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

Case No. ADJ6705178
Regular
Aug 07, 2014

JOSE MORALES vs. PAYLESS SHOESOURCE, INC., administered by GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board dismissed defendant Payless Shoesource's petition for reconsideration because it was filed untimely. The defendant sought to challenge the finding of industrial injury to the applicant's bilateral lower extremities and right upper extremity. The petition was filed 29 days after the August 7, 2014 Opinion and Decision, exceeding the jurisdictional 25-day deadline for reconsideration. Even if timely, the Board indicated it would have been denied on the merits.

Workers' Compensation Appeals BoardPetition for ReconsiderationOpinion and Order Dismissing PetitionIndustrial InjuryBilateral Lower ExtremitiesRight Upper ExtremityLabor Code Section 3600(a)(10)Post Termination DefenseUntimely PetitionJurisdictional Deadline
References
Case No. ADJ7139146
Regular
Jul 15, 2013

RAUL REYES vs. PAUL RIGHETTI RANCHO CO.; EVEREST NATIONAL INSURANCE CO, administered by AMERICAN CLAIMS MANAGEMENT

This case involved an applicant seeking workers' compensation benefits for back and extremity injuries. The Workers' Compensation Appeals Board affirmed the finding that the applicant did not meet his burden of proof for industrial injury. The applicant's argument that Dr. Pratley's reports should have been admitted was rejected. The Board found the WCJ's reliance on the employer's testimony regarding the applicant's credibility and timely reporting of the injury was permissible. The Board gave great weight to the WCJ's credibility determination between the applicant and his employer.

ADJ7139146Raul ReyesPaul Righetti Rancho Co.Everest National Insurance Co.American Claims Managementindustrial injuryback injuryleg injuryupper extremitiesankle injury
References
Case No. ADJ9815883 ADJ9815873
Regular
Apr 03, 2017

OCTAVIO AVILEZ vs. ANDRE LANDSCAPE SERVICE, INC., STARR INDEMNITY & LIABILITY CO.

The Workers' Compensation Appeals Board granted reconsideration to clarify the applicant's alleged industrial injuries to his cervical and lumbar spine. An agreed medical evaluator's reports present conflicting opinions regarding causation and permanent disability from the incidents on August 12, 2014, and January 9, 2015. The Board is deferring the spine injury issue pending further clarification from the evaluator on whether these incidents caused any disability or required medical treatment. The Board also expressly found no industrial injury to the upper and lower extremities and deferred all other body parts.

Workers' Compensation Appeals BoardPetition for ReconsiderationAgreed Medical EvaluatorOrthopedistIndustrial InjuryCervical SpineLumbar SpineUpper ExtremitiesLower ExtremitiesDeferred Issue
References
Case No. ADJ823138 (OXN 0142604)
Regular
Oct 25, 2010

CHERYL PEET vs. COUNTY OF VENTURA, Permissibly SelfInsured, Administered By CORVEL CORPORATION

The Workers' Compensation Appeals Board is reconsidering a prior decision that found a deputy probation officer sustained industrial injuries resulting in 78% permanent disability. The defendant sought reconsideration, arguing the Qualified Medical Examiner's (QME) opinion, which formed the basis of the award, was ambiguous and unsubstantiated. The Board agrees that the QME's assessment of 60% whole person impairment is not adequately supported by the record, particularly in light of the applicant's own testimony regarding her daily activities. Therefore, the case is returned to the trial level for further evidence development and a new decision, with consideration for cost of living adjustments if a life pension is awarded.

Workers Compensation Appeals BoardCheryl PeetCounty of VenturaCORVEL CORPORATIONADJ823138OXN 0142604Opinion and Decision After Reconsiderationdeputy probation officerindustrial injuryright upper extremity
References
Case No. ADJ13319691
Regular
Apr 08, 2025

Chester Taylor vs. State of California, Department of Corrections Inmate Claims, State Compensation Insurance Fund

Applicant Chester Taylor sought commutation of benefits from December 13, 2024, to his life expectancy, claiming financial hardship and borrowing from his daughter. The Workers' Compensation Appeals Board (WCAB) denied his petition for reconsideration, affirming the presiding workers' compensation administrative law judge's (PWCJ) finding that the applicant failed to establish the necessity of commutation for his protection or best interest, as required by Labor Code section 5100(a). The WCAB also highlighted the lack of clarity regarding how commutation would not cause undue expense or hardship to the applicant, as per Labor Code section 5100(b). The decision underscored that the burden of proof rests with the applicant to demonstrate the need for commutation.

Workers' Compensation Appeals BoardPetition for ReconsiderationCommutation of BenefitsLabor Code Section 5100Discretion of WCABBurden of ProofStipulated Findings and AwardPermanent DisabilityInmate ClaimsState Compensation Insurance Fund
References
Case No. ADJ7311200
Regular
Aug 03, 2017

SEAN HARRIS vs. COAST CRANE COMPANY, EMPLOYERS INSURANCE OF WAUSAU, THUNDER MACHINE WORKS, AIX INSURANCE COMPANY, AEROTEK, ALLEGIS GROUP INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

This case concerns a petition for reconsideration by defendant Wausau regarding an arbitrator's findings that applicant sustained industrial injury to his pulmonary system and upper extremities during a cumulative period. Wausau argued the claim was time-barred and that liability for upper extremity injury was improper. The Board denied Wausau's petition, finding Wausau failed to meet its burden of proof on the statute of limitations defense. The Board also determined that applicant properly amended his claim for upper extremities and that apportionment of liability based on days worked was appropriate.

Workers' Compensation Appeals BoardCoast Crane CompanyEmployers Insurance of WausauThunder Machine WorksAIX Insurance CompanyAerotekAllegis Group Insurance Companycumulative injurypulmonary systemupper extremities
References
Case No. ADJ7658097
Regular
Aug 14, 2017

John Cummins vs. VIP Limousines \& Coaches, Inc., Commerce and Industrial Insurance Company, Barrett Business Services, Inc.

This case involves an applicant who claimed injury to multiple body parts, including upper extremities, back, neck, abdomen (hernia), and lower extremities. The Workers' Compensation Appeals Board (WCAB) affirmed the original findings, except they specifically ruled against injury to the applicant's upper extremities based on the Agreed Medical Examiner's opinion. The WCAB also clarified that temporary disability benefits should commence from September 14, 2010, the date of hernia repair surgery, and deferred the determination of the exact date of injury for the cumulative trauma. The court also upheld the applicant's average weekly earnings determination, finding the applicant's testimony and records credible and unrebutted.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAgreed Medical Examiner (AME)Qualified Medical Evaluator (QME)temporary disability indemnitydate of injurycumulative traumahernia repairpulmonary embolism
References
Case No. ADJ7160893
Regular
Feb 18, 2014

Kenneth Burns vs. Linkus Enterprise, Travelers Property Casualty Company of America

The applicant, Kenneth Burns, sought reconsideration of an order dismissing his workers' compensation case due to his failure to appear at trial. Burns contended he was unable to attend due to hardship. The Workers' Compensation Appeals Board (WCAB) granted reconsideration on its own motion, adopting the WCJ's recommendation. The WCAB rescinded the dismissal order and returned the matter to the WCJ for further appropriate proceedings.

WORKERS' COMPENSATION APPEALS BOARDReconsiderationOrder Dismissing CaseFailure to AppearTrialHardshipReport and RecommendationLabor Code section 5900(b)RescindDecision After Reconsideration
References
Case No. ADJ559742 (LAO 0886579) ADJ2524675 (LAO 0886580)
Regular
Oct 18, 2010

Maureen Simmons vs. TELEPACIFIC COMMUNICATIONS, HARTFORD WORK COMP PROGRAM, GALLAGHER BASSETT SERVICES

The Appeals Board dismissed the applicant's untimely petition for reconsideration of the WCJ's August 19, 2010 Findings and Orders denying benefits. However, the Board granted reconsideration on its own motion due to the applicant's inability to attend trial approximately 400 miles from her home and her claim that her attorney failed to inform the court. The Board rescinded the WCJ's decision and returned the matter for further proceedings, also noting the applicant's request for a change of venue due to hardship.

Workers' Compensation Appeals BoardTelepacific CommunicationsHartford Work Comp ProgramGallagher Bassett ServicesPetition for ReconsiderationDismissing PetitionGranting ReconsiderationDecision After ReconsiderationFindings and OrdersAdministrative Law Judge
References
Case No. ADJ7000759
Regular
Oct 31, 2013

EUWANDA SEXTON vs. AMERICAN RED CROSS

The Workers' Compensation Appeals Board affirmed the administrative law judge's award of 41% permanent disability for bilateral wrist injury, finding substantial evidence supported the applicant's vocational expert's assessment of diminished earning capacity. The Board also upheld the judge's discretionary decision to grant the employer credit only for duplicate temporary disability overpayments, denying credit for payments made beyond 104 weeks due to employer fault and potential hardship on the applicant. The Board's reasoning incorporated the judge's report and relevant case law regarding rebuttal of scheduled ratings and employer credit for overpayments.

Workers' Compensation Appeals BoardOpinion and Decision After Reconsiderationbilateral wristscumulative injurypermanent disabilityvocational expertrebutting scheduled ratingdiminished future earning capacitycredit for overpaymentstemporary disability indemnity
References
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