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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
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. RDG 0095368; RDG 0095369; RDG 0095573; RDG 0126270
Regular
Sep 25, 2007

HENRY PHILLIPE vs. GOTTSCHALKS, LIBERTY MUTUAL INSURANCE

The Appeals Board granted reconsideration to allow reimbursement for the applicant's vocational expert fees, reversing the WCJ's decision. The Board found it reasonable for the applicant to hire his own vocational expert to rebut the defendant's expert, especially given the passage of time since the original vocational feasibility report. Consequently, the defendant was ordered to reimburse the applicant's attorney for the $1,075.00 vocational expert cost.

Workers' Compensation Appeals BoardReconsiderationExpert Witness FeesVocational ExpertLabor Code Section 5811Qualified Rehabilitation Representative (QRR)LeBoeuf argumentAgreed Medical Examination (AME)Permanent DisabilityIndustrial Injury
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. 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. ADJ8210063; ADJ8621818
Regular
Feb 27, 2025

GRACE NUNES vs. STATE OF CALIFORNIA, DEPARTMENT OF MOTOR VEHICLES; administered by STATE COMPENSATION INSURANCE FUND

Grace Nunes, an applicant, sustained industrial injuries to her neck, left shoulder, and bilateral upper extremities while employed by the State of California, Department of Motor Vehicles. Following a prior reconsideration, the Workers' Compensation Appeals Board (WCAB) clarified that 'vocational apportionment' is impermissible and vocational evidence must align with medical apportionment. The Workers' Compensation Judge (WCJ) ordered further development of the record with the Qualified Medical Evaluator (QME) and vocational experts to comply with the Board's decisions. Applicant petitioned for reconsideration or removal of this interlocutory order, which the Appeals Board denied, affirming the WCJ's discretion to develop the record for a just and reasoned decision.

Industrial injuryNeck injuryShoulder injuryBilateral upper extremitiesField representativeVocational retrainingPermanent and total disabilityVocational apportionmentMedical apportionmentQualified Medical Evaluator
References
Case No. ADJ2649808 (STK 0209059)
Regular
May 16, 2017

CHRIS ARSENAULT vs. CARPET MASTER, MID-CENTURY INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding a finding of 100% permanent disability for an admitted back injury. The defendant argued the vocational expert's report was flawed and unsubstantiated, but the Board affirmed the WCJ's finding of credibility. The WCJ's decision correctly applied *Dahl* to find the applicant not amenable to vocational rehabilitation due to his functional limitations, pain, and depression. The Board also rejected the defendant's attempt to admit newly discovered evidence, as it did not meet the criteria for such admission.

Vocational evaluatorpermanent disabilityreconsiderationindustrial injuryvocational reportingmedical evidencesubjective evidencedepressionvocational rehabilitationchronic pain
References
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