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

Case No. ADJ10656062
Regular
Jul 20, 2018

FLORIVINA VIEYRA vs. KAISER PERMANENTE, SEDGWICK CMS

The Appeals Board denied Kaiser Permanente's Petition for Removal because it failed to demonstrate substantial prejudice or irreparable harm. Removal is an extraordinary remedy rarely granted, requiring more than the possibility of an adverse reconsideration. The Board found the WCJ's analysis persuasive, concluding that reconsideration would be an adequate remedy. Kaiser Permanente and its counsel were admonished that filing a frivolous petition could result in sanctions.

Petition for RemovalExtraordinary RemedySubstantial PrejudiceIrreparable HarmReconsiderationFrivolous PetitionSanctionsLab Code § 5813Cal. Code Regs. § 10561WCJ Report
References
3
Case No. ADJ3871980 (SBR 0332495) ADJ1578450 (SBR 0333829) ADJ7125261
Regular
Nov 05, 2010

ANITA BAKER vs. SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP, PSI, Adjusted and Administered By KAISER PERMANENTE MEDICAL GROUP

This case involves Anita Baker's workers' compensation claim against Southern California Permanente Medical Group. The Workers' Compensation Appeals Board denied reconsideration of the judge's decision. The primary dispute centered on the calculation of diminished future earning capacity, with the applicant arguing for a calculation based on actual lost earnings and the defendant relying on statutory guidelines and expert testimony. The Board adopted the judge's report, which found in favor of the applicant regarding the calculation of permanent disability, incorporating aspects of both expert opinions and considering the applicant's specific circumstances.

Workers Compensation Appeals BoardSouthern California Permanente Medical GroupKaiser Permanente Medical GroupPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeOgilvie v. City and County of San Franciscodiminished future earning capacityFindings and Awardcontinuous traumabilateral upper extremities
References
1
Case No. ADJ10477247
Regular
Oct 31, 2017

ESTELA WALLE vs. THE PERMANENTE MEDICAL GROUP

Here's a summary of the two cases for a lawyer, in max four sentences each: **Case 1: Estela Walle vs. The Permanente Medical Group (ADJ10477247)** The Workers' Compensation Appeals Board denied reconsideration, affirming the WCJ's finding that the applicant did not sustain a back injury arising out of and in the course of employment. The Board gave significant weight to the WCJ's credibility determination, finding no substantial evidence to warrant overturning it. Therefore, the applicant was awarded nothing on her claim. **Case 2: Estela Walle vs. The Permanente Medical Group (ADJ8620015, ADJ9183471)** The Appeals Board rescinded the WCJ's award for psychiatric injury and returned the case to the trial level for further proceedings. The Board found the analysis of whether the injury was predominantly caused by employment events, and specifically by lawful, good faith personnel actions, to be inadequate under *Rolda*. Further development of the record is required to clarify the events of May 21, 2012, and to determine the precise causal contribution of employment-related factors versus good faith personnel actions.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderApplicantInjury Arising Out of and In the Course of EmploymentAOE/COEBack InjuryWCJCredibility DeterminationGarza v. Workmen's Comp. Appeals Bd.
References
1
Case No. ADJ1622766 (STK 0175350)
Regular
Oct 07, 2008

FRANCIS NZIBO vs. KAISER PERMANENTE, CALIFORNIA WORKERS' COMPENSATION

The applicant sought penalties against Kaiser Permanente for allegedly delaying authorization of cervical surgery. While an initial award favored the applicant, subsequent proceedings addressed the proper dispute resolution mechanism for medical treatment denials under California law. The Board affirmed the denial of penalties, finding Kaiser Permanente reasonably relied on utilization review and followed the then-available dispute process, even if later clarified by the Supreme Court.

Workers' Compensation Appeals BoardKaiser PermanenteFrancis NziboUtilization ReviewSpinal SurgeryBrasher v. Nationwide Studio FundDWC Form 233Labor Code Sections 4062(b)46105814.5
References
2
Case No. ADJ461140 (MON 0313465) ADJ7648143
Regular
Jul 10, 2013

MARIA MARTIN vs. KAISER PERMANENTE

The Workers' Compensation Appeals Board denied Kaiser Permanente's petition for reconsideration. The Board adopted the WCJ's report, finding the defendant's factual misstatement regarding Dr. Sohn's apportionment testimony significant. Despite Kaiser's assertions, the Board affirmed the applicant's 100% permanent total disability after applying a small portion of non-industrial apportionment to the lumbar spine. This apportionment did not alter the applicant's inability to compete in the open labor market.

Workers' Compensation Appeals BoardKaiser PermanentePetition for ReconsiderationDeniedWCJDr. SohnLumbar SpineNon-Industrial ApportionmentPermanently Totally DisabledBenson Case
References
1
Case No. ADJ12441930
Regular
Dec 21, 2020

MARIA ESQUIVEL vs. THE PERMANENTE MEDICAL GROUP

This case involves a worker's compensation claim for a psychiatric injury sustained by Maria Esquivel against The Permanente Medical Group. The Appeals Board denied the employer's petition for reconsideration, affirming the finding that Esquivel's injury was predominantly caused by actual events of employment, not merely a stage for personal issues. Evidence included coworker harassment, a restraining order against a coworker who stalked her daughter using company resources, and threats perceived as life-threatening. The Board distinguished this case from precedent where workplace gossip was deemed incidental, finding instead a direct causal link between Esquivel's employment and her injury.

WCABPetition for ReconsiderationExecutive Order N-68-20Atascadero Unified School District v. Workers' Comp. Appeals Bd. (Geredes)causal connectionpsychiatric injuryneuropsychological panel qualified medical examinationDr. Kyle Van Gaasbeekco-employeesGlenda Carrera
References
5
Case No. ADJ10269638
Regular
Feb 09, 2017

LUIS SANTANA vs. KAISER PERMANENTE, SEDGWICK CMS

Defendant Kaiser Permanente sought removal of a trial setting order, arguing discovery was incomplete. The Appeals Board denied removal, deeming it an extraordinary remedy not warranted here. The Board found defendant failed to demonstrate irreparable harm or that reconsideration would be inadequate. Defendant's discovery and trial-related issues can be addressed later in the proceedings.

Petition for RemovalMinute OrderDiscoveryWCJ ReportReconsiderationSubstantial PrejudiceIrreparable HarmAppeals BoardAdministrative Law JudgeKaiser Permanente
References
2
Case No. ADJ10933682
Regular
Dec 04, 2020

AMY LI vs. KAISER PERMANENTE, SEDGWICK CMS

This case involves a petition for reconsideration by Essential Interpreting Inc. (cost petitioner) concerning its claim for deposition preparation interpreting services. The Workers' Compensation Appeals Board denied the petition, affirming the administrative law judge's finding that the cost petitioner failed to prove its services were reasonable and necessary under Labor Code section 5811. The defendant, Kaiser Permanente, had specifically stated in its deposition notice that it would provide the interpreter for both preparation and deposition time. Since the cost petitioner did not demonstrate why using an interpreter of its choosing was necessary over the one provided by the defendant, their claim for reimbursement was denied.

WCABPetition for ReconsiderationLabor Code Section 5811Labor Code Section 5813deposition preparationinterpreting servicescost petitionerapplicantdefendantWCJ
References
2
Case No. ADJ9497391
Regular
Nov 19, 2014

STEVEN TOTH vs. KAISER PERMANENTE, administered by SEDGWICK CMS

The Workers' Compensation Appeals Board (WCAB) dismissed Kaiser Permanente's Petition for Removal because the issue giving rise to the petition was resolved. Kaiser sought removal of a WCJ's order requiring their claims adjuster to appear with the entire claims file. However, the adjuster appeared, the case was resolved, and no further issues remained pending. Consequently, the WCAB deemed the removal petition moot and dismissed it.

Petition for RemovalWorkers' Compensation Appeals BoardClaims FileMootDismissedWCJClaims AdjusterResolved CaseADJ9497391Kaiser Permanente
References
0
Case No. STK 0175350
Regular
Jul 08, 2008

FRANCIS NZIBO vs. KAISER PERMANENTE, CALIFORNIA WORKERS' COMPENSATION

This case involves applicant Francis Nzibo's claim for penalties against Kaiser Permanente for alleged unreasonable delay in providing cervical surgery. The Workers' Compensation Appeals Board is issuing a notice of intention to dismiss the petition for reconsideration as moot because there is no evidence presented as to whether the applicant has actually undergone the authorized surgery. If surgery was not performed, no compensation payment was delayed, rendering the penalty claim moot.

Moot petitionPetition for reconsiderationCervical surgeryUnreasonable delayMedical care provisionPenaltiesWCJ findingsLabor Code section 5814Authorization of surgeryFailure to present
References
0
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