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

Case No. ADJ1941131 (LAO 0855247) ADJ3900171 (LAO 0854773)
Regular
Jan 11, 2012

HENRY SIMMONS vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The WCAB dismissed the Defendant's Petition for Reconsideration as it sought review of a non-final order striking submission to develop the record. The Board also denied the alternative Petition for Removal, finding no demonstration of substantial prejudice or irreparable harm to justify removal. The WCJ correctly struck the submission due to insufficient medical reports, particularly concerning the applicable rating schedule and MMPI-2 results. The WCJ's decision to develop the record was deemed necessary for a decision of passable quality, and the Defendant was found to have lacked due diligence in obtaining adequate reports.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationPetition for RemovalOrder Striking SubmissionDevelop the RecordAMA Guides1997 Rating ScheduleMMPI-2Industrial CausationPermanent Disability
References
Case No. ADJ2855195 (VNO 0550470)
Regular
Feb 06, 2014

MARCELO RUEDA vs. DRIVE SERVICE, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration of a WCJ's decision awarding $7,200 for shockwave therapy to the applicant's elbows. The Board found that the lien claimant failed to establish the medical reasonableness and necessity of the treatment, as the Agreed Medical Examiner's opinion did not specifically endorse shockwave therapy. The WCJ's exclusion of the defendant's utilization review denial letters was also questioned, but the Board reopened the record to allow for further development of evidence regarding the treatment's necessity. Consequently, the matter was returned to the trial level for further proceedings and a new decision.

Utilization Reviewshockwave therapymedical necessityAgreed Medical Examinerdeposition testimonydue processdevelopment of recordlien conferencePetition for ReconsiderationFindings and Award
References
Case No. ADJ9002100
Regular
Feb 05, 2015

KENA PIERRE vs. KAISER PERMANENT, SEDGWICK CMS

The Workers' Compensation Appeals Board denied Kaiser Permanente's petition for reconsideration of an earlier decision. The Board adopted the findings of the Workers' Compensation Administrative Law Judge (WCJ), giving significant weight to the judge's credibility determination of the applicant. The WCJ found the applicant's testimony credible, despite minor inconsistencies, and supported by medical opinions from treating and QME physicians. The defendant's arguments regarding the substantiality of the evidence were rejected, and the judge's credibility assessments of defense witnesses were also unfavorable.

AOE/COEPetition for ReconsiderationCredibility DeterminationWCJSubstantial EvidencePsychiatric InjurySexual HarassmentLicensed Vocational NurseWorkers' Compensation Appeals BoardQME
References
Case No. ADJ70 84052
Regular
Mar 23, 2015

Edwin Martinez vs. Coca-Cola Enterprises, Inc.

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The Board adopted the Workers' Compensation Judge's report, which found a compensable sleep disorder and awarded additional permanent disability. The Board also found that the judge's order regarding the Employment Development Department (EDD) lien was a non-final order and denied the defendant's related contention.

Sleep disordercompensable sleep disorderpermanent disabilityWCJ discretionEDD lienreimbursementpetition for reconsiderationabuse of discretionWPIpsychiatric injury
References
Case No. ADJ10305680
Regular
Oct 10, 2017

COURTNEY HILTON vs. TORRANCE UNIFIED SCHOOL DISTRICT, KEENAN AND ASSOCIATES

Applicant Courtney Hilton's Petition for Reconsideration is dismissed because it is a successive petition addressing issues already decided and no new evidence was presented. The Appeals Board found that the applicant failed to appear for trial, leading to a notice of intention to dismiss her claim. The Board defers procedural and discovery matters to the Workers' Compensation Judge, including the applicant's excuse for missing trial. The applicant also submitted an unauthorized supplemental pleading, for which she was admonished.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalChange of VenueIn Pro PerWCJSupplemental PleadingSanctionable ConductMMPI-2Substantial Medical Evidence
References
Case No. ADJ3189130 (STK 0188538)
Regular
Dec 08, 2010

DAVID DYKES vs. E. & J. GALLO WINERY

The Workers' Compensation Appeals Board granted reconsideration of a prior decision that found the applicant sustained a compensable industrial injury to his psyche. The Board found that the applicant failed to meet the burden of proof under Labor Code section 3208.3(b)(1) that actual employment events were the predominant cause of his psychiatric injury. Medical evidence submitted by the applicant's own psychologist was deemed insufficient due to lack of clear reasoning and an inability to establish predominant causation. Therefore, the Board amended the findings to reflect that no compensable industrial injury to the psyche was proven.

Workers' Compensation Appeals BoardE. & J. Gallo WineryDavid Dykesindustrial injurypsyche injurycompensable consequenceLabor Code section 3208.3(b)(1)predominant causesubstantial medical evidenceDr. Robert Schneider
References
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