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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ8212306
Regular
Oct 22, 2013

BELEN DOMINGUEZ vs. DEPARTMENT OF IN-HOME SUPPORTIVE SERVICES, Legally Uninsured, YORK INSURANCE SERVICES

This case involves a Petition for Removal filed by Belen Dominguez against the Department of In-Home Supportive Services. The Workers' Compensation Appeals Board has denied this petition. The Board adopted the reasoning of the workers' compensation administrative law judge's report. Therefore, the Petition for Removal is dismissed.

Petition for RemovalWorkers' Compensation Appeals BoardWCJ reportDeny removalLegally UninsuredYORK INSURANCE SERVICESIn-Home Supportive ServicesADJ8212306San Jose District OfficeAdministrative Law Judge
References
Case No. ADJ3196685 (PAS 0043967)MF ADJ2175299 (PAS 0043966)
Regular
Oct 02, 2019

ALICIA SZUMAN vs. JAY NOLAN COMMUNITY SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION on behalf of HIH INSURANCE in liquidation, administered by INTERCARE, STATE OF CALIFORNIA, DEPARTMENT OF SOCIAL SERVICES-IN HOME SUPPORT SERVICES

This case involved applicant Alicia Szuman alleging cumulative and specific injuries as a home health provider resulting in multiple physical and psychological conditions. The administrative law judge initially awarded permanent total disability against the State of California, Department of Social Services (DSS), dismissing CIGA, which defendant DSS sought to overturn. The parties subsequently reached a Compromise and Release agreement for $618,313, providing an annuity and lump sum payment to the applicant. The Workers' Compensation Appeals Board approved this agreement, rescinding the prior award and deeming the settlement adequate and in the applicant's best interest.

COMPROMISE AND RELEASECALIFORNIA INSURANCE GUARANTEE ASSOCIATIONHIH INSURANCEINTERCAREDEPARTMENT OF SOCIAL SERVICESIN-HOME SUPPORT SERVICESYORK SERVICES GROUPCUMULATIVE INJURYPERMANENT TOTAL DISABILITYPERMANENT PARTIAL DISABILITY
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ3357317 (OAK 0311479)
Regular
May 04, 2016

MERY CORDOBA vs. CALIFORNIA DEPARTMENT OF SOCIAL SERVICES IN-HOME SUPPORTIVE SERVICES, YORK RISK SERVICES

The Workers' Compensation Appeals Board denied Mery Cordoba's petition for reconsideration. Applicant sought reconsideration of the denial of her psychiatric injury claim, arguing that her trial testimony revealed new information not considered by the Qualified Medical Evaluators (QMEs). The Board found that the applicant's testimony regarding childhood molestation and a past stable marriage was unrelated to work events and did not meet the burden of proof for a predominantly work-related psychiatric injury. Furthermore, the Board held that discovery was properly closed, and the applicant had ample opportunity to present this information to the QMEs.

WORKERS' COMPENSATION APPEALS BOARDIN-HOME SUPPORTIVE SERVICESYORK RISK SERVICESPetition for ReconsiderationDENIEDwcjtimely filedDate of Injurycare providerneck
References
Case No. ADJ3589318
Regular
Dec 17, 2018

ESTELA CAMBEROS vs. DEPARTMENT OF SOCIAL SERVICES OF THE STATE OF CALIFORNIA, IN HOME SUPPORTIVE SERVICES, YORK RISK SERVICES GROUP

The Workers' Compensation Appeals Board granted reconsideration to review a WCJ's award for applicant's 2001 industrial injury. The defendant disputed findings of additional temporary disability and denial of credit for overpayments. The parties subsequently entered into a partial Compromise and Release, settling the disputed issues for $72,846.52, while reserving applicant's right to future medical treatment for specific body parts. The Board approved the Compromise and Release, rescinded the original award, and substituted a new award in accordance with the agreement.

Workers' Compensation Appeals BoardReconsiderationFindings Award and OrderTemporary DisabilityPermanent Partial DisabilityCompromise and ReleaseMedical TreatmentAttorney FeesLabor CodeStipulations
References
Case No. ADJ10469262 ADJ9725605
Regular
Dec 21, 2017

MARIA GALERA vs. STATE OF CALIFORNIA, DEPARTMENT OF SOCIAL SERVICES; IN-HOME SUPPORTIVE SERVICES; YORK RISK SERVICES GROUP

This case involves a defendant's petition for removal from a WCJ's order admitting deposition extracts and vacating submission. The defendant argued the WCJ failed to provide reasoning for the order to develop the record. However, the WCJ's subsequent report explained the necessity of record development due to insufficient medical evidence. A status conference confirmed the need for further development, rendering the removal petition moot. Consequently, the Workers' Compensation Appeals Board dismissed the Petition for Removal.

Petition for RemovalDeposition ExtractsVacating SubmissionFurther DevelopmentWorkers' Compensation Administrative Law JudgeReport and RecommendationPetition for ReconsiderationSubstantial Medical EvidenceStatus ConferenceOff Calendar
References
Case No. ADJ10572648
Regular
Jul 31, 2017

MONICA RAMIREZ vs. DEPARTMENT OF SOCIAL SERVICES-IN HOME SUPPORTIVE SERVICES

This case involves a clerical error in a WCJ's Findings and Order which erroneously stated the applicant did not sustain injury to her psyche. The applicant petitioned for reconsideration, arguing this finding was contrary to evidence. The Appeals Board granted reconsideration solely to correct this clerical error, clarifying the applicant did not sustain injury to her left ankle, foot, and skin. The Board affirmed the WCJ's original decision regarding the applicant taking nothing, largely due to giving great weight to the WCJ's credibility determination.

WCABPetition for ReconsiderationFindings and OrderWorkers' Compensation Judgeindustrial injurypsycheclerical errorcredibility determinationGarza v. Workmen's Comp. Appeals Bd.Toccalino v. Workers' Comp. Appeals Bd.
References
Case No. ADJ4702564 (RDG 0094598) ADJ6944237
Regular
Apr 17, 2018

CLAUDETTE GILBERT vs. DEPARTMENT OF SOCIAL SERVICES, INHOME SUPPORTIVE SERVICES, YORK RISK SERVICES, ADVENTIST HEALTH OF CALIFORNIA, LIBERTY MUTUAL INSURANCE COMPANY

This case concerns a dispute over reimbursement for medical expenses following two lumbar spine injuries sustained by the applicant. The Department of Social Services (IHSS) sought reimbursement from Liberty Mutual Insurance Company for treatment costs after the applicant's 2008 injury, arguing the 1999 injury contributed to the need for care. However, the Appeals Board found Dr. Sommer's medical opinions lacked substantiality due to inconsistent apportionment and a failure to adequately explain the causal link between the 1999 injury and the 2008 treatment needs. Consequently, IHSS failed to meet its burden of proof, and their claims for reimbursement and shared medical expenses were denied.

Workers' Compensation Appeals BoardReconsiderationIn-Home Supportive Services (IHSS)Legally UninsuredYORK RISK SERVICESADVENTIST HEALTH OF CALIFORNIALIBERTY MUTUAL INSURANCE COMPANYlumbar spine injuryapportionmentmedical opinions
References
Case No. ADJ4305719 (GOL 0094595)
Regular
May 28, 2010

HELEN BOUGH vs. DANA L. MANCHESTER, DDS.; STATE COMPENSATION INSURANCE FUND

This case concerns an applicant seeking compensation for cumulative injury and attendant home care services. The defendant sought reconsideration of the original award, arguing there was insufficient evidence applicant actually received the full hours of home care awarded. The Appeals Board granted reconsideration, agreeing that the prior award was not supported by substantial evidence. The Board amended the decision to state the applicant is entitled to reimbursement for in-home care and housekeeping services, but only up to specified hours and *subject to documentation of the actual provision of such services*.

Petition for ReconsiderationFindings and Awardin-home carehousekeeping servicescumulative injurybilateral upper extremitiespsychereflex sympathetic dystrophysubstantial evidenceself-procured medical treatment
References
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