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

Case No. MON 0316510
Regular
Jul 18, 2008

MIGUEL LOPEZ vs. MV TRANSPORTATION, AMERICAN HOME ASSURANCE, BROADSPIRE CLAIM SERVICES

The Workers' Compensation Appeals Board granted reconsideration of an amended award finding applicant incurred industrial injury causing 78% permanent disability. The Board found the applicant's neurologist's report regarding post-traumatic head syndrome lacked substantial evidence due to contradictions with applicant's testimony. Consequently, the case is returned to the trial level to further address permanent disability and apportionment issues.

WCABMV TransportationAmerican Home AssuranceBroadsire Claim ServicesMIGUEL LOPEZBus DriverIndustrial InjuryNeck InjuryBack InjuryRight Shoulder Injury
References
Case No. ADJ8501790
Regular
Jul 29, 2015

Kelly Chase vs. St. Louis Blues Hockey Club, Federal Insurance Company

The Workers' Compensation Appeals Board (WCAB) reversed a prior finding of industrial injury for a professional hockey player against the St. Louis Blues. The WCAB found insufficient connection to California for jurisdiction, citing the player's limited games in the state compared to his overall career. This decision followed the precedent set in *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)*, which requires a legitimate and substantial connection to the state for jurisdiction. The WCAB concluded that 21 games out of 485 did not meet this standard for a cumulative injury claim.

WCABSt. Louis Blues Hockey ClubFederal Insurance CompanyADJ8501790Opinion and Decision After Reconsiderationcumulative industrial injuryprofessional hockey playersubject matter jurisdictionstatute of limitationssubstantial medical evidence
References
Case No. ADJ469779 (RIV 0067408)
Regular
Apr 13, 2009

REGINALD LESLIE, JR. vs. SUN BOSS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and amended the original award to include injury to the applicant's low back and bilateral wrists, correcting a clerical error based on prior stipulations. The Board affirmed the original temporary disability award, finding the applicant's medical evidence for continuing disability lacked substantial evidence. New evidence from Dr. Kessler was deemed insufficient to warrant a change in the original decision. Therefore, the original award was affirmed with the corrected finding of injury to the low back and wrists.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardIndustrial InjuryBilateral ShouldersNeckHeadClosed Head InjuryJaw and TeethLumbar Spine
References
Case No. ADJ10419700 (MF) ADJ10543011
Regular
May 09, 2019

CHERIE BATES vs. PRIDE INDUSTRIES, UNITED STATES FIRE INS. CO., BROADSPIRE

This case involves an applicant's claim for a head injury allegedly sustained at work after losing balance and hitting her head. While her testimony and initial claim documentation suggest a work-related incident occurred, the Workers' Compensation Appeals Board (WCAB) found insufficient medical evidence to confirm the injury's industrial nature due to the applicant's history of seizures and conflicting medical reports. Consequently, the WCAB rescinded the previous award and returned the case to the trial level for further development of expert medical opinion on the industrial causation of the head injury. The applicant's knee injury claim from a separate date was affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationIndustrial InjuryHead InjuryCredibilityFraudMedical EvidenceLay TestimonyExpert Medical OpinionOccult Injury
References
Case No. ADJ4205101
Regular
Jul 23, 2013

SUSAN HECHT vs. WARNER BROTHERS, INC.

This case involved an applicant claiming an industrial injury to her psyche, digestive system, and head, stemming from a change in overtime policy. The defendant argued the psychological injury was non-compensable under Labor Code sections 3208.3(b)(2) and 3208.3(h), as it arose from a good faith personnel action. However, the Board affirmed the WCJ's award, adopting the WCJ's report which found the injury compensable despite the personnel action. The Board also ordered the matter returned to the WCJ to determine the reasonable value of medical treatment provided by lien claimants.

Workers' Compensation Appeals BoardReconsiderationIndustrial InjuryPsycheDigestive SystemHeadSleep DisorderTemporary DisabilityEmployment Development DepartmentLien Claimants
References
Case No. ADJ6611484
Regular
Jan 14, 2014

JERRY SAULSBERRY vs. NATOMAS UNIFIED SCHOOL DISTRICT

This Workers' Compensation Appeals Board case involved applicant Jerry Saulsberry's claim against Natomas Unified School District. The Board granted reconsideration of a prior decision that found industrial injury to the applicant's right eye, head, and spines, but denied home health care. Applicant contended the denial of home health care lacked substantial evidence and misapplied the law. Adopting the WCJ's recommendation, the Board deferred the issue of home health care for further proceedings. The original findings of fact regarding the industrial injury are affirmed, but the matter is returned to the trial level solely for a decision on home health care.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Factindustrial injuryright eyeheadcervical spinelumbar spineright upper extremityleft upper extremity
References
Case No. ADJ9368263, ADJ9380293
Regular
Sep 15, 2015

JOSE MELCHOR vs. BRUTOCAO VINEYARDS, STAR INSURANCE COMPANY

This case involves a defendant's petition for removal regarding an order for a second Qualified Medical Examiner (QME) panel concerning the applicant's head injury. The Workers' Compensation Appeals Board (WCAB) granted removal to correct a clerical error in the original order. The WCAB affirmed the necessity of a second QME to further develop the medical record on the head injury claim, specifically in the specialty of Psychology-Clinical Neuro Psychology.

Petition for RemovalSecond QME PanelHead InjuryMedical Record DevelopmentWCJ Duty to Develop RecordPQME SpecialtyPSNPsychology-Clinical Neuro PsychologyMandatory Settlement ConferenceLack of Diligence
References
Case No. ADJ7509842
Regular
Jul 01, 2014

Latrisha Majors vs. Palmdale School District, York Insurance Services Group

The Appeals Board granted reconsideration and amended the original award to include an injury to the applicant's head, in addition to her back. However, they affirmed the finding of $0\%$ permanent disability and no need for further medical treatment. This decision relied on the applicant's primary treating physician's opinion, deeming it more persuasive and giving significant weight to the WCJ's credibility finding of the applicant. The amendment to include the head injury was based on the WCJ's report acknowledging a concussion, even if subjective complaints of headaches were not found credible.

Latrisha MajorsPalmdale School DistrictYork Insurance ServicesPetition for ReconsiderationFindings and Awardspecial education substituteindustrial injuryback injurypermanent disabilitymedical treatment
References
Case No. ADJ611155 (SRO 0137927)
Regular
Sep 14, 2015

DANIEL OVERBY vs. DUCKWORTH CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

Here's a summary of the case in four sentences for a lawyer: This case concerns a $100\%$ permanent disability award for an applicant who sustained a severe head injury in 2005, followed by a subsequent lumbar injury in 2006. The defendant sought apportionment of the permanent disability award, arguing the lumbar injury contributed to the applicant's unemployability. However, the Appeals Board found the medical evidence regarding apportionment between the two injuries insufficient and remanded the case for further development of the record. A dissenting opinion argued that the evidence supported a $100\%$ award without apportionment, as the primary disabilities were clearly linked to the initial head injury.

Industrial injuryPermanent disabilityApportionmentSubsequent injuryHead injuryBrain injuryNeurological deficitsSeizuresIncontinenceSexual dysfunction
References
Case No. ADJ9042929
Regular
Jun 11, 2018

Hayat Zarifi vs. Group 1 Automotive, National Union Fire Insurance Company, ESIS WEST WC CLAIMS

Applicant Hayat Zarifi sought increased permanent disability for a psyche injury, claiming his head striking a glass wall constituted a "violent act" or "severe head injury" under Labor Code section 4660.1. The Board denied reconsideration, affirming the WCJ's finding that the incident did not meet the statutory exceptions for psychiatric injuries stemming from physical harm. Unlike cited cases involving severe trauma, applicant here did not lose consciousness, require immediate medical care, or experience extreme force. Therefore, his psychiatric claim arising from the physical injury was denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationPermanent DisabilityLabor Code Section 4660.1Compensable Consequence InjuryViolent ActSevere Head InjuryConsciousness DisorderCognitive ImpairmentCatastrophic Injury
References
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