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

Case No. ADJ12669513
Regular
Jan 18, 2023

AMALIA CABERA LOZA vs. GREG AND GREG, INC., SECURITY NATIONAL INSURANCE, AMTRUST

In *Amalia Cabera Loza v. Greg and Greg, Inc.*, the Workers' Compensation Appeals Board dismissed a petition for disqualification of the trial judge. The petitioner voluntarily withdrew their petition for disqualification. Therefore, the Board ordered the petition dismissed.

Petition for DisqualificationDismissing PetitionWithdrawn PetitionWorkers' Compensation Appeals BoardTrial JudgeAdjudication NumberSan Francisco District OfficeCommissionerChairSecurity National Insurance
References
Case No. ADJ7254561 ADJ7254565
Regular
Dec 21, 2018

GREG WALLOCH vs. CITY OF LAGUNA BEACH POLICE DEPARTMENT

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration regarding an awarded permanent disability. The Board upheld the finding that the defendant was not entitled to credit for overpaid permanent disability advances in one case against an award in another. The Board found the defendant's arguments regarding public gift and inequity to be without merit, emphasizing the applicant's good faith and the defendant's awareness of the cumulative trauma injury for an extended period. The decision highlights the Board's discretion in allowing credit for overpayments, balancing equities and applicant hardship.

Workers' Compensation Appeals BoardGreg WallochCity of Laguna Beach Police DepartmentJoint Findings and AwardPermanent DisabilityCreditOverpaymentCumulative TraumaSpecific InjuryMaximum Medical Improvement
References
Case No. ADJ3726285 (SRO 0134086) ADJ3984614 (SRO 0134094)
Regular
Aug 24, 2009

GREG FOSS vs. COUNTY OF MENDOCINO

In this workers' compensation case, the defendant sought full credit for $\$8,960.00$ paid in temporary disability beyond the statutory 104-week limit. The Workers' Compensation Appeals Board (WCAB) denied reconsideration, affirming the judge's decision to allow only $\$2,800.00$ in credit. The WCAB held that while estoppel did not apply, it had discretion under Labor Code section 4909 to limit credit due to the defendant's own error in overpaying benefits. Allowing full credit would be inequitable and create hardship for the applicant who received the overpayments without fault.

Workers' Compensation Appeals BoardGREG FOSSCOUNTY OF MENDOCINOG. B. BRAGG & ASSOCIATESINC.ADJ3726285ADJ3984614Denying ReconsiderationCreditTemporary Disability Indemnity
References
Case No. ADJ2223312 (ANA 0409909)
Regular
Oct 28, 2015

GREG CALLAHAN vs. ROSS & BARROWS, STATE COMPENSATION INSURANCE FUND

This case concerns a lien claimant, Western Medical Center, seeking payment for medical services rendered to applicant Greg Callahan. The Workers' Compensation Appeals Board (WCAB) denied reconsideration of an administrative law judge's ruling that the WCAB lacks jurisdiction to determine the lien dispute. This is because an "express agreement," established through a chain of contracts between Western Medical Center, Blue Cross, and the defendant insurer (SCIF), fixed the payment rates. Labor Code section 5304 divests the WCAB of jurisdiction when such an agreement exists, and section 5307.11 does not grant jurisdiction in this scenario.

Workers' Compensation Appeals BoardLabor Code Section 5304Lien DisputeJurisdictionContract RateManaged Care NetworkOther PayorsExpress AgreementChain of ContractsSection 5307.11
References
Case No. ADJ9097334
Regular
Apr 25, 2016

CHARLES GELETKO vs. CALIFORNIA HIGHWAY PATROL, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of an award granting applicant benefits, arguing the administrative law judge (WCJ) improperly calculated the applicant's permanent disability. The SIBTF contended the WCJ erred by applying a 1.4 adjustment factor and by adding individual impairments rather than combining them. The Appeals Board granted reconsideration, agreeing with the WCJ's report to affirm the award while correcting a mathematical error, ultimately awarding applicant 82% permanent disability. The Board found the 1.4 modifier applicable under the relevant statute, but upheld the prohibition against using the Combined Values Chart when assessing SIBTF eligibility due to statutory exclusions for age and occupation adjustments.

Subsequent Injuries Benefits Trust FundLabor Code section 4751permanent disability thresholdwhole-person impairmentsection 4660.11.4 modifierCombined Values ChartCalifornia Highway Patrolcumulative trauma injurycardiovascular system
References
Case No. ADJ6825349
Regular
Aug 19, 2010

GREG JOHNSON vs. MONTEBELLO UNIFIED SCHOOL DISTRICT

The Appeals Board granted the defendant's petition for reconsideration, rescinded the prior finding of industrial injury to the applicant's left knee and low back, and returned the matter for further proceedings. The Board rejected the defendant's attempt to introduce medical websites on reconsideration as a violation of due process, and found insufficient evidence to support claims of fraud. However, due to a recent invalidation of Administrative Director Rule 30(d)(3), the defendant has a due process right to further medical evaluation, necessitating the case's return to the trial level.

WCABPetition for ReconsiderationIndustrial InjuryJudicial NoticeDue ProcessFraudMedical Record DevelopmentAdministrative Director Rule 30(d)(3)Qualified Medical EvaluatorsLabor Code Sections 4060(c)
References
Case No. ADJ6796410
Regular
Jan 10, 2011

GREG BOATMAN vs. CITY OF LOS ANGELES, TRISTAR

This case involves a firefighter seeking reconsideration of a denial of temporary disability benefits. The applicant underwent knee surgery on February 10, 2009, and testified about his recovery and need for light duty. Despite no explicit medical opinion stating temporary disability, the Appeals Board found a reasonable inference of temporary disability from February 10, 2009, to March 6, 2009, based on the surgery's nature and the applicant's reliance on his wife for assistance. The Board rescinded the original award and returned the matter for further proceedings, including determination of temporary disability and potential Labor Code Section 4850 benefits.

Workers' Compensation Appeals BoardReconsiderationTemporary DisabilityFirefighterOperative ReportOrthopedistAgreed Medical EvaluatorPartial Medial MeniscectomyChondroplastyMedial Femoral Condyle
References
Case No. ADJ11836757
Regular
Sep 09, 2019

Greg Joshua vs. Legend Transportation, National Interstate Insurance

The Workers' Compensation Appeals Board granted reconsideration to defer the issue of Labor Code section 5814 penalties, finding the administrative law judge's initial award premature. The Board determined that Dr. Schmidt's reports constituted substantial medical evidence regarding the applicant's temporary total disability for his left shoulder injury, despite the defendant's arguments about incomplete medical history. However, the Board found that section 5814 penalties are not appropriate for expedited hearings and must be addressed separately. The case is returned to the WCJ for further proceedings specifically on the section 5814 penalty issue.

ADJ11836757AOE/COEPetition for ReconsiderationFindings and AwardTemporary Disability IndemnityLabor Code Section 5814Substantial Medical EvidencePrimary Treating PhysicianDr. SchmidtCredibility
References
Case No. ADJ11160722, ADJ11383679, ADJ11398700
Regular
Feb 27, 2020

GREG EISERT vs. CITY OF VACAVILLE, INNOVATIVE CLAIMS SOLUTIONS, INC.

The Workers' Compensation Appeals Board granted removal, rescinding an order that quashed subpoenas for an applicant police officer's personnel records. The Board ruled that Evidence Code sections 1043-1046 do not apply to routine discovery of medical and injury-related records in workers' compensation cases when an applicant puts their health at issue. However, the request for "POST" documents was returned to the trial level for further determination as their nature and relevance to routine discovery were unclear. The Board aims for substantial justice, emphasizing that procedural technicalities should not impede necessary discovery in such claims.

Petition for RemovalEvidence Code 1043Penal Code 832.7Personnel RecordsPeace OfficerRoutine DiscoveryMedical RecordsInjury-Related RecordsPOST DocumentsSubpoena Duces Tecum
References
Case No. ADJ638568 (AHM 0116132)
Regular
Oct 11, 2010

GREG TURNER vs. THOMASON MECHANICAL CORP., AIU, ZURICH NORTH AMERICA, ACE/USA

This case involves cross-petitions for reconsideration by the applicant and defendant Zurich North America concerning an Amended Findings and Award. The applicant sustained cumulative industrial injuries to multiple body parts, resulting in an 84% permanent disability award. The defendant contested the permanent disability calculation and argued for 30% apportionment to non-industrial causes, while the applicant sought temporary disability benefits for a specific period. Ultimately, both petitions were denied as the Board found no error in the original award and no supporting evidence in the record for the applicant's temporary disability claim.

cumulative injurymillwrightcervical spinelumbar spinehearing lossbilateral extremitiespermanent disabilitylife pensiontemporary disabilityapportionment
References
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