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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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. 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. 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
Case No. SFO 0499272
Regular
Jul 07, 2008

Helen Miller vs. Green Gulch Farm and Zen Center, EVEREST NATIONAL INSURANCE

The Workers' Compensation Appeals Board affirmed the administrative law judge's finding that Helen Miller was an employee of Green Gulch Farm and Zen Center and sustained an industrial injury to her left ankle. The Board found Miller was not a volunteer due to the extensive benefits received and the employer's control, and her jogging injury during a lunch break was a reasonable expectancy of employment, not barred by Labor Code section 3600(a)(9). Therefore, her injury arose out of and occurred in the course of her employment.

Workers' Compensation Appeals BoardHelen MillerGreen Gulch Farm and Zen CenterEverest National InsuranceGallagher BassettSFO 0499272Opinion and Decision After ReconsiderationLabor Code Section 3351Labor Code Section 3352(i)Employee definition
References
Case No. SAC 0282000; SAC 0354233
Regular
Jun 03, 2008

JON EDWARDS vs. COUNTY OF SACRAMENTO

The Workers' Compensation Appeals Board granted reconsideration and reversed the trial judge, finding the applicant deputy sheriff is not entitled to Labor Code section 4850 benefits or temporary disability for time missed from work. This decision is based on the finding that the applicant was provided with full or modified duty work during the periods in question, according to medical reports. Therefore, the applicant's claim for wage replacement benefits for these periods was denied.

Labor Code section 4850Deputy SheriffTemporary DisabilityFull DutyModified DutyMedical AppointmentsIndustrial InjuryPermanent and StationaryWage ReplacementMedical Reports
References
Case No. ADJ3540065 (SAC 0361552)
Regular
Jan 23, 2017

BRADLEY MAXHAM vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted the defendants' Petition for Removal, rescinding a prior WCJ order. The Board clarified that "information" provided to an Agreed Medical Evaluator (AME) includes treating physician records and relevant medical/non-medical records. A communication becomes "information" if it contains, references, or encloses such records. The case was returned for further proceedings to determine if applicant's letters to the AMEs improperly conveyed "information" without party agreement.

Agreed Medical EvaluatorInformationCommunicationLabor Code Section 4062.3Petition for RemovalEn Banc DecisionWorkers' Compensation Appeals BoardPrejudiceIrreparable HarmSubstantial Evidence
References
Case No. ADJ7825020
Regular
Aug 31, 2015

MILTON LEWIS vs. BARLOW RESPIRATORY HOSPITAL, ZENITH INSURANCE COMPANY

This case concerns a lien claimant's petition for reconsideration of a stipulation and order where they agreed to accept \$1,000.00 in full satisfaction of their lien. The lien claimant argued the stipulation was entered into by unilateral mistake as their representative lacked authorization. The Workers' Compensation Appeals Board denied reconsideration, finding the claimant failed to present evidence of unilateral mistake or to properly seek to set aside the stipulation. Furthermore, the claimant did not plead sufficient facts to support a unilateral mistake claim, such as the opposing party's knowledge and advantage, nor did they demonstrate they fulfilled their legal duty of reasonable inquiry.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationStipulation and OrderUnilateral mistakeAffirmative defenseGood causeRescinding contractMaterial factLegal duty
References
Case No. MON 284627
Regular
Aug 11, 2008

BEVERLY DE ROSA vs. STATE OF CALIFORNIA

The Workers' Compensation Appeals Board granted reconsideration to review a sanctions order against the defendant for alleged willful failure to comply with a prior order. The defendant's claims adjuster asserted they had provided the required earnings information within the deadline, which conflicted with the initial finding of non-compliance. The Board rescinded the sanctions and returned the case for further proceedings to determine whether the defendant actually complied with the order.

Workers' Compensation Appeals BoardBeverly De RosaState Compensation Insurance FundLabor Code section 5813willful failure to complySupplemental Findings and Order Imposing Sanctionsapplicant's earningscervical spinepsychestipulated Findings and Award
References
Case No. ADJ10351910
Regular
Aug 09, 2017

SELENA MCINTOSH vs. MILITARY DEPARTMENT OF THE STATE OF CALIFORNIA, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

This case concerns whether a California Army National Guard member injured during "active duty for training" under federal Title 10 is eligible for California workers' compensation benefits. The Board found that California Military and Veterans Code Section 340(b) expressly prohibits state workers' compensation benefits for service performed under Title 10. Therefore, the applicant cannot collect benefits under Division 4 of the Labor Code. While the applicant's VA benefits were denied, her recourse was to appeal that denial, not to pursue state workers' compensation.

Military Departmentlegally uninsuredState Compensation Insurance FundTitle 10Labor Code Division 4Petition for ReconsiderationFindings of FactWCJpsyche injurysexual assault
References
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