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Case Law Database

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

Case No. ADJ8939849
Regular
Jan 04, 2016

GEORGE KIMMEL vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation claim for hearing loss. The applicant, a former correctional officer, alleged injury from a 1978 bomb blast and cumulative trauma from noise exposure throughout his career. The Workers' Compensation Appeals Board (WCAB) rescinded the initial award finding a cumulative trauma injury with a 2014 date of injury. The WCAB determined the case involves potential specific and cumulative injuries, requiring further development of the record regarding the date of injury, last injurious exposure, and the exact nature of the injuries. The matter was returned to the trial level for these further proceedings.

Cumulative traumaStatute of limitationsLachesDate of injurySpecific injuryTinnitusHearing lossQualified Medical ExaminerImprovised explosive deviceMatch bomb
References
3
Case No. OXN 0128150, OXN 0128151, OXN 0128152
Regular
Sep 17, 2007

PEGGY A. RICO vs. AQUARIA, INC., CHUBB GROUP OF INSURANCE COMPANIES, CIGA, For RELIANCE INSURANCE, In Liquidation

The Workers' Compensation Appeals Board granted reconsideration to determine if applicant Peggy Rico sustained separate cumulative trauma injuries. The WCAB found that the applicant's return to work with a different insurer, involving distinct injurious exposures and new medical symptoms, constituted a separate industrial injury from her earlier cumulative trauma. Consequently, the case was remanded for a new determination of liability for benefits based on these separate injuries.

Workers' Compensation Appeals BoardCIGAReliance InsuranceChubb GroupCumulative Trauma InjurySeparate Industrial InjuryMedical EvidenceDate of InjuryLabor Code Section 5412Labor Code Section 5500.5
References
9
Case No. ADJ1936857
Regular
Jul 08, 2010

Robert Terrazas vs. COMPUSA, Westmont College, Zurich Los Angeles, COMPWEST Newport Beach

The Workers' Compensation Appeals Board (WCAB) amended a prior award concerning Robert Terrazas's cumulative trauma knee injury. The WCAB corrected the cumulative trauma injury date to February 25, 2008, establishing liability for employers during the final year of exposure, specifically Westmont College and COMPUSA. Apportionment of disability was confirmed, but the division of liability and reimbursement between the two employers was deferred pending mandatory arbitration. The WCAB also admonished Westmont's counsel for violating procedural rules in their petition for reconsideration.

Cumulative traumaSpecific injuryApportionmentDate of injuryContinuous traumaLeft kneePermanent disabilityIndustrial exposureEmployer liabilityContribution
References
4
Case No. ADJ6445314
Regular
Jul 30, 2009

CYNTHIA KRAUSE vs. WAL-MART ASSOCIATES, INC.

This case involves an applicant claiming cumulative trauma to her right eye, allegedly occurring in 2007, despite stipulated employment ending in 2001. The WCJ denied the claim based on employment status and statute of limitations. The Appeals Board granted reconsideration, rescinded the prior order, and remanded for further proceedings. This is because crucial medical evidence regarding injurious exposure and the connection to employment was not developed. The Board will allow further development of the record, including potential consideration of a compensable consequence claim if cumulative trauma is not established.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaSpecific InjuryStatute of LimitationsCompensable ConsequenceInjurious ExposureEmployment StatusPetition to ReopenMedical Issue
References
1
Case No. ADJ4258158 (OXN 0128983) ADJ4450153 (OXN 0136267)
Regular
Jun 01, 2010

BRENDA K. ROACH vs. BRIDAL TRADITIONS, CALIFORNIA INDEMNITY INSURANCE COMPANY, PREFERRED EMPLOYERS INSURANCE COMPANY

This case involves California Indemnity Insurance Company (CIIC) seeking reconsideration of a Workers' Compensation Arbitrator's decision. CIIC disputes the finding of a single cumulative trauma injury period and the assigned date of injury, arguing for a longer exposure period. The Appeals Board granted reconsideration and amended the prior findings to establish one cumulative trauma injury from March 5, 1999, through November 24, 2002. The original decision regarding CIIC's contribution claim against Preferred Employers Insurance Company was otherwise affirmed.

Cumulative traumaDate of injuryLabor Code section 5412Labor Code section 5500.5Petition for ContributionReconsiderationFindings and OrderCompromise and ReleaseAnti-merger statutesApportionment
References
2
Case No. ADJ2719991 (VNO 0485134) ADJ1334047 (VNO 0428744)
Regular
Aug 20, 2009

Catalina Barajas vs. WELLPOINT HEALTH NETWORK, INC., ZURICH LOS ANGELES

This case involves an applicant who initially sustained a cumulative trauma injury to her upper extremities during a period covered by one insurer. After returning to work with modified duties, she experienced a recurrence and worsening of symptoms, necessitating further treatment and surgery, which the Board now recognizes as a separate cumulative trauma injury. The Workers' Compensation Appeals Board granted reconsideration, reversing the prior finding of a single cumulative trauma injury. The Board held that distinct periods of compensable temporary or permanent disability, as established by medical evidence and treatment, demarcate separate cumulative trauma injuries, aligning with the *Rodarte* precedent. Consequently, the applicant was found to have sustained two separate cumulative trauma injuries, each attributed to different insurance coverage periods.

cumulative traumaanti-merger doctrineLabor Code sections 3208.25303Rodartecompensable temporary disabilitypermanent disabilitywage lossmodified workbilateral upper extremities
References
3
Case No. ADJ2639902 (RIV 0043796)
Regular
Oct 25, 2010

FELICITAS HELLMICH vs. LAKE ELSINORE UNIFIED DISTRICT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ICW GROUP, ACE USA

ACE sought reconsideration of an arbitrator's award finding a single cumulative trauma injury and holding ACE responsible for reimbursement to CIGA and ICW. The Board denied reconsideration, affirming that under Labor Code § 5500.5, ACE is solely liable for the cumulative trauma injury due to its coverage during the final year of exposure. ACE's arguments regarding specific injuries and applicability of case law were rejected as contrary to Agreed Medical Evaluator findings and statutory mandates. The Board found ACE's liability for all benefits is established regardless of prior payments by other insurers or the reasonableness of treatment, which can be addressed separately if needed.

Cumulative traumaLast year of exposureLabor Code Section 5500.5CIGAWeitzmanContributionReimbursementAgreed Medical EvaluatorMedical treatmentSpecific injury
References
8
Case No. ADJ1256092 (VNO 0458544)
Regular
Oct 07, 2011

MARIA TOLEDO vs. WELLPOINT HEALTH NETWORK INC, CIGA for FREMONT in liquidation, administered by XCHANGING, ZURICH AMERICAN INSURANCE

This case involves Zurich American Insurance seeking reconsideration of a decision that extended applicant Maria Toledo's cumulative trauma injury period to November 1, 2001, placing liability on Zurich. Zurich argued the injury date should be December 2000, during Fremont/CIGA's coverage, as medical evidence, including the Agreed Medical Examiner (AME) Dr. Sohn's reports, allegedly only supported exposure until that earlier date. The Board denied reconsideration, affirming that the AME found the totality of applicant's employment duties, including those as a sales assistant after a job change, contributed to her cumulative trauma until November 1, 2001. Therefore, Zurich remains liable for the injury.

Cumulative traumaDate of injuryPeriod of injurious exposureLabor Code section 5412Section 5500.5Agreed Medical Examiner (AME)Dr. Roger SohnMedical evidenceZurich North AmericaFremont Compensation Insurance
References
1
Case No. ADJ7110663
Regular
May 09, 2016

WILLIAM BO MATTHEWS vs. SAN DIEGO CHARGERS, ZENITH INSURANCE COMPANY, NEW YORK GIANTS, INSURANCE COMPANY OF NORTH AMERICA/ACE USA, DENVER GOLD, THE NORTH RIVER INSURANCE COMPANY

This case involves a petition for reconsideration of an arbitrator's decision regarding workers' compensation liability for a professional football player's cumulative trauma injuries. The Workers' Compensation Appeals Board (WCAB) granted reconsideration and modified the arbitrator's award, finding the applicant sustained two separate cumulative trauma injuries due to distinct periods of employment exposure. Consequently, the WCAB ruled that the petitioner, Insurance Company of North America/ACE USA (ESIS), is not liable for contribution to another insurer, The North River Insurance Company (NRIC), which had mistakenly paid a portion of a settlement. The Board affirmed the finding of two injuries, citing a significant break in employment as creating separate compensable periods, but rescinded the award to NRIC, holding NRIC should recover nothing from ESIS.

WCABPetition for ReconsiderationArbitration DecisionContributionCumulative InjuryProfessional Football PlayerInsurance Company of North America/ACE USAZenith Insurance CompanyThe North River Insurance CompanyLabor Code Section 5500.5
References
9
Case No. LBO 0377371
Regular
Apr 28, 2008

EDUBIJES TORREZ vs. RED HILLS COUNTRY CLUB, CHUBB SERVICES CORPORATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Chubb Insurance's petition for reconsideration, affirming the original finding that Edubijes Torrez sustained a cumulative trauma injury (leiomyosarcoma) due to chemical exposure as a groundskeeper. The Board found that despite the provision of protective gear in 1998, the applicant's exposure continued through his last year of employment, making Chubb, the insurer during that period, liable for the $100\%$ permanent disability award. Chubb's argument that exposure ceased in 1998 was rejected due to evidence of ineffective protective gear and continued exposure.

LeiomyosarcomaCumulative traumaLabor Code section 5500.5Injurious exposureRespirator protective gearLatency periodIndustrial chemical exposurePermanent disabilityGroundskeeperRed Hill Country Club
References
3
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