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

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. ADJ6693720
Regular
Mar 15, 2010

KERRY NECHODOM vs. CITY OF GROVER BEACH

The Workers' Compensation Appeals Board granted reconsideration to amend the date of injury for Kerry Nechodom's right shoulder injury in case ADJ6693720 from February 3, 2007 - September 10, 2009 to August 12, 2008 - September 10, 2009. This amendment acknowledges a separate cumulative trauma injury due to distinct periods of disability and lack of continuous treatment between injuries. The Board affirmed the original award, finding that the applicant sustained two separate cumulative trauma injuries causing distinct periods of temporary disability. The employer's arguments regarding the cumulative trauma period and Labor Code $\S 4656$ limitations were addressed and resolved by this clarification.

Workers' Compensation Appeals BoardKerry NechodomCity of Grover BeachADJ6693720ADJ5791464ReconsiderationJoint Findings and AwardIndustrial InjuryRight ShoulderCumulative Injury
References
11
Case No. ADJ2307991 (VNO 0427797) (MF) ADJ3536405 (VNO 0336819) ADJ487962 (VNO 0533632)
Regular
Jun 14, 2018

JACQUELINE AUSTIN vs. FIRST FOURSQUARE CHURCH OF VAN NUYS, GUIDE ONE MUTUAL INSURANCE COMPANY, FREMONT, CIGA, CYPRESS INSURANCE COMPANY, FOREST LAWN MEMORIAL PARK, SAFECO INSURANCE, TRAVELERS PROPERTY CASUALTY COMPANY

This case involves an applicant who sustained two separate cumulative trauma injuries to her neck, back, and gastrointestinal system, including GERD and fibromyalgia. The Workers' Compensation Appeals Board (WCAB) affirmed the findings that the applicant suffered distinct industrial injuries during employment with First Foursquare Church (insured by Cypress) and Forest Lawn Memorial Park (insured by Travelers). Defendant Cypress contested the dating of the injury and the finding of two separate cumulative trauma periods, while Travelers challenged the sufficiency of medical evidence for one injury. The WCAB found Cypress waived the issue of one versus two cumulative trauma injuries by failing to raise it timely. Ultimately, the WCAB adopted the WCJ's findings, confirming the two separate cumulative trauma periods and the respective carrier liabilities.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaDate of InjuryLabor Code Section 5412Labor Code Section 5500.5Findings of FactAward and OrderAdministrative Law JudgeCypress Insurance Company
References
9
Case No. ADJ8514073 (MF) ADJ9995510 ADJ2721680 (FRE 0187462)
Regular
Sep 24, 2018

VICTOR VILLA vs. JOE CARDOZA DAIRY, PAULA INS. in receivership by CIGA, INSURANCE COMPANY OF THE WEST, SECURITY NATIONAL administered by RISICO, REPUBLIC INDEMNITY administered by SEDGWICK

This case concerns a dispute over the dates of a cumulative trauma injury to the applicant's left knee, following an admitted 1998 specific injury. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to amend the injury period. The WCAB determined the date of cumulative trauma injury under Labor Code § 5412 was September 4, 2012, the date the applicant retained counsel and gained awareness of the cumulative trauma concept. Consequently, liability for the cumulative trauma injury under Labor Code § 5500.5 was established as September 4, 2011, to September 4, 2012.

WORKERS COMPENSATION APPEALS BOARDJOE CARDOZA DAIRYPAULA INSCIGAINSURANCE COMPANY OF THE WESTSECURITY NATIONALREPUBLIC INDEMNITYSEDGWICKVICTOR VILLASUBSEQUENT CUMULATIVE TRAUMA
References
0
Case No. ADJ1817205 (RIV 0076837) ADJ2824273 (RIV 0076838)
Regular
Jul 02, 2014

SONNY LOVELESS vs. NEWPORT FARMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ZURICH AMERICAN INSURANCE CO., VIRGINIA SURETY INSURANCE COMPANY

This case involves a dispute over reimbursement for workers' compensation benefits paid by CIGA. The Appeals Board affirmed an arbitrator's decision granting CIGA full reimbursement from Virginia Surety and Zurich for benefits paid to the applicant. Virginia Surety's arguments that the cumulative trauma periods should be reevaluated and that CIGA was liable for the first period were rejected. The Board found Virginia Surety is bound by prior stipulations establishing two cumulative trauma periods, making its coverage "other insurance" under Insurance Code § 1063.1(c)(9) and thus excluding CIGA's liability for those benefits.

Workers' Compensation Appeals BoardSonny LovelessNewport FarmsCalifornia Insurance Guarantee Association (CIGA)Superior NationalZurich American Insurance Co.Virginia Surety Insurance Companycumulative traumastipulated awardreimbursement
References
4
Case No. ADJ7250315
Regular
Feb 14, 2020

ROBYN ARIAS vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS & REHABILITATION

This case involves a correctional officer's cumulative trauma claim. The employer sought reconsideration, arguing the cumulative trauma ended on July 8, 2014, as the applicant allegedly sustained no disability prior to that date. However, the Board denied reconsideration, affirming the WCJ's finding that the applicant experienced disability earlier due to chemotherapy for non-Hodgkins lymphoma. This disability, occurring from February 2007 to February 2008, establishes the injury's cumulative trauma period under Labor Code section 5412.

Cumulative traumaCorrectional officerLumbar spine injuryPsyche injuryNon-Hodgkins LymphomaPermanent disability indemnityCompensable consequence injuryLabor Code section 5412Date of injuryCumulative injury end date
References
5
Case No. ADJ 4252592 (VNO 0411668)ADJ 3234790 (VNO 0443319) (MF)
Regular
May 04, 2012

HARRY WINSTON vs. CITY OF LOS ANGELES

This case concerns a petition for reconsideration by the City of Los Angeles challenging the Administrative Law Judge's (ALJ) finding of a single cumulative trauma injury. The applicant stipulated to two separate cumulative trauma periods for various injuries, but subsequent medical opinions from treating physicians concluded there was one continuous cumulative trauma injury spanning the applicant's entire employment. The ALJ amended the stipulations to align with this medical evidence and dismissed one of the applicant's cases as duplicative. Therefore, the ALJ recommends denying the employer's petition for reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationCumulative Trauma InjuryAmended FindingsOpinion on DecisionStipulationsMedical EvaluationQualified Medical EvaluationAgreed Medical EvaluationDate of Injury
References
10
Case No. ADJ 10459549, ADJ 10459544
Regular
Jul 07, 2017

SAUL MEJIA VALLADARES vs. SERVICON SYSTEMS, INCORPORATED

In this case, the Appeals Board affirmed the Arbitrator's denial of the applicant's specific injury claim from March 7, 2016, due to credibility issues and lack of substantial evidence. However, the Board rescinded the denial of the cumulative trauma claim from April 2011 to April 2016. The Board found that medical records indicated prior orthopedic complaints within the cumulative trauma period, necessitating further medical evaluation despite the applicant's credibility issues on other claims. Therefore, the cumulative trauma claim is returned to the Arbitrator for further development of the medical record.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaSpecific InjuryArbitratorCredibility DeterminationMedical EvaluationLabor Code Section 4060Carve-out CaseLabor Code Sections 3201.5
References
7
Case No. ADJ1242432 (LAO 0810317) ADJ1936406 (LAO 0857303)
Regular
Feb 01, 2011

REYNA MEZA vs. PACPRO MANAGEMENT, Dba COAST SPORTSWEAR, AMERICAN CLAIMS MANAGEMENT for EVEREST NATIONAL INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, By Its Facilitating Agent, INTERCARE INS. SERVICES, for PAULA INSURANCE COMPANY, In Liquidation

Everest National Insurance Company seeks reconsideration of an arbitrator's decision awarding CIGA $\$95,245.36$ in reimbursement for cumulative trauma benefits. Everest argues the arbitrator erred by finding the cumulative trauma extended over the applicant's entire employment, contrary to the Agreed Medical Examiner's (AME) opinion. The Appeals Board granted reconsideration, finding the AME's opinion legally flawed and lacking substantial evidence for the extended cumulative trauma period. The matter is remanded to the arbitrator for further proceedings to develop the medical record and render a new decision.

Workers' Compensation Appeals BoardIndustrial InjuryCumulative TraumaSpecific InjuryAgreed Medical ExaminerPetition for ReimbursementCalifornia Insurance Guarantee AssociationInsurance Coverage PeriodInjurious ExposureSubstantial Evidence
References
9
Case No. LAO 0833762
Regular
Sep 07, 2007

IRMA MARTINEZ, IRMA A. NAVAREZ-MARTINEZ vs. CORONA CLIPPER, STATE COMPENSATION INSURANCE FUND, LIBERTY MUTUAL INSURANCE COMPANY, AMERICAN HOME ASSURANCE COMPANY

The Appeals Board granted reconsideration, rescinded the WCJ's decision, and returned the case for further proceedings. This action defers the issue of injury to the psyche while affirming findings of industrial injury to the back, neck, shoulders, elbows, wrists, and fibromyalgia, based on a cumulative trauma period ending August 23, 1999. Fibromyalgia was properly considered as an issue, and substantial evidence supports the established cumulative trauma period and related injuries, despite the defendant's contentions.

FibromyalgiaCumulative traumaDate of injuryMandatory settlement conferenceIndustrial injuryAgreed medical examinationRheumatologistOccupational diseaseSubstantial evidenceStipulation
References
11
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