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

Case No. ADJ10222181 (MF) ADJ10222198
Regular
Jan 30, 2019

SAM ALBOUDOOR vs. AMJES, INC. dba K&B FREIGHT SYSTEMS

This case concerns claims for hernias and spine injuries sustained by a truck driver. The Workers' Compensation Appeals Board granted reconsideration to review the finding that hernias were work-related, noting the medical evaluator's conflicting opinions on causation. The Board determined further medical development is required on the hernia issue due to contradictory expert testimony. Additionally, the issue of reimbursement for self-procured medical treatment was deferred pending the resolution of the hernia claims.

Workers' Compensation Appeals BoardAMJES INCK&B Freight SystemsSam Alboudoorherniahiatal herniainguinal hernialumbar spinethoracic spinePQME
References
Case No. ADJ300802 (AHM 0109743) ADJ2310921 (AHM 0115931)
Regular
Nov 21, 2008

CHRISTOPHER SHIELDS vs. LAIDLAW TRANSIT; BROADSPIRE

The Appeals Board granted reconsideration, amending the original award to establish a permanent and stationary date of January 3, 2005, for applicant's abdominal hernia injuries. The Board deferred the issues of permanent disability and attorneys' fees, returning the case to the trial level for re-rating based on hernia/abdominal injuries rather than spinal injuries. The Board affirmed the finding of an industrial inguinal hernia injury, while also noting that the defendant did not provide evidence of unreasonable refusal of medical treatment for the hernias.

HerniaUmbilical herniaInguinal herniaLow back painPermanent and stationary dateTemporary total disabilityMedical treatmentAttorney's feesReconsiderationWorkers' Compensation Appeals Board
References
Case No. SDO 0322942
Regular
Jan 31, 2008

ROBERT WEIS vs. VULCAN MATERIALS COMPANY, ZURICH NORTH AMERICA

The applicant claims an admitted industrial spinal injury caused his umbilical hernia, but the WCJ denied benefits for the hernia, finding it nonindustrial. The applicant argues the Qualified Medical Evaluator's opinion supports industrial causation for the hernia, contradicting the defense. The Appeals Board granted reconsideration to obtain a report from the WCJ regarding this contested issue.

Workers' Compensation Appeals BoardVulcan Materials CompanyZurich North AmericaRobert Weisindustrial injuryspineherniaumbilical herniatruck driverqualified medical evaluator
References
Case No. ADJ10782441 ADJ9193836
Regular
Apr 15, 2019

Stacy Smith vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration to affirm the applicability of Labor Code section 3212 presumptions for hypertension and hernia injuries to an ocean lifeguard. However, the Board amended the decision to defer issues of permanent disability and apportionment. This deferral is due to the apparent conflict between the WCJ's 50% apportionment of hernia disability and the non-attribution clause of Labor Code section 3212. The Board returned these issues to the trial level for further hearing and determination.

Workers' Compensation Appeals BoardLabor Code Section 3212Heart trouble presumptionHernia presumptionFire department memberOcean lifeguardCumulative injuryLumbar spine injuryRight knee injurySkin injury
References
Case No. ADJ2653887 (SAL 0116844)
Regular
Dec 24, 2008

CARROL BARRIE vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, amending a prior finding to award further medical treatment for admitted industrial hernias. While the original finding denied permanent disability and further treatment, the Board found a stipulation by the parties and the Agreed Medical Evaluator's opinion supported the need for ongoing medical follow-up. The Board affirmed the original finding that the injury did not cause ratable permanent disability based on the AME's report and statutory guidelines.

Workers' Compensation Appeals BoardIndustrial InjuryVentral HerniaUmbilical HerniaRegistered NursePermanent DisabilityFurther Medical TreatmentAgreed Medical EvaluatorAMA GuidesLabor Code Section 5802
References
Case No. ADJ6475661
Regular
May 11, 2015

ALAN COLGROVE vs. SANTA ROSA PRESS DEMOCRAT, TRAVELERS PROPERTY & CASUALTY COMPANY OF AMERICA

The Appeals Board rescinded the WCJ's decision finding a hernia to be a compensable consequence of a back injury, citing insufficient medical evidence. Dr. Klein’s opinion on causation was found to be inconsistent and not substantial evidence. The Board concluded the medical record requires further development to determine if the hernia is causally related to the industrial injury. Therefore, the case is returned to the trial level for further proceedings and a new decision by the WCJ.

COMPENSABLE CONSEQUENCEPETITION TO REOPENMEDICAL RECORD DEVELOPMENTQUALIFIED MEDICAL EVALUATOR (PQME)OPINIONCAUSAL RELATIONSHIPHERNIABACK INJURYSTIPULATIONSSUBSTANTIAL EVIDENCE
References
Case No. ADJ1038622
Regular
Nov 19, 2012

PAUL SOTEROPOULOS vs. LOS ANGELES COUNTY FIRE DEPARTMENT

The Workers' Compensation Appeals Board denied the applicant's reconsideration of a prior decision. The Board affirmed the finding that the applicant, a firefighter, did not sustain an injury arising out of and in the course of employment for his testicular cancer. The Board found the agreed medical evaluator's opinion on the latency period provided substantial evidence to rebut the statutory presumption. Furthermore, the Board determined the applicant's hernia was a complication of non-industrial cancer treatment, thus controverting the presumption of compensability for hernias.

Workers' Compensation Appeals BoardPaul SoterepoulosLos Angeles County Fire DepartmentReconsiderationFirefighterRight Testicular CancerHerniaLabor Code Section 3212.1Presumption of CompensabilityLatency Period
References
Case No. POM 0290497
Regular
Feb 22, 2008

WALID THOMAS vs. KAZI FOODS, ST. PAUL TRAVELERS

The Workers' Compensation Appeals Board denied Walid Thomas's petition for reconsideration of a decision that found his alleged back and hernia injuries sustained while employed by Kazi Foods were not industrial. The Board adopted the findings of the administrative law judge, who found Dr. Hajj's opinion to be substantial medical evidence supporting this conclusion. The judge also found Thomas's testimony not credible due to his extensive prior medical history of similar back injuries and a hernia.

Workers' Compensation Appeals BoardReconsideration deniedIndustrial injuryDr. Hajj's opinionSubstantial medical evidenceCredibility findingPlace v. Workers' Comp. Appeals Bd.Garza v. Workmen's Comp. Appeals Bd.Kazi FoodsInc.
References
Case No. ADJ9158183
Regular
Feb 07, 2020

JOSE DE LEON vs. SANTANA RIOS FARM LABOR, STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, affirming a prior award but amending it to find 17% permanent disability for the applicant's hernia injury. The Board ruled that res judicata precluded re-litigating the applicant's low back permanent disability, as it had been previously decided in his favor. Expert medical opinions, particularly from Dr. Bronshvag, supported the finding of disability from the hernia. The applicant's average earnings were stipulated at $384.00 per week, which was upheld.

AOE/COEPetition for ReconsiderationFindings of Fact & AwardPermanent Partial DisabilityRes JudicataIssue PreclusionContinuing JurisdictionLabor Code § 5803Labor Code § 5804Regular Physician
References
Case No. ADJ14154023
Regular
Sep 26, 2022

COREY CASTILLO vs. CENTINELA STATE PRISON, CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a decision finding a hernia injury sustained by a correctional officer to be compensable. While the specific statutory presumption for certain public safety officers did not apply, the Board affirmed the judge's finding that the applicant met their burden of proof. This was based on the substantial medical evidence from Dr. Woolf, who opined the hernia was caused by the applicant's heavy lifting and aggravated by a specific work incident. The claim was also found to be timely filed within the statute of limitations.

Workers' Compensation Appeals BoardCorey CastilloCentinela State PrisonCalifornia Department of Corrections and RehabilitationState Compensation Insurance FundPetition for ReconsiderationWCJ Reportsubstantial medical evidencePlace v. Workmen's Comp. Appeals Bd.industrial injury
References
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