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

Case No. MISSING
Regular Panel Decision

Kurz v. St. Francis Hospital

The defendants moved to preclude plaintiffs' expert testimony on causation or, alternatively, for a pretrial hearing regarding the plaintiff's vision loss. The plaintiff developed visual disturbances shortly after receiving Amiodarone intravenously following cardiac bypass surgery in 2008. Defendants argued a lack of scientific evidence linking short-term Amiodarone use to optic neuropathy, while the plaintiff's expert contended that rapid drug absorption could cause optic disc edema, a known side effect. Furthermore, the plaintiff highlighted medical records where defendant physicians themselves initially attributed the vision loss to the medication. The court, applying the Frye standard, determined that general causation—Amiodarone causing vision loss—is an established medical theory. It further ruled that the specific causation tests from Parker and Cornell, typically applied to toxic tort cases, were not strictly applicable here due to the distinct nature of medical malpractice. Consequently, the court denied the defendants' motion, finding an adequate foundation for the admissibility of the plaintiff's expert testimony, with any disputes regarding specific timing affecting only the weight of the evidence, not its admissibility.

Medical MalpracticeExpert TestimonyCausationAmiodaroneOptic NeuropathyVision LossMotion in LimineFrye StandardParker StandardCornell Standard
References
9
Case No. ADJ8513866
Regular
Oct 11, 2013

GARY HICKS vs. COUNTY OF SACRAMENTO

The Appeals Board granted reconsideration of an award for future medical treatment, including spinal surgery, stemming from a 1996 industrial injury. The defendant employer argued that no reporting doctors addressed causation for the surgery. The Board noted the defendant's violation of rules by submitting unadmitted exhibits. Consequently, the Board amended the award to defer the issue of whether the 1996 injury contributes to the need for surgery, returning the matter for further proceedings to develop the record on causation.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardFuture Medical TreatmentSpinal SurgeryCausationLabor Code section 4062 (b)Substantial EvidencePropria PersonaPanel Qualified Medical Examiner (QME)
References
0
Case No. ADJ6500027
Regular
Jun 22, 2009

MARK SCOTT vs. SOUTHERN CALIFORNIA EDISON

The Workers' Compensation Appeals Board granted reconsideration of a finding that applicant Mark Scott sustained an industrial injury to his left knee. The Board found that the medical evidence presented, specifically operative reports, lacked any causation analysis and therefore did not substantially support the finding of industrial injury. Consequently, the case was remanded to the trial level for further development of the medical record concerning causation. The Board also deferred ruling on the statute of limitations defense pending this further development.

Workers' Compensation Appeals BoardSouthern California EdisonMark ScottAOE/COEStatute of LimitationsContinuous TraumaCumulative InjuryLabor Code Section 5405Reynolds v. Workers' Comp. Appeals Bd.Statute of Limitations Tolling
References
23
Case No. ADJ2552674 (STK 0182074), ADJ2434993 (LAO 0814353), ADJ815249 (STK 0199201)
Regular
Jan 24, 2012

CARLOS GASCA vs. HOWARD MARTIN FARMS, CIGA through its servicing facility INTERCARE INSURANCE for PAULA INSURANCE, in liquidation, CALIFORNIA INDEMNITY

The Workers' Compensation Appeals Board rescinded the prior award and remanded the case for further proceedings. The Board found that Dr. Abelow's medical opinion lacked substantial evidence due to factual inaccuracies and assumptions, particularly regarding the applicant's injury causation and apportionment. Additionally, Dr. Kimmel's psychiatric opinion failed to meet legal causation standards, deferring to orthopedic findings. The lien claimant's contentions will be reviewed anew by the WCJ upon remand.

Workers' Compensation Appeals BoardCarlos GascaHoward Martin FarmsCIGAIntercare InsurancePaula InsuranceCalifornia IndemnityJoint Findings and AwardAdministrative Law JudgeReconsideration
References
0
Case No. AD10769216
Regular
Dec 13, 2019

Richard Hovannisian vs. UCLA, Permissibly Self-Insured, Administered By SEDGWICK CMS

The WCAB granted reconsideration and deferred issues of lumbar spine injury and permanent disability from a prior award. The WCJ's decision relied on a QME report that failed to establish industrial causation for the lumbar spine injury and lacked sufficient explanation for departing from AMA Guides methodology for permanent disability ratings. The Board found these deficiencies meant the decision was not based on substantial medical evidence. Further proceedings are required for the QME to adequately address causation, rating methodology, and lumbar spine classification.

WCABPetition for ReconsiderationFindings of Fact & Awardindustrial injurylumbar spinepermanent disabilitysubstantial medical evidencedue processDisability Evaluation Unitpanel qualified medical evaluator
References
4
Case No. ADJ6596343
Regular
May 16, 2018

GARY GOBIN vs. INTEL CORPORATION

The Appeals Board rescinded the WCJ's decision and returned the case for further development, finding the WCJ erred by deferring the determination of whether personnel actions were a substantial cause of the psychiatric injury to the medical evaluator. The Board noted that the applicant's psychiatric injury likely stemmed from job stressors predating the employer's subsequent personnel actions. Competent medical evidence is required to distinguish causation of injury from causation of permanent disability, and the applicant's injury may have been caused by inability to adapt to workload demands before personnel actions were taken.

Workers' Compensation Appeals BoardGary GobinIntel Corporationcumulative traumapsyche injurygood faith personnel actionsLabor Code section 3208.3(h)Panel Qualified Medical Evaluator (PQME)Dr. Alberto LopezRolda v. Pitney Bowes
References
7
Case No. ADJ9157780
Regular
Jun 13, 2019

GEORGE GALLARDO vs. AT&T MOBILITY SERVICES, LLC., OLD REPUBLIC INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) partially affirmed a prior award, finding that the applicant sustained industrial injuries to his neck, back, psyche, hips, and knees. However, the WCAB deferred the issues of injury in the form of diabetes, the applicant's overall permanent disability, and his average weekly wage. This deferral stems from insufficient substantial evidence regarding the industrial causation of diabetes and the applicant's full earnings from all concurrent employments. The case is returned to the Workers' Compensation Judge for further proceedings to develop the record on these deferred issues.

AOE/COEPetition for ReconsiderationFindings Award and Ordertemporary disability indemnityaverage weekly wageorthopedic examinationdiabetic neuropathyvascular diseaseadjustment disordercontinuous trauma
References
0
Case No. ADJ9815883 ADJ9815873
Regular
Apr 03, 2017

OCTAVIO AVILEZ vs. ANDRE LANDSCAPE SERVICE, INC., STARR INDEMNITY & LIABILITY CO.

The Workers' Compensation Appeals Board granted reconsideration to clarify the applicant's alleged industrial injuries to his cervical and lumbar spine. An agreed medical evaluator's reports present conflicting opinions regarding causation and permanent disability from the incidents on August 12, 2014, and January 9, 2015. The Board is deferring the spine injury issue pending further clarification from the evaluator on whether these incidents caused any disability or required medical treatment. The Board also expressly found no industrial injury to the upper and lower extremities and deferred all other body parts.

Workers' Compensation Appeals BoardPetition for ReconsiderationAgreed Medical EvaluatorOrthopedistIndustrial InjuryCervical SpineLumbar SpineUpper ExtremitiesLower ExtremitiesDeferred Issue
References
1
Case No. ADJ8067157
Regular
Nov 30, 2012

MARISOL PERALTA vs. FROZEN YOGURT OF VALLEY VILLAGE, INC., STAR INSURANCE CO.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to further develop the record regarding applicant Marisol Peralta's alleged industrial injury. The WCAB rescinded the prior decision finding an injury, citing that the medical opinions were not substantial evidence as they lacked definitive causation findings and weren't based on complete medical histories. Crucially, neither physician reviewed applicant's full medical records, and one deferred causation due to pregnancy while the other awaited X-ray results. The case is returned to the trial level for further proceedings and a new decision by the WCJ.

Workers' Compensation Appeals BoardMarisol PeraltaFrozen Yogurt of Valley VillageInc.Star Insurance Co.Illinois Midwest Insurance AgencyLLCADJ8067157Opinion and Order Granting ReconsiderationDecision After Reconsideration
References
0
Case No. ADJ8586896
Regular
Dec 27, 2017

, Jose Benitez (Deceased), Zeferina Higuera Quezada vs. , AG Force, LLC, , Intercare Holding Insurance Services, , Gurmail Chehal and Samarjit Kaur, as Husband and Wife, Uninsured

This case concerns a deceased laborer, Jose Benitez, whose widow claimed his death from cellulitis resulted from an insect bite sustained while working for AG Force, LLC. Despite the lack of direct witnesses, the Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration. The WCAB found that the Administrative Law Judge's (ALJ) determination of industrial causation was supported by the credible testimony of the applicant's wife and medical reports. The Board emphasized the "reasonable probability" standard for industrial causation and gave deference to the ALJ's credibility findings.

Industrial causationreasonable probabilitycircumstantial evidencecredible testimonyWCJ credibility assessmentinsect bitecellulitisspider bitebrown recluse spiderattending physician
References
4
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