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

Case No. OAK 0326623
Regular
Jan 22, 2008

HENRIETTA BARCLAY vs. RITE AID, TRAVELERS INSURANCE COMPANY

The applicant's claim that the excision of her distal clavicle constitutes an "amputation" under Labor Code section 4656(c)(2)(C) was denied, as the Board held that term refers to external body parts. However, the Board deferred the issue of temporary disability indemnity, allowing further proceedings on the applicant's claims of unreasonable medical treatment delays estopping the defendant from asserting the statutory limits. The Board also declined to rule on the constitutionality of the statute, citing lack of jurisdiction.

Workers' Compensation Appeals BoardRite AidTravelers Insurance CompanyReconsiderationIndustrial InjuryRight ShoulderSurgeryExcisionDistal ClavicleAmputation
References
Case No. ADJ3056232 (ANA 0317428)
Regular
Apr 30, 2009

LYLE GUIDRY vs. STATE OF CALIFORNIA, DEPARTMENT OF DEVELOPMENTAL SERVICES/LANTERMAN STATE HOSPITAL, Legally Uninsured; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES, Adjusting Agency

This case concerns an applicant who sustained a right wrist injury in 1993. The Workers' Compensation Appeals Board (WCAB) granted reconsideration of an award of temporary disability indemnity (TDI) issued more than five years after the injury date. The WCAB rescinded the prior award because the medical evidence lacked substantial support regarding the applicant's ongoing temporary total disability post-surgery. The matter was returned to the trial level for further development of the record and a new decision.

Workers' Compensation Appeals BoardPsychiatric TechnicianIndustrial InjuryRight WristTemporary Disability IndemnityTemporary Total DisabilityDate of InjuryAgreed Medical ExaminerPermanent and StationaryExcision of Ganglion Cyst
References
Case No. SRO 0132150
Regular
Sep 11, 2007

DAVID BLOOMQUIST vs. SIRI GRADING & PAVING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to address the defendant's argument that temporary disability payments exceeded the statutory 104-week limit. The Board clarified that the applicant's shoulder surgery did not constitute an "amputation" as defined by Labor Code section 4656(c)(2)(C), which is an exception to the limit. Consequently, the case is returned to the trial level to determine the exact date temporary disability payments first commenced, as this is crucial for calculating the applicable 104-week cap.

Petition for ReconsiderationFindings and Awardcumulative traumatemporary disability indemnitydate of commencementLabor Code section 4656(c)amputationtwo-year/104-week capseverancelimb
References
Case No. ADJ9883212
Regular
May 19, 2018

LADONNA PALEGA vs. CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

This case concerns a California Highway Patrol officer diagnosed with adenocarcinoma in situ of the cervix. The defendant, California Highway Patrol, sought reconsideration of a finding that this condition constituted an industrial injury under Labor Code section 3212.1. The defendant argued that the applicant's condition was not considered "cancer" and therefore the statutory presumption of industrial causation did not apply. The Workers' Compensation Appeals Board denied reconsideration, upholding the finding based on qualified medical evaluator Dr. Ngo's opinion that adenocarcinoma in situ qualifies as cancer under the statute. The Board found the defendant failed to rebut the presumption by providing evidence that the exposure to carcinogens was not linked to the disabling cancer.

Labor Code section 3212.1presumption of injurycervical canceradenocarcinoma in situLoop Electrosurgical Excision Procedure (LEEP)substantial medical evidencepanel qualified medical evaluatordisputable presumptionrebuttal evidencecarcinogen exposure
References
Case No. SFO 0492831
Regular
Jan 23, 2008

ELIAS MONTOYA vs. ASTON BARNES, INC., STATE COMPENSATION INSURANCE FUND

The Board granted reconsideration to clarify the application of Labor Code section 4656 regarding temporary disability indemnity limits. The Board held that "new and further" disability does not extend the 104-week limit under section 4656(c)(1), nor do spinal disc excisions and bone grafts qualify as "amputations" under section 4656(c)(2)(C). Consequently, the applicant is entitled to temporary disability indemnity only up to two years from the date of the first payment.

Workers' Compensation Appeals BoardElias MontoyaAston Barnes Inc.State Compensation Insurance FundSFO 0492831Opinion and Decision After ReconsiderationTemporary Disability IndemnityIndustrial InjuryThoracic SpineChest Injury
References
Case No. ADJ8249857
Regular
Jan 19, 2016

LARRY ADAIR vs. CITY OF SAN DIEGO

The applicant sought reconsideration of a workers' compensation award for skin cancer, arguing the permanent disability rating was insufficient and jurisdiction should be reserved due to the progressive nature of the disease. The Appeals Board granted reconsideration, affirming the original award but amending it to include a finding that the applicant is entitled to the presumption of compensability for skin cancer under Labor Code section 3212.1. The Board found no substantial evidence that the applicant's skin cancer was an insidious progressive disease warranting jurisdiction reservation, as it had been excised and declared permanent and stationary.

ADJ8249857Petition for ReconsiderationAmended Findings and Awardarising out of and in the course of employmentAOE/COEpermanent disabilityreservation of jurisdictionsubstantial medical evidenceprimary treating physicianpanel qualified medical evaluator
References
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