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

Case No. VNO 529825
Regular
Jun 06, 2008

ANTONIO BERMUDEZ vs. DOUBLE K INDUSTRIES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration, finding no final order subject to review, as the administrative law judge's order merely vacated a prior dismissal to allow the case to proceed on its merits. The Board also denied the defendant's petition for removal, concluding that no extraordinary circumstances or significant prejudice were demonstrated to warrant such an intervention. Consequently, the case will move forward to address the applicant's workers' compensation claim.

WCABPetition for ReconsiderationPetition for RemovalOrder Vacating DismissalLack of ProsecutionTimely ObjectionPetition to Set AsideFinal OrderSubstantive RightProcedural Order
References
Case No. ADJ8049289
Regular
Dec 04, 2012

MARCOS RODRIGUEZ vs. MCR TRANSPORT, INC., CALIFORNIA LIVESTOCK PRODUCERS

The Workers' Compensation Appeals Board denied reconsideration of a decision regarding applicant Marcos Rodriguez's admitted injuries. The defendant argued for apportionment based on a prior claim settlement, but the Board found this lacked merit. The Board determined different rating methodologies and schedules applied to the distinct injuries and body regions, meaning the defendant failed to meet its burden of proof for apportionment or overlap. Consequently, the petition for reconsideration was denied.

WCABMARCOS RODRIGUEZMCR TRANSPORTINC.CALIFORNIA LIVESTOCK PRODUCERSYORK INSURANCE SERVICES GROUPINC.ADJ8049289Petition for ReconsiderationWCJ
References
Case No. ADJ8672614
Regular
Aug 07, 2015

ROBERT OSBORN vs. COUNTY OF FRESNO, AMERICAN ALL RISK LOSS ADMINISTRATORS

This case involves Robert Osborn, a correctional sergeant, who filed a workers' compensation claim for Hepatitis C contracted in 2006. The County of Fresno is challenging the finding that the presumption of injury under LC 3212.8 applies to a correctional sergeant, arguing the applicant did not prove specific exposure or that the injury was work-related. The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, adopting the WCJ's report which found the presumption applicable to the applicant's role. The WCJ determined that correctional sergeants are engaged in "active law enforcement" and that LC 3212.8 does not require proof of specific exposure, only that the disease manifested during service.

Workers' Compensation Appeals BoardPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeCorrectional SergeantHepatitis CPresumption of InjuryLC 3212.8Active Law EnforcementCustodial EmergenciesCumulative Trauma
References
Case No. ADJ7454224, ADJ7135204
Regular
Mar 10, 2016

JEFF REECE vs. SAN BERNARDINO COUNTY PROBATION DEPARTMENT, COUNTY OF SAN BERNARDINO

The Workers' Compensation Appeals Board granted reconsideration of a prior award regarding applicant Jeff Reece's back and shoulder injury. The primary amendment to the award concerns the reimbursement of $\$5,542.23$ to the California Law Enforcement Association (CLEA). The Board found that CLEA has withdrawn its lien, therefore neither the applicant nor the defendant is required to reimburse CLEA. All other findings and awards, including the $25\%$ permanent disability rating and entitlement to further medical treatment, were affirmed.

Workers' Compensation Appeals BoardSan Bernardino County Probation DepartmentPermissibly Self-InsuredIndustrial InjuryPermanent DisabilitySelf-Procured Medical TreatmentLaser Spine InstituteCalifornia Law Enforcement AssociationLien WithdrawalTemporary Disability Indemnity
References
Case No. ADJ6824732
Regular
Sep 06, 2012

SHEILA CORREIA, KENNETH BURNETT (Deceased) vs. VERIZON COMMUNICATIONS, AMERICAN HOME ASSURANCE COMPANY, CHARTIS, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case concerns a deceased worker, Kenneth Burnett, diagnosed with mesothelioma due to asbestos exposure. The sole issue was determining the date of last injurious exposure to establish liability. The Workers' Compensation Appeals Board denied reconsideration of the judge's decision. The judge found the applicant's medical expert's opinion on a five to ten-year latency period to be more persuasive than the defendant's expert's twenty-year period. This led to a finding that the decedent's last injurious asbestos exposure occurred between 1996 and 2001, during his employment with Verizon.

MesotheliomaLatency PeriodAsbestos ExposureDate of Last Injurious ExposureLC §5500.5LC §5412Verizon CommunicationsSedgwick Claims Management ServicesDr. LurosDr. Raybin
References
Case No. ADJ8477952
Regular
Jan 15, 2013

ADAN CASTANEDA, JOAQUINA CASTANEDA vs. CITY OF ROSEMEAD, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a decision awarding death benefits. The Board found that the Workers' Compensation Judge (WCJ) adequately considered all evidence, and the defendant's accusations of partiality were unfounded. The Board affirmed the WCJ's reliance on specific physician reports and the applicant's widow's testimony, which established a causal link between the applicant's industrial injuries and his death. The Board also recommended sanctions against defense counsel for using unprofessional and intemperate language.

Workers' Compensation Appeals BoardAdan CastanedaJoaquina CastanedaCity of RosemeadState Compensation Insurance FundADJ8477952Order Denying Reconsiderationsubstantial evidenceWCJReport and Recommendation on Petition for Reconsideration
References
Case No. OAK 0295936
Regular
May 20, 2008

ANGELA LOPEZ vs. ENVIRONMENT & LAND MANAGEMENT, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration, finding the WCJ's March 11, 2008 order was not a final determination. However, the Board granted the defendant's petition for removal to correct procedural confusion, rescinding the WCJ's order. The Board will return the case to the trial level for the WCJ to determine if good cause exists under Labor Code § 5803 to vacate the original May 12, 2006 dismissal, allowing the applicant to proceed with her existing claim number.

Petition for ReconsiderationPetition for RemovalMinute OrderDismissal with PrejudiceReopen ClaimLabor Code § 5803Rescind OrderVacate DismissalPetition to ReopenDeclaration of Readiness
References
Case No. ADJ9134227
Regular
Dec 18, 2015

VICTOR DIAZ vs. EXXEL OUTDOORS, INC.; THE HARTFORD

The applicant sought reconsideration of a dismissal order, arguing the judge failed to issue a proper notice of intent to dismiss. The Board denied the petition, finding the judge correctly amended an initial dismissal order to correct an error specifying dismissal "with prejudice" instead of "without prejudice" as initially noticed. This amendment was authorized by WCAB Rule 10859 and Labor Code 5803 to rectify a mistake and conform the order to the notice, which the applicant had not objected to. Therefore, no due process violation occurred, and the applicant received the relief sought.

WCABPetition for ReconsiderationAmended Order Dismissing CaseNotice of Intention to DismissDismissal without prejudiceDismissal with prejudiceWCJWCAB Rule 10582WCAB Rule 10780WCAB Rule 10859
References
Case No. ADJ 11017618
Regular
Oct 29, 2020

Robert Shelven vs. RALPHS GROCERY COMPANY, SEDGWICK CMS, INC.

In this workers' compensation case, the applicant sought reconsideration of a decision denying their petition. The core issue was whether a February 2020 request for a cervical spine epidural injection constituted the "same treatment recommendation" as a previously denied September 2019 request, thereby preventing mandatory utilization review under LC § 4610(k). The Board denied reconsideration, adopting the WCJ's reasoning that the February 2020 request, while for one level instead of two, was for the "same treatment" at C5-C6 which had been denied within the prior 12 months. The Board further agreed that no documented change in facts material to the basis of the prior denial was presented, thus the Court lacked jurisdiction to determine the medical necessity of the treatment.

Utilization ReviewRequest for AuthorizationCervical Spine Epidural InjectionLC § 4610(k)Medical Treatment Utilization ScheduleInternational Medical Reviewtimelinessjurisdictionreasonable and necessaryFindings and Order
References
Case No. LAO 0827308
Regular
Jul 30, 2007

David Phillips vs. ON LINE COMMUNICATIONS, STATE COMPENSATION INSURANCE FUND

This case involves an applicant who sought to reopen a workers' compensation settlement, alleging improper temporary disability payments. The Court of Appeal found "good cause" to reopen under Labor Code section 5803, even without evidence of fraud. Consequently, the Appeals Board granted reconsideration, rescinded the prior decision, and returned the matter to the trial level for further proceedings.

RemittiturPetition to ReopenSet Aside Compromise and ReleaseGood Cause to ReopenLabor Code Section 5803FraudTemporary Disability PaymentsCourt of Appeal OpinionAnnulled OrderRescinded Findings and Order
References
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