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

Case No. ADJ10256108, ADJ10255968, ADJ10256212, ADJ10256223, ADJ10489875
Regular
Sep 23, 2022

JOSEPH RYAN vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Appeals Board affirmed the finding of permanent and total disability for the applicant, Joseph Ryan, stemming from industrial injuries sustained while employed as a correctional captain. However, the Board remanded the matter for further proceedings to specifically address apportionment of the permanent disability under Labor Code section 4663, considering the Agreed Medical Evaluator's opinion on pre-existing spinal disease. The Board found that the applicant's specific and cumulative trauma injuries to his spine resulted in intertwined disabilities, justifying a combined award, but that Dr. Hasday's apportionment findings require further development and determination at the trial level.

Workers' Compensation Appeals BoardJoseph RyanCalifornia Department of CorrectionsLegally UninsuredState Compensation Insurance FundADJ10256108ADJ10255968ADJ10256212ADJ10256223ADJ10489875
References
Case No. ADJ9184413
Regular
Oct 27, 2020

JEFFREY SPRINGER vs. RJ DONOVAN CORRECTIONAL FACILITY, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation claim by Jeffrey Springer against RJ Donovan Correctional Facility. The Applicant sustained injuries resulting in industrially caused hypertension, hypertensive kidney disease, and hypertensive heart disease. The primary dispute centered on how to combine a prior 28% permanent disability rating for kidney disease with a new 49% rating for heart disease. The defendant argued these were part of a single cardiovascular system and sought to subtract the prior award's monetary value from the new rating. The WCJ found the injuries to the kidney and heart were distinct, justifying combining them, and awarded 63% permanent disability after deducting the prior award's value. The Appeals Board denied the defendant's petition for reconsideration, adopting the WCJ's reasoning.

Workers Compensation Appeals BoardRJ Donovan Correctional FacilityLegally UninsuredState Compensation Insurance FundPetition for ReconsiderationPermanent DisabilityHypertensionHypertensive Kidney DiseaseHypertensive Heart DiseaseHypertensive Cardiovascular Disease
References
Case No. ADJ6854571
Regular
Oct 08, 2018

TED HIRSCHBERGER vs. STOCKWELL HARRIS WOOLVERTON AND MUEHL, STATE COMPENSATION INSURANCE FUND

Here's a summary of the case for a lawyer, in max four sentences: The Appeals Board granted reconsideration, overturning the WCJ's apportionment of permanent disability. The Board found that the applicant's industrial psyche injury aggravated Parkinson's disease, causing brain injury and permanent mental incapacity. This condition conclusively presumes total permanent disability under Labor Code section 4662(a)(4), precluding apportionment. Therefore, the applicant is found totally permanently disabled without apportionment.

WCABPetition for ReconsiderationFindings And AwardIndustrial InjuryPsycheParkinson's DiseasePermanent DisabilityApportionmentLabor Code Section 4662(a)(4)Conclusive Presumption
References
Case No. SAC 286368
Regular
Jan 25, 2008

DALE OLIVER vs. BRIAN WILLIAMS CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

This case involves an applicant seeking approval for disc replacement surgery for a work-related back injury. The defendant argued the surgery is experimental per ACOEM guidelines, thus not covered. The Board denied reconsideration, finding the applicant's physician rebutted the presumption of experimental status. The Board determined the surgery is no longer experimental, citing FDA approval, and is reasonably required for the applicant's specific condition, supported by expert medical opinion.

Workers' Compensation Appeals BoardBrian Williams ConstructionState Compensation Insurance Fundindustrial injuryright anklefootelbowshoulderskneesleft lower extremity
References
Case No. ADJ3843514
Regular
Sep 15, 2008

Ramona J. Ornelas vs. COUNTY OF SACRAMENTO

Reconsideration granted to address errors in permanent disability rating and apportionment. Matter returned for new rating considering walker use and clarifying apportionment.

RAMONA J. ORNELASCOUNTY OF SACRAMENTOADJ3843514SAC 0274104OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONLEFT MINOR SHOULDERLEFT MINOR WRISTBILATERAL KNEESPSYCHE
References
Case No. STK 0189388
Regular
Oct 01, 2007

Frances L. Wylie vs. GOTTSCHALK'S, INC., THE HARTFORD INSURANCE Through SPECIALTY RISK SERVICES

This case concerns a dispute over the necessity and causation of left knee replacement surgery. The defendant argued the surgery was due to degenerative disease, not the industrial injury. The Workers' Compensation Appeals Board granted reconsideration primarily to address attorney's fees for enforcing the medical treatment award. The Board ultimately affirmed the original decision regarding the surgery while amending it to include attorney's fees.

Left knee replacementDegenerative diseaseIndustrial injuryCausationUtilization reviewMedical necessityAttorney's feesLabor Code section 4067Petition to ReopenCompensable consequence
References
Case No. ADJ2748573
Regular
May 11, 2009

THOMAS HERNON vs. COUNTY OF SANTA CLARA

The Appeals Board granted reconsideration, reversing the prior finding on the applicant's occupational group number from 560 to 380 (painter), based on evidence of the applicant's actual job duties. The Board also modified the decision regarding apportionment, accepting the Agreed Medical Evaluator's opinion that 10% of the disability should be apportioned to pre-existing degenerative disease. However, the Board affirmed the application of the 1997 Permanent Disability Rating Schedule, as temporary disability payments were terminated before January 1, 2005, triggering notice requirements. Ultimately, the applicant's permanent disability was reduced to 63% after apportionment.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardApplicantDefendantPublic Service WorkerOccupational Group NumberIndustrial InjuryLow BackNeck
References
Case No. ADJ8906863
Regular
Feb 17, 2023

YURI MARKEVITCH vs. HITACID GLOBAL STORAGE TECHNOLOGY, TOKIO MARINE and FIRE INSURANCE COMPANY LTD, BROADSPIRE

The Workers' Compensation Appeals Board denied reconsideration of a Legionnaires' disease claim. The applicant contracted the disease during a business trip abroad, which was deemed to have arisen out of and in the course of employment. The Board found the applicant was exposed to a special risk due to travel, distinguishing this case from prior precedents involving non-infectious diseases. Therefore, the Board upheld the compensability of the applicant's injury.

AOE/COELaTourette v. Workers' Comp. Appeals Bd.course of employmentarise out of employmentcommercial traveler ruleinfectious diseasespecial exposurerisk of communitymedical expert opinionLegionella Pneumonia
References
Case No. OXN 131251
Regular
Dec 05, 2007

DORIS STOCKS vs. THE URBAN GROUP dba THE GABLES OF OJAI, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, INTERCARE INSURANCE SERVICES, LEGION INSURANCE

The Appeals Board rescinded a penalty against CIGA for delayed temporary disability payments, finding penalties are not covered claims. The Board also amended the award to apportion one-third of the applicant's permanent disability to pre-existing degenerative disease, reducing the awarded permanent disability based on Dr. Berman's opinion. Consequently, the applicant's awarded permanent disability is reduced to 51%.

Workers' Compensation Appeals BoardDORIS STOCKSTHE URBAN GROUPTHE GABLES OF OJAICALIFORNIA INSURANCE GUARANTEE ASSOCIATION (CIGA)INTERCARE INSURANCE SERVICESLEGION INSURANCEOpinion and Decision After ReconsiderationTemporary DisabilityPermanent Disability
References
Case No. ADJ2428736 (SJO 0217650)
Regular
Jan 26, 2017

PAMELA GRAHAM vs. MONTESSORI SCHOOL OF FREMONT; CIGA

This Workers' Compensation Appeals Board decision denies reconsideration, upholding the administrative law judge's finding that the defendant failed to meet their burden of proof on apportionment. The Board found the orthopedic agreed medical examiner's opinions on apportionment were not substantial evidence because they lacked detailed reasoning, failed to explain the causal connection between degenerative disc disease and permanent disability, and did not adequately address apportionment to non-industrial causes. Therefore, the defendant's petition for reconsideration was denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedApportionmentBurden of ProofMedical OpinionReasonable Medical ProbabilitySpeculativePertinent FactsAdequate Examination
References
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