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

Case No. ADJ11027267
Regular
Feb 03, 2023

LUIS ROSALES vs. IRELAND TILE AND STONE INC., SEDGWICK 14779 SAN DIEGO

This case involves an injured tile setter, Luis Rosales, who claimed lumbar radiculopathy stemming from an admitted industrial lumbar contusion. The Workers' Compensation Appeals Board denied reconsideration of a prior order, upholding a finding of 0% permanent disability. This decision was based on the Qualified Medical Examiner's (QME) reports, which the Board found to be substantial evidence. The Board specifically rejected the applicant's argument that the QME's opinions were inconsistent, clarifying that the QME found the sacral cyst unrelated to the lumbar contusion, not that the symptoms were unrelated to the cyst.

Petition for ReconsiderationQualified Medical ExaminerPQMEDr. Sonusupplemental reportsubstantial evidencelumbar contusionsacral cystradiculopathypermanent disability
References
2
Case No. ADJ8611746
Regular
Feb 27, 2017

VILMA AGUILAR vs. SLATKIN RESIDENCE, STATE FARM INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration. The defendant argued the administrative law judge erred in awarding 17% permanent disability by relying on the applicant's treating physician over a qualified medical evaluator. The Board found the treating physician's opinion was well-supported by objective clinical findings and consistent with the diagnosis of lumbar radiculopathy. Therefore, the Board gave significant weight to the administrative law judge's findings and denied the petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent DisabilityPrimary Treating PhysicianQualified Medical EvaluatorMedical OpinionCredibility DeterminationsSubstantial EvidenceLumbar Radiculopathy
References
8
Case No. ADJ14216452
Regular
Sep 12, 2025

JAIME VILLANUEVA vs. DALEY'S DRYWALL & TAPING, INC.; ARCH INSURANCE

Applicant Jaime Villanueva sought reconsideration of a June 16, 2025 decision that found 0% permanent disability based on a Qualified Medical Examiner's report. The Appeals Board found the QME's report by Dr. Bruce Huffer to be unsubstantial due to its conclusory nature, lack of reasoning, and failure to discuss pertinent medical records from other physicians. Consequently, the Board granted the petition, rescinded the original decision, and returned the matter for further proceedings to properly develop the medical record regarding the applicant's lumbar spine injury and claimed radiculopathy.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPanel Qualified Medical ExaminerPQMERadiculopathyPermanent DisabilityDRE Lumbar Category IIAMA GuidesSubstantial Evidence
References
9
Case No. MISSING
Regular Panel Decision

Claim of Reddien v. Joseph Davis Inc.

Claimant suffered work-related injuries to his back and left wrist in July 1999, with a schedule loss of use of his left hand determined in 2001. In 2011, claimant sought treatment for lumbar radiculopathy. The employer’s workers’ compensation carrier filed a request to transfer liability for the claim to the Special Fund for Reopened Cases pursuant to Workers’ Compensation Law § 25-a. The Workers’ Compensation Board denied the transfer, ruling the case was never truly closed because the issue of permanency for the back injury had not been addressed. The Appellate Division affirmed the Board's decision, finding substantial evidence that the case was not truly closed and thus Workers’ Compensation Law § 25-a was inapplicable.

Workers' CompensationSpecial FundReopened CasesSchedule Loss of UseLumbar RadiculopathyPermanent Partial DisabilityBoard DecisionAppellate ReviewCausally Related InjuryMedical Opinion
References
5
Case No. MISSING
Regular Panel Decision
Nov 19, 1998

Claim of Escala v. Cecilware Corp.

The Workers’ Compensation Board's decision, filed November 19, 1998, which ruled that the claimant had a continuing causally related disability resulting from a work altercation on August 23, 1994, and was entitled to benefits post-February 12, 1996, was affirmed. Substantial evidence, including the treating physician Peta Carrera's diagnosis of lumbar radiculopathy and conclusion of total disability, supported the Board's finding. The Court found no abuse of discretion in precluding the testimony of the employer's physician, Robert Koval, due to his repeated non-appearances, despite the Board improperly considering Carrera’s recent medical reports. Conflicts in medical evidence were for the Board to resolve, and the argument concerning the claimant's prior unemployment benefits was rejected as they were received before the period at issue.

Causally Related DisabilityLumbar RadiculopathyCervical HerniationDisc BulgesMuscle SpasmsTreating Physician TestimonyMedical Evidence ConflictPreclusion of TestimonyUnemployment Insurance BenefitsAppellate Review
References
5
Case No. 531404
Regular Panel Decision
May 26, 2022

In the Matter of the Claim of Stacy Seymour

Stacy Seymour, a customer service representative, filed a workers' compensation claim for neck, back, and wrist injuries, alleging they resulted from repetitive stress during her eight years of employment. The Workers' Compensation Law Judge (WCLJ) and subsequently the Workers' Compensation Board (Board) disallowed her claim, finding she failed to establish a causally-related occupational disease. The claimant appealed this decision. The Appellate Division, Third Judicial Department, affirmed the Board's decision, stating that the Board's finding was supported by substantial evidence. The court noted that claimant's treating neurologist, Ranga Krishna, diagnosed carpal tunnel syndrome and lumbar radiculopathy, but admitted he had not conducted certain diagnostic studies and was unaware of the claimant's extensive school activities which also involved prolonged sitting and computer use. The Board was therefore free to reject this "less-than-compelling medical evidence," and its decision was not disturbed.

Workers' CompensationOccupational DiseaseCausally Related InjuryRepetitive Stress InjuryCarpal Tunnel SyndromeLumbar RadiculopathyMedical EvidenceSubstantial EvidenceAppellate ReviewBoard Decision Affirmed
References
6
Case No. ADJ10679103
Regular
Dec 14, 2017

LARRY SYKES vs. THE ANSCHUTZ CORPORATION, STARR INDEMNITY & LIABILITY COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior finding of industrial injury to the applicant's lumbar spine. The Board found that the existing medical reporting from Dr. Hong, Dr. Jamasbi, and the PQME Dr. Schofferman did not constitute substantial evidence to support this lumbar spine injury finding. Therefore, the case is returned to the trial level to develop the record further on the lumbar spine injury issue.

Workers' Compensation Appeals BoardPetition for ReconsiderationIndustrial InjuryCervical SpineThoracic SpineLumbar SpineStagehandSecurity OfficerMedical Treatment RecordsSubstantial Evidence
References
0
Case No. ADJ10384099
Regular
Jan 29, 2018

RODOLFO RODRIGUEZ vs. ROBERT BOSCH AFTERMARKET DIVISION, ZURICH NORTH AMERICA

The Appeals Board granted reconsideration to amend the finding of fact, clarifying that the applicant sustained a compensable injury to his lumbar spine arising out of and occurring within the course of employment. While medical evidence supported the lumbar spine injury, the Board deferred the issue of lower extremities as an injured body part for further development. This decision affirmed the original finding regarding the lumbar spine, based on applicant's credible testimony and medical opinions from Drs. Hutchinson and Schaffzin.

AOE/COELumbar spineLower extremitiesPetition for ReconsiderationFinding of FactWCJMedical evidencePreexisting conditionAggravationLighting up
References
14
Case No. AD10769216
Regular
Dec 13, 2019

Richard Hovannisian vs. UCLA, Permissibly Self-Insured, Administered By SEDGWICK CMS

The WCAB granted reconsideration and deferred issues of lumbar spine injury and permanent disability from a prior award. The WCJ's decision relied on a QME report that failed to establish industrial causation for the lumbar spine injury and lacked sufficient explanation for departing from AMA Guides methodology for permanent disability ratings. The Board found these deficiencies meant the decision was not based on substantial medical evidence. Further proceedings are required for the QME to adequately address causation, rating methodology, and lumbar spine classification.

WCABPetition for ReconsiderationFindings of Fact & Awardindustrial injurylumbar spinepermanent disabilitysubstantial medical evidencedue processDisability Evaluation Unitpanel qualified medical evaluator
References
4
Case No. ADJ8413521
Regular
Apr 13, 2020

STEVEN KING vs. COUNTY OF SAN BERNARDINO

This Workers' Compensation Appeals Board case involves applicant Steven King's claims for injury arising out of and occurring in the course of employment, including bilateral shoulders, lumbar spine, cardiac system, hernia, skin disorder, hearing loss, and hypertension. The Board affirmed the finding of injury AOE/COE and the hypertension rating but remanded the case for further development of the record regarding the applicant's lumbar spine impairment. The administrative law judge's prior rejection of the Agreed Medical Examiner's (AME) supplemental opinion on lumbar spine disability was deemed an improper disregard of substantial medical evidence.

Workers' Compensation Appeals BoardPetition for ReconsiderationAmended Findings and Awardinjury arising out of and occurring in the course of employmentbilateral shoulderslumbar spinecardiac systemherniaskin disorderhearing loss
References
8
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