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

Case No. ADJ1455856
Regular
Aug 24, 2012

GUILLERMO HERNANDEZ vs. SPIESS CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of a finding of 79% permanent disability. The Board found the applicant's vocational expert's opinions regarding diminished future earning capacity unsubstantiated. Consequently, the Board amended the award to reflect 37% permanent disability based on a prior stipulation, and removed any apportionment to non-industrial factors due to lack of substantial medical evidence from the defendant.

WCABSpiess ConstructionState Compensation Insurance FundGuillermo HernandezADJ1455856GRO 0032468ReconsiderationPermanent DisabilityDiminished Future Earning CapacityDFEC
References
Case No. ADJ7558173
Regular
Oct 28, 2014

JESSIE MOORE vs. PASADENA AREA COMMUNITY COLLEGE DISTRICT

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior award, and found the applicant was not temporarily totally disabled after her retirement. The Board determined that while the applicant stated her retirement was reluctant, the primary reasons cited were hostile work environment and emotional stress, not solely orthopedic injuries. Medical evidence did not substantially support the claim that the admitted orthopedic injuries alone rendered her temporarily totally disabled. Consequently, temporary disability benefits were not awarded for the orthopedic injuries.

Workers' Compensation Appeals BoardJessie MoorePasadena Area Community College DistrictKeenan & Associatesstatute of limitationstemporary disabilitycumulative traumacervical spinelumbar spineleft wrist
References
Case No. ADJ7412203
Regular
Jul 15, 2011

RIGOBERTO GARCIA vs. COLE RANCH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding that the applicant's industrial injury was caused by a "sudden and extraordinary" event, thereby exempting it from the six-month employment rule for psychiatric injuries under Labor Code section 3208.3(d). The Board corrected a clerical error in the citation of the relevant statute. While the defendant argued the event was an inherent risk of the job, the applicant's uncontradicted testimony provided the only evidence suggesting it was not routine. A dissenting opinion argued that a simple fall from a ladder, without more, should not qualify as extraordinary, especially given the short employment duration and lack of evidence for truly unusual circumstances.

Workers' Compensation Appeals BoardRigoberto GarciaCole RanchState Compensation Insurance FundADJ7412203Opinion and Order Denying Petition for ReconsiderationCorrecting Clerical ErrorFindings and Ordersavocado pickerhigh tree worker
References
Case No. ADJ3358392
Regular
Oct 04, 2011

JESUS HERNANDEZ vs. KERN COUNTY SHERIFF'S DEPARTMENT, Permissibly Self-Insured, AIMS

This case involves a deputy sheriff's claim for a left knee injury sustained in August 2005. The defendant employer argued the claim was barred by Labor Code section 3600(a)(10) due to a post-termination filing and insufficient evidence. The Appeals Board affirmed the WCJ's findings, ruling the employer had actual notice of the injury prior to termination, satisfying an exception to section 3600(a)(10)(A). Therefore, the claim was deemed compensable and not barred by the post-termination defense.

Workers' Compensation Appeals Boardindustrial injurydeputy sheriffKern County Sheriff's DepartmentLabor Code section 3600(a)(10)post-termination defensenotice of injurySergeant Goodingqualified medical evaluatorThor Gjerdrum M.D.
References
Case No. ADJ7555409
Regular
Mar 04, 2014

JESUS ESCANUELA vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the defendant's Petition for Reconsideration and dismissed the applicant's untimely petition. The WCAB found that the Agreed Medical Examiner's (AME) opinion regarding psychiatric permanent disability was not supported by substantial evidence, as it did not properly address causation under the current PDRS. Consequently, the case is remanded to the trial level for further development of the record concerning psychiatric permanent disability. The WCAB deferred the issue of permanent disability and attorney's fees pending this further development.

Workers' Compensation Appeals BoardJesus EscanuelaCalifornia Department of Correctionslegally uninsuredState Compensation Insurance FundADJ7555409Fresno District OfficeOpinion and OrderPetition for ReconsiderationFindings and Award
References
Case No. A111853680 (OAK 0338647)
Regular
Jan 12, 2009

MARILYN HOLLIS vs. VALENT USA CORP.; MITSUI SUMITOMO MARINE MANAGEMENT

Reconsideration granted due to insufficient medical evidence supporting temporary disability claim from 2007. Case returned for further proceedings to develop the record.

Labor Code section 4656Temporary disability indemnityTwo-year limitationDate of commencementSubstantial evidenceDevelop the recordReconsiderationFindings and AwardWCJIndustrial injury
References
Case No. ADJ1833781 (VNO 0506228)
Regular
Jan 19, 2012

LESLIE OSBORNE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS - CSP - LAC; legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board affirmed the WCJ's decision denying an applicant's claim for psychiatric injury. The applicant, a former correctional officer, argued that actual employment events predominantly caused her injury and that she was unable to file a claim prior to termination. The Appeals Board found that the applicant failed to meet her burden of proof. Substantial evidence supported the WCJ's finding that no industrial psychiatric injury occurred.

Workers' Compensation Appeals BoardPsychiatric InjuryCorrectional OfficerActual Events of EmploymentPredominant CauseMental CapacityFindings and OrderPetition for ReconsiderationReport and RecommendationBurden of Proof
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. ADJ1119129 (GOL 099292)
Regular
Dec 22, 2008

TIM GILLES vs. SANTA BARBARA COMMUNITY COLLEGE DISTRICT, ACE INSURANCE

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding a prior award of 25% permanent disability and future medical treatment for the applicant's neck and back injuries. The Board affirmed the finding that the cumulative trauma period ended with the applicant's January 2003 neck surgery. The Board found that apportionment issues were properly addressed by the medical evidence and that the defendant's arguments did not warrant disturbing the original award.

Workers Compensation Appeals BoardTim GillesSanta Barbara Community College DistrictACE InsuranceKeenan & AssociatesADJ1119129GOL 099292Findings and Awardpermanent disabilityapportionment
References
Case No. GOL 0088273
Regular
Aug 18, 2008

ROBERT SIEBURG vs. RONALD WOLFE & ASSOCIATES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the original award, and returned the case for further development of the record. The Board found the findings of the administrative law judge regarding $97\%$ permanent disability and apportionment were not supported by substantial medical evidence. Specifically, the opinion of Dr. Kahmann was deemed deficient due to internal inconsistencies, lack of explanation for apportionment, and undefined work restrictions. The Board also found Dr. Basham's report did not meet the standard for substantial medical evidence regarding cognitive dysfunction.

WORKERS' COMPENSATION APPEALS BOARDROBERT SIEBURGRONALD WOLFE & ASSOCIATESSTATE COMPENSATION INSURANCE FUNDGOL 0088273OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONFindings and AwardWCJmaintenance person
References
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