CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. LAO 733786
Regular
Jul 25, 2007

David Coe vs. PROFESSIONAL ASSOCIATION OF DIVING INSTRUCTORS, MISSION INSURANCE COMPANY, CIGA

The Appeals Board granted reconsideration of the trial judge's decision that barred the applicant's claim due to the statute of limitations. The Board found that the applicant's severe head injury and resulting dementia raised serious questions about his competency to file a timely claim. Therefore, the case was returned to the trial level for further proceedings to determine if the statute of limitations should be tolled due to the applicant's mental incapacity.

Statute of LimitationsIncompetencyGuardian Ad LitemTollingWorkers' Compensation Appeals BoardMission InsuranceCIGAScuba Diving InstructorCatastrophic InjuryHypoxic Encephalopathy
References
Case No. ADJ302560 (LAO 0733786)
Regular
Aug 11, 2009

DAVID COE vs. PROFESSIONAL ASSOCIATION OF DIVING INSTRUCTORS, MISSION INSURANCE COMPANY

The applicant, injured in 1984, filed a workers' compensation claim in 1996, outside the typical statute of limitations. The Administrative Law Judge found the claim barred due to the applicant's failure to prove incompetence during the intervening period. The Appeals Board, while granting reconsideration to address a separate fee issue, affirmed the statute of limitations bar, finding insufficient evidence that the applicant was legally incompetent to file his claim between 1984 and 1996. The Board concluded that the medical expert, while diagnosing dementia, could not definitively state the applicant was incompetent for the entire relevant period, thus applicant failed to meet his burden of proof.

Statute of LimitationsIncompetencyTollingDementiaExecutive FunctioningAgreed Medical EvaluatorEquitable EstoppelLabor Code Section 5710Petition for ReconsiderationWCJ
References
Case No. ADJ1885105
Regular
Dec 16, 2010

SCOTT SIMONS vs. SUPERHEAT SERVICES, INC., SPECIALTY RISK PLEASANTON

The Appeals Board denied the applicant's petition for reconsideration regarding penalties and attorney fees, finding no evidence of unreasonable delay by the defendant. The Board granted the defendant's petition in part, reversing the order for a medical-legal examination by Dr. Sadoff for left knee surgery due to an underdeveloped record. However, the Board affirmed the WCJ's award of significant medical treatments, including home care, a motorized wheelchair, and neurological treatment for dementia, finding the treating physician's opinions more persuasive than utilization review denials. Finally, the Board clarified that transportation expenses are only for medical and medical-legal appointments, not legal ones.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardFurther Medical TreatmentDr. DeSallesDr. SadoffHome CareMotorized WheelchairTilt-Table TestENG Study
References
Case No. ADJ9088316
Regular
Sep 20, 2022

FRANKLIN OLIVER vs. TAMPA BAY BUCCANEERS, ESIS

This case involves a former professional athlete claiming permanent total disability due to a progressive brain injury. The Appeals Board affirmed a 98% permanent disability award but will reserve jurisdiction for future reassessment due to the insidious and progressive nature of the applicant's condition, as per the *Jackson* doctrine. The Board rejected the claim for conclusive presumption of permanent total disability under Labor Code section 4662(a)(4), finding insufficient evidence of permanent mental incapacity based on medical opinions. Further, temporary disability benefits were denied as the applicant was employed post-football career until retirement.

Workers' Compensation Appeals BoardFranklin OliverTampa Bay BuccaneersESISAdjudication Number ADJ9088316ReconsiderationFindings and AwardProfessional AthleteOccupational Group 590California Subject Matter Jurisdiction
References
Case No. ADJ7204145
Regular
Nov 09, 2016

RALPH WENZEL vs. SAN DIEGO CHARGERS, ZENITH INSURANCE COMPANY

This case involves a workers' compensation claim by a former professional football player alleging cumulative injury to his head, brain, and psyche. The administrative law judge found the claim barred by the statute of limitations, as the application was filed almost eight years after the determined date of injury. The applicant contended the statute was tolled due to his alleged mental incompetence. The Appeals Board has granted reconsideration to further develop the record, deferring the decision on tolling under Labor Code section 5408 pending expert opinion on the applicant's mental competency during the relevant period.

Workers' Compensation Appeals BoardSan Diego ChargersZenith Insurance CompanyPetition for Reconsiderationstatute of limitationsLabor Code section 5412Labor Code section 5405(a)Labor Code section 5408mental incompetencytolling
References
Case No. ADJ1885105 (LAO 0822725)
Regular
May 15, 2012

SCOTT SIMONS vs. SUPERHEAT SERVICES, INC/INSPERITY, KEMPER INSURANCE, SEDGWICK CMS/ SPECIALTY RISK SERVICES

The Appeals Board granted reconsideration and rescinded the prior award, finding no unreasonable delay in the provision of medical treatment. Applicant failed to establish a delay in the provision of home care or transportation services as no bills had been submitted to the defendant. The issue of the reasonable value of home health care services was deferred pending a bill submission and potential negotiation between the parties. The Board emphasized the need for better communication between the parties to avoid further litigation.

Workers' Compensation Appeals BoardReconsiderationUnreasonable DelayMedical TreatmentHome Health CareTransportationPenaltyLabor Code Section 5814Petition for ReconsiderationFindings and Award
References
Case No. ADJ2208887 (FRE 0219890)
Regular
May 05, 2015

VITO GIOTTA vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration regarding an amended order finding the applicant sustained industrial psychiatric injury and other conditions, resulting in permanent total disability. The defendant argued the finding of permanent total disability was unsubstantiated and that a psychiatric AME's apportionment should have been applied. The Board adopted the workers' compensation judge's report and recommendation, denying reconsideration and upholding the original decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationAmended Findings of FactOrderIndustrial Psychiatric InjuryCognitive ImpairmentDistal Sensory NeuropathyDementiaHepatitis CStaph Infection
References
Case No. ADJ4462136 (MON 0357470)
Regular
Dec 14, 2015

MARTIN REYES vs. CVS CAREMARK CORPORATION/CVS PHARMACY, AMERICAN HOME ASSURANCE

This Workers' Compensation Appeals Board decision reversed a prior finding of 98% permanent partial disability for Martin Reyes, awarding him 100% permanent total disability after a stroke. The Board found error in the exclusion of applicant's treating physician reports and determined that psychiatric disability, even with a 5% non-industrial apportionment, combined with other impairments, resulted in total disability. The decision also addressed the admissibility of medical reports and the mootness of vocational rehabilitation arguments given the ultimate finding of permanent total disability.

Permanent Total DisabilityPsychiatric InjuryApportionmentSubstantial EvidenceMedical OpinionQualified Medical ExaminerVocational RehabilitationSelf-Procured TreatmentStrokeVascular Dementia
References
Case No. ADJ2530222 (MON 0304365)
Regular
Jun 06, 2013

DIANE DAVIS vs. LOS ANGELES COUNTY METROPOLITAN TRANSPORTATION AUTHORITY, TRAVELERS INDEMNITY COMPANY

The Workers' Compensation Appeals Board (WCAB) rescinded a WCJ's decision awarding applicant 58% permanent disability for injuries to her wrists and psyche. The WCAB found that the WCJ's decision lacked substantial evidence because the medical opinions on apportionment and permanent disability were insufficient, particularly Dr. Gilberg's unclear apportionment and the failure to consider Drs. Richman and Furst's opinions. The case is returned to the trial level for further proceedings to obtain clearer medical evidence and address specific contentions from the Subsequent Injuries Benefits Fund regarding apportionment and overall permanent disability.

Subsequent Injuries Benefits Trust FundPermanent Total DisabilityApportionmentCumulative TraumaCognitive DisorderPseudo-dementiaChronic Pain SyndromeNeuropathic Pain SyndromeSubstantial EvidenceMedical Probability
References
Showing 1-9 of 9 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational