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

Case No. ADJ6705178
Regular
Aug 07, 2014

JOSE MORALES vs. PAYLESS SHOESOURCE, INC., administered by GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board dismissed defendant Payless Shoesource's petition for reconsideration because it was filed untimely. The defendant sought to challenge the finding of industrial injury to the applicant's bilateral lower extremities and right upper extremity. The petition was filed 29 days after the August 7, 2014 Opinion and Decision, exceeding the jurisdictional 25-day deadline for reconsideration. Even if timely, the Board indicated it would have been denied on the merits.

Workers' Compensation Appeals BoardPetition for ReconsiderationOpinion and Order Dismissing PetitionIndustrial InjuryBilateral Lower ExtremitiesRight Upper ExtremityLabor Code Section 3600(a)(10)Post Termination DefenseUntimely PetitionJurisdictional Deadline
References
Case No. ADJ9815883 ADJ9815873
Regular
Apr 03, 2017

OCTAVIO AVILEZ vs. ANDRE LANDSCAPE SERVICE, INC., STARR INDEMNITY & LIABILITY CO.

The Workers' Compensation Appeals Board granted reconsideration to clarify the applicant's alleged industrial injuries to his cervical and lumbar spine. An agreed medical evaluator's reports present conflicting opinions regarding causation and permanent disability from the incidents on August 12, 2014, and January 9, 2015. The Board is deferring the spine injury issue pending further clarification from the evaluator on whether these incidents caused any disability or required medical treatment. The Board also expressly found no industrial injury to the upper and lower extremities and deferred all other body parts.

Workers' Compensation Appeals BoardPetition for ReconsiderationAgreed Medical EvaluatorOrthopedistIndustrial InjuryCervical SpineLumbar SpineUpper ExtremitiesLower ExtremitiesDeferred Issue
References
Case No. ADJ9785796
Regular
Oct 14, 2019

Victor Gonzalez vs. CITY OF TORRANCE

This case involves applicant Victor Gonzalez's petition for reconsideration of a WCJ's decision finding industrial injury to his back and left lower extremity, but not his psyche or in the form of stroke. The Board granted reconsideration, finding that the neurological evaluator applied an incorrect legal standard to the stroke claim and that Dr. Silver's deposition testimony was improperly excluded. Consequently, the Board amended the decision to preserve the findings of injury to the back and left lower extremity and denied injury to the psyche, while deferring the stroke and permanent disability issues for further development of the record.

Workers' Compensation Appeals BoardVictor GonzalezCity of Torrancebus operatorindustrial injuryback injuryleft lower extremitystrokepsycheDr. Lee Silver
References
Case No. ADJ3203306 (LAO 0871862)
Regular
Jul 13, 2011

Vanessa Bruce vs. SOUTHWEST HEALTHCARE MEDICAL, TRAVELERS

The applicant sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that found industrial injury to the lumbar spine but denied injury to the internal systems and sleep disorder. The applicant argued the WCJ erred by ignoring a stipulation for injury to the left lower extremity, hip, and buttocks, and by rejecting evidence of an industrially-caused sleep disorder. The WCAB granted reconsideration, amended the findings to include injury to the left lower extremity, left hip, and buttocks, but otherwise affirmed the original decision, finding no industrial basis for the sleep disorder.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardIndustrial InjuryLumbar SpineInternal SystemsSleep DisorderLeft Lower ExtremityLeft HipButtocks
References
Case No. ADJ4111589, ADJ2809505, ADJ4372783, ADJ1391390, ADJ2081394, ADJ8992669
Regular
Oct 09, 2015

GUILLERMO CORNEJO vs. SOLAR TURBINES, INC.

This case involves a worker who sustained multiple admitted industrial injuries to his right foot, back, right thigh, psyche, right lower extremity, and hands. The applicant alleged a subsequent left shoulder condition arose as a compensable consequence of these prior injuries due to a fall. Initially, an administrative law judge found the fall was not industrial, ruling the applicant merely tripped. However, the Workers' Compensation Appeals Board granted reconsideration, finding that medical evidence established the applicant's admitted industrial injuries caused weakness in his right lower extremity and balance issues, which contributed to his fall. Therefore, the Board reversed the prior ruling, determining the left shoulder condition was a compensable consequence of the original industrial injuries.

compensable consequenceadmitted industrial injuriesleft shoulder conditionright footright lower extremitybalanceweaknessfallL4-L5 fusionradiculopathy
References
Case No. ADJ7139146
Regular
Jul 15, 2013

RAUL REYES vs. PAUL RIGHETTI RANCHO CO.; EVEREST NATIONAL INSURANCE CO, administered by AMERICAN CLAIMS MANAGEMENT

This case involved an applicant seeking workers' compensation benefits for back and extremity injuries. The Workers' Compensation Appeals Board affirmed the finding that the applicant did not meet his burden of proof for industrial injury. The applicant's argument that Dr. Pratley's reports should have been admitted was rejected. The Board found the WCJ's reliance on the employer's testimony regarding the applicant's credibility and timely reporting of the injury was permissible. The Board gave great weight to the WCJ's credibility determination between the applicant and his employer.

ADJ7139146Raul ReyesPaul Righetti Rancho Co.Everest National Insurance Co.American Claims Managementindustrial injuryback injuryleg injuryupper extremitiesankle injury
References
Case No. ADJ3490254 (ANA 0399990)
Regular
Sep 25, 2009

MICHAEL TILLMANNS vs. JAY AND DANA RODRIGUEZ, KEMPER AUTO & HOME INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior award. The Board affirmed the applicant's average weekly earnings but reversed the finding on apportionment of permanent disability. The Board found that the medical examiner's opinion on apportionment, attributing significant portions of the disability to pre-existing conditions, should have been followed. Consequently, the permanent disability award was reduced from 44% to 11%. Additionally, the Board reversed the award of attorney's fees for attending a deposition.

ReconsiderationPermanent DisabilityApportionmentAverage Weekly EarningsQualified Medical ExaminerLabor Code Section 4663Labor Code Section 4062.3(g)Medical-Legal ExpensesFindings and AwardWorkers' Compensation Judge
References
Case No. ADJ7073718
Regular
Mar 08, 2016

RECARD ON GONZALES vs. PHILIP SERVICES CORPORATION, ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to correct a typographical error in a prior award. The original decision found the applicant sustained an industrial injury to his right lower extremity, resulting in temporary disability and a 55% permanent disability rating after apportionment. The employer sought reconsideration, arguing for a lower rating based on a QME's opinion attributing 90% of the disability to non-industrial factors. The WCJ recommended amending the award to remove the erroneous reference to the QME's 90% apportionment and to simply state that 45% of the impairment existed prior to the industrial injury. The Board affirmed the substance of the original decision but amended Finding No. 10 as recommended.

WORKERS' COMPENSATION APPEALS BOARDRECONSIDERATION GRANTEDDECISION AFTER RECONSIDERATIONTRUCK DRIVERINDUSTRIAL INJURYRIGHT LOWER EXTREMITYTEMPORARY DISABILITYPERMANENT DISABILITYAPPORTIONMENTLABOR CODE SECTION 4663
References
Case No. ADJ3408326
Regular
Jan 07, 2013

MOISES MENDOZA vs. WORLD SUPER SERVICES, INC., TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award. The Board found that the lien claimant, Precision Occupational Medical Group, failed to meet its burden of proof. Specifically, the claimant did not demonstrate that the EMG/NCV study of the applicant's lower extremities was reasonable and necessary to treat the admitted left ankle injury. The matter was returned to the trial level with the lien claim disallowed.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardLien ClaimantReasonable and Necessary TreatmentBurden of ProofStipulations with Request for AwardMaximum Medical ImprovementEMG/NCV StudyLower Extremities
References
Case No. ADJ3685689 (ANA 0335527) ADJ1125665 (ANA 0345901) ADJ1288486 (ANA 0345902) ADJ3581550 (ANA 0345904) ADJ2369046 (ANA 0335528) MF ADJ2208312 (ANA 0349503)
Regular
Nov 16, 2012

MARIA WENCES vs. JC RESORTS, INC., dba SAND & SURF HOTEL, et. al.; CALIFORNIA INSURANCE GUARANTEE ASSOCIATION; by BROADSPIRE, for CALIFORNIA COMPENSATION and HIH, in liquidation, EBIC, administered by ARROWWOOD INDEMNITY COMPANY

The Appeals Board granted reconsideration of a WCJ's decision, amending the date of cumulative injury to the applicant's lower extremities to September 21, 1998, through February 18, 2000. The Board affirmed the finding that EBIC, as a solvent carrier, must administer the claim and reimburse CIGA for payments made. This reimbursement amount is to be adjusted by the parties. The Board found the Agreed Medical Examiner's opinions constituted substantial evidence supporting the cumulative trauma finding.

Workers' Compensation Appeals BoardMaria WencesJC ResortsSand and Surf HotelCalifornia Insurance Guarantee AssociationCIGABroadspireHIHEBICArrowpoint Capital
References
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