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

Case No. ADJ9785802
Regular
Aug 16, 2017

Edix PORTILLO vs. BRIMCO, LLC, AIG, administered by HELMSMAN MANAGEMENT

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of the WCJ's Findings of Fact. The applicant sought reconsideration of the finding that he did not sustain injury arising out of and in the course of employment (AOE/COE) for his right foot, constipation, IBS, and internal/external hemorrhoids. The Board adopted the WCJ's reasoning, finding that the medical evidence supporting the applicant's claims was speculative. Specifically, the applicant's chosen physician's opinions were considered less credible than those of the employer-appointed QMEs, who found no substantial medical issues.

AOE/COEPetition for ReconsiderationWCJQualified Medical Evaluator (QME)substantial evidencemedical opinionNSAIDsconstipationIBShemorrhoids
References
Case No. ADJ1170386 (OXN 0133453) ADJ2465830 (VNO 0334877)
Regular
Jul 24, 2012

LARRY SALIT vs. ALPHA INDUSTRIES, CHARTIS COSTA MESA, CITY OF INGLEWOOD

The Court of Appeal remanded *Salit v. Workers' Comp. Appeals Bd.*, finding the WCJ's denial of industrial IBS was unsupported by substantial evidence. The Court also found no basis for the 15.5% apportionment of prior injuries to fibromyalgia. Consequently, the WCAB affirmed the findings in one case and, in the other, amended the award to recognize the industrial injury to IBS and deferred issues of permanent disability, apportionment, and attorney's fees. The matter is returned to the trial level for further proceedings consistent with the appellate court's opinion.

RemittiturCourt of AppealAnnulledRemandedPolice OfficerIT TechnicianFibromyalgiaIrritable Bowel Syndrome (IBS)ApportionmentPermanent Disability
References
Case No. ADJ1170386 (OXN 0133453) ADJ2465830 (VNO 0334817)
Regular
May 17, 2010

Larry Salit vs. ALPHA INDUSTRIES, CHARTIS COSTA MESA, CITY OF INGLEWOOD

This case involves Larry Salit's petitions for reconsideration of two workers' compensation awards. The applicant sought compensation for cumulative trauma injuries to his upper extremities and for injuries to his back, TMJ, hearing, neck, upper extremities, and fibromyalgia. The applicant contended the judge erred in apportioning prior injuries, awarding liens, and discounting medical opinions regarding fibromyalgia and its connection to IBS. The Workers' Compensation Appeals Board denied reconsideration, adopting the judge's findings that apportionment was proper and supported by substantial medical evidence.

Workers' Compensation Appeals BoardCumulative trauma injuryBilateral upper extremitiesPermanent disabilityApportionmentLabor Code 4663Labor Code 4664FibromyalgiaTMJIrritable Bowel Syndrome (IBS)
References
Case No. ADJ1016521 (MON 0350650)
Regular
Aug 16, 2012

DEBRA KENNEDY vs. KAISER FOUNDATION HEALTH PLAN

The Workers' Compensation Appeals Board rescinded a prior award due to procedural and evidentiary issues. Key findings were that the WCJ's decision lacked proper documentation of evidence and the permanent disability rating calculation was unclear. Additionally, the medical reporting for psychological injury and apportionment lacked thorough analysis required by statute. The case is returned to the WCJ for further proceedings and a new decision, considering a 104-week limit on temporary disability and credit for EDD payments.

Agreed Medical EvaluatorSubstantial EvidenceIndustrial InjuryLumbar SpineCervical SpineRight WristLeft WristHypertensionGERDIBS
References
Case No. ADJ8415524
Regular
Jun 26, 2015

SYLVIA FERRAR BALCOMBE vs. WEST END YMCA, UNITED STATE FIRE INSURANCE COMPANY

This case concerns an applicant's petition for reconsideration following a Workers' Compensation Appeals Board decision. The Board denied the petition, adopting the judge's report which found the applicant's attorney failed to follow proper procedure in requesting medical panels. The judge also determined that medical reports from specific doctors were inadmissible due to this procedural error and lack of persuasive medical evidence. Consequently, the Board denied reconsideration and admonished the applicant's attorney regarding future fee requests.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ ReportCal. Code Regs tit. 8 § 10778Attorney's FeesInjuriesGERDIBSSpineQME
References
Case No. ADJ3770794 (MON 0325184)
Regular

KATHRYN MOSS vs. VIVENDI/UNIVERSAL (UNIVERSAL MUSIC GROUP), AMERICAN HOME ASSURANCE COMPANY, CHARTIS

The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration, rescinded the previous Findings and Award, and returned the case for a new decision. The WCAB found that the original decision by the Workers' Compensation Judge (WCJ) failed to adequately reference specific evidence and failed to provide a sufficient basis for its findings on permanent disability and apportionment. Additionally, the WCAB determined that the attorney's fee award lacked proper explanation and calculation. The matter is to be returned to the WCJ to issue a new decision that fully complies with legal requirements, particularly Labor Code section 5313.

Workers' Compensation Appeals BoardFindings and AwardPetition for ReconsiderationIndustrial InjuryPermanent DisabilityApportionmentFibromyalgiaIrritable Bowel Syndrome (IBS)Skin DisorderNeurodermatitis
References
Case No. ADJ10256108, ADJ10255968, ADJ10256212, ADJ10256223, ADJ10489875
Regular
Sep 23, 2022

JOSEPH RYAN vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Appeals Board affirmed the finding of permanent and total disability for the applicant, Joseph Ryan, stemming from industrial injuries sustained while employed as a correctional captain. However, the Board remanded the matter for further proceedings to specifically address apportionment of the permanent disability under Labor Code section 4663, considering the Agreed Medical Evaluator's opinion on pre-existing spinal disease. The Board found that the applicant's specific and cumulative trauma injuries to his spine resulted in intertwined disabilities, justifying a combined award, but that Dr. Hasday's apportionment findings require further development and determination at the trial level.

Workers' Compensation Appeals BoardJoseph RyanCalifornia Department of CorrectionsLegally UninsuredState Compensation Insurance FundADJ10256108ADJ10255968ADJ10256212ADJ10256223ADJ10489875
References
Case No. ADJ7844393
Regular
Jun 20, 2014

EDUARDO GUADARRAMA vs. CATALINA RESTAURANT GROUP, INC.; MITSUI SUMITOMO MARINE MANAGEMENT

This case involves Eduardo Guadarrama's claim for cumulative industrial injuries to his wrists, left knee, digestive system, and psyche against Catalina Restaurant Group, Inc. The Workers' Compensation Appeals Board denied Guadarrama's Petition for Reconsideration, upholding the finding that he failed to meet his burden of proof. The Board adopted the Administrative Law Judge's report, which found Guadarrama lacked credibility and that the medical evidence presented was not substantial. Ultimately, the judge determined that the alleged injuries were not predominantly work-related, especially considering the uncorroborated and exaggerated nature of some claims.

ReconsiderationWCJ ReportGarza v. Workmen's Comp. Appeals Bd.Credibility FindingCumulative InjuryLabor Code Section 3600(a)(10)Post-Termination DefenseSomatization DisorderExaggerationEmbellishment
References
Case No. ADJ4008604 (LBO 0390525) ADJ7754215
Regular
Dec 12, 2013

JOEL WILLIS vs. CITY OF ANAHEIM, Permissibly Self-Insured

The Workers' Compensation Appeals Board denied the City of Anaheim's petition for reconsideration. The Board upheld the administrative law judge's finding that a police officer sustained industrial injury to his psyche, hypertension, GERD, and IBS. Defendant argued the psychiatric injury stemmed from financial difficulties, not work stress, and that the Agreed Medical Evaluator's report was unsubstantiated. The Board found the AME's report constituted substantial evidence and was properly relied upon by the WCJ, despite the defendant's claims.

Workers' Compensation Appeals Boardindustrial injurypsycheinsomniahypertensiongastro-esophageal reflux diseaseirritable bowel syndromepolice officerreconsiderationAgreed Medical Evaluator
References
Case No. ADJ1 398270 (VNO 0553926)
Regular
Aug 15, 2016

JESUS JOSE RAMIREZ vs. ZIXTA ENTERPRISES, SPRINGFIELD INSURANCE COMPANY

This case involves an applicant seeking reconsideration of a workers' compensation award. The applicant argued the award incorrectly excluded injuries to diabetes, IBS, constipation, and hypertension, and that psychiatric temporary disability and permanent disability were improperly calculated. The Appeals Board granted reconsideration solely to correct a clerical error, amending the findings to reflect injury to the applicant's *left* lower extremity instead of the right. The Board affirmed the original award regarding the excluded conditions and the determination of temporary and permanent disability based on substantial medical evidence.

Workers' Compensation Appeals BoardPetition for ReconsiderationAmended Findings and AwardInjury to PsycheTemporary DisabilityPermanent DisabilitySubstantial Medical EvidencePQMEConflicting Medical ReportsClerical Error
References
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