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

Case No. ADJ6445214, ADJ7300126, ADJ4142400 (SRO 0141131), ADJ1321514 (SRO 0141130)
Regular
Aug 03, 2016

BONNIE MCLAUGHLIN vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND, ALBERTSON'S/SAVE MART

This case involves Bonnie McLaughlin's claim for Subsequent Injuries Benefits Trust Fund (SIBTF) benefits stemming from multiple industrial injuries to her neck, back, extremities, and psyche. The Workers' Compensation Appeals Board (WCAB) overturned a prior decision denying these benefits. The WCAB found that McLaughlin met the criteria for SIBTF eligibility under Labor Code section 4751, as her cumulative injury through May 3, 2007, resulted in additional permanent disability that, when combined with prior injuries, caused a disability greater than that from the subsequent injury alone. Therefore, SIBTF benefits are awarded.

Subsequent Injuries Benefits Trust FundSIBTFpermanent disabilitycumulative traumaspecific injuryapportionmentvocational expertAgreed Medical EvaluatorQualified Medical Evaluatorcompensable injury
References
4
Case No. ADJ6519716
Regular
Feb 10, 2017

HAO TRAN vs. CITY OF SANTA ANA

The Workers' Compensation Appeals Board denied reconsideration of an administrative law judge's decision that barred a lien claimant's recovery. The judge found the applicant sustained industrial injuries only to her back and right upper extremity, not her psyche. This psyche injury denial was based on a good faith personnel action defense and was no longer subject to reconsideration. Because the applicant's industrial injury did not include a psyche injury, the lien claimant, standing in the applicant's shoes, could not recover for services related to a non-compensable injury.

WCABPetition for ReconsiderationLien ClaimantFindings & OrderPsyche InjuryGood Faith Personnel Action DefenseLabor Code Section 3208.3(h)Preponderance of the EvidenceTrial on the MeritsIndustrial Injury
References
1
Case No. ADJ3321235 (SFO 0492639)
Regular
Apr 29, 2011

Nick Calvan vs. Pacific Gas & Electric, Subsequent Injuries Benefits Trust Fund

This Workers' Compensation Appeals Board decision grants reconsideration of a prior award and rescinds the original findings. The Board finds that the applicant sustained industrial injury to his low back, legs, shoulders, and psyche. However, the case is returned to the trial level for further proceedings because the original decision lacked necessary findings on permanent disability, apportionment, and the liability of the Subsequent Injuries Benefits Trust Fund, specifically regarding Labor Code section 4751. The Board did affirm the finding of psychiatric injury arising out of and occurring in the course of employment.

Workers Compensation Appeals BoardSubsequent Injuries Benefits Trust Fundpermanent disabilitypsychiatric injuryapportionmentLabor Code 4751Labor Code 4659Labor Code 4662vocational assessmentcausation
References
0
Case No. ADJ3953602 (SRO 0133844) ADJ2646453 (SRO 0133845)
Regular
Dec 21, 2012

ROBERTO HERNANDEZ vs. MILL VALLEY SCHOOL DISTRICT, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board affirmed an earlier decision awarding applicant 100% permanent disability, less credits and fees, due to industrial injuries to his right knee, psyche, and lumbar spine. The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration, arguing the applicant's disability was solely from the latter injury and thus not eligible for SIBTF benefits. The Board accepted the applicant's late-filed answer to the SIBTF's petition and, agreeing with the original judge, denied the SIBTF's petition for reconsideration. The Board also admitted two exhibits previously marked for identification into evidence.

WORKERS' COMPENSATION APPEALS BOARDSUBSEQUENT INJURIES BENEFITS TRUST FUNDRECONSIDERATIONFINDINGS AND AWARDPERMANENT DISABILITYINDUSTRIAL INJURYPSYCHELUMBAR SPINEMAINTENANCE WORKERADMINISTRATIVE LAW JUDGE
References
2
Case No. ADJ10908652, ADJ10908914
Regular
Sep 16, 2025

ZENAIDA AVILES vs. PIH HEALTH HOSPITAL, ATHENS ADMINISTRATORS

Applicant sought reconsideration of a Joint Findings and Award that denied industrial psyche injury (cumulative) and barred permanent disability from psyche injury (specific injury). Applicant contended that medical evidence supported cumulative psyche injury and that the WCJ erred in denying compensability of psychiatric permanent disability due to catastrophic consequences. The Appeals Board granted the petition for reconsideration, rescinded the prior Findings and Award, and returned the matter to the trial level for further proceedings, citing the need for further development of the medical record regarding intertwined disability and the application of the catastrophic injury exception.

Petition for ReconsiderationJoint Findings and AwardIndustrial InjuryPsycheCumulative PeriodSpecific InjuryPermanent DisabilityLabor Code section 4660.1Substantial Medical EvidenceQualified Medical Evaluator
References
27
Case No. ADJ6466823 ADJ6465939 ADJ7844561
Regular
Jan 08, 2016

CLIVIA PALACIOS vs. COUNTY OF FRESNO, Permissibly Self-Insured, Administered By RISCO

This case concerns a lien claimant, Michael Kesselman, seeking payment for psyche-related treatment. Kesselman argues he has standing because his bills weren't fully covered by the applicant's health insurer, and he disputes the prior finding of no industrial psyche injury. The Board granted reconsideration, clarifying that a prior unappealed award determined no industrial psyche injury occurred. Consequently, Kesselman's lien for psyche treatment cannot be recovered as it was not reasonably required to cure an industrial injury.

Lien claimantReconsiderationStandingPsyche injuryAgreed medical evaluatorSubstantial evidenceFinal determinationIndustrial injuryMedical treatmentReasonably required
References
2
Case No. ADJ1211037
Regular
May 10, 2010

ANGELICA DAYRIT vs. WALGREENS

The Workers' Compensation Appeals Board granted Walgreens' petition for reconsideration, overturning the prior award for cervical, lumbar spine, and psyche injuries. The Board found the applicant failed to provide sufficient evidence and testimony to establish industrial injury to her cervical and lumbar spine. However, the Board affirmed the finding of a psyche injury, acknowledging that hearsay evidence from a physician's report could support this claim. The case is remanded for further proceedings to determine temporary disability, permanent disability, and attorney's fees based solely on the psyche injury.

Workers' Compensation Appeals BoardSenior Pharmacy TechnicianCumulative TraumaOrthopedic ComponentsPsychiatric ComponentsMandatory Settlement ConferenceApplicant Failure to AppearNotice to AppearDue ProcessSubstantial Evidence
References
7
Case No. ADJ3259433 (GOL 0088786) ADJ1074235 (GOL 0094396)
Regular
Aug 28, 2009

Sonnia Waugh vs. FRANCISCAN FRIARS OF CALIFORNIA, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE INSURANCE COMPANY, In Liquidation

This case involves a workers' compensation claim for industrial injuries to the back, lower extremities, and heart, with a dispute over psyche injury. The Appeals Board affirmed the finding of industrial heart injury, relying on medical evidence that the prescribed pain medication contributed to the heart attack. However, the Board deferred the issue of psyche injury, remanding it for further proceedings to determine if it arose from the industrial injury and to potentially reassess permanent disability and attorney's fees. The matter of cumulative trauma injury in a separate claim was also left unresolved at the trial level.

CIGAReliance Insurance CompanyWCJindustrial injuryspecific injurycumulative traumareconsiderationsubstantial evidenceapportionmentmedical treatment
References
8
Case No. ADJ8920276 ADJ8920282 ADJ9919338
Regular
Oct 29, 2018

MARIA JARAMILLO vs. U.S. AVIATION SERVICES CORPORATION, OLD REPUBLIC INSURANCE COMPANY, GALLAGHER BASSETT SERVICES

This case involves Maria Jaramillo's appeal regarding her workers' compensation claims, specifically her alleged injury to the psyche. The Appeals Board granted her petition for reconsideration, reversing the prior finding that she had not alleged a psyche injury. The Board found that the parties' own stipulations and the substantial medical evidence, including treating physician and QME reports, constituted an amendment to her application to include this claim. The case is remanded for further determination on the psyche injury and any statute of limitations defenses.

Petition for ReconsiderationAmended Joint Findings and OrderInjury to the psycheStatute of limitationsPre-Trial Conference StatementQualified Medical EvaluatorsLiberal pleading rulesCompensable consequenceCumulative trauma injurySpecific injury
References
4
Case No. ADJ10373160
Regular
Apr 25, 2023

RICK BOURISK vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board denied the Subsequent Injuries Benefits Trust Fund's (SIBTF) petition for reconsideration. SIBTF argued that medical reports used to establish applicant's industrial disability were inadmissible as they were not obtained through the Labor Code section 4062.2 process. However, the Board found that this process applies to disputes between an employee and employer, not claims against SIBTF, which is not an employer. The Board also rejected SIBTF's claims that pre-existing conditions of GERD, psyche, and addiction were not supported by substantial evidence, upholding the original findings of 65% permanent disability from the industrial injury, compounded by pre-existing disabilities to reach an overall permanent total disability.

SIBTFsubsequent injuriespermanent disabilitypre-existing disabilitymedical-legal processLabor Code section 4062.2Labor Code section 4751substantial evidenceGERDpsyche
References
4
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