liability against the SIBTF, while clarifying the applicant's eligibility for SIBTF benefits and addressing the issue of potential offsets.

Subsequent Injuries Benefits Trust Fundpsychiatric disabilitypre-existing disabilityindustrial injurypermanent partial disabilityLabor Code section 4751Workers' Compensation Appeals Boardreconsiderationcumulative traumaspecific injury
References
0
Case No. ADJ12672803, ADJ12979844, ADJ12673709
Regular
Apr 24, 2023

FREDDIE BANUELOS vs. ROBERT BERCU, STATE FARM FIRE AND CASUALTY COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Workers' Compensation Appeals Board granted reconsideration of three prior decisions, affirming the dismissal of the post-termination defense for a right knee injury (ADJ12979844) and a cumulative trauma psychiatric injury claim (ADJ12673709), finding employer knowledge prior to termination. However, the Board amended the decision for a cumulative orthopedic injury claim (ADJ12672803), deferring the finding of industrial injury pending further development of the record regarding specific body parts and treatment needs. The Board also clarified that no psychiatric injury was found to date in ADJ12673709, and arguments regarding medical evidence for that claim were premature.

Post-termination defenseLabor Code 3600(a)(10)Labor Code 3208.3(e)Employer knowledgeIndustrial injuryOrthopedic injuryPsychiatric injuryCumulative traumaSpecific injuryRight knee injury
References
3
Case No. ADJ3758714 (VNO 0553350) ADJ3611380 (ANA 0372874)
Regular
Nov 24, 2008

Herbert J. Ware, Jr. vs. LOS ANGELES TIMES, Permissibly SelfInsured, Administered by GALLAGHER BASSETT SERVICES

The Appeals Board denied reconsideration of a decision that reversed a finding of cumulative trauma psychiatric injury for the applicant. The denial was based on the lack of substantial medical evidence establishing the cumulative trauma claim in one case, and the fact that a separate claim for psychiatric injury as a consequence of a back injury was not properly litigated. The Board indicated the case would return to the trial level for further proceedings on other issues.

Workers' Compensation Appeals BoardCumulative TraumaPsyche InjurySpecific InjuryBack InjuryCompensable ConsequenceReconsideration DeniedMedical EvidenceTemporary DisabilityFurther Medical Treatment
References
0
Case No. ADJ9068768 (MF)
Regular
Sep 15, 2017

CHEILITA LANE vs. SAN BERNARDINO COUNTY

This case involves an applicant alleging cumulative trauma injury to her neck, shoulders, lower extremities, and a psychiatric injury due to her employment as a probation officer. The defendant sought reconsideration of the original award, challenging the applicant's credibility and the compensability of the psychiatric injury, arguing it stemmed from subjective perceptions rather than actual events. The Appeals Board granted reconsideration, affirming the psychiatric injury finding based on substantial evidence and the WCJ's report. However, they amended the award to defer issues related to the orthopedic injury, medical treatment for it, and permanent disability, remanding the matter for further proceedings to develop the medical record regarding the orthopedic claim.

Workers' Compensation Appeals BoardCumulative TraumaPsychiatric InjuryOrthopedic InjuryQualified Medical EvaluatorSubstantial EvidencePermanent DisabilityMedical TreatmentPermanent and Stationary DateVocational Rehabilitation
References
0
Case No. MISSING
Regular Panel Decision

Claim of Kessler v. Fairmont Theater, Inc.

Claimant, employed for two days in 1986 as a projectionist, sought workers' compensation benefits for psychiatric injury and eye injury. He alleged harassment from his employer and supervisor caused a nervous breakdown, and projector light injured his eyes. The Workers’ Compensation Law Judge dismissed the psychiatric injury claim but found prima facie evidence for vision impairment, remitting that part for further development. The Workers’ Compensation Board subsequently ruled against the psychiatric trauma claim, a decision supported by employer and supervisor testimony denying harassment and claimant's psychiatrist confirming prior psychiatric issues. The appellate court affirmed the Board's decision, concluding that it was based on substantial evidence and that issues of credibility are within the Board's purview.

Psychiatric InjuryNervous BreakdownEye InjuryEmployment TerminationIntoxicationHarassmentCredibilitySubstantial EvidenceWorkers' Compensation BenefitsAppellate Review
References
2
Case No. ADJ7382041
Regular
May 11, 2012

Donna Larson vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, Legally Uninsured, SCIF STATE EMPLOYEES ROHNERT PARK, Adjusting Agency

The Workers' Compensation Appeals Board granted reconsideration to clarify the Administrative Law Judge's (ALJ) findings on applicant Donna Larson's psychiatric injury. The ALJ found Larson sustained cumulative trauma injury to her circulatory system and psyche, with ongoing temporary disability. Defendant argued the psychiatric injury finding was unsubstantiated, particularly regarding whether actual employment events were the predominant cause and if lawful personnel actions were a substantial cause. The Board found the ALJ's analysis under Labor Code section 3208.3 and the *Rolda* case lacked sufficient clarity regarding the predominant cause of the psychiatric injury and the impact of lawful personnel actions, including the applicant's termination. Therefore, the case was remanded to the trial level for further proceedings and a new decision to clarify these critical legal standards.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardCumulative TraumaHypertensionPsycheTemporary DisabilityPredominantly CausedActual Events of EmploymentGood Faith Personnel Actions
References
4
Case No. 10-93-224-CV
Regular Panel Decision
May 18, 1994

Subsequent Injury Fund of the State of Texas (Formerly the Second Injury Fund) v. Larry Milligan

The Subsequent Injury Fund appeals a judgment awarding Larry Milligan lifetime benefits for injuries sustained at work. Milligan suffered two ankle injuries in 1987 and a third in 1989, leading to the total loss of use of both feet. He sued the Fund for lifetime benefits after settling with the workers' compensation carrier. The jury found permanent, total loss of use of both feet. The Fund challenged its statutory liability for lifetime benefits and the court's refusal to submit a jury question on total and permanent incapacity. The appellate court affirmed, finding the first issue unpreserved and the second resolved by a statutory conclusive presumption of total and permanent incapacity for the loss of both feet.

Workers' Compensation LawSubsequent Injury FundLifetime BenefitsTotal Permanent IncapacityAnkle InjuriesStatutory InterpretationAppellate ReviewJury InstructionsConclusive PresumptionOccupational Injuries
References
6
Case No. ADJ3135090 (SAC 0355157) ADJ6834808
Regular
Sep 12, 2019

GUY LEE vs. UOP/MCGEORGE SCHOOL OF LAW, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board affirmed the WCJ's decision denying benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). Applicant's prior stipulation dismissing claims for sleep disturbance, sexual dysfunction, and psychiatric injury bound him from pursuing these for SIBTF benefits. Even without those dismissals, applicant's permanent disability rating for the subsequent injury, after adjustments, did not meet the 35% threshold required for SIBTF eligibility. The WCJ's finding that the industrial injury was not the predominant cause of the claimed psychiatric injury also contributed to the denial.

Subsequent Injuries Benefits Trust FundLabor Code section 4751permanent partial disabilitystipulated dismissalpredominant causepsychiatric injurybilateral carpal tunneldiminished future earning capacityWCJWorkers' Compensation Appeals Board
References
4
Case No. ADJ6577328, ADJ7895770
Regular
Jan 21, 2014

CLAIRE AMMONS vs. REDLANDS COMMUNITY HOSPITAL, INTERCARE INSURANCE SERVICES

This case involves an applicant alleging two industrial injuries, a specific injury in 2007 and a cumulative trauma injury from 2003 to 2011, resulting in temporary and permanent disability, including a psyche injury. The defendant sought reconsideration, arguing the WCJ erred in identifying only two injuries and awarding temporary disability when a medical evaluator found maximum medical improvement earlier. The Appeals Board granted reconsideration, rescinded the prior award, and remanded the case for further proceedings to develop the medical record, particularly regarding the number of cumulative trauma injuries and apportionment of disability. The Board specifically directed further evaluation from Dr. Kent on injury dates and apportionment, and potentially from a psychiatric evaluator, due to conflicting medical opinions and potential insufficiencies in the existing reports.

ReconsiderationJoint Findings and AwardCumulative TraumaSpecific InjuryTemporary DisabilityPermanent DisabilityPanel Qualified Medical EvaluatorPQMEDr. KentDr. Lustig
References
23
Case No. No. 08-07-00346-CV
Regular Panel Decision
Feb 24, 2010

W.C. LaRock, D.C., P.C. D/B/A Auto & Work Injury Clinic and Maria Del Carmen Gallardo/Rosemary Smith v. Rosemary Smith/W.C. LaRock, D.C., P.C. D/B/A Auto & Work Injury Clinic and Maria Del Carmen Gallardo

Rosemary Smith, an El Paso Police Officer, sued W.C. LaRock, D.C., P.C., d/b/a Auto & Work Injury Clinic, and its employee Maria Gallardo, alleging negligence after a physical therapy session aggravated a prior back injury. The City of El Paso, Smith's worker's compensation subrogee, joined as a plaintiff. The jury found Gallardo negligent, awarding Smith $488,000, which the trial court reduced to $339,983.58. Both parties appealed. The Court of Appeals found the expert testimony on causation insufficient to establish that Gallardo's therapy proximately caused Smith's reherniation, as the expert only stated it was "possible." The court reversed the trial court's judgment.

Medical MalpracticeNegligenceCausationExpert TestimonyPhysical TherapyHerniated DiscSpinal SurgeryProximate CauseLegal SufficiencyAppeal
References
33
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