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Case Law Database

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

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 The Workers' Compensation Appeals Board (WCAB) rescinded the administrative law judge's decision, finding the claim was not barred by res judicata.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
6
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
2
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
1
Case No. MISSING
Regular Panel Decision
Apr 19, 1995

Claim of Tomlin v. Asplundh Tree Expert Co.

The claimant, a site manager for 23 years, began experiencing chest pains in February 1984. His employer granted him a medical leave and requested documentation. The claimant's treating physician, Patrick McAndrew, diagnosed essential hypertension, left ventricular hypertrophy, and chest pain of undetermined origin. The employer then used a disability claim form as a claim for a self-administered salary continuation plan, paying benefits under it. After an examination by the employer's physician, John Walters, who found no organic heart disease, the employer terminated the claimant, considering his absence a voluntary termination due to lack of a "bona fide" disability. The claimant subsequently filed for statutory disability benefits and a claim for discriminatory discharge with the Workers’ Compensation Board, alleging a violation of Workers’ Compensation Law § 241 for retaliation. The Board asserted jurisdiction, found discrimination, but reduced damages due to the claimant's failure to actively seek employment. The employer appealed, arguing lack of jurisdiction and insufficient evidence, but the decision was affirmed.

References
3
Case No. 2007 NY Slip Op 32740(U)
Regular Panel Decision

Rivers v. New York City Department of Sanitation

The court upheld its decision to dismiss the petitioner's case, stating that the petition failed to present a legally sound cause of action. The court determined that the respondents' finding, which deemed the petitioner medically unqualified for a sanitation worker position, was based on rational grounds due to her suffering from left ventricular hypertrophy and elevated blood pressure. The court also affirmed that the respondents were justified in relying on the medical director's conclusions, even when faced with contradictory medical opinions from the petitioner's own physicians, citing prior case law to support this stance.

Medical DisqualificationSanitation WorkerLeft Ventricular HypertrophyElevated Blood PressureJudicial ReviewArbitrary and CapriciousRational BasisMedical Director OpinionConflicting Medical OpinionsPetition Dismissal
References
5
Case No. ADJ12288761
Regular
Dec 29, 2020

MICHAEL GOMEZ vs. CALIFORNIA INSTITUTION FOR WOMEN, STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding a finding of 62% permanent disability for a correctional officer with cumulative trauma. The core issue was whether Left Ventricular Hypertrophy (LVH), found by a QME, constituted "heart trouble" under Labor Code section 3212.2, triggering a presumption of industrial injury. The Board affirmed the WCJ's decision, relying on prior case law and expert medical opinions that LVH, even if minor, qualifies as "heart trouble" for purposes of the presumption. Defendant's arguments that LVH was not "heart trouble" and that medical opinions were contradicted were rejected as insufficient to rebut the presumption.

Workers' Compensation Appeals BoardCalifornia Institution for Womencorrectional officercumulative traumainternal organshypertensionGERDheart trouble presumptionLabor Code section 3212.2Left Ventricular Hypertrophy
References
13
Case No. MISSING
Regular Panel Decision

Howard v. National Educ. Ass'n of New York

Plaintiff Carole Howard sued defendants National Education Association of New York (NEANY) and Hartford Life Insurance Company after Hartford Life denied accidental death benefits following the death of her husband, Richard Howard. Mr. Howard, an NEANY employee, died suddenly from ventricular arrhythmia, which Hartford Life attributed to heart disease, not an accident. The Court conducted a bench trial and performed a de novo review of the policy's "accidental" definition under ERISA. Despite testimony about Mr. Howard's significant job-related stress, the Plaintiff's medical experts could not definitively link his death to an accidental cause, listing factors like age, cholesterol, hypertension, and obesity. Concluding that the Plaintiff failed to overcome the presumption of death by natural causes, the Court found in favor of the Defendants on all claims.

ERISAAccidental Death PolicyInsurance BenefitsHeart AttackVentricular ArrhythmiaCoronary AtherosclerosisMyocardial InfarctionWork-Related StressMedical EvidenceDe Novo Review
References
23
Case No. MISSING
Regular Panel Decision
Mar 18, 1997

Claim of De Salvo v. Prudential Insurance

The claimant, an insurance salesperson, stopped working in January 1992, citing disability from hypertension and an anxiety disorder. Initial medical reports from Dr. Andrew Greenberg and an unnamed psychiatrist suggested that the claimant's high-stress job exacerbated his hypertension and caused a psychiatric condition. A Workers’ Compensation Law Judge initially found prima facie evidence for these conditions. However, the carrier's medical expert, Carl Friedman, attributed the hypertension to lifestyle factors. After further proceedings, including the Workers’ Compensation Board restoring the case to allow the claimant to present more evidence, the claim was ultimately denied. The appellate court affirmed this decision, concluding that the claimant failed to provide competent medical evidence to establish a causally related psychiatric disability and that his own physician's report indicated his hypertension was not caused by his job.

HypertensionAnxiety DisorderPsychiatric DisabilityCausationMedical EvidencePro Se RepresentationAppellate ReviewWorkers' Compensation BoardMedical Expert TestimonyExacerbation of Preexisting Condition
References
1
Case No. ADJ7683112
Regular
May 16, 2016

EUFEMIA TELLEZ vs. PEREZ CONTRACTING, EVEREST NATIONAL INSURANCE COMPANY

The Appeals Board granted the applicant's petition for reconsideration, reversing the judge's exclusion of a medical report and remanding issues of hypertension and sleep disorder for further development of the record. While the judge correctly excluded the late-filed medical report, substantial medical evidence was lacking regarding the industrial causation of the applicant's hypertension and sleep disorder. The Board affirmed the judge's findings on other accepted injuries and permanent disability but deferred issues related to hypertension and sleep disorder, returning the case for further proceedings on those specific conditions.

AOE/COEPetition for ReconsiderationFindings Award and Orderssubstantial medical evidenceinadmissible evidencedevelopment of the recordPQMEhypertensionsleep disorderdiabetes
References
0
Case No. ADJ8508948
Regular
Apr 04, 2014

JOHN GIESE vs. COUNTY OF SAN LUIS OBISPO, SHERIFF'S DEPARTMENT, SEDGWICK CMS

The applicant sought reconsideration for additional benefits related to his hypertension, claiming it was a work-related heart injury under Labor Code sections 3212 and 3212.5. The Board denied reconsideration, affirming the judge's finding that hypertension alone, without end-organ damage, is not considered "heart trouble" for the purposes of these presumptions. Medical evidence indicated the applicant had no loss of cardiac function due to coronary artery disease and that the cause of his hypertension was complex and not demonstrably work-related. Therefore, his petition was denied.

Workers Compensation Appeals BoardPetition for ReconsiderationCumulative Industrial InjuryCardiovascular SystemSheriff's DepartmentTemporary DisabilityPermanent DisabilityHypertensionPresumption of CompensabilityLabor Code Sections 3212
References
3
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