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

Case No. ADJ9184413
Regular
Oct 27, 2020

JEFFREY SPRINGER vs. RJ DONOVAN CORRECTIONAL FACILITY, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation claim by Jeffrey Springer against RJ Donovan Correctional Facility. The Applicant sustained injuries resulting in industrially caused hypertension, hypertensive kidney disease, and hypertensive heart disease. The primary dispute centered on how to combine a prior 28% permanent disability rating for kidney disease with a new 49% rating for heart disease. The defendant argued these were part of a single cardiovascular system and sought to subtract the prior award's monetary value from the new rating. The WCJ found the injuries to the kidney and heart were distinct, justifying combining them, and awarded 63% permanent disability after deducting the prior award's value. The Appeals Board denied the defendant's petition for reconsideration, adopting the WCJ's reasoning.

Workers Compensation Appeals BoardRJ Donovan Correctional FacilityLegally UninsuredState Compensation Insurance FundPetition for ReconsiderationPermanent DisabilityHypertensionHypertensive Kidney DiseaseHypertensive Heart DiseaseHypertensive Cardiovascular Disease
References
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
Case No. ADJ307882 (VNO 0453543)
Regular
Oct 03, 2008

CEHEL WARE vs. LOS ANGELES COUNTY METROPOLITAN TRANSPORTATION AUTHORITY

The Appeals Board granted reconsideration, rescinded the prior award, and returned the case for further proceedings. This decision was based on the inadequacy of the medical evidence supporting the applicant's claim of industrial hypertension and hypertensive heart disease, as the court-appointed QME's opinion lacked sufficient factual basis and adherence to procedural requirements. Additionally, the initial trial record was found to be unclear regarding the stipulated and disputed issues, necessitating clarification before a new decision can be rendered.

Workers Compensation Appeals BoardCumulative TraumaHypertensionHypertensive Heart DiseaseIndustrial InjuryMedical EvidenceReconsiderationSubstantial EvidenceAgreed Medical EvaluatorQualified Medical Evaluator
References
Case No. ADJ7464646
Regular
Apr 24, 2017

DONALD THOMPSON vs. STATE OF CALIFORNIA

The Workers' Compensation Appeals Board granted reconsideration and increased the applicant's permanent disability award from 22% to 52%. This decision stemmed from the Board's finding that the applicant's hypertension constituted "heart trouble" under Labor Code section 3212.2, a presumption applicable to Department of Corrections employees with custodial duties. Consequently, the hypertension-related disability is not subject to apportionment, unlike the prior award which had applied apportionment. The applicant, a teacher at a correctional facility, is thus entitled to an unapportioned award for his industrial injury.

Labor Code § 3212.2presumption of injurycustodial dutiesheart troubleapportionmenthypertensioncoronary heart diseaseindustrial injurypermanent disabilityLabor Code § 4663(e)
References
Case No. ADJ3339526
Regular
Oct 14, 2008

Jeffrey Zajdel vs. CALIPATRIA STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to address the issue of apportionment of the applicant's permanent disability due to a heart and brain injury. The Board rescinded the prior decision that apportioned 50% of the disability to non-industrial factors, finding the medical opinion supporting apportionment speculative and not based on established legal principles. Consequently, the Board issued a new award for 100% permanent disability without apportionment and reinstated the applicant's attorney's fees based on this higher award.

WORKERS' COMPENSATION APPEALS BOARDJEFFREY ZAJDELCALIPATRIA STATE PRISONSTATE COMPENSATION INSURANCE FUNDADJ3339526VNO 0491968OPINION AND ORDER GRANTING RECONSIDERATIONSUPPLEMENTAL FINDINGS AND AWARDINDUSTRIAL INJURYHEART INJURY
References
Case No. ADJ9506185
Regular
Jul 13, 2016

JIM NEWELL vs. COUNTY OF KERN

The Workers' Compensation Appeals Board denied the County of Kern's petition for reconsideration of an award to Jim Newell. The award was based on industrial cumulative trauma to the lumbar spine and hypertensive cardiovascular disease, including left ventricular hypertrophy (LVH). The County argued there was insufficient evidence of LVH and sought further medical development, specifically a cardiac MRI. The Board found that the existing medical evidence, including echocardiograms and expert testimony, constituted substantial evidence to support the LVH diagnosis, making further testing unnecessary.

Workers' Compensation Appeals BoardCounty of KernJim NewellSheriff's Sergeantcumulative traumalumbar spinecirculatory systemhypertensionhypertensive cardiovascular diseaseleft ventricular hypertrophy
References
Case No. ADJ3962286 (LAO 0847943) ADJ2118358 (MON 0320906)
Regular
Oct 11, 2013

MARIANO DURAN vs. CBS OUTDOOR, Permissibly Self-Insured

This case involves two industrial injuries for the applicant, Mariano Duran, sustained in 2004. The Workers' Compensation Judge (WCJ) issued an award finding industrial injuries to the applicant's back, spine, shoulder, elbow, hypertension, heart disease, headaches, cognitive disorder, and sleep disorder, with a $91\%$ permanent disability rating after apportionment. Both applicant and defendant petitioned for reconsideration. The Appeals Board affirmed the WCJ's decision after reconsideration, finding substantial evidence supported the award and declining to remand for further proceedings regarding the sleep disorder.

Workers' Compensation Appeals BoardReconsiderationIndustrial InjuryPermanent DisabilityApportionmentCervical SpineLumbar SpineHypertensionHypertensive Heart DiseaseCognitive Disorder
References
Case No. ADJ10763960
Regular
May 20, 2019

DENNIS ROMERO vs. COUNTY OF SAN DIEGO

This case involves a workers' compensation appeal where the defendant, County of San Diego, sought reconsideration of an award granting the applicant, Dennis Romero, permanent disability. The defendant argued that the administrative law judge improperly overlapped factors of disability when assessing the applicant's $94\%$ permanent disability rating. The Appeals Board denied reconsideration, adopting the judge's report which found that the qualified medical evaluator considered factors beyond shortness of breath, such as left ventricular hypertrophy and lightheadedness, when determining impairments for hypertensive and coronary heart disease. The Board also cited legal precedent that the multiple disabilities rating schedule accounts for any overlap.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderDeputy SheriffIndustrial InjuryHeart InjuryHypertensionPermanent DisabilityHypertensive Heart DiseaseCoronary Heart Disease
References
Case No. ADJ6820873
Regular
Oct 29, 2010

Thomas Wong vs. CITY OF LOS ANGELES/LAPD, TRISTAR 29106 GLENDALE

Here's a summary of the case in four sentences for a lawyer: The Workers' Compensation Appeals Board denied the City of Los Angeles' petition for reconsideration of an award for an injured police officer. The defendant contended the WCJ erred in adopting the PQME's whole person impairment (WPI) ratings for hypertension and cardiomyopathy, and in finding the defendant failed to rebut the diminished future earning capacity (DFEC) component. The Board affirmed the WCJ's reliance on Dr. Carlish's WPI ratings, finding them supported by the AMA Guides and substantial evidence. Furthermore, the Board found the defendant failed to meet its burden of proof to rebut the scheduled DFEC rating, as their arguments lacked sufficient evidentiary support.

Workers' Compensation Appeals BoardIndustrial InjuryHypertensionHypertensive Heart DiseaseCardiomyopathyWhole Person Impairment (WPI)AMA GuidesDisability Evaluation SpecialistDiminished Future Earning Capacity (DFEC)Ogilvie v. City and County of San Francisco
References
Case No. ADJ2046824 (FRE 0248514)
Regular
Oct 11, 2010

OSCAR CARTER vs. COUNTY OF FRESNO, YORK INSURANCE SERVICES GROUP

The Workers' Compensation Appeals Board granted reconsideration of an award finding a deputy sheriff sustained industrial hypertension, stroke, and heart disease. The defendant argued the medical evidence was insufficient for the presumption of industrial injury. The Board rescinded the award and remanded for further proceedings because the trial judge's order for further development of the record was untimely, but the judge's rationale for needing more evidence regarding potentially erroneous medical measurements was persuasive. Therefore, the case will return to the trial level for additional proceedings to ensure substantial evidence supports the findings.

Workers' Compensation Appeals BoardDeputy SheriffIndustrial HypertensionStrokeHypertensive Heart DiseaseLabor Code Section 4850Petition for ReconsiderationAmended Findings and AwardWCJAgreed Medical Evaluator
References
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