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

Case No. ADJ2215482
Regular
Oct 14, 2008

NANCY MCLEARY vs. SATURN OF THOUSAND OAKS, DCH MANAGEMENT, ZURICH NORTH AMERICA

This case concerns an applicant seeking workers' compensation for an industrial injury to her back and neck, which exacerbated her need for refills of an intrathecal opiate pump. The defendant argued the pump refills were not industrial in origin, but the Board affirmed the original award, applying the principle that if an industrial injury contributes to the need for medical treatment, the employer is responsible for the entire cost. The Board granted reconsideration solely to defer the issue of the applicant's attorney's fees pending a Supreme Court decision on a related matter.

intrathecal pumpopiate solution refillsindustrial injurypreexisting conditionmedical treatment apportionmentcure or relieveagreed medical evaluatorpain management specialistprior motor vehicle accidentapplicant testimony
References
Case No. ADJ7166686
Regular
Jul 24, 2012

RICHARD ANDERSON vs. JAGUAR/LANDROVER OF VENTURA, COMPWEST INSURANCE COMPANY

This case involves an applicant who suffered a stroke and subsequent 100% permanent disability following surgery for an industrial shoulder injury. The defendant sought reconsideration, arguing for apportionment to pre-existing conditions and challenging the attorney's fee calculation. The Appeals Board affirmed the 100% permanent disability finding, finding no basis for apportionment as the applicant's pre-existing conditions did not cause the disability itself. However, the Board modified the attorney's fee award, requiring commutation using a specific method and a 3% cost of living adjustment, finding the previously assumed 4.6% to be speculative.

Workers Compensation Appeals BoardRichard AndersonJaguar/Landrover of VenturaCompwest Insurance CompanyADJ7166686ReconsiderationFindings and AwardIndustrial InjuryBrain InjuryNeurological System
References
Case No. ADJ2488411 (RIV 0017588)
Regular
Jun 30, 2011

ROBERT DOODY vs. MERLI CONCRETE PUMPING COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

Defendant Merli Concrete Pumping Company petitioned for removal, arguing insufficient discovery time regarding the applicant's petition for third-party credit and restitution. However, prior to the Appeals Board ruling on the petition, the parties jointly requested and the judge granted a continuance off the trial calendar. Consequently, the defendant's petition for removal became moot. The Workers' Compensation Appeals Board dismissed the petition as moot.

Petition for RemovalThird-party CreditRestitutionDiscoveryOff CalendarMootWorkers' Compensation Appeals BoardPro Tempore JudgeContinuanceJoint Request
References
Case No. ADJ10191047
Regular
Dec 29, 2018

MIGUEL GARCIA vs. CONCO COMPANIES, ZURICH NORTH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding applicant sustained an industrial hernia injury. While affirming the finding of injury, the Board amended the award to correct the employer's name to Clark Construction Group LLC, addressing defendant's argument about misidentification of the employer. The Board incorporated the WCJ's reasoning in their decision. Further development of the record is deferred for issues beyond injury AOE/COE.

Petition for ReconsiderationFindings and Awardindustrial injurygroin herniapump operatorConco CompaniesClark Construction GroupZurich North American Insurance CompanyWCJReport and Recommendation
References
Case No. ADJ162353
Regular
Nov 02, 2012

GARY NORTH vs. AERO ELECTRIC CONNECTOR, ST. PAUL TRAVELERS

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration of an interim order finding an applicant sustained industrial cumulative trauma injury to his neck and internal systems. The defendant argued the Agreed Medical Examiner's (AME) opinion was not substantial evidence due to an inaccurate history and failure to review all records. The Board found the AME's opinion was based on a thorough evaluation and job duties, affirming the finding of neck injury. The defendant also challenged the reliance on Dr. David's report for internal injuries, citing issues with his appointment and unavailability for deposition; however, the Board found Dr. David's report constituted substantial evidence and that defendant waived objections to his appointment and deposition unavailability by failing to raise them timely.

Cumulative traumaAgreed Medical ExaminerSubstantial medical evidenceLabor Code section 5701Regular physicianPetition for reconsiderationIndustrial injuryWCJDRE Cervical Category IIWhole Person Impairment
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. OAK 263916
Regular
Jun 04, 2008

JEFFREY HONEYWELL vs. SAFEWAY STORES

The Workers' Compensation Appeals Board denied lien claimant Bay Surgery Center's petition for reconsideration, upholding the administrative law judge's decision to award partial payment for medical services. The Board also dismissed Safeway Stores' petition for reconsideration as untimely filed. Additionally, the Board admonished the lien claimant's representative for unprofessional comments made about the judge.

Bay Surgery Centerdiscographypump proceduresitemized billsLabor Code section 4603.2substantial evidencereasonableness of chargespenalty assessmentpenalty for unreasonable delayfictitious name permit
References
Case No. SAC 310979
Regular
Feb 26, 2008

BARBARA HART vs. STATE OF CALIFORNIA, DEPARTMENT OF SOCIAL SERVICES, legally uninsured and administered by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded the WCJ's order, finding that the record regarding temporary disability needed further development. The Board ordered the matter returned to the trial level to obtain a supplemental report from the agreed medical evaluator, Dr. Bray, specifically addressing whether the admitted industrial injury caused additional temporary disability. All other issues were deferred for future proceedings.

Workers' Compensation Appeals BoardPetition for RemovalPetition for ReconsiderationFindings and OrdersAdministrative Law JudgeAgreed Medical EvaluatorTemporary Disability IndemnityStipulated OrderPermanent and StationarySupplemental Report
References
Case No. ADJ3747523 (POM 0264468)
Regular
Oct 17, 2008

RICHARD E. GONZALES vs. DEPARTMENT OF YOUTH AUTHORITY, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and rescinded the WCJ's decision, returning the case to the trial level for further proceedings. The Board found the prior decision relied on an improper evidentiary basis by using a stipulation from a nearly identical case to determine the reasonableness of the facility fee. The matter must be re-evaluated with proper evidence and adherence to the guidelines set forth in *Scott Kunz v. Patterson Floor Coverings, Inc.* for determining reasonable facility fees.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFacility FeeReasonable ChargesOfficial Medical Fee ScheduleLabor Code Section 4600Kunz GuidelinesEvidentiary BurdenDiagnostic Arthroscopy
References
Case No. ADJ473373 (ANA 0406381)
Regular
Feb 10, 2012

FERNANDO GUTIERREZ vs. SOCAL FRAMING aka BMHC; ACE AMERICAN INSURANCE, administered by ESIS, INC.

This case concerns applicant's claim for extended temporary disability (TD) benefits beyond 104 weeks due to a left eye injury. The Appeals Board affirmed the WCJ's denial of the "amputation" exception, ruling that the surgical removal of an eye does not fit the statutory definition. However, the Board remanded the case for further development of the record on the "high-velocity eye injury" exception, as the velocity and force of the object that struck the applicant's eye were unclear. The applicant's Petition for Removal was dismissed as reconsideration was the appropriate remedy.

Workers' Compensation Appeals BoardFernando GutierrezSoCal FramingBMHCACE American InsuranceESISInc.ADJ473373ANA 0406381Opinion and Decision
References
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