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

Case No. ADJ628128 (RDG 0130262) ADJ7454093
Regular
Dec 04, 2015

LARRY TRIPLETT vs. NORDIC INDUSTRIES, EAGLE INSURANCE, ENSTAR, KIN ENTERPRISES, INCOPORATED, STATE COMPENSATION INSURANCE FUND

This case involves applicant Larry Triplett's industrial injury claims against Nordic Industries and Kin Enterprises. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address Nordic Industries' arguments against the Administrative Law Judge's (ALJ) findings, including disputes over dual employment, evidence of cumulative trauma, and notice of injury. The WCAB rescinded the prior award, finding it necessary to join and consider a third, overlapping cumulative trauma claim (ADJ7454084) with the current matters. The case is returned to the trial level for a comprehensive new decision addressing all issues, including insurance coverage and liability.

Workers Compensation Appeals BoardReconsiderationCumulative TraumaSpecific InjuryDual EmploymentJoint EmploymentTemporary DisabilityPermanent DisabilityIndustrial InjuryNotice of Claim
References
1
Case No. ADJ4048703 (MON 0246736) ADJ3995603 (MON 0246737) ADJ534884 (MON 0295064)
Regular
May 21, 2018

HERMINEGILDA CHAVEZ vs. CHIEF AUTO PARTS, AUTOZONE, INC., INSURANCE COMPANY OF WAUSAU, LIBERTY MUTUAL, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, INTERCARE INSURANCE FOR HIH INSURANCE COMPANY, SEDGWICK CMS, FREMONT INDEMNITY

The Appeals Board rescinded the WCJ's decision regarding applicant Herminegilda Chavez's cumulative trauma injury claim. While acknowledging the applicant sustained a cumulative trauma injury and 100% permanent disability, the Board found error in merging three distinct industrial injuries into a single claim without proper apportionment. Further development of the medical record is required to determine apportionment of disability between the cumulative trauma, a specific injury, and non-industrial factors. The case is remanded for further proceedings and a new decision by the WCJ consistent with established apportionment principles.

Cumulative traumaApportionmentBenson v. WCABSpecific injuryInsurance Guarantee AssociationCIGALiberty MutualWausauMedical opinionPermanent disability
References
5
Case No. ADJ8855485
Regular
Nov 07, 2019

IMELDA SOSA vs. BRAWLEY UNION HIGH SCHOOL DISTRICT, ATHENS ADMINISTRATORS, LIBERTY MUTUAL INSURANCE, SELF-INSURED SCHOOLS OF CALIFORNIA

This case involves an employer's reconsideration request concerning a finding of cumulative trauma injury. The applicant was found to have sustained a cumulative trauma injury through June 13, 2011, resulting in 23% permanent disability and an award for indemnity and future medical treatment. The employer argued against compensable temporary disability for a single day's absence and questioned the applicant's knowledge of the cumulative trauma's industrial cause. The Board affirmed the original award, finding the applicant had knowledge of an industrial injury and suffered disability on June 13, 2011.

Cumulative trauma injuryDate of injuryLabor Code section 5412Compensable temporary disabilityPermanent disabilityIndustrial accident leaveEducation CodeWorkers' Compensation Appeals BoardReconsiderationFindings Award and Order
References
2
Case No. ADJ2307991 (VNO 0427797) (MF) ADJ3536405 (VNO 0336819) ADJ487962 (VNO 0533632)
Regular
Jun 14, 2018

JACQUELINE AUSTIN vs. FIRST FOURSQUARE CHURCH OF VAN NUYS, GUIDE ONE MUTUAL INSURANCE COMPANY, FREMONT, CIGA, CYPRESS INSURANCE COMPANY, FOREST LAWN MEMORIAL PARK, SAFECO INSURANCE, TRAVELERS PROPERTY CASUALTY COMPANY

This case involves an applicant who sustained two separate cumulative trauma injuries to her neck, back, and gastrointestinal system, including GERD and fibromyalgia. The Workers' Compensation Appeals Board (WCAB) affirmed the findings that the applicant suffered distinct industrial injuries during employment with First Foursquare Church (insured by Cypress) and Forest Lawn Memorial Park (insured by Travelers). Defendant Cypress contested the dating of the injury and the finding of two separate cumulative trauma periods, while Travelers challenged the sufficiency of medical evidence for one injury. The WCAB found Cypress waived the issue of one versus two cumulative trauma injuries by failing to raise it timely. Ultimately, the WCAB adopted the WCJ's findings, confirming the two separate cumulative trauma periods and the respective carrier liabilities.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaDate of InjuryLabor Code Section 5412Labor Code Section 5500.5Findings of FactAward and OrderAdministrative Law JudgeCypress Insurance Company
References
9
Case No. ADJ2651648 (MON 0342704)
Regular
Jul 18, 2017

TERESA SANCHEZ vs. HAWTHORNE UNIFIED SCHOOL DISTRICT, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of an award granting applicant benefits for a 2006 industrial injury, arguing the prior disability rating was insufficient. The applicant had two industrial injuries: a 1997-2002 cumulative trauma and the 2006 specific injury, both causing fibromyalgia. The WCJ found the combined disability from both injuries exceeded the threshold for SIBTF benefits, based on her primary treating physician's rating. The Appeals Board affirmed the WCJ's decision, adopting the judge's report which found the applicant met the criteria for SIBTF benefits, and denied the SIBTF's petition.

Subsequent Injuries Benefits Trust FundSIBTFcumulative traumacompensable consequencefibromyalgiapermanent and stationaryAgreed Medical ExaminerAMA Guides1997 rating scheduleprimary treating physician
References
0
Case No. ADJ2925672 (MON 0319752) ADJ176214 (MON 0319757)
Regular
Apr 24, 2009

GEORGE ZIMMERMAN vs. WARNER BROTHERS STUDIO FACILITIES, WARNER BROTHERS WORKERS' COMP.

The Workers' Compensation Appeals Board denied George Zimmerman's petition for reconsideration regarding a March 26, 2004 injury, agreeing that it did not arise out of his employment. However, the Board granted reconsideration to correct a mathematical error in the permanent disability award for a cumulative trauma back injury, adjusting the award from 31.5% to 30.5% after a 50% apportionment to non-industrial factors. The Board affirmed the WCJ's determination regarding the apportionment for the cumulative trauma injury, while clarifying that the specific March 26, 2004 injury was not industrial. The Amended Findings and Award were modified to reflect the corrected permanent disability rating and attorney fees.

Workers' Compensation Appeals BoardIndustrial InjuryCumulative TraumaSpecific InjuryBack InjuryLeft Knee InjuryApportionmentPermanent Disability RatingAgreed Medical ExaminerTemporary Disability
References
0
Case No. ADJ3280434 (MF) ADJ6953178
Regular
Dec 07, 2012

WILLIAM RICHARDSON vs. CHECKMATE TRANSPORT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for CASCADE NATIONAL INSURANCE, in liquidation, TONY'S SONS MOVING & STORAGE, STATE COMPENSATION INSURANCE FUND

This case concerns applicant William Richardson's claim for permanent disability due to specific and cumulative industrial injuries. The Workers' Compensation Appeals Board (WCAB) affirmed the finding of total permanent disability stemming from a specific injury in 2004. The WCAB clarified that the presumption of total permanent disability does not preclude apportionment, but found that the applicant's current total permanent disability was solely caused by the specific injury, not the cumulative trauma. Therefore, apportionment to the cumulative injury was denied, and the claim for cumulative trauma was dismissed.

Workers Compensation Appeals BoardCIGASCIFReconsiderationJoint FindingsAwardOrderAdministrative Law JudgeSpecific Industrial InjuryCumulative Trauma
References
2
Case No. ADJ3015289 (FRE 0242633)
Regular
Jan 06, 2012

SHARON LONG vs. KAISER FOUNDATION HOSPITALS administered by KAISER PERMANENTE

This case involves applicant Sharon Long's claim for workers' compensation benefits due to cumulative trauma sustained as a registered nurse for Kaiser Foundation Hospitals. The Workers' Compensation Appeals Board granted reconsideration, reversing the initial denial of industrial injury. The Board found that Dr. Dureza's opinion, which attributed 33% of applicant's injuries to cumulative trauma from her nursing duties, constituted substantial evidence of industrial causation. The Board remanded the case for further proceedings on orthopedic benefits and the psychiatric injury claim, deferring the EDD lien.

Workers' Compensation Appeals BoardKaiser Foundation HospitalsSharon LongIndustrial InjuryCumulative TraumaRegistered NurseNeck InjuryLow Back InjurySpine InjuryPsyche Injury
References
6
Case No. ADJ8061890
Regular
Sep 24, 2012

MARIA TIBURCIO VALERIANO vs. BEU INDUSTRIES, STAR INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and rescinded the original finding of industrial injury. The Board found the applicant failed to provide substantial medical evidence establishing industrial causation for her cumulative trauma injury. Furthermore, the Board determined the claim was barred by Labor Code section 3600(a)(10) due to the applicant filing after notice of termination without demonstrating applicable exceptions. Consequently, the applicant was ordered to take nothing by her claim.

Labor Code section 3600(a)(10)post-termination defenseindustrial causationsubstantial evidencePR-2 formprimary treating physiciancumulative traumamedical evidenceEDD claim formnotice of injury
References
5
Case No. ADJ7894308, ADJ7661229, ADJ9465603
Regular
Jun 12, 2015

ASSADOUR ASSADOURIAN vs. ARI G. MINASSIAN SCHOOL, CHURCH MUTUAL INSURANCE COMPANY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to further develop the medical record regarding applicant's claims for cumulative trauma and specific industrial injuries. The Board found the existing medical evidence insufficient to determine whether the applicant sustained one or multiple cumulative trauma injuries, or a combination of cumulative and specific injuries. Consequently, the Board rescinded the prior determinations and remanded the cases for a new evaluation by an Agreed Medical Examiner or a physician appointed by the judge.

cumulative traumacardiovascular systemsleep and sexual dysfunctionpsychiatric injuryschool principalLabor Code section 5412Labor Code section 5500.5duplicative claimspecific industrial injuryangioplasty
References
12
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