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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ8128282
Regular
Jan 23, 2014

ANGELA EGBIKUADJE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings. The defendant, California Department of Corrections and Rehabilitation, argued that the applicant's psychiatric injury claim was preempted by the ADA and not proven under Labor Code section 3208.3. The Board found the original decision lacked proper analysis regarding predominant industrial causation and the good faith personnel action defense. Therefore, the case was remanded for further development of the record, including expert medical opinion on these issues.

Workers' Compensation Appeals BoardAngela EgbikuadjeCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8128282Van Nuys District OfficeReconsiderationFindings and AwardIndustrial cumulative trauma injury
References
Case No. ADJ3512142 (MON 0288509)
Regular
Jan 12, 2009

JOSE LUIS LARA vs. BRATIFF HOME CORP. dba METRO DINER and SCOTT BROFFMAN as substantial shareholder; UNINSURED EMPLOYERS BENEFIT TRUST FUND

The Appeals Board reversed the WCJ's finding that the applicant was an employee of Metro Diner on the date of injury, concluding that he was an independent contractor.

Workers' Compensation Appeals BoardBratiff Home Corp.Metro DinerScott BroffmanUninsured Employers Benefit Trust FundADJ3512142MON 0288509Opinion and Order Granting ReconsiderationDecision After ReconsiderationAdministrative Law Judge
References
Case No. ADJ1577836
Regular
May 04, 2009

JESUS GAVINO-REMIGIO vs. STRATUS SERVICES GROUP, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant injured when stepping on a metal hook, sustaining an admitted industrial injury to his right foot. The applicant sought reconsideration after the Workers' Compensation Judge (WCJ) denied findings that the injury also affected his internal systems (diabetes), eyes, and psyche, along with associated disability. The Board denied reconsideration, finding the defendant's medical expert's opinion on non-industrial diabetes causation to be substantial evidence, while deeming the applicant's medical experts' opinions insufficient. A dissenting commissioner argued the applicant's medical evidence sufficiently supported industrial causation for diabetes aggravation, warranting reconsideration.

Workers' Compensation Appeals Boardindustrial injuryright footinternal systemseyespsychediabetes mellituspermanent disabilitytemporary disabilityGerald Markovitz M.D.
References
Case No. ADJ10159316
Regular
Sep 25, 2017

Rowdy Rushing vs. Foster Farms

The Workers' Compensation Appeals Board denied reconsideration of a decision finding that Rowdy Rushing did not sustain a left shoulder injury arising out of and occurring in the course of employment with Foster Farms. The Administrative Law Judge found the applicant's testimony regarding a pallet striking his arm not credible, noting inconsistencies with coworker statements and medical reports. Specifically, the applicant's account of the incident and the mechanism of injury was deemed unlikely and not supported by Dr. Ozaeta's medical opinion, which concluded the MRI findings were inconsistent with the described incident. Therefore, the Board affirmed the judge's take-nothing order.

Workers' Compensation Appeals BoardFoster FarmsRowdy RushingFindings and OrderTake nothing orderIndustrial injuryLeft shoulderOctober 92015Taper/packer
References
Case No. ADJ4225526 (GOL 0092072)
Regular
Apr 20, 2017

JESUS ARROYO vs. JOHN CRAVENS PLASTERING, STATE COMPENSATION INSURANCE FUND

This case involves Jesus Arroyo's petition for reconsideration of a Workers' Compensation Appeals Board decision. The Board denied reconsideration, adopting the reasoning of the workers' compensation administrative law judge. Medical evidence from Dr. Markovitz established that Arroyo suffered a total and permanent disability resulting from industrial injuries, including an aortic aneurysm repair and subsequent strokes. The Board found Dr. Markovitz's opinions constituted substantial medical evidence, despite conflicting defense opinions, and affirmed that all necessary medical care and permanent disability were industrially caused.

Workers' Compensation Appeals BoardJesus ArroyoJohn Cravens PlasteringState Compensation Insurance FundPetition for ReconsiderationAgreed Medical ExaminerGerald Markovitzechocardiogramaortic root dilationexpanding aortic aneurysm
References
Case No. ADJ3357881
Regular
Apr 06, 2012

HELEN DEMBY vs. MAXIM HEALTHCARE SERVICES, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

The Workers' Compensation Appeals Board granted reconsideration, rescinding a previous award. The Board found that medical treatment provided by True Sleep LLC was not reasonable or necessary for the applicant's industrial injury. This decision was based on the lack of substantial medical evidence linking the treatment to the applicant's admitted back injury, and no evidence establishing a separate industrial sleep injury.

Workers' Compensation Appeals BoardHelen DembyMaxim Healthcare ServicesInsurance Company of the State of PennsylvaniaESISADJ3357881LAO 0874404Petition for ReconsiderationFindings and AwardWCJ
References
Case No. ADJ3904484 (VNO 0451173)
Regular
Nov 20, 2008

TONY WILLIAMS vs. MODERN HEALTHCARE, INC., AD-RX DRUGSTORE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of a decision awarding continuing temporary disability and home healthcare benefits. The Board found that the administrative law judge failed to adequately address the applicant's subsequent non-industrial and industrial injuries, which may be responsible for the current disability. Furthermore, the medical evidence relied upon by the judge did not sufficiently link the disability to the original 2002 injury, and the record lacked sufficient detail and organization for a proper decision.

Petition to ReopenNew and Further DisabilitySubsequent InjuryIndustrial InjuryTemporary DisabilityHome HealthcareDue ProcessPre-trial Conference StatementMedical ReportsAgreed Medical Examiner
References
Case No. ADJ557069 (LBO 0383687)
Regular
Mar 20, 2012

LEON SMITH vs. SECURITAS SECURITY SERVICES/PSI as administered by BROADSPIRE SERVICES

This case concerns an applicant who claimed an industrial injury from pushing hydraulic doors, resulting in a neck injury and quadriparesis. The WCJ found no industrial injury, relying on the opinion of a qualified medical evaluator (QME). The QME concluded that the applicant's severe cervical condition was caused by a pre-existing infectious abscess and would have manifested independently of the claimed industrial incident. The Appeals Board affirmed the WCJ's decision, finding substantial medical evidence from the QME that negated industrial causation and no need to further develop the record. The Board also admonished applicant's counsel for failing to properly verify and cite evidence in the petition for reconsideration.

Industrial injuryReconsiderationFindings of FactWCJIndustrial causationMedical evidenceQualified Medical EvaluatorCervical abscessSpinal collapseSubstantial evidence
References
Case No. ADJ11030955
Regular
Jan 06, 2020

JOSE RIVAS ESCALANTE vs. WEST ANAHEIM MEDICAL CENTER, SAFETY NATIONAL INSURANCE

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's finding of industrial injury. The Board agreed that the claim was not barred by post-termination provisions because the applicant's date of injury, defined by disability and knowledge of its industrial cause, occurred after notice of termination. Evidence showed the applicant did not suffer a compensable disability or ratable permanent disability until after he was terminated. Furthermore, the Board found that medical evaluators adequately considered non-industrial conditions in their findings of industrial causation.

Labor Code section 3600(a)(10)post-termination provisionsexception 3600(a)(10)(D)date of injurynotice of terminationcertified nurse's assistantindustrial injurycervical spinelumbar spineleft wrist
References
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