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Case Law Database

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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ3834810 (SRO 0121550)
Regular
Sep 03, 2009

MICHAEL RISCH vs. AT HOME NURSING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's finding of 100% permanent disability for the applicant. The Board found substantial evidence supported the total permanent disability rating and the applicant's average weekly earnings. The 1997 Permanent Disability Rating Schedule was correctly applied due to pre-January 1, 2005 medical reporting indicating permanent disability. The Board also affirmed the WCJ's rejection of apportionment to pre-existing conditions, as the applicant had fully recovered and returned to strenuous work.

Workers' Compensation Appeals BoardMichael RischAt Home NursingState Compensation Insurance FundADJ3834810Opinion and Order Denying Petition for ReconsiderationFindings and Awardadministrative law judgecumulative traumaindustrial injury
References
Case No. ADJ8990294
Regular
Oct 26, 2015

VELMA CRUZ vs. TRINITY NURSING HOME MANAGEMENT/SERRANO SOUTH CONVALESCENT HOSPITAL, SEABRIGHT INSURANCE COMPANY

This case involves an applicant seeking workers' compensation for injuries allegedly sustained as a certified nursing assistant. The Workers' Compensation Appeals Board denied reconsideration of the administrative law judge's (WCJ) decision that found no industrial injury, adopting the WCJ's reasoning that the applicant failed to meet her burden of proof regarding causation. While one commissioner dissented, advocating for further record development due to credible testimony of injury mechanisms and potentially insufficient medical evidence, the majority upheld the denial. The majority also noted that, separate from the causation issue, a post-termination provision might also bar the claim.

WCABVelma CruzTrinity Nursing HomeSerrano South ConvalescentSeabright InsuranceADJ8990294Petition for ReconsiderationAdministrative Law JudgeFindings and OrderCertified Nursing Assistant
References
Case No. ADJ515169 ADJ620656
Regular
Oct 04, 2017

SERGIO CHAIREZ vs. CHEROKEE BINDERY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for PAULA INSURANCE

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, affirming the administrative law judge's finding that \$13.75 per hour was an adequate rate for home healthcare services. The Board found insufficient evidence that the applicant's spouse performed services requiring a higher Licensed Vocational Nurse (LVN) rate. However, the case was removed to the Appeals Board to return the issue of applicant's attorney's fees to the trial level for further proceedings and decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationHome Healthcare RateLicensed Vocational NurseCatheterizationHourly RateStipulated AwardAttorney's FeesRemovalDecision After Removal
References
Case No. ADJ7987695 ADJ7987686
Regular
May 08, 2014

VANESSA BRUCE vs. VALLEY HEALTH SYSTEM/PHYSICIANS FOR HEALTHY HOSPITALS; CRUM & FORSTER AND TRISTAR RISK MANAGEMENT

The applicant, a licensed vocational nurse, sought workers' compensation for injuries sustained when she fell asleep driving home after working three extra hours off the clock due to a coworker's issue. The Workers' Compensation Appeals Board (WCAB) denied her petition for reconsideration. The WCAB found the injury did not arise out of or occur in the course of employment, as the "going and coming rule" applied and neither the "special mission" nor "special risk" exceptions were met. The applicant's decision to stay late was voluntary, not at the employer's request, and falling asleep while driving is a common risk, not a special employment-related hazard.

Workers' Compensation Appeals BoardLicensed Vocational NurseSpecific InjuryNeck InjuryBack InjuryHeadachesCumulative InjurySleep DisorderGoing and Coming RuleSpecial Mission Exception
References
Case No. ADJ18210611
Regular
May 08, 2025

ELENITA JOVER vs. COUNTY OF SAN BERNARDINO DEPARTMENT OF PUBLIC HEALTH

Elenita Jover, a licensed vocational nurse, sought reconsideration of a Findings and Award that denied her request for additional Qualified Medical Evaluation (QME) panels. The initial F&A found injuries to her cervical and lumbar spine, shoulders, and right thumb, but not to other claimed body parts like stress, psyche, or internal systems. The Appeals Board granted the petition, rescinded the original F&A, and ordered additional QME panels for pulmonology, internal medicine (diabetes), ophthalmology, ENT, and neurology, returning the case to the trial level for further proceedings. This decision was based on the original QME's recommendation for further evaluations and the need to develop the evidentiary record to ensure substantial justice.

Petition for ReconsiderationQualified Medical EvaluationLicensed Vocational NurseArising out of and in the course of employmentPermanent DisabilityDue ProcessPulmonologistInternistOphthalmologistOtolaryngologist
References
Case No. ADJ7781219
Regular
Nov 19, 2019

CHARLES SINCLAIR vs. RICHARD J. DONOVAN CORRECTIONAL FACILITY; Legally Uninsured; administered by STATE COMPENSATION INSURANCE FUND/ STATE CONTRACT SERVICES

This case involves Charles Sinclair, a Licensed Vocational Nurse, who sustained an injury to his hands, wrists, and upper extremities on December 21, 2010, resulting in complex regional pain syndrome. The WCJ found Sinclair to be 100% permanently disabled based on the opinions of treating physicians Dr. Baker and Dr. Pelton, and vocational expert Enrique Vega, despite conflicting opinions from other medical examiners. The defendants petitioned for reconsideration, arguing a lack of substantial evidence and insufficient apportionment to prior injuries. The Board denied reconsideration, upholding the WCJ's findings and adopting the WCJ's report, which found the defendant failed to meet their burden of proof regarding apportionment.

Complex Regional Pain SyndromeVocational ExpertApportionmentSubstantial EvidenceAgreed Medical ExaminerQualified Medical ExaminerPermanent DisabilitySynergistic EffectPain ManagementCredibility Determination
References
Case No. ADJ2270309 (VNO 0113668) ADJ4503834 (VNO 0113665) ADJ3103605 (VNO 0113666) ADJ2309113 (VNO 0113667)
Regular
Nov 10, 2010

MARIA GARCIA vs. CITY OF LOS ABNGELES, Permissibly Self-Insured

The Workers' Compensation Appeals Board granted reconsideration of a previous award, finding merit in the applicant's contentions regarding denied medical treatments. The Board intends to admit a nurse case manager's report that was previously excluded. This reconsideration aims to further review the factual and legal issues to ensure a just decision regarding the applicant's extensive care needs stemming from long-term quadriplegia. The Board is specifically addressing disputes over various requested services, including nursing care, home modifications, and specific medical treatments.

Workers' Compensation Appeals BoardSupplemental Findings and AwardHomecareNursing ServicesBedsore TreatmentHousekeeping ServicesHospital BedQuadriplegiaInternal InjuryLabor Code §5803
References
Case No. ADJ6644580
Regular
Aug 30, 2010

EVER GONZALEZ vs. PLUS INTERNATIONAL CORPORATION, CHARTIS COSTA MESA On Behalf Of GRANITE STATE INSURANCE COMPANY

This case involves a worker injured on January 26, 2009, alleging employment by Plus International Corporation. The trial judge found the worker was employed by a subcontractor, Santos, who was unlicensed and uninsured. The Appeals Board granted reconsideration, rescinding the trial judge's finding. The Board remanded the case for further proceedings to develop evidence on whether the applicant was a roofer and if the project's total cost required a contractor's license. The Board noted that if a license was required, the subcontractor's lack of insurance would automatically render them unlicensed.

Labor Code section 2750.5Blew v. Hornerunlicensed contractoruninsured contractorpresumption of employmentrooferspecialty contractorClass C-39 licenseaggregate contract priceautomatic suspension of license
References
Case No. ADJ13119319
Regular
Jul 07, 2025

LUIS CALDERA vs. PORTUGUESE FRATERNAL SOCIETY OF AMERICA/SES HALL, OAK RIVER INSURANCE

The defendant sought reconsideration of a finding that the applicant was an employee when he sustained a left wrist injury. The defendant contended the employment finding was contrary to law, unsupported by evidence, and that the WCJ misapplied Labor Code section 2750.5 and failed to consider Borello factors. The Appeals Board denied reconsideration, adopting the WCJ's report. The report affirmed the WCJ's findings, noting the applicant's credibility and the defendant's failure to rebut the employment presumption, particularly regarding the applicant's lack of a contractor's license as required by Labor Code section 2750.5.

WCABPetition for ReconsiderationEmployment StatusIndependent ContractorLabor Code Section 2750.5Borello FactorsSubstantial EvidencePresumption of EmploymentControl and SupervisionBusiness License
References
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