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Case Law Database

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

Case No. FRE 213077; FRE 213078 FRE 194033; FRE 194034 FRE 194035
Regular
Mar 11, 2008

ROSA NUNEZ vs. FRESNO UNIFIED SCHOOL DISTRICT

This case involves an applicant seeking reconsideration of a prior workers' compensation award for multiple injuries, including cumulative trauma and specific injuries. The Appeals Board rescinded the previous award, remanding the matter for further development of the record. The primary issue is the proper apportionment of permanent disability based on the causation standard established by SB 899 and the *Benson* decision, as prior medical reports lacked sufficient detail for this analysis.

ReconsiderationFindings of FactAward and OrdersStipulated AwardCumulative InjurySpecific InjuryPermanent DisabilityApportionmentFormula AFormula C
References
7
Case No. FRE 0217800; FRE 0218000; FRE 0222219; FRE 0222220; FRE 0222221
Regular
Jun 23, 2008

JULIO ALVAREZ vs. CLOVIS UNIFIED SCHOOL DISTRICT; Permissibly Self-Insured, Adjusted By TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board granted applicant's petition for reconsideration to correct a clerical error, increasing the permanent disability rating from 10% to 11% after apportionment, as stipulated by the parties. The Board affirmed the WCJ's findings that the applicant did not sustain industrial injury due to mold exposure or psychological injury, as the applicant failed to meet the burden of proof for these claims. The Board found the WCJ's reliance on the toxicology expert's opinion was supported by substantial evidence, thus affirming the denial of mold-related injury.

Workers' Compensation Appeals BoardPermanent DisabilityApportionmentMold ExposureIndustrial InjuryAOE/COEClaim FormPresumption of CompensabilitySubstantial EvidenceClerical Error
References
15
Case No. FRE 0233572, FRE 0233574, FRE 0233575, FRE 0237180
Regular
Jan 16, 2008

WILLIAM R. ALTMAN vs. PPG INDUSTRIES, INC., SENTRY INSURANCE

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, determining that the older permanent disability rating schedule should apply due to the defendant's obligation to provide specific statutory notices. The case is returned to the trial level to re-rate permanent disability using the correct schedule and to issue a decision on a previously undecided claim. The Board affirmed the denial of transportation and lodging costs for the applicant's trial attendance.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardCumulative TraumaPermanent Disability Rating ScheduleLabor Code Section 4061Labor Code Section 4660(d)Old Rating ScheduleNew Rating ScheduleIndustrial Injury
References
0
Case No. ADJ408647 (FRE 0248555)
Regular
Apr 26, 2013

PATROCINA RAMSEY vs. SKYWEST AIRLINES, SEDGWICK CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board granted reconsideration in *Ramsey v. Skywest Airlines* and amended the prior decision. Specifically, the first paragraph of the "Orders" from the February 14, 2013 decision was rescinded. The matter was then returned to the trial level for further proceedings regarding potential sanctions.

Patrocina RamseySkyWest AirlinesSedgwick Claims ManagementADJ408647FRE 0248555Workers' Compensation Appeals BoardOpinion and Order Granting ReconsiderationDecision After ReconsiderationWCJsanctions
References
0
Case No. ADJ3317169 (FRE 0210465); ADJ2130054 (FRE 0162261); ADJ4055925 (FRE 0210461); ADJ728821 (FRE 0210462); ADJ2475719 (FRE 0210463); ADJ3052880 (FRE 0226010); ADJ207659 (FRE 0210464)
Regular
May 21, 2025

Earl Meyers vs. Fresno Unified School District, CNA Claims Plus

The Workers' Compensation Appeals Board (WCAB) affirmed the Workers' Compensation Administrative Law Judge's (WCJ) June 9, 2021, Joint Findings of Fact, Award, and Opinion on Decision. The WCJ had found the applicant, Earl Meyers, to be 100% permanently totally disabled due to multiple industrial injuries precluding him from vocational rehabilitation and competing in the open labor market. Defendant, Fresno Unified School District, petitioned for reconsideration, arguing misapplication of Labor Code sections 4662 and 4663 regarding apportionment and insufficient evidence for total disability. The Board, reviewing medical and vocational expert opinions, concluded that the defendant failed to provide substantial medical evidence for apportionment of the applicant's work restrictions to non-industrial causes, thereby upholding the 100% permanent total disability finding.

Workers Compensation Appeals BoardJoint Findings of FactAwardOpinion on DecisionPetition for Reconsiderationvocational rehabilitationopen labor marketpermanent total disabilityapportionmentLabor Code Section 4662
References
10
Case No. FRE 218718 FRE 215344 FRE 215345
Regular
Jul 09, 2007

SHAEANN YOUNG vs. SAVE MART, permissibly self-insured and administered by PEGASUS RISK MANAGEMENT

The Workers' Compensation Appeals Board denied reconsideration of an award to Shaeann Young, finding that her nolo contendere plea to misdemeanor insurance fraud did not bar her from receiving benefits. The Board determined that Young had sustained actual industrial injuries, that the awarded compensation was supported by substantial medical evidence unrelated to the fraud, and that her credibility was not entirely destroyed. Consequently, Young remains entitled to the temporary disability indemnity and medical treatment benefits.

nolo contendereinsurance fraudcompensable industrial injurymedical treatmenttemporary disability indemnitypermanent disability indemnityTensfeldtGarzaworkers' compensation administrative law judgepanel qualified medical evaluator
References
2
Case No. FRE 192364, FRE 192365, FRE 198592
Regular
Sep 21, 2007

CAROL MCKINLEY vs. RAMALLAH, INC./GENERAL INSURANCE COMPANY OF AMERICA

This case involves a request for additional attorney's fees and costs following a successful defense against a defendant's petition for writ of review. The Appeals Board reviewed the itemized hours and requested rate, disallowing time spent on specific tasks deemed clerical or administrative. Ultimately, the Board awarded $\$ 2,100.00$ in attorney's fees and $\$ 49.45$ in costs, recognizing the applicant's attorney's experience and the outcome of the appeal.

Workers' Compensation Appeals BoardAttorney's FeesPetition for Writ of ReviewCourt of AppealRemandLabor Code § 5801Labor Code § 5811Certified Workers' Compensation SpecialistHourly RateCosts on Appeal
References
4
Case No. FRE 0245256
Regular
Jun 05, 2007

FRE 27 XYZZX vs. BUTTON TRANSPORTATION INC., STATE COMPENSATION INSURANCE FUND

The applicant sought reconsideration of an approved Compromise and Release agreement concerning his cumulative injury claim for Valley Fever. He alleged fraud based on misrepresentation of his job title and work environment by the defendant and its adjuster. The Appeals Board dismissed the petition for reconsideration because it was filed significantly outside the statutory 20-day deadline, rendering it untimely.

Valley FeverCoccidioidomycosisCompromise and ReleasePetition for ReconsiderationTimelinessJurisdictionOrder Approving Compromise and ReleaseIndustrial InjuryTruck DriverDispatcher
References
5
Case No. ADJ4699173 (FRE 204280) ADJ2234380 (FRE 204242) ADJ201252 (FRE 206405) ADJ3631426 (FRE 213090)
Regular
Nov 14, 2008

JOHNNY DURAN vs. DARRYL HITCHMAN, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE COMPANY, in liquidation, by BROADSPIRE, CENTREX HOMES, AMERICAN GUARANTEE AND LIABILITY INSURANCE/ZURICH NORTH AMERICAN OCIP

This case concerns applicant Johnny Duran's industrial injuries to his back and knees. The California Insurance Guarantee Association (CIGA) sought reconsideration of a finding that the cases should be returned to arbitration for insurance coverage issues. The Appeals Board rescinded the prior decision, finding no arbitration is necessary because Zurich already established coverage for cumulative trauma injuries. However, the cases are returned to the Workers' Compensation Judge to determine CIGA's liability for benefits solely attributable to specific injuries where Superior National was the sole available insurer.

CIGASuperior National Insurance CompanyliquidationreconsiderationWorkers' Compensation Appeals BoardArbitratorinsurance coverageLabor Code Section 5275(a)(1)compromise and releaseZurich North American
References
4
Case No. ADJ2186498 (FRE 0183762), ADJ4344567 (FRE 0183763), ADJ1298565 (FRE 0187558), ADJ4148705 (FRE 0213169)
Regular
Jul 02, 2010

DELORES GUILLEN vs. HORIZON HEALTH, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, RGIS INVENTORY SPECIALISTS, ZURICH AMERICAN INSURANCE

The Workers' Compensation Appeals Board granted Zurich American Insurance's petition for reconsideration. The Board rescinded the Arbitrator's decision and returned the case for further proceedings, citing deficiencies in the record. Specifically, the Board found that the record lacked clarity on stipulated issues, admissions, and admitted evidence, as required by established precedent. Therefore, the Arbitrator must develop the record to ensure a fair adjudication of CIGA's reimbursement claims.

CIGAZurich American InsuranceLegion Insurance Companyliquidationreimbursementstipulated awardcausationvocational rehabilitationcompromise and releasereconsideration
References
2
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