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

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ8452616
Regular
Sep 11, 2012

GUILLERMO SANDOVAL DE LA CRUZ vs. DMS FACILITY SERVICES, ZURICH NORTH AMERICA

This case concerns a Petition for Reconsideration filed by a lien claimant, Tri-County Medical Group, challenging an arbitrator's disallowance of its liens. The Appeals Board dismissed the petition because it was not timely filed with the Board and was instead mailed to the arbitrator. Furthermore, the Board noted the petition lacked proper verification and the proof of service was defective. Even if timely, the Board would have denied the petition on its merits due to insufficient evidence presented by the lien claimant.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationDisallowed LiensMedical Provider Network (MPN)Arbitrator's FindingsTimely FilingJurisdictionRule 10865Proof of Service
References
Case No. ADJ7850439
Regular
Oct 15, 2012

Edgar Tabo vs. CITY AND COUNTY OF SAN FRANCISCO POLICE DEPARTMENT

The applicant, a police officer, injured himself in an off-duty bicycle crash. The Board denied compensation because the applicant failed to establish that his subjective belief of needing to train for an optional bicycle patrol course was objectively reasonable. His off-duty recreational activity did not meet the requirements for an exception to the exclusion for such injuries under Labor Code section 3600(a)(9). Therefore, the applicant takes nothing by way of his claim.

Workers' Compensation Appeals BoardEdgar TaboCity and County of San Francisco Police DepartmentPermissibly Self-InsuredADJ7850439Oakland District OfficeOpinion and Order Granting ReconsiderationFindings and AwardWCJindustrial injury
References
Case No. ADJ808823 (SDO 0342114), ADJ7289296
Regular
Jul 31, 2012

, JOHN LASER, vs. , CITY OF OCEANSIDE POLICE DEPARTMENT, CITY OF OCEANSIDE,

The Workers' Compensation Appeals Board denied the City of Oceanside's petition for reconsideration regarding John Laser's workers' compensation claim. The employer sought to apportion or offset a prior permanent disability award from a new award for continuous trauma injury. The Board adopted the WCJ's report, which found that apportionment was not permissible under Labor Code section 3213.2, which presumes industrial injury from a duty belt. The employer failed to provide sufficient medical evidence to demonstrate overlap between the prior and current injuries, thus not meeting their burden of proof for apportionment.

Labor Code section 3213.2duty belt presumptionapportionmentLabor Code section 4663(e)industrial back injuryprior injurycontinuous traumapermanent disabilityAMA guides1997 PDRS
References
Case No. ADJ6929350, ADJ7133107, ADJ8881791
Regular
Aug 16, 2019

TIMOTHY RODRIGUEZ vs. DEPARTMENT OF CORRECTIONS, CALIFORNIA MEN'S COLONY, STATE COMPENSATION INSURANCE FUND

The Appeals Board rescinded the WCJ's decision, finding legal error in requiring proof of conspiracy for workers' compensation claims. The WCJ incorrectly applied the burden of proof and failed to adequately consider medical opinions regarding applicant's claims of physical and psychiatric injuries. The case is remanded for further proceedings and a new decision, requiring the WCJ to analyze each claimed injury and body part separately under the correct burden of proof and to further develop the medical record as necessary.

AOE-COEAgreed Medical Evaluatorhostile work environmentconspiracy theoryburden of proofpreponderance of the evidencespecific injurycumulative traumapsychiatric injurygood faith personnel action
References
Case No. ADJ3964372 (MON 0247784) ADJ4081926 (MON 0247785)
Regular
Dec 07, 2018

ROBERT BAKER vs. CITY OF COMPTON

The Workers' Compensation Appeals Board dismissed applicant Robert Baker's Petition for Reconsideration because it was filed *in pro per* without proof of service on all adverse parties, including his own attorney. The petition also failed to meet the requirements of Appeals Board Rule 10856 by not providing a specific offer of proof for newly discovered evidence or fraud. Consequently, the Board found the petition defective on multiple grounds.

Petition for Reconsiderationin pro perJoint Order Approving C&RWCJAppeals Board Rule 10856newly discovered evidenceoffer of proofcumulative evidenceproof of serviceadverse parties
References
Case No. ADJ6535842
Regular
May 04, 2012

HENRY PEREIRA vs. NND DESIGNS, INC., ENDURANCE INSURANCE CO.

Lien claimants sought reconsideration of an award disallowing their liens and imposing sanctions. Their petition was dismissed by the Appeals Board as untimely filed and lacking proof of service. The Board also noted that the underlying award found applicant did not sustain an industrial injury, making the lien claimants' arguments regarding burden of proof and sanctions meritless. The dismissal prioritized procedural defects over the substantive arguments raised.

WCABPetition for ReconsiderationLien ClaimantsJoint Amended Findings and AwardBurden of ProofIndustrial InjurySanctionsLabor Code Section 5813Compromise and ReleaseTimeliness
References
Case No. ADJ1543782 (VNO 0540728)
Regular
May 27, 2009

Richard E. Knudsen vs. CITY OF BEVERLY HILLS

The Workers' Compensation Appeals Board granted reconsideration, reversing a previous decision that denied benefits for a police officer's shoulder injury. The Board found the injury sustained in the on-duty gym was industrial because the applicant's belief that working out was expected was objectively reasonable, given the employer provided gym facilities and allowed officers to stay overnight for safety and duty readiness. The injury is now considered a compensable industrial injury.

Workers' Compensation Appeals BoardCity of Beverly Hillspolice officeroff-duty injuryindustrial injuryreasonable expectancypersonal comfort doctrineexertional injurygym workoutpremises
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. ADJ10713529
Regular
Nov 30, 2017

MARIA SOSA vs. CINTAS CORPORATION, TRAVELERS PROPERTY AND CASUALTY INSURANCE COMPANY OF AMERICA, SEDGWICK

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding applicant entitled to temporary total disability. The Board found insufficient evidence regarding applicant's specific job duties and whether they conflicted with the agreed medical evaluator's work restrictions. Therefore, the case is returned to the trial level for further development of the record, specifically for the AME to review a detailed job analysis. This is to determine if applicant could have continued her usual and customary duties but for her termination for cause.

Temporary total disabilityPetition for ReconsiderationFindings and AwardAgreed Medical Evaluator (AME)Work restrictionsTermination for causeJob dutiesFurther proceedingsDevelop the recordModified work
References
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