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Case Law Database

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

Case No. ADJ8700541
Regular
Oct 17, 2019

ZAHRA STEPHENS vs. COX ENTERPRISES, INC.

The Appeals Board granted reconsideration to review the WCJ's finding of permanent and total disability based on the opinions of a psychologist, Dr. Windman, and a vocational expert, Mr. Wilkinson. The Board found that Dr. Windman's opinion lacked substantial evidence due to inconsistencies, inadequate record review, and conflicts with other medical opinions. Consequently, Mr. Wilkinson's vocational opinion, which relied heavily on Dr. Windman's findings, was also deemed not substantial evidence. The case is remanded to the trial level for further proceedings and a new determination of permanent disability.

Workers' Compensation Appeals BoardReconsiderationPermanent Total DisabilityMedical OpinionVocational ExpertSubstantial EvidencePQMENeurologistPsychologistOrthopedist
References
10
Case No. ADJ9859900
Regular
Dec 24, 2018

KRSYTOL LARTEY vs. FOREVER 21, FEDERAL INSURANCE COMPANY

This case involves a workers' compensation claim where the applicant alleged injury to her throat and voice due to her employment with Forever 21. The defendant sought reconsideration of the WCJ's finding of injury arising out of and occurring in the course of employment (AOE/COE), arguing the medical examiner's opinion lacked substantial evidence. The Board denied reconsideration, finding the QME's reports and deposition testimony provided a reasoned opinion based on examination and history. The Board concluded that the QME's opinion constituted substantial evidence supporting the AOE/COE finding.

AOE/COEOtolaryngology QMEAlfred N. RovenMethicillin-resistant Staphylococcus aureusMRSAIndustrial causationPetition for ReconsiderationWorkers' Compensation Appeals BoardWCJDust exposure
References
2
Case No. ADJ1142998 (RDG 0118288)
Regular
Aug 18, 2009

STEVE REYNOLDS vs. WYCKOFF LOGGING, STATE COMPENSATION INSURANCE FUND

This case concerns a defendant's petition for reconsideration of a prior Workers' Compensation Appeals Board (WCAB) decision. The WCAB had previously rescinded a finding that avascular necrosis was not a compensable consequence of the applicant's injury, finding the relied-upon medical opinion speculative. The defendant argues the WCJ correctly favored the opinion of Dr. Glancz over Dr. Barber. The WCAB denied reconsideration, reaffirming that Dr. Glancz's opinion was not substantial evidence due to repeated questioning of the injury mechanism, while Dr. Barber's opinion was persuasive and based on a complete history. Therefore, the WCAB maintained its prior decision that Dr. Barber's opinion constituted substantial evidence supporting the applicant's claim.

Avascular necrosiscompensable consequencesubstantial evidencemedical opinionworkers' compensation administrative law judgereconsiderationfindings and ordermedical treatmentindustrial basissubstantial evidence
References
1
Case No. ADJ3147799 (RIV 0080159)
Regular
Aug 19, 2010

PETER TORCELLINI vs. SATURN ELECTRIC INC.

The Workers' Compensation Appeals Board denied Saturn Electric's petition for reconsideration, affirming the finding that Peter Torcellini sustained an injury arising out of and occurring in the course of his employment. The Board found that the Qualified Medical Evaluator's opinion constituted substantial medical evidence supporting the conclusion that a work-related stressor, even if subjectively experienced by the applicant, triggered the plaque rupture causing his cardiac arrest. The Board reasoned that the applicant's testimony about finding the work stressful and the medical opinion linking the rupture to an immediate stress response provided a reasonable basis for the finding. Defendant failed to provide evidence to contradict this medical opinion.

Workers' Compensation Appeals BoardReconsideration DeniedFinding of FactSaturn Electric Inc.Peter TorcelliniCirculatory System InjuryHeart AttackHypoxic Brain InjuryUnderground Utility TechIndustrial Causation
References
0
Case No. ADJ4681761
Regular
Feb 16, 2010

GEOFFREY MALINE vs. COUNTY OF SAN BERNARDINO

This case concerns an applicant's admitted industrial injury in May 2003, which the defendant sought to limit. The defendant contested findings that the injury extended to the applicant's right shoulder and left upper extremity, and that it caused additional temporary disability and 40% permanent disability. The Workers' Compensation Appeals Board denied reconsideration, finding the opinion of Dr. Hunt, one of the applicant's treating physicians, constituted substantial evidence supporting these findings. Dr. Hunt's detailed opinions on the injury's extent, the need for ongoing treatment, and the applicant's temporary and permanent disability were persuasive, particularly given later diagnostic findings.

Workers' Compensation Appeals BoardGeoffrey MalineCounty of San BernardinoFindings and Awardtemporary disabilitypermanent disabilityorthopedic surgeontreating physicianindustrial injuryprobation officer
References
3
Case No. ADJ10870145, ADJ8277957
Regular
Jan 30, 2023

CARLOS LOPEZ vs. PORTERVILLE SHELTERED WORKSHOP, MANUFACTURERS ALLIANCE INSURANCE COMPANY, AMERICAN CLAIMS MGMT., TREE & SIERRA MGMT., SIERRA MGMT., CIGA, INTERCARE HOLDINGS, ULLICO CASUALTY COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a decision finding the applicant sustained cumulative trauma injury while employed by both Sierra Management and Porterville Sheltered Workshop. This decision was based on the WCJ adopting the opinion of Dr. Bernhard, which was found to be substantial evidence despite conflicting medical opinions. The Board affirmed that a single physician's considered opinion can suffice as substantial evidence, even if it contradicts other medical findings. The Petitioner's arguments regarding the WCJ's reasoning and conflicting medical opinions were rejected.

ADJ10870145ADJ8277957Petition for ReconsiderationWorkers' Compensation Appeals BoardWCJ Report and Opinionsubstantial evidencephysician opinioncumulative injuryCIGAManufacturers Alliance Insurance Company
References
2
Case No. ADJ4617752 (VNO 0390167), ADJ1668605 (VNO 0470519)
Regular
Nov 01, 2010

ROBERT SCHENCK vs. COLIN CLINTON, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, RELIANCE INSURANCE COMPANY, AFFORDABLE QUALITY MOVING & STORAGE, STATE COMPENSATION INSURANCE FUND

This case involves applicant Robert Schenck's petition for reconsideration of a workers' compensation award. Schenck argued the judge erred by admitting sub-rosa video evidence and by not finding total disability based on Dr. Lavi's opinion. The Board denied the petition, finding the sub-rosa evidence was properly admitted and that Dr. Lavi's opinion lacked substantial evidentiary support for total disability. The Board affirmed the WCJ's reliance on defense medical reports finding permanent disability of 29% after apportionment.

SubrogationSub rosa evidenceMandatory Settlement ConferencePermanent DisabilityApportionmentWorkers' Compensation JudgeReconsiderationSubstantial EvidenceQualified Medical ExaminerDoctor-shopping
References
4
Case No. ADJ635934
Regular
Sep 09, 2010

FRANCES LARUE vs. NORDMAN, CORMANY, HAIR & COMPTON, STATE COMPENSATION INSURANCE FUND

Here's a summary of the case for a lawyer in four sentences: The Workers' Compensation Appeals Board granted reconsideration of an administrative law judge's award finding permanent total disability and no apportionment for an applicant's back injury. The Board rescinded the award, finding the judge erred by relying on an orthopedist's opinion that failed to properly apportion disability to pre-existing scoliosis. The case is remanded for further proceedings to incorporate the apportionment opinion of the defendant's medical expert, who found 70% of the disability attributable to non-industrial scoliosis. A dissenting opinion argued that the defendant's medical expert's apportionment was also insufficient.

ApportionmentPermanent Total DisabilityQualified Medical EvaluatorOrthopedistDegenerative ScoliosisCausationLabor Code Section 4663Senate Bill 899Substantial EvidenceFindings and Award
References
2
Case No. VNO 400907, VNO 400906
Regular
Jan 24, 2008

JORGE ESCOBEDO vs. WESTLAKE INN RESTAURANT & HOTEL, CALIFORNIA INDEMNITY INSURANCE COMPANY, SIERRA INSURANCE GROUP

This Workers' Compensation Appeals Board case involves applicant Jorge Escobedo seeking benefits for injuries presumed compensable under Labor Code section 5402. The Appeals Board affirmed the Administrative Law Judge's (WCJ) decision, finding that the defendant failed to rebut the presumption of injury and that applicant's injuries did not require further medical treatment or result in temporary disability, largely based on the WCJ's adverse credibility finding. A dissenting opinion argued that the WCJ's findings on no treatment or disability improperly abrogated the 5402 presumption and suggested appointing a "regular physician" to resolve conflicting medical opinions.

ReconsiderationRebuttable presumptionCompensabilityLabor Code 5402Medical treatmentTemporary disabilityPermanent disabilityApportionmentAttorney's feesSubstantial evidence
References
4
Case No. ADJ948816 (SFO 0499481)
Regular
Mar 07, 2013

Edwin Suarez vs. Barrett Business Services, Inc.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior award finding $100\%$ permanent total disability and psychiatric injury. The WCAB found the vocational expert's opinion regarding permanent disability was unsubstantial, and Dr. Goldfield's psychiatric opinion was questionable due to reliance on a previously rescinded heart injury finding. Consequently, the WCAB deferred the issues of psychiatric injury, permanent disability, and attorney fees, returning the case to the trial level for further proceedings. However, the WCAB affirmed the findings of injury to the lumbar and cervical spine and upper extremities, and awarded temporary disability and future medical treatment.

WCABPetition for ReconsiderationFindings and AwardIndustrial InjuryLumbar SpineCervical SpineUpper ExtremitiesPsychiatric InjuryPermanent Total Disability2005 Schedule for Rating Permanent Disability
References
0
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