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

Case No. ADJ7650259
Regular
Aug 20, 2012

DARA HANRAHAN vs. CALIFORNIA HORSEMEN'S ALLIANCE, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA, CHARTIS INSURANCE

This case involves a workers' compensation claim where the applicant, Dara Hanrahan, sustained an injury to her eye while working as an exercise rider. The defendant argued the injury did not qualify as "high-velocity" under Labor Code section 4656(c)(3)(F) due to a lack of velocity evidence. Medical reports documented a traumatic blowout fracture of the left orbit with significant soft tissue entrapment and residual symptoms, including diplopia and ongoing facial pain. The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding that the injury qualified for extended temporary disability benefits.

Workers' Compensation Appeals BoardDara HanrahanCalifornia Horsemen's AllianceInsurance Company of the State of PennsylvaniaChartis InsuranceADJ7650259Oakland District OfficePetition for ReconsiderationFindings Award and OrderAdministrative Law Judge
References
Case No. ADJ11672418
Regular
Mar 07, 2023

JOSE MARTIN vs. JORGE PERIBAN, FINISH LINE SELF INSURANCE GROUP

The Workers' Compensation Appeals Board granted reconsideration to correct arithmetic errors in the original award regarding temporary disability indemnity, net temporary disability owed, and attorney's fees. The Board amended the decision to reflect accurate calculations for temporary disability ($17,524.03 total, $5,597.06 net owed) and corresponding attorney's fees ($839.56). However, the Board denied the defendant's request for a credit against temporary disability for a supposed permanent disability overpayment, as the issue was not properly raised and equity did not support the claim.

Temporary disability indemnityNet temporary disabilityAttorney's feesPermanent disability indemnityCredit for overpaymentPetition for ReconsiderationWCJ decisionAmended Findings and AwardPermissibly Self-InsuredExercise rider
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. AHM 0099594
Regular
Apr 09, 2008

ANITA PABST vs. CRESTON FARMS, STATE COMPENSATION INSURANCE FUND

This case concerns whether the 1997 or 2005 workers' compensation rating schedule applies to an injury sustained in 2002. The Board granted reconsideration to amend the findings to include psyche as a compensable body part, affirming the original award. The Board found that an exception applied, allowing the use of the older 1997 schedule because a treating physician's September 2004 report indicated permanent disability prior to January 1, 2005.

ReconsiderationFindings and AwardRacehorse Exercise RiderRating ScheduleLabor Code Section 4660(d)Comprehensive Medical-Legal ReportTreating Physician ReportPermanent and Stationary StatusQualified Injured WorkerVocational Rehabilitation
References
Case No. ADJ7460656
En Banc
Jan 15, 2013

DENNIS MCKINLEY vs. ARIZONA CARDINALS, THE TRAVELERS INDEMNITY COMPANY

The Appeals Board affirmed the WCJ's decision, declining to exercise jurisdiction over a cumulative injury claim due to a reasonable mandatory forum selection clause in the employment contract specifying Arizona as the forum, coupled with the applicant's limited connection to California.

WORKERS' COMPENSATION APPEALS BOARDEN BANCCUMULATIVE INJURYPROFESSIONAL FOOTBALL PLAYERARIZONA CARDINALSTRAVELERS INDEMNITY COMPANYFORUM SELECTION CLAUSEMANDATORY FORUMLIMITED CONNECTIONEMPLOYMENT CONTRACT
References
Case No. ADJ10513647, ADJ10615093
Regular
Nov 26, 2018

JOSEPH NJOROGE vs. CITY OF WALNUT CREEK

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration because his injury while playing soccer did not arise out of and occur in the course of employment. While the applicant argued his employer required him to stay in top physical shape, the Board found the evidence insufficient to prove this expectation. Although the petition was initially questioned for timeliness due to defective service, the Board addressed it on the merits. The Board adopted the reasoning of the WCJ, which found no evidence the employer mandated specific off-duty exercises.

WORKERS' COMPENSATION APPEALS BOARDOPINION AND ORDER DENYING PETITION FOR RECONSIDERATIONFindings of Fact and OrderWCJINDUSTRIAL INJURYEZZY V. WORKERS' COMPENSATION APPEALS BOARDPHYSICAL CONDITIONINGOFF WORK EXERCISETimelinessPetition for Reconsideration
References
Case No. ADJ972426 (ANA 0405051)
Regular
Jan 14, 2010

DONALD STOW vs. SANTA ANA POLICE DEPARTMENT

The Workers' Compensation Appeals Board granted reconsideration of a prior award that found the employer liable for serious and willful misconduct. The Board rescinded the award, finding the applicant's failure to wear provided safety goggles was the proximate cause of his eye injury during a training exercise. While the employer's provision of goggles instead of a full face mask may have been negligent, it did not rise to the level of serious and willful misconduct as defined by law. Therefore, the applicant was not entitled to the 50% compensation increase.

Workers Compensation Appeals BoardDonald StowSanta Ana Police Departmentserious and willful misconductLabor Code section 4553industrial injuryright eyepolice officertraining exercisesimunition
References
Case No. ADJ7419350
Regular
Apr 27, 2015

MARLON WHITLEY vs. BELL PLASTICS, THE HARTFORD

The Appeals Board granted reconsideration of the WCJ's attorney fee split, rescinding the original order. The WCJ failed to adequately consider all statutory factors for a reasonable attorney fee, specifically the responsibility assumed, care exercised, and results obtained, relying too heavily on estimated hours. The case is returned to the WCJ for further proceedings, development of the record, and a new decision. This new decision must properly consider all relevant factors mandated by Labor Code section 4906 and WCAB Rule 10775.

Workers' Compensation Appeals BoardPetition for ReconsiderationAttorney's Fee SplitLabor Code section 4906WCAB Rule 10775Findings and OrderSanctionHourly Attorney's FeesGood Faith NegotiationTime Expended
References
Case No. ADJ2772961 (VNO 0505212)
Regular
May 20, 2011

Rodney Elkins vs. DE MOOR'S PAINTING, INC., STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration to clarify that the applicant's treating physician, not the Agreed Medical Evaluator, must direct and manage the decreasing narcotic treatment plan. The Board affirmed the award of a gym membership, exercise sessions, and sleep medication, finding these consistent with the AME's well-reasoned opinion and the treating physician's recommendations. The issue of radiofrequency nerve ablation was deferred as premature pending completion of the current treatment plan. Finally, the Board denied attorney fees under Labor Code section 5814.5, finding no unreasonable delay in compensation due to the defendant's reliance on the AME's medical opinion.

Workers' Compensation Appeals BoardAgreed Medical EvaluatorTreating PhysicianPetition for ReconsiderationFindings of Fact and AwardLabor Code Section 5814.5Medical TreatmentRadiofrequency Nerve AblationNarcotic AnalgesicsGym Membership
References
Case No. ADJ8110632, ADJ8110825
Regular
Apr 26, 2019

DOMINGO HERNANDEZ vs. WMLS, INC., and TWIN CITY FIRE INSURANCE/THE HARTFORD, and SOUTHERN INSURANCE COMPANY, adjusted by MAKEL SERVICES, INC.

Defendant sought reconsideration of an award of future medical treatment for a 2010 back injury, arguing it was erroneous. The Workers' Compensation Appeals Board denied reconsideration, finding the award supported by evidence. Medical evaluations recommended continued home exercises, over-the-counter medication for the back, and cognitive behavioral therapy for the psyche. Labor Code section 4600 mandates provision of all treatment reasonably required to cure or relieve the effects of an industrial injury, which includes recommended conservative care.

Workers Compensation Appeals BoardJoint Findings and AwardPetition for ReconsiderationPanel Qualified Medical EvaluatorPQMEPermanent DisabilityFurther Medical TreatmentLabor Code Section 4600Low Back InjuryPsyche Injury
References
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