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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ8788440
Regular
May 12, 2014

ROBERT WATSON vs. NOR-CAL MOVING SERVICES, VANLINER INSURANCE COMPANY

Applicant Robert Watson sought reconsideration of a Workers' Compensation Appeals Board (WCAB) finding that denied temporary disability benefits from August 27, 2013. The applicant argued that his treating physician's records constituted substantial evidence of his inability to perform modified duty, and that the WCJ should have developed the record further. The majority of the WCAB denied reconsideration, adopting the WCJ's report that found no substantial evidence to support the claim. However, one Commissioner dissented, arguing that the record should be further developed to clarify the treating physician's opinion on the applicant's ability to comply with employer-offered travel arrangements, which was the core dispute.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Facttemporary disability indemnitymodified dutysubstantial evidencedevelop the recordtreating physicianadministrative law judgedissenting opinion
References
Case No. ADJ2070973 (SAL 0092454)
Regular
Jun 12, 2015

CHARLENE MEEKS-CLOSE vs. RIVER RANCH FRESH FOODS, SEDGWICK CMS

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration due to untimely service on the applicant's counsel of record. The defendant failed to properly serve the petition, which is a procedural defect that deprives the applicant of due process rights. While one commissioner concurred with the dismissal on procedural grounds, she dissented regarding the merits, arguing the petition should have been granted to develop the record on the permanent disability rating. The majority opinion noted that even if properly served, the petition would have been denied on its merits.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderPermanent DisabilityLife PensionHousekeeping ExpensesMileage ExpensesUnreasonable DelayPenaltyAgreed Medical Evaluator
References
Case No. ADJ7714999
Regular
Dec 16, 2013

CERI ERNE (Widow) vs. COLLINS PLUMBING, INC. and LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to further develop the medical record concerning the industrial causation of Mr. Erne's death from cardiac arrest. The Agreed Medical Examiner opined that the death was work-related primarily due to its occurrence at the workplace, but failed to analyze the specific work activities' impact on Mr. Erne's pre-existing conditions. The Board rescinded the prior finding and returned the case for further proceedings, as the initial medical evidence was deemed insufficient to establish industrial causation. One Commissioner dissented, arguing that further development was inappropriate when the applicant failed to meet their initial evidentiary burden.

Industrial injurycardiac arrestdeath benefitagreed medical examinercausationpre-existing diseasesubstantial evidenceburden of prooffurther developmentmedical record
References
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
Case No. ADJ1283525
Regular
May 17, 2010

ANTOONIO OLIVERA (Decedent), MARIA GOMEZ OLIVERA (Surviving Spouse) vs. RICK PLANO STABLES, UNINSURED EMPLOYERS BENEFIT TRUST FUND

The Workers' Compensation Appeals Board (WCAB) rescinded a prior decision and returned the case for further proceedings due to insufficient evidence regarding the decedent's employer. The WCAB found conflicting testimony and lack of clear evidence establishing employment with Rick Plano Stables on the alleged date of injury. The matter was remanded to properly substitute the surviving spouse as the applicant and to develop the record on the employer's identity and the date of injury.

Workers' Compensation Appeals BoardDecedent's spouseReconsiderationFindings and OrderSubstantial evidenceDevelop the recordInsufficient evidenceConstitutional mandateDevelop the recordUninsured Employers Benefit Trust Fund
References
Case No. ADJ3344729 (OAK 309365)
Regular
Mar 26, 2009

Richard Faria vs. GHILOTTI BROTHERS, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a previous award to lien claimant Bay Surgery Center (BSC). The Board found the record deficient regarding BSC's licensure and the reasonableness of its charges. The case is returned to the trial level for further proceedings to develop evidence on whether BSC was properly licensed to operate as an outpatient setting and to determine the reasonable value of services rendered. Specifically, the Board clarified that BSC is not required to have a fictitious-name permit if it operated as an outpatient facility, but must prove proper licensure as such.

Workers' Compensation Appeals BoardLien ClaimantFictitious Name PermitLicensureOutpatient SettingSurgical ClinicReasonable FeeMedical TreatmentAdministrative Law JudgeStipulated Award
References
Case No. ADJ3042475 (SAL 0116557)
Regular
Apr 19, 2010

JEFFREY SIBAYAN vs. CITY OF GONZALES, JT2 INTEGRATED RESOURCES

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award, finding the medical record regarding the applicant's heart condition and hypertension inadequate. While the statutory presumption of industrial heart trouble for police officers was applicable, the Board found conflicting medical opinions and insufficient evidence to determine if a compensable injury had occurred. The case is returned to the trial level for further medical development and a new decision by the WCJ.

Labor Code section 3212.5heart trouble presumptionpolice officerindustrial injurycardiovascular systemhigh blood pressureventricular hypertrophypresumption rebuttalmedical record inadequacysecond opinion
References
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