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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. ADJ3640816 (SBR 0317873) ADJ1343688 (SBR 0317874)
Regular
Apr 10, 2009

ROBERT W. LEE vs. LAEGER'S INC., EVEREST NATIONAL INSURANCE CO., ACCA/BHHC, MID-CENTURY INSURANCE COMPANY

This case concerns a workers' compensation claim for cumulative injury where the liability period for employer Everest National Insurance Company (ENIC) was at issue. The Appeals Board granted reconsideration, amending the previous order to establish the cumulative injury ended on March 6, 2003, aligning with the applicant's first date of disability. Consequently, ENIC is now ordered to reimburse Mid-Century Insurance Company for 61% of benefits paid during the preceding one-year liability period. The Board affirmed the finding of a single cumulative injury, distinguishing it from prior cases with separate periods of disability and continued medical treatment.

Labor Code § 5500.5cumulative injuryspecific injurycompromise and releasetemporary total disabilitypermanent disability advancedate of injurylast day of workemployer liabilityapportionment
References
6
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. 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. 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
Case No. ADJ1766087 (LAO 0859443) ADJ3559115 (LAO 0859444)
Regular
Aug 28, 2014

SYLVIA REYES vs. IDLE ACRE CONVALESCENT HOSPITAL, EVEREST NATIONAL INSURANCE COMPANY, NATIONAL LIABILITY & FIRE INSURANCE COMPANY

This case concerns an insurer's petition for reconsideration of an arbitration award that altered a prior finding on the cumulative trauma injury period. The Appeals Board granted reconsideration, rescinding the arbitration award. The Board held that a prior Workers' Compensation Judge's finding of a cumulative trauma period ending June 23, 2005, which was stipulated to by the parties and not challenged, was binding. Therefore, the Arbitrator erred in redetermining this date. The issues of body part allocation are returned to the Arbitrator for a new decision.

cumulative traumadate of injuryspecific injuryapportionmentinsurer liabilityarbitrationreconsiderationfindings and awardcompromise and releasestipulation
References
9
Case No. ADJ1355980 (SAC 0285830) ADJ760169 (SAC 0285829)
Regular
May 28, 2013

BETTY FRISBY (Deceased), GEORGE FRISBY (Spouse) vs. THE PRESS TRIBUNE, INC.; TIG INSURANCE CO., TRISTAR RISK MANAGEMENT; RELIANCE INSURANCE CO., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, administered by TPA SEDGWICK CMS

This case concerns a deceased worker's cumulative injury claims against multiple insurers. The Appeals Board rescinded the arbitrator's decision, finding that crucial findings regarding the period of cumulative injury and whether the worker was an employee were missing. The Board remanded the case for the arbitrator to determine the precise injury dates, body parts affected, and the insurer(s) liable during the statutory period. This is necessary to ascertain if TIG Insurance provided coverage and thus constitutes "other insurance" before determining CIGA's liability.

Workers' Compensation Appeals BoardBetty FrisbyGeorge FrisbyThe Press TribuneTIG Insurance Co.Tristar Risk ManagementReliance Insurance Co.California Insurance Guarantee Association (CIGA)Sedgwick CMScumulative injury
References
5
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
0
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
10
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