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Case Law Database

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

Case No. ADJ9312928
Regular
Sep 11, 2019

Jeffrey DaVanon vs. Oakland Athletics, ACE Insurance Company, Sedgwick Claims Management

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration. The applicant, a former professional athlete, claimed cumulative trauma injury to multiple body parts, including gastrointestinal issues, neurological problems, and a sleep disorder not initially identified. The Board found that the WCJ erred by excluding medical evidence for these later-identified body parts, as they were included in the parties' stipulations and could have arisen or worsened after the applicant's deposition. The case is returned for further proceedings, allowing admission of relevant medical records and deferring final decisions on disputed body parts and permanent disability.

Mandatory Settlement ConferencePetition for ReconsiderationCumulative TraumaProfessional AthleteStatute of LimitationsLabor Code Section 5405Labor Code Section 5412Discovery CloseBifurcationIndependent Medical Evaluator
References
6
Case No. ADJ7288330
Regular
Oct 03, 2016

GLORIA BENITEZ vs. NEWPORT SUBACUTE HEALTH CARE CENTER, ALASKA NATIONAL INSURANCE COMPANY

The applicant, Gloria Benitez, sought to reopen her workers' compensation claim to include injury to additional body parts beyond her cervical spine and psyche. The original award found injury only to the cervical spine and psyche, with a 19% permanent disability rating for the cervical spine. While the WCJ's initial decision denied injury to additional body parts, the Board granted reconsideration. The Board amended the original findings to defer the issue of injury to the alleged additional body parts, while affirming other aspects of the WCJ's order, including the appointment of a regular physician to evaluate new and further disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderNew and Further DisabilityAgreed Medical ExaminerRegular PhysicianLabor Code Section 5410Petition to ReopenIndustrial InjuryCervical Spine
References
4
Case No. ADJ7390437
Regular
Mar 30, 2012

MARIA DUARTE vs. SHAKEY'S USA, INC., THE HARTFORD

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's findings, amending the order to find injury only to the applicant's right knee, with other body parts deferred. While affirming the WCJ's general findings, the Board found insufficient substantial medical evidence to support a finding of injury to the applicant's low back. The case is returned to the trial level for further proceedings regarding the deferred body parts. The Board also accepted the applicant's late-filed answer to the petition for reconsideration in its discretion.

AOE/COEReconsiderationFindings and OrderSubstantial Medical EvidenceMedical HistoryDeferred Body PartsApplicant TestimonyWitness TestimonyMedical RecordsCausation
References
7
Case No. ADJ18492736
Regular
Sep 30, 2025

MARIA HERNANDEZ vs. VALLARTA FOOD ENTERPRISES, INC.; SAFETY NATIONAL CASUALTY CORPORATION

The Workers' Compensation Appeals Board reviewed a petition for reconsideration filed by Safety National Insurance, challenging a WCJ's finding that Maria Hernandez sustained injury to multiple body parts. The Board found the treating physician's report lacked substantial medical evidence due to inadequate records and a flawed job description. Additionally, the Qualified Medical Evaluator's (QME) reports were incomplete and inconsistent regarding all body parts except the left hand. Consequently, the Board granted reconsideration, rescinded the original decision, and substituted new findings, determining that Hernandez sustained a cumulative injury only to her left hand while deferring the issue of injury to other body parts for further development of the record.

WCABPetition for ReconsiderationFindings of Fact and Ordersubstantial medical evidenceQualified Medical Evaluator (QME)cumulative traumabilateral shoulderswristshandsleft hand injury
References
19
Case No. ADJ10802406
Regular
Sep 23, 2022

DAVID STEINHAUER vs. CITY OF SIMI VALLEY

The Workers' Compensation Appeals Board granted reconsideration of the WCJ's award finding applicant sustained injury AOE/COE to multiple body parts. The Board affirmed the finding of injury to most body parts but deferred the issue of right hip injury due to lack of substantial medical evidence. The Board also ruled that applicant is not entitled to further temporary disability benefits as his employment was terminated for violating company policy after he returned to modified work. The matter was returned to the WCJ for further proceedings to develop the record regarding the right hip injury and to defer permanent disability and attorney fees.

AOE/COEPetition for ReconsiderationQualified Medical ExaminerPermanent DisabilityTemporary DisabilityRight Hip InjuryLumbar SpineDrug Test TerminationModified WorkReturn to Work
References
7
Case No. ADJ9767947
Regular
Jan 18, 2017

GILBERT PEREZ vs. ABC SHEET METAL, LIBERTY MUTUAL INSURANCE

This case involves an applicant who sustained industrial injury to his left knee and abdomen. The trial judge initially found injury to these parts but also found no injury to back, psyche, lower extremities, and stress, which the applicant appealed. The appellate court annulled the denial of reconsideration, finding the trial judge improperly ruled on body parts not fully at issue. The Appeals Board rescinded the negative finding, deferred the issue of additional injured body parts, and remanded for further proceedings to determine if injury to other parts occurred.

WCABindustrial injurywelderleft kneeabdomenbackpsychelower extremitiesstressCourt of Appeal
References
0
Case No. ADJ8533165
Regular
Mar 08, 2016

Margarito Trujillo vs. Cardenas Markets, Inc.

This case involves a worker claiming industrial injury to multiple body parts. The WCJ initially found injury only to the abdomen but applicant argued other claimed injuries were not addressed. The Appeals Board granted reconsideration to clarify the issues. They are rescinding the WCJ's decision and deferring the determination of injured body parts and the nature/extent of injury for further proceedings at the trial level.

Workers' Compensation Appeals BoardReconsiderationFindings of FactInjury AOE/COELabor Code section 5402Presumption of CompensabilityMandatory Settlement ConferencePre-Trial Conference StatementParts of Body InjuredNature and Extent of Injury
References
2
Case No. EUR 038931
Regular
Aug 08, 2007

STANLEY HOLCOMB, JR. vs. THE PACIFIC LUMBER COMPANY

This case concerns the application of the 104-week temporary disability payment limit under Labor Code Section 4656(c)(1) for a single cumulative injury to multiple body parts. The Board affirmed the judge's decision, holding that the statute applies regardless of whether one or multiple body parts are affected by a single injury. The specific commencement date for the 104-week period was deferred, with jurisdiction reserved for the parties to resolve this issue.

Workers' Compensation Appeals BoardStanley Holcomb Jr.The Pacific Lumber CompanyOpinion and Decision After ReconsiderationTemporary Total DisabilityLabor Code section 4656(c)(1)Aggregate Disability PaymentsCompensable WeeksDate of CommencementCumulative Injury
References
2
Case No. ADJ3437654 (AHM 0142431) ADJ317167 (AHM 0149524)
Regular
Feb 10, 2017

ETHAN PRATH KOLLAR vs. ENVIRONMENTAL & OCCUPATIONAL RISK MANAGEMENT, AMERICAN AUTOMOBILE INSURANCE COMPANY, FIREMAN'S FUND INSURANCE COMPANY

The Workers' Compensation Appeals Board denied defendant's petition for reconsideration or removal. The Board found the WCJ properly deferred issues of out-of-pocket medical expenses pending further discovery. The Board also affirmed the WCJ's order for reasonable and necessary medical treatment for the applicant's "stress" injury, noting that the defendant had stipulated to this injury and listed "stress" as a body part in a prior settlement agreement. Therefore, the defendant's arguments regarding lack of due process and the definition of "stress" as a body part were deemed unconvincing.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFindings and OrderWorkers' Compensation Administrative Law JudgeMedical TreatmentOut of Pocket Medical ExpensesAttorney's FeesRetroactive Requests for AuthorizationsUtilization Review
References
8
Case No. ADJ10065069
Regular
May 16, 2018

MARCIA FARRAR vs. STATE OF CALIFORNIA, UNEMPLOYMENT INSURANCE APPEALS BOARD, legally uninsured, administered by STATE COMPENSATION INSURANCE FUND

This case concerns defendant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) finding of injury arising out of and occurring in the course of employment (AOE/COE) to the applicant's right upper extremity. Defendant argued that no evidence supported injury to other alleged body parts and that the WCJ should have made findings on those parts instead of deferring the issue. The WCAB denied reconsideration, affirming the WCJ's decision to limit the trial to the threshold issue of right upper extremity injury AOE/COE. The WCAB found Dr. Amster's opinion constituted substantial evidence for the right upper extremity injury and that the WCJ acted within their authority by deferring other issues.

Workers' Compensation Appeals BoardAOE/COEQualified Medical ExaminerReconsiderationCumulative TraumaRepetitive Strain InjuryPreexisting ConditionAggravationContributing CauseMandatory Settlement Conference
References
7
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