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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ8128282
Regular
Jan 23, 2014

ANGELA EGBIKUADJE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings. The defendant, California Department of Corrections and Rehabilitation, argued that the applicant's psychiatric injury claim was preempted by the ADA and not proven under Labor Code section 3208.3. The Board found the original decision lacked proper analysis regarding predominant industrial causation and the good faith personnel action defense. Therefore, the case was remanded for further development of the record, including expert medical opinion on these issues.

Workers' Compensation Appeals BoardAngela EgbikuadjeCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8128282Van Nuys District OfficeReconsiderationFindings and AwardIndustrial cumulative trauma injury
References
Case No. VNO 0386181
Regular
Apr 05, 2007

SUSAN PASCALE vs. BLUE CROSS/WELLPOINT DENTAL, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION on behalf of FREMONT INDEMNITY

This case concerns applicant Susan Pascale's claim for workers' compensation benefits due to industrial injuries resulting in fibromyalgia and other conditions. The WCJ awarded 80% permanent disability, apportioning 20% to applicant's pre-existing personality traits based on medical opinions. The Appeals Board affirmed this decision, finding the apportionment was supported by substantial medical evidence of causation, as allowed by recent statutory changes.

Workers' Compensation Appeals BoardSusan PascaleBlue Cross/Wellpoint DentalCalifornia Insurance Guarantee AssociationFremont IndemnityVNO 0386181Opinion and Decision After ReconsiderationApplicantDefendantWCJ
References
Case No. ADJ1577836
Regular
May 04, 2009

JESUS GAVINO-REMIGIO vs. STRATUS SERVICES GROUP, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant injured when stepping on a metal hook, sustaining an admitted industrial injury to his right foot. The applicant sought reconsideration after the Workers' Compensation Judge (WCJ) denied findings that the injury also affected his internal systems (diabetes), eyes, and psyche, along with associated disability. The Board denied reconsideration, finding the defendant's medical expert's opinion on non-industrial diabetes causation to be substantial evidence, while deeming the applicant's medical experts' opinions insufficient. A dissenting commissioner argued the applicant's medical evidence sufficiently supported industrial causation for diabetes aggravation, warranting reconsideration.

Workers' Compensation Appeals Boardindustrial injuryright footinternal systemseyespsychediabetes mellituspermanent disabilitytemporary disabilityGerald Markovitz M.D.
References
Case No. SRO 0135735
Regular
Nov 06, 2007

ROBERT ANUSEWICZ vs. JOINT INDUSTRY BOARD OF PLUMBING, dba KONOCTI HARBOR INN AND RESORT, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's entitlement to temporary disability indemnity beyond the standard 104-week limit. The Appeals Board rescinded the prior award, ruling that the applicant's hip and knee replacement surgeries did not constitute "amputations" as defined by Labor Code section 4656(c)(2)(C). Therefore, the applicant is limited to 104 weeks of temporary disability indemnity from the commencement of payments, precluding indemnity beyond January 31, 2007.

Workers' Compensation Appeals BoardRobert AnusewiczJoint Industry Board of PlumbingKonocti Harbor Inn and ResortState Compensation Insurance FundSRO 0135735Opinion and Decision After Reconsiderationtemporary disability indemnityindustrial injuryleft knee
References
Case No. ADJ3512142 (MON 0288509)
Regular
Jan 12, 2009

JOSE LUIS LARA vs. BRATIFF HOME CORP. dba METRO DINER and SCOTT BROFFMAN as substantial shareholder; UNINSURED EMPLOYERS BENEFIT TRUST FUND

The Appeals Board reversed the WCJ's finding that the applicant was an employee of Metro Diner on the date of injury, concluding that he was an independent contractor.

Workers' Compensation Appeals BoardBratiff Home Corp.Metro DinerScott BroffmanUninsured Employers Benefit Trust FundADJ3512142MON 0288509Opinion and Order Granting ReconsiderationDecision After ReconsiderationAdministrative Law Judge
References
Case No. ADJ1124123 (BGN 0064929) ADJ3374432 (BGN 0061307)
Regular
Oct 22, 2018

MARY BAKER vs. SWEEETHEART CUPS; CIGA by SEDGWICK CMS for FREMONT INSURANCE in liquidation and PORTEOUS FASTENERS/PACIFIC INDEMNITY COMPANY, CHUBB INSURANCE

The Workers' Compensation Appeals Board granted CIGA's petition for reconsideration, reversing the finding that CIGA remained liable for permanent total disability indemnity and medical treatment for the applicant's industrial injuries. The Board found that because the applicant's injuries resulted in a joint and several award with a solvent insurer, Pacific Indemnity, CIGA has no obligation to pay as "other insurance" was available. The decision clarifies that CIGA is absolved of liability for medical treatment jointly caused by both injuries, but remains liable for treatment solely caused by the September 1979 injury. Pacific Indemnity is now solely responsible for all remaining permanent total disability indemnity and medical treatment costs, adjusting for payments already made by CIGA.

CIGASweetheart CupsPorteous FastenersFremont InsurancePacific IndemnityChubb InsuranceWilkinson doctrinejoint and several liabilitycovered claimsother insurance
References
Case No. ADJ1160933 (SAL 0073085) ADJ1668595 (SAL 0073084)
Regular
Mar 01, 2012

MARIA AYALA vs. MANN PACKING COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ZENITH INSURANCE COMPANY

This Workers' Compensation Appeals Board case involves a clerical error correction. CIGA, representing Industrial Indemnity, requested the correction of the liquidation date of Industrial Indemnity. The original order mistakenly stated the liquidation occurred in 2004, but CIGA correctly identified it as July 2, 2003. The Board agreed and ordered the amendment to reflect the accurate liquidation date, also adding Zenith Insurance to the caption, without altering the original decision's outcome.

CLERICAL ERROR CORRECTIONCIGAINDUSTRIAL INDEMNITY LIQUIDATIONFREMONT INDEMNITYSEDGWICK CMSZENITH INSURANCE COMPANYINSURANCE CODE SECTION 1063.1OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONDATE OF LIQUIDATION
References
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