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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ1124701 (OAK 0304697)
Regular
Jan 25, 2010

GENE THOMAS vs. SLEEP TRAIN MATTRESS CENTER, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) rescinded a prior decision favoring the applicant's spinal surgery, finding that proper procedural steps were not followed. The employer's utilization review (UR) had denied the surgery, but neither party followed the required second-opinion process under Labor Code section 4062(b). The WCAB returned the case to the trial level, allowing the employer ten days from receipt of the decision to object to the surgery and initiate the second-opinion process. This decision aligns with the WCAB's en banc ruling in *Cervantes*, which clarified the procedures for handling spinal surgery disputes after UR denials.

Workers' Compensation Appeals BoardUtilization ReviewLabor Code section 4062(b)Spinal SurgerySecond OpinionCervantes v. El Aguila Food ProductsACOEM GuidelinesExperimental TreatmentEn Banc DecisionAdministrative Director Rules
References
Case No. ADJ7048296
En Banc
Jul 14, 2011

Elayne Valdez vs. Warehouse Demo Services, Zurich North America

The Appeals Board granted reconsideration of its previous en banc decision to further study the legal and factual issues surrounding the admissibility of medical reports from outside a valid MPN.

MPNunauthorized treatmentinadmissible reportsnon-MPN doctorsWCABreconsiderationen bancpetition for reconsiderationsupplemental pleadingopinion and order
References
Case No. ADJ1350207 (SRO 0141409) ADJ7636521
Regular
May 08, 2012

MICHELE WOODRUFF vs. G\u0026K MANAGEMENT, GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board granted the defendant's petition for removal, rescinding the prior order for a second QME panel in orthopedics. The Board found the administrative law judge prematurely ordered the panel before evidence was presented or the case was submitted for decision. The Board clarified that a judge can only order supplemental medical evaluations after trial if specific opinions are found deficient, not beforehand. The matter was returned to the trial level for further proceedings and eventual trial.

Petition for RemovalQualified Medical EvaluatorSecond QME PanelMcDuffie v. Los Angeles County Metropolitan Transit AuthoritySubstantial EvidenceMedical Record DevelopmentTrial Level ProceedingsOpinion and OrderCumulative Trauma ClaimMandatory Settlement Conference
References
Case No. ADJ10680590 ADJ10680591
Regular
Dec 21, 2017

HYUNMI KIM vs. SHERRY PRECISION DENTAL ART, HARTFORD FIRE ISURANCE COMPANY

This case involves a worker, Hyunmi Kim, filing a second petition for reconsideration after her initial one was dismissed. The Appeals Board is treating her handwritten submission as a petition, but is dismissing it as successive and skeletal. The Board reiterates the rule that a party cannot file a second reconsideration petition if the first was unsuccessful, and any challenge must be via a writ of review. Furthermore, any discussion of a potential third-party credit issue in a prior opinion was not a final decision and thus not subject to reconsideration at this stage.

Successive petitionSkeletal petitionPetition for reconsiderationNewly aggrievedThird-party creditOpinion on decisionFinal determinationWrit of reviewAppeals BoardWorkers' compensation
References
Case No. VNO 0453567, VNO 0453569
Regular
Jan 23, 2008

GEORGE FORTNER, JR. vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board rescinded a prior decision that combined permanent disability ratings for two industrial injuries. This action was based on the recent en banc decision in *Benson v. The Permanente Medical Group*, which held that the *Wilkinson* rule for combining disabilities is generally no longer applicable due to new apportionment requirements. The case is returned to the trial level for the judge to revisit permanent disability ratings consistent with the *Benson* decision.

Workers Compensation Appeals BoardGeorge Fortner Jr.County of Los AngelesPermissibly Self-InsuredVNO 0453567VNO 0453569Opinion and Decision After ReconsiderationJoint Findings and AwardIndustrial InjuryLow Back
References
Case No. SJO 0251644
Significant
Apr 06, 2007

Joseph Baglione vs. Hertz Car Sales, AIG, Cambridge Integrated Services

The Workers' Compensation Appeals Board, in an en banc decision, reconsiders and reverses its prior ruling, holding that for pre-2005 injury claims, the 1997 Schedule for Rating Permanent Disabilities applies only if a pre-2005 comprehensive medical-legal report or a treating physician's report explicitly indicates the existence of permanent disability. The Board affirmed the original judge's decision to apply the 2005 Schedule in this case.

Workers Compensation Appeals BoardJoseph BaglioneHertz Car SalesAIGCambridge Integrated ServicesSJO 0251644Opinion and Order Granting ReconsiderationEn Banc1997 Schedule2005 Schedule
References
Case No. ADJ1728931
Regular
Apr 28, 2011

GEORGE PARGA vs. CITY OF FRESNO, AMERICAN ALL RISK LOSS FRESNO

This case involved an applicant, George Parga, who suffered an industrial injury to his right big toe and knee while employed as a police officer. The initial award apportioned 9% permanent disability, attributing half to pre-existing diabetes. The Appeals Board granted reconsideration, finding the medical expert's apportionment opinion lacked substantial evidence as diabetes did not cause disability at the time of evaluation. Consequently, the Board awarded an unapportioned 18% permanent disability.

Workers' Compensation Appeals BoardGeorge PargaCity of FresnoAmerican All Risk Loss FresnoOpinion and Order Granting ReconsiderationDecision After ReconsiderationPolice OfficerIndustrial InjuryRight Big ToeRight Knee
References
Case No. ADJ3385753 (SFO 0495153)
Regular
Mar 17, 2009

LORETTA L. ENNON vs. WALGREENS, permissibly self-insured

This case involves an admitted industrial injury to the applicant's back and hip. The primary dispute concerns the applicant's permanent disability rating, which the trial judge set at 41% based on a vocational expert's opinion on diminished future earning capacity (DFEC). The defendant appealed, arguing the rating was excessive and the expert's opinion improperly applied. The Appeals Board rescinded the original award, remanding the case to the trial level to apply recent en banc decisions regarding the rebuttal of the DFEC and AMA Guides portions of the permanent disability rating schedule. This remand allows for further proceedings to ensure correct application of these established legal standards.

Workers Compensation Appeals BoardReconsiderationPermanent DisabilityDiminished Future Earning CapacityDFEC2005 ScheduleAMA GuidesVocational ExpertJeffrey MalmuthAgreed Medical Evaluator
References
Case No. SAC 0347026
Regular
Aug 07, 2007

JOHN LINGBAOAN vs. STATE OF CALIFORNIA, CDCR SACRAMENTO STATE PRISION, Legally Uninsured

The Appeals Board granted reconsideration, clarifying that the 104-week temporary disability limit under Labor Code § 4656(c)(1) begins from the date temporary disability payments were *first paid*, not when they were owed or ordered. This decision aligns with the *Hawkins* en banc ruling, emphasizing the statutory language regarding commencement of payments. Jurisdiction is reserved for disputes over the exact initial payment date.

WCABReconsiderationTemporary DisabilityTerminationCumulative InjuryCorrectional OfficerHawkinsLabor Code 4656Industrial Disability LeaveIDL
References
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