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

Case No. ADJ1577836
Regular
May 04, 2009

JESUS GAVINO-REMIGIO vs. STRATUS SERVICES GROUP, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant injured when stepping on a metal hook, sustaining an admitted industrial injury to his right foot. The applicant sought reconsideration after the Workers' Compensation Judge (WCJ) denied findings that the injury also affected his internal systems (diabetes), eyes, and psyche, along with associated disability. The Board denied reconsideration, finding the defendant's medical expert's opinion on non-industrial diabetes causation to be substantial evidence, while deeming the applicant's medical experts' opinions insufficient. A dissenting commissioner argued the applicant's medical evidence sufficiently supported industrial causation for diabetes aggravation, warranting reconsideration.

Workers' Compensation Appeals Boardindustrial injuryright footinternal systemseyespsychediabetes mellituspermanent disabilitytemporary disabilityGerald Markovitz M.D.
References
Case No. VNO 348369 VNO 348370 VNO 348371 VNO 348372
Regular
Feb 13, 2008

RUBEN C. GONZALEZ vs. L.A.C.M.T.A.

The Workers' Compensation Appeals Board (WCAB) denied LACMTA's Petition for Removal, adopting the Workers' Compensation Administrative Law Judge's (WCJ) report. The WCJ recommended denial because LACMTA failed to demonstrate significant prejudice or irreparable harm, and the medical record needed further development regarding the applicant's new diabetes diagnosis and its potential industrial relation. Therefore, the petition was formally denied by the WCAB.

WORKERS' COMPENSATION APPEALS BOARDLACMTAMedical Record DevelopmentDiabetes DiagnosisIndustrially Related ConditionReasonable Medical ProbabilityPetition for RemovalWCAB Rule 10843Significant PrejudiceIrreparable HarmWorkers' Compensation Administrative Law Judge
References
Case No. ADJ7166686
Regular
Jul 24, 2012

RICHARD ANDERSON vs. JAGUAR/LANDROVER OF VENTURA, COMPWEST INSURANCE COMPANY

This case involves an applicant who suffered a stroke and subsequent 100% permanent disability following surgery for an industrial shoulder injury. The defendant sought reconsideration, arguing for apportionment to pre-existing conditions and challenging the attorney's fee calculation. The Appeals Board affirmed the 100% permanent disability finding, finding no basis for apportionment as the applicant's pre-existing conditions did not cause the disability itself. However, the Board modified the attorney's fee award, requiring commutation using a specific method and a 3% cost of living adjustment, finding the previously assumed 4.6% to be speculative.

Workers Compensation Appeals BoardRichard AndersonJaguar/Landrover of VenturaCompwest Insurance CompanyADJ7166686ReconsiderationFindings and AwardIndustrial InjuryBrain InjuryNeurological System
References
Case No. ADJ2590975 (STK 0190237)
Regular
Sep 12, 2011

RAFAEL DELEON vs. STATE OF CALIFORNIA, CDCR, MULE CREEK PRISON, adjusted by STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the Appeals Board affirmed a prior award granting medical treatment for applicant's diabetes. Despite the defendant's argument that diabetes treatment was for a non-industrial condition, the Board found it necessary to prevent worsening of the applicant's industrially caused heart disease. Medical evaluators concluded that controlling diabetes is an essential component of treating industrial heart conditions, making the treatment compensable. The decision hinges on the principle that treatment for non-industrial conditions is covered when essential to cure or relieve the effects of an industrial injury.

Workers' Compensation Appeals BoardIndustrial InjuryHeart ConditionDiabetesGastrointestinal DifficultiesAgreed Medical EvaluatorTreating PhysicianCardiologistMedical TreatmentLabor Code Section 4600
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. ADJ401125 (LAO 0843257)
Regular
Dec 24, 2010

ORETHA BOYD vs. SERVICE CRAFT LOGISTICS, COLONIAL RISK

The Workers' Compensation Appeals Board granted reconsideration to reverse the finding of temporary total disability and the need for future medical treatment for the applicant's heart condition and hypertension. The Board found insufficient substantial medical evidence to support that these pre-existing conditions, aggravated by work stressors, caused the claimed period of disability. Applicant's prior carpal tunnel injury and its ongoing treatment were identified as the primary cause of her absence from work. The award was modified to remove temporary disability and future medical treatment for the heart/hypertension, and attorney fees were adjusted accordingly.

Workers' Compensation Appeals BoardOretha BoydService Craft LogisticsColonial RiskAmended Findings and Awardindustrial injuryheart conditionhypertensiondiabetestemporary total disability
References
Case No. LBO 0370243
Regular
May 19, 2008

JOEL GRIMALDO vs. ABBEY EVENT SERVICES / STELLAR EVENT \& PRESENTATION, AMERICAN HOME INSURANCE, AIG CLAIMS SERVICES

The Workers' Compensation Appeals Board granted reconsideration and reversed a previous finding, ruling that the applicant's diabetes was not industrially caused. While the applicant sustained an admitted industrial injury to his left foot, the Board found substantial medical evidence indicating his diabetes was a pre-existing condition that complicated the foot injury rather than being caused by it. Consequently, the decision was amended to exclude diabetes as an industrial injury.

Workers' Compensation Appeals Boardindustrial injurydiabetesfoot injuryosteomyelitisamputationcausationmedical evidencereconsiderationapportionment
References
Case No. ADJ7091661
Regular
Apr 02, 2014

JOSE CONTRERAS vs. SPECIALTY MEATS, INC., TRAVELERS CASUALTY & SURETY COMPANY, COMPWEST INSURANCE COMPANY

This case involved Jose Contreras alleging a continuous trauma injury to multiple body parts while employed as a butcher. The Workers' Compensation Appeals Board denied his Petition for Reconsideration, adopting the findings of the administrative law judge (WCJ). The WCJ found no industrial injury, relying on Qualified Medical Evaluator (QME) reports that attributed the conditions to pre-existing or degenerative issues. The WCJ also found Contreras to be not credible due to inconsistencies and similarity to prior claims, and denied his attempt to elect against a specific defendant on the trial date.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJIndustrial injuryFinal orderRemovalSpecialty MeatsInc.Travelers Casualty & Surety CompanyCompWest Insurance Company
References
Case No. ADJ7948448
Regular
Nov 03, 1971

HENRY LOPEZ vs. WINDSOR SNF MANAGEMENT, TOWER SELECT INSURANCE COMPANY

This case involves an applicant who, while on a work assignment, experienced a diabetic episode causing dizziness. He stopped at a nearby market to eat and subsequently slipped and fell, injuring his hip and knee. The employer argued the injury was outside the scope of employment due to a deviation and the going and coming rule. However, the WCJ found the deviation was reasonable under the personal comfort rule for a known medical condition, and the Appeals Board adopted this reasoning, denying reconsideration. The Board gave great weight to the WCJ's credibility findings and resolved reasonable doubts in favor of the employee, consistent with precedent.

Workers' Compensation Appeals BoardPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeCredibility FindingInjury to left hip and left kneeDiabetic episodeLow blood sugarDeviation from work assignmentGoing and coming ruleInsbexual evidence
References
Case No. SFO 0478857
Regular
Jan 04, 2008

GEORGE JOHNSON vs. CITY OF BRENTWOOD

The Appeals Board granted reconsideration to reverse the prior award finding industrial injury to the heart in the form of diabetes. The Board determined there was no substantial medical evidence that diabetes constituted "heart trouble" under Labor Code section 3212, as it is a risk factor, not a present cardiac condition. Consequently, the award of permanent disability and further medical treatment related to the heart was rescinded, while affirming other findings regarding a hernia.

Workers' Compensation Appeals BoardGeorge JohnsonCity of BrentwoodSFO 0478857Opinion and Order Granting ReconsiderationFindings and Awardcumulative traumapolice officerindustrial injuryhernia
References
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