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

Case No. AD J8835024 AD J8996815
Regular
Jun 14, 2016

TRACIE KEILLOR vs. COUNTY OF SACRAMENTO

The Workers' Compensation Appeals Board granted reconsideration, rescinded a prior award, and found that the applicant, a deputy sheriff, did not sustain industrial injury from a stroke. While Labor Code section 3212.5 creates a presumption of industrial causation for heart trouble in peace officers, the applicant failed to establish, based on a qualified medical evaluator's opinions, that her stroke was caused by heart trouble or that she suffered from any heart trouble. The expert consistently found no evidence of heart trouble contributing to the stroke and opined that an intracranial thrombosis was the probable cause. Therefore, the presumption under section 3212.5 was not applicable as the applicant did not meet the threshold requirement of showing heart trouble.

Workers' Compensation Appeals BoardDeputy SheriffStrokeHeart PresumptionLabor Code Section 3212.5Occupational CausationMedical ProbabilityPanel Qualified Medical EvaluatorCardiologistIn Situ Thrombosis
References
6
Case No. ADJ12288761
Regular
Dec 29, 2020

MICHAEL GOMEZ vs. CALIFORNIA INSTITUTION FOR WOMEN, STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding a finding of 62% permanent disability for a correctional officer with cumulative trauma. The core issue was whether Left Ventricular Hypertrophy (LVH), found by a QME, constituted "heart trouble" under Labor Code section 3212.2, triggering a presumption of industrial injury. The Board affirmed the WCJ's decision, relying on prior case law and expert medical opinions that LVH, even if minor, qualifies as "heart trouble" for purposes of the presumption. Defendant's arguments that LVH was not "heart trouble" and that medical opinions were contradicted were rejected as insufficient to rebut the presumption.

Workers' Compensation Appeals BoardCalifornia Institution for Womencorrectional officercumulative traumainternal organshypertensionGERDheart trouble presumptionLabor Code section 3212.2Left Ventricular Hypertrophy
References
13
Case No. ADJ7494670
Regular
Jun 01, 2012

JOSEPH CURRAN, Deceased, JERI CURRAN, Spouse vs. CITY OF SACRAMENTO

The Workers' Compensation Appeals Board denied reconsideration of a decision finding that the deceased firefighter, Joseph Curran, suffered a heart injury arising out of and in the course of employment. The Board affirmed that the Labor Code Section 3212 heart trouble presumption applied. The defendant failed to rebut this presumption by demonstrating that a contemporaneous non-work-related event was the *sole* cause of the heart trouble. Dr. Bellinger's testimony, while stating the presumption was necessary, did not affirmatively prove exclusive non-industrial causation.

Labor Code 3212heart trouble presumptionindustrial causationrebutted presumptionanti-attribution clausesole causenonwork-related eventcumulative injuryfirefighterdeath benefits
References
5
Case No. ADJ8254799
Regular
Apr 21, 2014

TERRY MILLER vs. WASCO STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to find that correctional officer Terry Miller sustained an industrial heart injury, not just hypertension, based on Labor Code section 3212.2's presumption for heart trouble in correctional officers. The WCAB overturned the judge's decision to apportion the injury, ruling that Labor Code section 4663(e) prohibits apportionment for injuries covered by the heart trouble presumption. Consequently, Miller was awarded an unapportioned 60% permanent disability rating, an increase from the original 51%.

Labor Code section 3212.2heart trouble presumptioncorrectional officerleft ventricular hypertrophycumulative traumaindustrial hypertensionunapportioned awardpermanent disabilityWasco State PrisonState Compensation Insurance Fund
References
4
Case No. ADJ10343521
Regular
Jan 03, 2019

JESUS LOPEZ vs. CITY OF COMPTON

This case involves a firefighter's claim for workers' compensation benefits for heart trouble. The applicant, Jesus Lopez, was found to have sustained 54% permanent disability due to an industrial injury to his heart on December 17, 2015. The Workers' Compensation Appeals Board (WCAB) affirmed the administrative law judge's decision, relying on Labor Code section 3212, which presumes heart trouble in firefighters arises out of employment. The defendant, City of Compton, argued that the presumption was rebutted by evidence of non-industrial events and that the Qualified Medical Evaluator's opinion was not substantial medical evidence. However, the WCAB found that the defendant failed to provide substantial medical evidence to rebut the presumption, particularly in light of the anti-attribution clause in Labor Code section 3212.

Labor Code section 3212presumption of industrial causationheart troublefirefighter paramedicQualified Medical EvaluatorQMEsubstantial medical evidencedue processrebut the presumptionanti-attribution clause
References
7
Case No. ADJ10653999
Regular
Feb 11, 2020

Rodney McMillan vs. CITY OF RIVERSIDE

Applicant, a police officer, sought reconsideration after a WCJ denied his heart trouble claim under Labor Code § 3212.5. The parties stipulated the heart trouble presumption applied, shifting the burden to the employer to rebut it. While the Agreed Medical Examiner identified alcoholism as the probable cause of applicant's cardiomyopathy, he could not definitively state it was the "sole cause" or that employment played no role. The Appeals Board granted reconsideration, rescinded the original order, and remanded the case for further proceedings to determine if the presumption was adequately rebutted.

Heart trouble presumptionLabor Code section 3212.5Rebuttal of presumptionAgreed Medical ExaminerDilated cardiomyopathyNon-industrial alcoholismSole causeIndustrial causationPetition for ReconsiderationFindings of Fact and Order
References
1
Case No. ADJ10138674
Regular
Jan 21, 2020

JUAN BARRAGAN vs. NORTH KERN STATE PRISON, STATE COMPENSATION INSURANCE FUND

This case involves a correctional officer claiming industrial heart injury. The applicant benefits from a statutory presumption that his heart trouble arose from his employment. While the defense presented a medical opinion suggesting the applicant's heart attack was an exacerbation of a prior condition, the Appeals Board found this evidence insufficient to rebut the presumption. The Board is remanding the case for further medical development to determine if the applicant's work activities were a contributing cause to his current heart condition, placing the burden of proof on the defendant.

Workers Compensation Appeals BoardJuan BarraganNorth Kern State PrisonState Compensation Insurance FundADJ10138674Petition for ReconsiderationFindings and OrderIndustrial InjuryHeart Trouble PresumptionLabor Code section 3212.2
References
6
Case No. ADJ3526973 (SDO 0315558) ADJ2783481 (SDO 0355255)
Regular
Jan 21, 2011

THEMAS CARMODY vs. CITY OF SAN DIEGO POLICE DEPARTMENT

The Workers' Compensation Appeals Board reversed a WCJ's decision finding no industrial injury to the applicant's heart and hypertension. The Board found that the Agreed Medical Evaluator's initial reports strongly supported industrial causation for hypertension and heart trouble, triggering the Labor Code section 3212.5 presumption. The Board held the AME's subsequent deposition testimony, which reversed his opinion without adequate explanation and rejected the legislative premise of stress-induced heart disease, was insufficient to rebut the presumption. Consequently, both the applicant's heart/hypertension claim and a previously decided claim for lung and hernia injuries were returned to the trial level for benefit determination.

Workers' Compensation Appeals BoardPolice SergeantHeart ConditionHypertensionLabor Code Section 3212.5Presumption of CompensabilityAgreed Medical EvaluatorRebuttal of PresumptionIndustrial CausationDeposition Testimony
References
6
Case No. ADJ9430358
Regular
May 20, 2015

GARY HALL vs. COUNTY OF LAKE, Permissibly Self-Insured, administered by INTERCARE HOLDINGS INSURANCE SERVICES, INC.

The Workers' Compensation Appeals Board granted reconsideration, finding the applicant's claim for cumulative heart injury was not barred by the statute of limitations, res judicata, or collateral estoppel. The Board determined that previous medical opinions concluding the applicant had no heart trouble did not address the current claim of manifestation of heart trouble within the statutory presumption period for deputy sheriffs. Therefore, the case was returned to the trial level for further proceedings and a decision on the merits.

Workers' Compensation Appeals BoardDeputy SheriffCumulative TraumaStatute of LimitationsCollateral EstoppelRes JudicataMedical-Legal EvaluationsHeart InjuryLabor Code Section 3212.5Agreed Medical Examiner
References
4
Case No. ADJ7941040
Regular
Sep 30, 2014

JESSE NICASIO vs. CITY OF MODESTO, Administered by YORK INSURACE SERVICES

The applicant, a former fire chief, sustained industrial injuries to his heart and multiple myeloma. The Appeals Board affirmed the WCJ's finding that his heart trouble was industrially caused, based on the presumption under Labor Code section 3212 and the AME's opinion that it developed during employment. Regarding cancer, the Board found the applicant's multiple myeloma developed within the statutory timeframe, making it presumptively compensable under Labor Code section 3212.1, and the defendant failed to rebut this presumption. Therefore, the applicant is entitled to benefits for both conditions.

Labor Code section 3212.1heart trouble presumptioncancer presumptionmultiple myelomabenzene exposureleft ventricular hypertrophyfire chieflatency periodmanifestationdevelopment
References
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