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

Case No. ADJ10523325 ADJ10523356 ADJ10789474 ADJ10523323
Regular

SANDRA GARCIA vs. DIMENSION DEVELOPMENT TWO, LLC, CYPRESS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Sandra Garcia's petition for reconsideration. The Board adopted and incorporated the findings of the workers' compensation administrative law judge in their decision. Therefore, the petition to reconsider the prior ruling was officially denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationDenying ReconsiderationWCJ reportAdministrative Law JudgeDimension Development TwoCypress Insurance CompanyBerkshire Hathaway Homestate CompaniesADJ10523325Van Nuys District Office
References
Case No. ADJ8734182
Regular
Dec 17, 2018

JONATHAN MCINTYRE vs. COUNTY OF SAN DIEGO

This case involves an applicant, Jonathan McIntyre, a deputy sheriff, claiming bladder cancer as a work-related injury. The Workers' Compensation Appeals Board (WCAB) rescinded the prior decision, finding that the medical evidence regarding the latency period of the applicant's bladder cancer was insufficient. The WCAB determined further development of the medical record is required to accurately assess when the cancer "developed" and "manifested" relative to the statutory presumption period. Therefore, the case is returned to the trial level for further proceedings and a new decision by the Workers' Compensation Judge.

Workers' Compensation Appeals BoardDeputy SheriffBladder CancerLabor Code section 3212.1Presumption of CompensabilityLatency PeriodAgreed Medical EvaluatorManifestation of DiseaseDevelopment of CancerStatutory Presumption
References
Case No. MON 254928
Significant
Feb 25, 2002

James McDuffie, Applicant vs. Los Angeles County Metropolitan Transit Authority, Permissibly Self-Insured, c/o Constitution State Service Company

The Board holds that where the medical record requires further development after trial, the preferred procedure is to first seek supplemental opinions from the physicians who have already reported in the case before considering the appointment of a new medical examiner.

En Banc DecisionMedical Record DevelopmentSupplemental OpinionsAgreed Medical Evaluator (AME)Qualified Medical Evaluator (QME)Court Appointed Medical EvaluatorFurther DevelopmentApportionmentPermanent DisabilityBus Operator
References
Case No. ADJ8269580
Regular
Nov 30, 2015

RALPH LARUE vs. SANTA CLARA VTA, permissibly self-insured; administered by TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration, rescinding the prior award that allowed the Employment Development Department (EDD) a $2,300 lien. The WCAB found the record lacked sufficient evidence to establish EDD's lien, as defendant argued EDD failed to prove benefits were for the same industrial injury. The Board clarified that EDD's lien attaches to permanent disability caused solely by the industrial injury, not to the apportionment of disability. The case is remanded for further proceedings to develop the record on EDD's lien claim.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardEmployment Development Department (EDD)Lien ClaimPermanent Disability IndemnityApportionmentLabor Code 4904(b)Causation of InjuryCausation of Disability
References
Case No. ADJ8566421 ADJ8581967
Regular
May 06, 2013

MARIBEL JIMENEZ vs. VIA VENETO OF CALIFORNIA CORPORATION

The Workers' Compensation Appeals Board denied Maribel Jimenez's Petition for Reconsideration, upholding the Workers' Compensation Judge's finding that she was not credible and suffered no industrial injury. The Judge found Jimenez's testimony regarding two slip-and-fall incidents lacked credibility due to inconsistencies and her failure to report or seek treatment for nearly two years. Furthermore, the Board agreed with the Judge's assessment of Jimenez's credibility, giving it great weight as per *Garza v. Workmen's Comp. Appeals Bd.* The Board adopted and incorporated the Judge's report, concluding no further development of the record was warranted.

WCABPetition for Reconsiderationcredibilityindustrial injuryAOE/COEdeferred psychological injurydemeanorslip and fallno medical treatmentno lost time
References
Case No. ADJ2972614 (VNO 0551694) ADJ3199572 (VNO 0558860)
Regular
Jan 31, 2012

ALI POURFARZAD vs. PALMIRA ASSOCIATES, INC., PREFERRED EMPLOYERS INSURANCE COMPANY

This case involves an applicant claiming industrial injuries to his spine, psychological system, and central nervous system (sleep disorder) from two separate dates of employment. The administrative law judge initially found injury to the psychological and central nervous systems but required further development of the record for permanent disability and apportionment. The Appeals Board determined that neither party presented substantial evidence regarding the causation and permanency of the claimed psychological and central nervous system injuries. Consequently, these issues are deferred, and the record will be developed further, potentially through an Agreed Medical Evaluator or a court-appointed physician.

Petition for ReconsiderationPartial Joint Findings of FactPanel Qualified Medical Evaluator (QME)Substantial EvidenceDevelop the RecordAgreed Medical Evaluator (AME)Regular PhysicianLabor Code Section 5701CausationPsychological Injury
References
Case No. ADJ2237816 (VNO 0533019) ADJ4364633 (VNO 0515869)
Regular
Jun 02, 2009

YOUBERT MOREH vs. LEXUS OF WESTMINSTER, CYPRESS INSURANCE COMPANY

This case involves an applicant seeking reconsideration of a denial of additional temporary disability indemnity (TDI) for two industrial injuries: a right shoulder injury in January 2005 and a back injury on March 21, 2005. The original judge denied further TDI, citing a two-year statutory limit under Labor Code section 4656(c)(1). The applicant contends the TDI for the back injury should not count towards the shoulder injury limit, as the shoulder injury was not yet claimed or accepted when TDI for the back was paid. The Appeals Board granted reconsideration, rescinded the prior order, and returned the case for further development of the record. This is to determine the precise periods of temporary disability for each injury and the extent of any overlap, which is crucial for applying the TDI limitations.

Workers' Compensation Appeals BoardTemporary Disability IndemnityLabor Code section 4656Overlapping InjuriesRight Shoulder InjuryBack InjuryAuto MechanicQualified Medical EvaluatorFindings of FactReconsideration
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. ADJ2551086 (LAO 857007) ADJ4086512 (LAO 856224)
Regular
Jun 01, 2009

JESUS CHAVEZ vs. ALVARADO MANUFACTURING COMPANY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded findings of fact regarding two injury cases, ADJ2551086 and ADJ4086512. The defendant argued the judge erred by not apportioning permanent disability to non-industrial factors, citing conflicting opinions from the agreed medical evaluator. The Board found the WCJ erred by failing to further develop the medical record to clarify the evaluator's inconsistent opinions on apportionment. The cases are returned to the trial level for further development of the medical record and decision.

ApportionmentAgreed Medical EvaluatorCumulative TraumaSpecific InjuryPermanent DisabilityLumbar SpineDegenerative Disc DiseaseNon-industrial FactorsFurther Development of Medical RecordInconsistent Medical Opinions
References
Case No. A111853680 (OAK 0338647)
Regular
Jan 12, 2009

MARILYN HOLLIS vs. VALENT USA CORP.; MITSUI SUMITOMO MARINE MANAGEMENT

Reconsideration granted due to insufficient medical evidence supporting temporary disability claim from 2007. Case returned for further proceedings to develop the record.

Labor Code section 4656Temporary disability indemnityTwo-year limitationDate of commencementSubstantial evidenceDevelop the recordReconsiderationFindings and AwardWCJIndustrial injury
References
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