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

Case No. ADJ9625407
Regular
Sep 12, 2018

KEITH FIELD vs. CITY OF PINOLE

This case involves a firefighter who sustained bilateral carpal tunnel syndrome after retirement. The Appeals Board reversed the trial judge, holding that Labor Code section 4458.5 applies, entitling the applicant to permanent disability benefits calculated at the maximum indemnity rate. This applies regardless of the applicant's actual earnings or the fact that carpal tunnel syndrome is not a specifically enumerated presumptive injury. The case is remanded for determination of the precise date of injury to calculate the benefit rate.

Workers' Compensation Appeals BoardKeith FieldCity of PinolePermissibly Self-InsuredMunicipal Pooling AuthorityADJ9625407Opinion and Decision After Reconsiderationindustrial injuryfirefighterbilateral upper extremities
References
Case No. ADJ2552674 (STK 0182074), ADJ2434993 (LAO 0814353), ADJ815249 (STK 0199201)
Regular
Jan 24, 2012

CARLOS GASCA vs. HOWARD MARTIN FARMS, CIGA through its servicing facility INTERCARE INSURANCE for PAULA INSURANCE, in liquidation, CALIFORNIA INDEMNITY

The Workers' Compensation Appeals Board rescinded the prior award and remanded the case for further proceedings. The Board found that Dr. Abelow's medical opinion lacked substantial evidence due to factual inaccuracies and assumptions, particularly regarding the applicant's injury causation and apportionment. Additionally, Dr. Kimmel's psychiatric opinion failed to meet legal causation standards, deferring to orthopedic findings. The lien claimant's contentions will be reviewed anew by the WCJ upon remand.

Workers' Compensation Appeals BoardCarlos GascaHoward Martin FarmsCIGAIntercare InsurancePaula InsuranceCalifornia IndemnityJoint Findings and AwardAdministrative Law JudgeReconsideration
References
Case No. ADJ15763825
Regular
Sep 16, 2025

CLAUDIO CARDOZO vs. ROCK AND ROLL CAR WASH, REDWOOD FIRE AND CASUALTY INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the Petition for Reconsideration filed by Redwood Fire and Casualty Insurance Company dba Berkshire Hathaway Homestate Companies. The petition challenged a lien trial decision concerning a medical-legal evaluation performed by Dr. Michaels of Premier Psychological Services. The WCJ found that a medical dispute regarding psyche existed at the time of the evaluation, Dr. Michaels was validly designated as the Primary Treating Physician, and the evaluation was not barred by the 60-day rule for new claims as it was an amendment to an already accepted claim. The Appeals Board adopted the WCJ's reasoning and denied the petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code Section 5909Adjudication NumberOpinion and Order Denying PetitionWCJ ReportEAMS TransmissionNotice of TransmissionProof of ServiceFindings and Order
References
Case No. ADJ3726826
Regular
Mar 04, 2010

MARIBEL ESCOBAR vs. YGNACIO VALLEY CARE CENTER, CARE WEST INSURANCE

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, finding it timely filed. The Board affirmed the WCJ's finding that the applicant sustained industrial injuries to her lumbar spine and psyche, with compensable consequential injuries to her gastrointestinal system and a sleep disorder. Substantial medical evidence, including opinions from Dr. Cayton for the sleep disorder and Dr. Noriega for the gastrointestinal issues, supported the award. The Board also found Dr. Walcott's psychiatric opinion constituted substantial evidence, justifying the WCJ's disability findings.

Workers' Compensation Appeals BoardMaribel EscobarYgnacio Valley Care CenterCare West InsurancePegasus Risk ManagementFindings Award and OrderNursing AssistantIndustrial InjuriesLumbar SpinePsyche Injury
References
Case No. ADJ8128282
Regular
Jan 23, 2014

ANGELA EGBIKUADJE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings. The defendant, California Department of Corrections and Rehabilitation, argued that the applicant's psychiatric injury claim was preempted by the ADA and not proven under Labor Code section 3208.3. The Board found the original decision lacked proper analysis regarding predominant industrial causation and the good faith personnel action defense. Therefore, the case was remanded for further development of the record, including expert medical opinion on these issues.

Workers' Compensation Appeals BoardAngela EgbikuadjeCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8128282Van Nuys District OfficeReconsiderationFindings and AwardIndustrial cumulative trauma injury
References
Case No. ADJ 8560911
Regular
May 02, 2016

TIM MCDONALD vs. SAN FRANCISCO 49ERS, TIG SPECIALTY COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, rescinding the original award of 73% permanent disability and attorney fees. The Board determined that the 2005 Permanent Disability Rating Schedule, not an older schedule, should be used for rating the applicant's cumulative trauma injury claim filed in 2012. The case is returned to the trial level for a new determination of permanent disability using the 2005 schedule, affirming findings on injury and medical treatment.

Workers' Compensation Appeals BoardSan Francisco 49ersTIG Specialty Companyindustrial injuryprofessional athletefootball playerstrong safetycumulative traumapermanent disabilityapportionment
References
Case No. ADJ4151507 (SFO 0487197)
Regular
Feb 02, 2020

Tracy Sullivan vs. Café Amsterdam, State Compensation Insurance Fund

The Appeals Board granted reconsideration and amended the previous award, finding the applicant's burn injury did not qualify for the "severe burns" exception to the temporary disability indemnity limit under Labor Code section 4656(c)(3)(D). Consequently, temporary disability indemnity is limited to 104 weeks from the commencement of payments on August 10, 2004. The Board affirmed the WCJ's finding that the applicant's psychiatric injury was compensable, meeting the "sudden and extraordinary" employment condition exception. Clerical errors in the original findings were also corrected.

ADJ4151507SFO 0487197Tracy SullivanCafé AmsterdamState Compensation Insurance FundPetition for ReconsiderationFindings Award and OrderWCJindustrial injurycervical spine
References
Case No. GOL 0088273
Regular
Aug 18, 2008

ROBERT SIEBURG vs. RONALD WOLFE & ASSOCIATES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the original award, and returned the case for further development of the record. The Board found the findings of the administrative law judge regarding $97\%$ permanent disability and apportionment were not supported by substantial medical evidence. Specifically, the opinion of Dr. Kahmann was deemed deficient due to internal inconsistencies, lack of explanation for apportionment, and undefined work restrictions. The Board also found Dr. Basham's report did not meet the standard for substantial medical evidence regarding cognitive dysfunction.

WORKERS' COMPENSATION APPEALS BOARDROBERT SIEBURGRONALD WOLFE & ASSOCIATESSTATE COMPENSATION INSURANCE FUNDGOL 0088273OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONFindings and AwardWCJmaintenance person
References
Case No. ADJ865311 (LAO 0880913)
Regular
Sep 19, 2016

MARIA AGUILERA vs. COLLINS CHIROPRACTIC GROUP, STATE COMPENSATION INSURANCE FUND

The Board denied the applicant's petition for reconsideration, affirming its prior decision to reduce her permanent disability from $100\%$ to $88\%$ after apportionment. The Board found the applicant's vocational expert's opinions unsubstantial and contrary to the well-reasoned opinions of the Agreed Medical Evaluators (AMEs). Specifically, the Board rejected Dr. Bluestone's opinion due to a failure to account for duplication in impairment factors between rheumatologic and psychiatric conditions. While one Commissioner dissented, believing the applicant to be $100\%$ permanently disabled based on Dr. Bluestone's findings and other evidence, the majority upheld the apportionment.

Workers' Compensation Appeals BoardOpinion and Order Denying Petition for ReconsiderationFindings and AwardPermanent Total DisabilityApportionmentAgreed Medical Evaluators (AMEs)Dr. BluestoneDr. FreemanDr. MajcherDr. Fedder
References
Case No. ADJ10443669
Regular
Oct 04, 2017

Donna Carter vs. Rose International Group, OneBeacon Insurance Group

The Appeals Board affirmed the Workers' Compensation Judge's finding that Donna Carter sustained an industrial injury to her right knee and left wrist on May 18, 2016. Despite inconsistencies in the applicant's testimony regarding a slip and fall incident, her account was corroborated by a witness who found her on the floor. Medical records from the day of the incident also supported the applicant's claim, establishing a clear mechanism of injury. The Board found that the common sense nature of a slip and fall does not require expert medical opinion to establish industrial causation for the incident itself.

ADJ10443669Rose International GroupOneBeacon Insurance GroupDonna CarterWorkers' Compensation Appeals BoardOpinion and Decision After Reconsiderationslip and fallindustrial injuryright kneeleft wrist
References
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