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

Case No. ADJ383777
Regular
Apr 04, 2011

Roxanna Ortiz vs. ONE SOURCE, ESIS

The Workers' Compensation Appeals Board denied Roxanna Ortiz's petition for reconsideration of a prior findings and order. The initial ruling determined she sustained industrial injury only to her cervical spine as a janitor, not to other body parts or any resulting temporary/permanent disability or need for further medical treatment. Ortiz argued the judge erred by favoring defense medical reports and discrediting her testimony due to minor inconsistencies in her injury description. The Board adopted the WCJ's report, emphasizing deference to credibility determinations and that admissibility of medical reports should have been challenged at trial, not on reconsideration. A dissenting opinion argued the judge overemphasized minor variations in Ortiz's account and that medical evidence did not sufficiently support denial of other injuries or further treatment.

OrtizOne SourceESISWCABFindings and OrderPetition for ReconsiderationWorkers' Compensation Administrative Law Judgeindustrial injurycervical spineright arm
References
Case No. ADJ1584272
Regular
Dec 03, 2010

RICHARD SILVA vs. PAZIN & MYERS, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding of 100% permanent disability for the applicant's back and psyche injuries. The Board found that the workers' compensation judge properly applied the 1997 Schedule for Rating Permanent Disabilities due to pre-existing medical reports indicating permanent disability. Substantial evidence, including the Agreed Medical Examiner's opinion on permanent total disability and the applicant's treating psychologist's opinion, supported the 100% disability rating. The defendant failed to meet its burden to prove apportionment of the disability.

ADJ1584272FRE 0244029Pazin & MyersInc.State Compensation Insurance FundFindings and AwardSeptember 142010industrial injuryback
References
Case No. TI11711888
Regular

ROBERT MCFARLAND vs. CHARLES ABBOTT ASSOCIATES, ST. PAUL TRAVELERS and its property casualty affiliates and subsidiaries

In this workers' compensation case, the defendant sought reconsideration of an award finding the applicant 100% permanently disabled without apportionment. The Appeals Board denied the petition, upholding the finding that the applicant's total disability stemmed directly from unsuccessful spinal surgery following an industrial injury. The Board relied on the *Hikida* case, which permits unapportioned awards when permanent disability arises directly from unsuccessful medical treatment, even if non-industrial factors contributed to the need for that treatment. Prior stipulations regarding apportionment were deemed not binding on new and further disability claims arising from failed surgery syndrome.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent DisabilityApportionmentFailed Medical TreatmentHikidaAgreed Medical EvaluatorStipulationsNew and Further Disability
References
Case No. ADJ3758714 (VNO 0553350) ADJ3611380 (ANA 0372874)
Regular
Nov 24, 2008

Herbert J. Ware, Jr. vs. LOS ANGELES TIMES, Permissibly SelfInsured, Administered by GALLAGHER BASSETT SERVICES

The Appeals Board denied reconsideration of a decision that reversed a finding of cumulative trauma psychiatric injury for the applicant. The denial was based on the lack of substantial medical evidence establishing the cumulative trauma claim in one case, and the fact that a separate claim for psychiatric injury as a consequence of a back injury was not properly litigated. The Board indicated the case would return to the trial level for further proceedings on other issues.

Workers' Compensation Appeals BoardCumulative TraumaPsyche InjurySpecific InjuryBack InjuryCompensable ConsequenceReconsideration DeniedMedical EvidenceTemporary DisabilityFurther Medical Treatment
References
Case No. VNO 0428535
Regular
Nov 19, 2007

KATHERINE GRAMMER vs. LOS ANGELES COMMUNITY COLLEGE DISTRICT, LOS ANGELES VALLEY COLLEGE, SOUTHERN CALIFORNIA RISK MANAGEMENT ASSOCIATES

The applicant sustained industrial injuries to her back, neck, right shoulder, and regional pain syndrome, but not fibromyalgia, according to the WCJ's findings. The WCJ awarded temporary partial disability from January 27, 2001, to February 12, 2003, but found zero percent permanent partial disability and no temporary disability indemnity due to increased earnings post-injury. Upon reconsideration, the Appeals Board affirmed the WCJ's decision, adopting the WCJ's reasoning.

GrammerLos Angeles Community College DistrictLos Angeles Valley CollegePetition for ReconsiderationFindings and Awardindustrial injurybackneckshoulderregional pain syndrome
References
Case No. ADJ790852
Regular
Apr 05, 2016

LAURA BREITIGAN vs. COUNTY OF RIVERSIDE

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, amending the award to include attorney fees on accrued unpaid permanent disability benefits and correcting clerical errors. The Board denied the defendant's petition for reconsideration, upholding the finding of 100% permanent disability and injury to the lumbar spine. The defendant was also admonished for filing a document exceeding the page limit without prior permission. The applicant, a nurse, sustained industrial injuries to her thoracic spine, lumbar spine, and psyche.

Workers' Compensation Appeals BoardLaura BreitiganCounty of RiversideFindings and Awardindustrial injurythoracic spinelumbar spinepsychepermanent disabilityapportionment
References
Case No. ADJ102175 (MON 0317302)
Regular
Mar 22, 2011

TERRY LYNN ROSS vs. BERNARD & SONS, INC., STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the Appeals Board affirmed a finding of 100% permanent disability for Terry Lynn Ross, a truck driver injured in 2004. The defendant contested the total disability finding, arguing the wrong rating schedule was applied and medical evidence didn't support the rating. The Board found the 2005 rating schedule was applicable and that medical opinions from multiple physicians, particularly Dr. Salick's, established the applicant's inability to compete in the open labor market, thus supporting the total disability award. The Board also reaffirmed that permanent total disability can be established under Labor Code Section 4662 based on factual inability to work, even if the scheduled rating is less than 100%.

Permanent disability rating scheduleWhole Person ImpairmentAgreed Medical ExaminerQualified Medical EvaluationPain Related ImpairmentFuture earning capacityOpen labor marketVocational rehabilitationLabor Code Section 4662AMA Guides
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. ADJ2554534
Regular
Jan 03, 2023

WENDY COLLIE vs. STATE OF CALIFORNIA, EMPLOYMENT DEVELOPMENT DEPARTMENT, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration of a prior award. The initial award found the applicant sustained an injury AOE/COE to multiple body parts, resulting in permanent total disability without apportionment. The employer argued the finding of chronic pain syndrome was improper, and that the WCJ ignored credibility issues and apportionment opinions. The Appeals Board found substantial medical evidence supported the chronic pain syndrome diagnosis and that the employer failed to provide sufficient evidence for apportionment of permanent disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderAdministrative Law JudgeInjury AOE/COELumbar SpineCervical SpineLeft ShoulderRight HipRight Knee
References
Case No. ADJ237483
Regular
Nov 13, 2012

RAYEK J. FAHOUM vs. KAISER FOUNDATION HOSPITAL

The Workers' Compensation Appeals Board denied Rayek J. Fahoum's petition for reconsideration, upholding the findings of the Workers' Compensation Judge. The Judge's report found Fahoum sustained industrial injury to his neck and low back with secondary chronic pain syndrome, awarding 41% permanent disability. This decision relied on the opinions of the Agreed Medical Examiner and Dr. Renee Rinaldi, who concluded Fahoum experienced symptom magnification and that his condition was chronic pain syndrome, not fibromyalgia as claimed by Dr. Allen Salick. The Board extended great weight to the Judge's credibility findings regarding the medical opinions.

Workers' Compensation Appeals BoardReconsideration DeniedAgreed Medical ExaminerSubstantial Medical EvidenceFibromyalgiaChronic Pain SyndromeSymptom MagnificationOrthopedic InjuryLumbosacral StrainCervical Strain
References
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