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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. 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. 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. 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. ADJ6456347
Regular
Jan 30, 2012

MARK WILLIAMS vs. CITY OF PASADENA

This case involves a police officer claiming industrial injury to his heart due to hypertensive heart disease, a condition he argued was distinct from previously compensated hypertension. The Workers' Compensation Appeals Board (WCAB) rescinded the administrative law judge's decision, finding the claim was not barred by res judicata. The WCAB clarified that while hypertension alone is not considered heart trouble, left ventricular hypertrophy, as diagnosed in the current claim, constitutes a distinct condition. The case is returned to the trial level for further proceedings on other unresolved issues.

res judicatahypertensive heart diseasepolice officerLabor Code section 3212.5heart trouble presumptionleft ventricular hypertrophystipulated awardindustrial injurypermanent disabilityapportionment
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. ADJ8279816 ADJ9818108
Regular
Aug 29, 2017

JAY SEVOIAN vs. COUNTY OF LOS ANGELES

This case involves a deputy sheriff seeking workers' compensation for cumulative industrial injuries. The Administrative Law Judge (ALJ) found compensable injuries to the applicant's knees, asthma, sleep disorder, hemorrhoids, irritable bowel syndrome, and hypertensive heart disease. The Defendant sought reconsideration, arguing that the hypertensive heart disease should only be attributed to the later injury date. The Board denied reconsideration, adopting the ALJ's report, which found that the stress from the original cumulative injury contributed to the hypertensive heart disease as a "new and further disability" or a "compensable consequence injury." Therefore, the injuries were correctly combined for a single permanent disability award, with no apportionment.

Workers' Compensation Appeals BoardDeputy SheriffCumulative InjuryHypertensive Heart DiseaseLabor Code Section 3212Permanent DisabilityApportionmentNew and Further DisabilityCompensable Consequence InjuriesAgreed Medical Evaluator
References
Case No. ADJ2335090 (SFO 0510716)
Regular
Oct 07, 2010

YOLANDA SMITH vs. CITY AND COUNTY OF SAN FRANCISCO

The Workers' Compensation Appeals Board denied reconsideration of a decision finding a deceased deputy sheriff's death to be industrially related due to a heart presumption under Labor Code section 3212.5. Despite the deceased being involved in a non-work-related car accident, the court found the heart presumption applicable, deeming his hypertension a contributing factor to his death. The defendants' arguments regarding the "going and coming rule" and lack of substantial evidence were rejected. The Board affirmed that the presumption, along with medical evidence of hypertensive heart disease hastening death, established the injury arose out of and occurred in the course of employment.

Labor Code 3212.5Heart PresumptionGoing and Coming RuleProximate CauseHypertensionEnd Organ DamageAnatomic EvidenceEnlarged HeartLeft Ventricular HypertrophySarcoidosis
References
Case No. ADJ7760117
Regular
Jul 10, 2020

SAMUEL SMITH vs. KERN COUNTY SHERIFF'S DEPARTMENT, COUNTY OF KERN

This case involves Samuel Smith, a deputy sheriff, seeking workers' compensation for claimed industrial injuries to his heart. The Workers' Compensation Appeals Board rescinded the prior decision, finding the medical record regarding the applicant's heart condition insufficiently developed. The Board remanded the case for further proceedings to determine when the applicant's hypertensive heart disease developed and whether it falls under the statutory presumption of industrial injury for sheriffs. Crucially, the Board requires additional medical evidence to establish causation by a reasonable medical probability.

Workers' Compensation Appeals BoardSamuel SmithKern County Sheriff's DepartmentDeputy SheriffReconsiderationFindings Orders and AwardLumbar SpineUpper ExtremitiesGERDCardiovascular System
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
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