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

Case No. ADJ8109410
Regular
Apr 03, 2015

KRISTINA BROOKS vs. COUNTY OF TULARE

The Workers' Compensation Appeals Board reversed the Administrative Law Judge's decision, finding that the applicant's hiatal hernia and GERD were not industrial injuries. The Board determined that the Labor Code section 3212 presumption for hernias in law enforcement officers was rebutted by medical evidence. Specifically, the Board found that the applicant's hiatal hernia was primarily caused by complications from a prior non-industrial bariatric surgery, not her employment. Therefore, the Board rescinded the award for medical treatment and temporary/permanent disability.

Labor Code section 3212presumptionrebuttalhiatal herniaGERDQualified Medical EvaluatorIra FishmanM.D.deposition testimonybariatric surgery
References
1
Case No. 2014-01-0016
Regular Panel Decision

Careathers, Will v. Cardin Forest Products, LLC

Will Careathers, an employee of Cardin Forest Products, LLC, filed a Request for Expedited Hearing seeking medical and temporary disability benefits after reporting a midsection injury while lifting wood on August 11, 2014. He was referred to Dr. Charles R. Adcock, who diagnosed a small hiatal hernia. A post-accident drug test was positive for Oxycodone and Oxymorphone, leading Cardin to deny the claim. Careathers contended the medication was prescribed and that Cardin failed to provide a panel of physicians. Judge Thomas Wyatt denied Careathers' request, finding he failed to establish by medical expert opinion that his hiatal hernia arose primarily out of employment, as required by the Tennessee Workers' Compensation Act. The Court also found that Careathers accepted Dr. Adcock as his treating physician instead of waiting for a panel, thus denying his request for a new panel.

Workers' CompensationHiatal HerniaDrug TestCausationMedical BenefitsTemporary DisabilityPanel of PhysiciansExpedited HearingTennessee LawEmployer Liability
References
2
Case No. ADJ9635847
Regular
Oct 07, 2016

GANNON MASZK vs. CITY OF CARLSBAD

This case involves a workers' compensation claim for a hiatal hernia, GERD, and Barrett's Esophagus. The defendant sought to apportion the applicant's permanent disability, arguing that the presumed industrial cause of the hernia did not extend to subsequent GERD complications. However, the Appeals Board denied reconsideration, finding that the medical examiner's apportionment was not based on the *cause of the permanent disability*, but rather on the *cause of the injury*. Therefore, in the absence of legally sufficient apportionment, the applicant was awarded unapportioned permanent disability.

WCABGannon MaszkCity of CarlsbadKeenan AssociatesADJ9635847Petition for ReconsiderationFindings and Awardcumulative traumahiatal herniaGERD
References
2
Case No. 2015-02-0210
Regular Panel Decision
Nov 12, 2015

Perrault, Katherine v. Gem Care, Inc.

The employee, Katherine Perrault, alleged she developed a hiatal hernia, hemorrhoids, and acute appendicitis due to heavy lifting at work. The employer, Gem Care, Inc., denied the claim, asserting a lack of evidence connecting her conditions to the work incident. Following an expedited hearing, the trial court denied temporary disability and medical benefits, concluding the employee failed to demonstrate a likelihood of prevailing on the merits. The Workers' Compensation Appeals Board affirmed this decision, citing inconsistencies in the employee's testimony and medical records, and the absence of evidence meeting the specific requirements for hernia claims. The case was remanded for further proceedings.

Hernia ClaimExpedited HearingMedical Benefits DenialTemporary Disability DenialBurden of Proof StandardWitness Credibility DeferenceInterlocutory Appeal ReviewInjury CausationRectal Bleeding SymptomsHiatal Hernia Requirements
References
4
Case No. MISSING
Regular Panel Decision

Northern Assurance Co. v. Gutierrez

In a worker's compensation case, the Appellee sustained an incisional hernia and sought total and permanent disability benefits. The Appellant argued that the injury was limited to a hernia under Tex.Rev.Civ. Stat.Ann. art. 8306, sec. 12b, which would limit compensation to twenty-six weeks for a successful surgical repair. The trial court disregarded jury findings that the injury was confined to a hernia and that the operation was successful, instead awarding total and permanent benefits. The appellate court reversed the trial court's judgment, holding that the injury met the statutory criteria for a compensable hernia and the repair was successful. The case was remanded with instructions to enter judgment for the Appellee for twenty-six weeks of compensation as provided by the hernia statute.

Worker's CompensationIncisional HerniaHernia StatuteTexas LawJury FindingsTrial Court ErrorAppellate ReviewRemandDisability BenefitsMedical Examination
References
6
Case No. MISSING
Regular Panel Decision

Cook v. Great West Casualty Co.

This worker's compensation case addresses a claim for benefits stemming from the recurrence of an occupational hernia. The employee, who had a compensable hernia in 1981, experienced a recurrence in 1982 while working, leading to further surgeries and temporary total disability benefits from the insurer. The trial court denied additional compensation for the recurrence, citing T.C.A. § 50-6-212(a)(5) which states a hernia must not exist prior to the accident. The Tennessee Supreme Court reversed, clarifying that this statute applies to pre-existing non-compensable hernias, not to the recurrence or aggravation of a previously compensable one. The Court held that an employee is entitled to further benefits if a compensable hernia recurs or is aggravated in the course of employment, and remanded the case for a new trial to determine causation and additional benefits.

worker's compensationherniarecurrenceoccupational injurystatutory interpretationTennessee Supreme Courtremandtemporary total disabilitypermanent partial disabilitycausation
References
7
Case No. MISSING
Regular Panel Decision

Mannery v. WAL-MART DISTRIBUTION CENTER

This workers' compensation appeal concerns Robert Phillip Mannery's claim for a right inguinal hernia sustained while working for Wal-Mart Distribution Center in 1998. The central issue was whether the hernia existed prior to the accident, which would bar recovery under Tenn.Code Ann. § 50-6-212(a)(5). Despite a 1994 medical note mentioning a small right inguinal hernia, the trial court found that the 1998 hernia was a new injury in a different location, a finding supported by Mannery's testimony. The trial court awarded 21% permanent partial disability, which was affirmed by the Special Workers’ Compensation Appeals Panel and subsequently by the Supreme Court of Tennessee. The Supreme Court emphasized that the statute refers to the current hernia resulting from the accident, not a past, unrelated condition.

Workers' CompensationHernia ClaimPre-existing ConditionCausationMedical TestimonyPermanent Partial DisabilityAppellate ReviewInguinal HerniaStatutory InterpretationCredibility Determination
References
10
Case No. 2018-03-1517
Regular Panel Decision
Jul 30, 2019

Mullis, Sr., Phillip v. Blount County Community Action Agency

Phillip Mullis Sr., an employee of Blount County Community Action Agency (BCCAA), filed a Request for Expedited Hearing seeking benefits for an alleged work-related hernia. Mullis claimed he sustained a hernia in September 2018 while lifting a box of food, experiencing sharp pain and a 'pop'. BCCAA disputed the claim, stating Mullis provided no medical evidence, failed to give timely notice, and time records contradicted his account. Furthermore, BCCAA presented evidence from co-workers and VA records indicating Mullis had a pre-existing right inguinal hernia since 2011. The Court found Mullis failed to definitively prove the hernia criteria, including a work injury resulting in a hernia, immediate appearance, immediate follow-up to an accident, and that it did not exist prior to the accident. Therefore, the Court denied his claim.

HerniaDenied BenefitsExpedited HearingPre-existing ConditionTimely NoticeMedical EvidenceEmployment InjuryVA RecordsEmployee TestimonyEmployer Dispute
References
2
Case No. ADJ326796 (SDO 0356156) ADJ6986002
Regular
Jan 19, 2010

THOMAS A. SMITH vs. COUNTY OF SAN DIEGO, Permissibly Self-Insured

This case involves applicant Thomas A. Smith, a deputy sheriff, seeking workers' compensation benefits for industrial injuries including hypertension, GERD, hiatal hernia, back injury, and skin conditions. The defendant, County of San Diego, sought reconsideration of a prior award, arguing new case law (*Almaraz II* and *Ogilvie II*) and factual errors in the original decision regarding cumulative trauma, permanent disability ratings, and reliance on medical evidence. The Appeals Board granted reconsideration to further study the issues and has rescinded the prior findings and award. The case is returned to the trial level for further proceedings and a new decision by the WCJ.

Workers' Compensation Appeals BoardDeputy SheriffHypertensionGastroesophageal reflux diseaseHiatal herniaIndustrial injurySkin injuryPermanent disabilityPetition for ReconsiderationAlmaraz
References
2
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
0
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