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

Case No. ADJ400686 (VNO 0499836)
Regular
Nov 08, 2016

MICHAEL CURZI vs. PHARMAVITE, LLC, TRAVELERS DIAMOND BAR

In *Curzi v. Pharmavite, LLC*, the Workers' Compensation Appeals Board (WCAB) granted reconsideration to further study the case. The WCAB amended the original decision to defer issues of sleep disorder, permanent disability, apportionment, and attorney fees. This action was taken to allow for further development of the record regarding the industrial causation of the sleep disorder. The matter is returned to the trial level for further proceedings and a new decision by the WCJ.

Workers' Compensation Appeals BoardPharmaviteLLCTravelers Diamond BarADJ400686VNO 0499836Opinion and Decision After ReconsiderationFindings and Awardcomputer operatorindustrial injury
References
Case No. ADJ7295285
Regular
Dec 05, 2012

CARL SIRL vs. VSJ, INC., ENDURANCE INSURANCE COMPANY, FIRSTCOMP INSURANCE AGENCY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the prior award finding applicant suffered a 23% permanent disability, including 12% for sleep disturbance. The PQME's reliance on the Epworth Sleepiness Scale for the sleep impairment rating was deemed insufficient without further explanation, particularly regarding the absence of formal sleep studies. The WCAB remanded the case to the trial level for further development of the medical record concerning the sleep disorder and its impairment rating. Defendants were directed to continue paying uncontested permanent disability indemnity for the applicant's back injury.

Workers' Compensation Appeals BoardPermanent DisabilitySleep DisturbanceEpworth Sleepiness ScalePQMEAMA GuidesWhole Person ImpairmentActivities of Daily LivingDue ProcessMedical Record Development
References
Case No. ADJ70 84052
Regular
Mar 23, 2015

Edwin Martinez vs. Coca-Cola Enterprises, Inc.

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The Board adopted the Workers' Compensation Judge's report, which found a compensable sleep disorder and awarded additional permanent disability. The Board also found that the judge's order regarding the Employment Development Department (EDD) lien was a non-final order and denied the defendant's related contention.

Sleep disordercompensable sleep disorderpermanent disabilityWCJ discretionEDD lienreimbursementpetition for reconsiderationabuse of discretionWPIpsychiatric injury
References
Case No. ADJ6772869
Regular
Jan 17, 2012

Michelle Jones vs. CITY OF LONG BEACH

This case involves a worker seeking compensation for a sleep disorder in addition to her admitted industrial shoulder injury. The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award. The Board found that the applicant's hypersomnia was not a separate ratable sleep disorder, but rather a consequence of pain from her industrial shoulder injury. Therefore, the case was returned for a new permanent disability rating that excludes the sleep disorder.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjurySleep DisorderPermanent DisabilityRight ShoulderHypersomniaAMA GuidesPain Questionnaire
References
Case No. ADJ6527507
Regular
Oct 18, 2010

Wayne Moore vs. EAST BAY MUNICIPAL UTILITY DISTRICT, ATHENS ADMINISTRATORS

The Appeals Board granted reconsideration, finding the WCJ improperly substituted his medical judgment for the Qualified Medical Evaluator's (QME) regarding the applicant's industrial sleep disturbance. The WCJ's finding of no industrial sleep impairment, despite the QME's opinion indicating such, was deemed erroneous. The Board rescinded the original award and remanded the case for a new rating that incorporates the QME's findings on sleep disturbance. Additionally, the WCJ must correct an identified occupational group number error in future rating calculations.

Workers' Compensation Appeals BoardWayne MooreEast Bay Municipal Utility DistrictAthens Administratorsmachinist maintenance workermachinistmachinist maintenancepermanent disabilityapportionmentQualified Medical Evaluator
References
Case No. ADJ793701 (MON 0360803)
Regular
Nov 01, 2010

RAYMUNDO CASTILLO vs. BRIMCO, LLC, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the prior award due to insufficient medical evidence supporting the applicant's sleep disorder claim. The WCAB found Dr. Navab's report lacked specific causation, explanation for impairment rating, and failed to address specific complaints. The case is returned for further development of the record regarding the sleep disorder, including clarification from Dr. Navab and an evaluation by another specialist. The issue of the claim being barred as a post-termination claim was not reached.

Workers' Compensation Appeals BoardIndustrial InjurySleep DisorderBack InjuryPost-Termination ClaimLabor Code Section 3600(a)(10)Substantial Medical EvidencePermanent DisabilityReconsiderationFindings of Fact and Award
References
Case No. ADJ7037201
Regular
Apr 22, 2013

Eddie Avakian vs. CITY OF BALDWIN PARK, ADMINSURE

This case involves an applicant police officer seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that awarded 72% permanent partial disability. The applicant contended the WCJ erred by excluding sleep disturbances and sexual dysfunction from the disability rating and by apportioning his cardiovascular disability. The WCAB granted reconsideration, rescinded the original award, and found the applicant's sexual dysfunction and sleep disorder compensable. The matter was returned to the trial level for a new decision, with the WCAB stating it would not disturb other findings, including the hypertension apportionment.

Workers' Compensation Appeals BoardEddie AvakianCity of Baldwin ParkPermissibly Self-InsuredAdministered By ADMINSUREADJ7037201Opinion and Order Granting ReconsiderationDecision After ReconsiderationFindings and Award and OrderAdministrative Law Judge
References
Case No. ADJ7527781; ADJ7527786
Regular
Feb 05, 2016

OCTAVIO ESPINOZA vs. TORRES FARM LABOR, SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, amending the original award to defer the finding of permanent disability and attorney's fees. The Board denied the defendant's petition for reconsideration, affirming the original award regarding future medical treatment for internal injuries. The case is returned to the WCJ for further proceedings, including consideration of a sleep study report and development of the record concerning permanent disability. The Board agreed that substantial evidence supported the finding of industrial injury to internal organs and the need for future medical treatment.

Workers' Compensation Appeals BoardIndustrial InjuryPermanent DisabilityTemporary Total DisabilityFuture Medical TreatmentPetition for ReconsiderationFindings of FactJoint AwardWCJSubstantial Evidence
References
Case No. ADJ6776516
Regular
May 30, 2017

FRANCIS HARGREAVES vs. SOUTHWEST AIRLINES, ACE USA INSURANCE CO.

This case involves an applicant seeking workers' compensation benefits for injuries sustained on the job, including to his back, left shoulder, left wrist, and psyche, as well as complex regional pain syndrome, coronary artery disease, and a sleep disorder. The defendant sought reconsideration of the initial award, arguing that the medical evidence did not support the $90\%$ permanent disability finding. The Appeals Board granted reconsideration, affirming the findings of injury and treatment for Complex Regional Pain Syndrome but reducing the permanent disability to $88\%$ by excluding the sleep disorder impairment due to insufficient objective evidence. The applicant's permanent disability payments were recalculated and ordered to commence from January 21, 2011.

Workers' Compensation Appeals BoardFrancis HargreavesSouthwest AirlinesACE USA Insurance Co.Sedgwick CMSADJ6776516Opinion and Order Granting Petition for ReconsiderationFindings Award and OrderAOE/COEback injury
References
Case No. MON 0340665
Regular
Jul 02, 2008

DANIEL EARL PETERSON vs. STATE OF CALIFORNIA, DEPARTMENT OF MENTAL HEALTH, legally uninsured and adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to further develop the record, specifically ordering a formal sleep study. This action rescinded the previous award because the medical evidence presented regarding the applicant's sleep disturbance was deemed unsubstantial, lacking a formal sleep laboratory diagnosis as required by AMA Guides. The Board also noted potential correct contentions by the defendant regarding indemnity rates and overlapping temporary and permanent disability payments.

Workers' Compensation Appeals BoardAgreed Medical EvaluatorAMESleep StudyPermanent DisabilityFindings and AwardReconsiderationSubstantial Medical EvidenceEpworth Sleepiness ScaleAMA Guides
References
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