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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ473373 (ANA 0406381)
Regular
Feb 10, 2012

FERNANDO GUTIERREZ vs. SOCAL FRAMING aka BMHC; ACE AMERICAN INSURANCE, administered by ESIS, INC.

This case concerns applicant's claim for extended temporary disability (TD) benefits beyond 104 weeks due to a left eye injury. The Appeals Board affirmed the WCJ's denial of the "amputation" exception, ruling that the surgical removal of an eye does not fit the statutory definition. However, the Board remanded the case for further development of the record on the "high-velocity eye injury" exception, as the velocity and force of the object that struck the applicant's eye were unclear. The applicant's Petition for Removal was dismissed as reconsideration was the appropriate remedy.

Workers' Compensation Appeals BoardFernando GutierrezSoCal FramingBMHCACE American InsuranceESISInc.ADJ473373ANA 0406381Opinion and Decision
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. ADJ2750886 (VNO 0423874)
Regular
Apr 01, 2011

ROSALIND PRESS vs. LOS ANGELES UNIFIED SCHOOL DISCTRICT, Permissibly Self-Insured, administered by SEDGWICK CMS

The Appeals Board granted reconsideration and rescinded the WCJ's Findings and Award, finding the applicant sustained industrial injury resulting in psychosomatic disorder. The Board noted the WCJ's decision heavily relied on applicant's credibility, but crucial evidence, the April 13, 2010 Minutes of Hearing, was missing from the record. The matter was returned to the trial level for further proceedings and a new decision to ensure a complete record for review. Removal was denied as reconsideration provided an adequate remedy.

Workers' Compensation Appeals BoardRosalind PressLos Angeles Unified School DistrictSEDGWICK CMSADJ2750886VNO 0423874Opinion and Order Denying RemovalGranting ReconsiderationDecision After ReconsiderationFindings and Award
References
Case No. ADJ6655702
Regular
Mar 18, 2010

GERICK CATUGDA vs. WINKLEBLACK CONSTRUCTION, CALIFORNIA INSURANCE COMPANY c/o APPLIED RISK SERVICES

This case concerns whether the "going and coming rule" bars applicant's workers' compensation claim for injuries sustained during his commute. The defendant argued the rule applied, but the Workers' Compensation Appeals Board denied their petition for reconsideration. The Board adopted the WCJ's finding that the applicant's employment required him to have transportation for multiple job sites, creating an exception to the rule. This decision aligns with established precedent, where transportation necessity for the employer's benefit removes the commute from the rule's exclusion.

Going and coming ruleindustrial injuryconstruction laborerhead injurybrain injurypsyche injuryspine injuryribs injurypelvis injuryarms injury
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ383454
Regular
Jun 13, 2011

ALVARO RAMOS vs. HIGHRISE CONCRETE SYSTEMS, CONTINENTAL CASUALTY COMPANY

The Appeals Board granted reconsideration and rescinded the prior decision, returning the case to the trial level for further proceedings. This was due to the original decision lacking substantial evidence and a clear basis for its findings regarding the extent of the applicant's industrial injuries. The Board found the WCJ failed to adequately explain the evidence relied upon for both the admitted injuries and the denied injuries. Additionally, the Board clarified that the applicant's credibility was initially misstated and further medical evidence may be required for denied conditions.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardIndustrial InjuryBack InjuryLower ExtremitiesPermanent DisabilityFurther Medical TreatmentPsyche InjuryInternals Injury
References
Case No. ADJ 1612085, ADJ 3458861, VNO 407730, VNO 407729
Regular
Aug 29, 2008

JOHN HANSEN vs. TILE TRENDS, STATE COMPENSATION INSURANCE FUND, ZC INSURANCE

The WCAB denied reconsideration of a decision awarding permanent disability benefits to the applicant for industrial injuries to his spine, shoulders, knees, back, neck, and heart/internal system. The defendants argued that the WCJ erred in finding the date of injury, relying on certain medical opinions, and apportioning liability.

WCABTile SetterSpine InjuryShoulder InjuryKnee InjuryBack InjuryNeck InjuryHeart InjuryInternal System InjuryTemporary Disability
References
Case No. ADJ7412203
Regular
Jul 15, 2011

RIGOBERTO GARCIA vs. COLE RANCH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding that the applicant's industrial injury was caused by a "sudden and extraordinary" event, thereby exempting it from the six-month employment rule for psychiatric injuries under Labor Code section 3208.3(d). The Board corrected a clerical error in the citation of the relevant statute. While the defendant argued the event was an inherent risk of the job, the applicant's uncontradicted testimony provided the only evidence suggesting it was not routine. A dissenting opinion argued that a simple fall from a ladder, without more, should not qualify as extraordinary, especially given the short employment duration and lack of evidence for truly unusual circumstances.

Workers' Compensation Appeals BoardRigoberto GarciaCole RanchState Compensation Insurance FundADJ7412203Opinion and Order Denying Petition for ReconsiderationCorrecting Clerical ErrorFindings and Ordersavocado pickerhigh tree worker
References
Case No. OXN 0132192
Regular
Jan 23, 2008

JAMES NICHOLS vs. ENTERTAINMENT PARTNERS, CNA CLAIMS PLUS

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address the applicant's and defendant's challenges to a previous decision. The WCAB rescinded the prior award, finding that the administrative law judge improperly applied the now-obsolete *Wilkinson* rule for apportionment. The case is returned to the trial level for further proceedings and a new decision, applying the causation-based apportionment principles established in *Benson v. The Permanente Medical Group*.

Workers' Compensation Appeals BoardReconsiderationJoint Findings and AwardIndustrial InjuryNeck InjuryHead InjuryBack InjuryKnee InjuryShoulder InjuryHernia
References
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