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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ8501522
Regular
Nov 19, 2014

AMADOR VILLAREAL vs. FRESH START BAKERIES, THE HARTFORD

This Workers' Compensation Appeals Board case concerns an applicant injured as a maintenance technician whose employer challenges an award of transportation services for his children. The Board granted reconsideration to further study the record regarding this specific expense. While the initial administrative law judge found the transportation reasonable and necessary due to the applicant's inability to drive after his injury, the Board determined the applicant had not yet met his burden of proof that these services are medically necessary. The case is returned to the trial level for further development of the record on the medical necessity of child transportation services.

Workers' Compensation Appeals BoardReconsiderationFindings of FactMaintenance TechnicianIndustrial InjuryNeck InjuryHead InjuryVision InjuryPsyche InjuryBrain Injury
References
Case No. FRE 0191108
Regular
Oct 01, 2007

RICK L. REITZ vs. COUNTY OF FRESNO, CLAIMS MANAGEMENT, INC.

This case involves a worker's compensation claim where the applicant, a Corrections Officer, sustained industrial injuries to his low back and legs, leading to significant permanent disability. Despite completing a prior vocational rehabilitation plan, the applicant was approved for a second plan and awarded vocational rehabilitation maintenance allowance (VRMA) for a period when benefits were initially denied. The defendant appealed, arguing the second plan was unwarranted and the VRMA award inequitable, but the Board denied reconsideration, upholding the award based on existing case law, though expressing concern over delays.

Second vocational rehabilitation planVocational rehabilitation maintenance allowanceVRMACounty Service Disability RetirementRehabilitation Unit determinationProbation TechnicianMedical feasibilityIndustrial injuryLow backLegs
References
Case No. ADJ2209378 (VNO 0366651)
Regular
Oct 07, 2013

SCOTT LENETT vs. CITY OF MONTEREY PARK, CORVEL CORPORATION/HAZELRIGG RISK MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to address the defendant's petition to terminate liability for Applicant's pool maintenance award. The Board rescinded the prior decision and remanded the case for further proceedings. The core issue is whether the Applicant is entitled to the full maintenance award when he no longer directly pays for or maintains the pool, but rather pays HOA dues that contribute to pool upkeep. The Board clarified that while the award itself is not inappropriate, reimbursement should be based on Applicant's actual out-of-pocket costs for pool maintenance.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPool Maintenance AllowanceAqua TherapyContinuing JurisdictionLabor Code Section 5803Labor Code Section 5804Termination of LiabilityMedical Treatment Award
References
Case No. AHM 0116452 AHM 0116457 AHM 0116470
Regular
Jul 21, 2008

BRUCE SERVISS vs. RALPH'S GROCERY, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration and amended the award to clarify that the applicant is not entitled to duplicative temporary disability and vocational rehabilitation maintenance allowance payments for the same period. The Board found the defendant breached its duty to provide timely vocational rehabilitation notices after the applicant's January 16, 2004 permanent and stationary date. Consequently, the defendant remains liable for vocational rehabilitation maintenance allowance from that date, adjusted for prior payments.

Workers' Compensation Appeals BoardReconsiderationVocational RehabilitationMaintenance AllowanceTemporary DisabilityIndustrial InjuryMeat CutterRalph's GrocerySedgwick Claims Management ServicesPermanent and Stationary
References
Case No. ADJ6605852, ADJ6605850
Regular
Aug 06, 2010

ANTHONY SOLER vs. MEADOWBROOK DAIRY, ZENITH INSURANCE COMPANY

The applicant, Anthony Soler, petitioned for removal from a WCJ's order taking his workers' compensation case off-calendar. Soler alleged widespread industrial injuries stemming from two periods of employment with Meadowbrook Dairy. The WCJ removed the case to allow for further discovery, specifically noting that the applicant's deposition was incomplete and there was no evidence of defendant dilatoriness. The Appeals Board denied the petition for removal, adopting the WCJ's reasoning that trial cannot be set until reasonable discovery is completed and concluding no significant prejudice resulted from the delay.

Petition for RemovalLabor Code § 5310Off-Calendar OrderIndustrial InjuryMaintenance TechnicianCumulative PeriodDeclaration of Readiness to ProceedMandatory Settlement ConferenceAOE/COESelf-Procured Medical Treatment
References
Case No. ADJ233266
Regular
Apr 13, 2010

Angel Vargas vs. ST. MARY'S HOSPITAL, SEDGWICK VAN NUYS

The Workers' Compensation Appeals Board granted reconsideration of a finding regarding a credit for temporary disability overpayment. The Board amended the finding to defer the credit issue, allowing it to be addressed at the trial level. They also corrected a clerical error regarding the permanent disability award amount. The matter was returned for further proceedings and a supplemental decision on the credit issue.

Petition for ReconsiderationAmended Findings and AwardTemporary Disability OverpaymentCredit ApplicationIndemnity BenefitsIndustrial InjuryPermanent DisabilityMaintenance TechnicianWorkers' Compensation Appeals BoardWCJ
References
Case No. ADJ6527507
Regular
Oct 18, 2010

Wayne Moore vs. EAST BAY MUNICIPAL UTILITY DISTRICT, ATHENS ADMINISTRATORS

The Appeals Board granted reconsideration, finding the WCJ improperly substituted his medical judgment for the Qualified Medical Evaluator's (QME) regarding the applicant's industrial sleep disturbance. The WCJ's finding of no industrial sleep impairment, despite the QME's opinion indicating such, was deemed erroneous. The Board rescinded the original award and remanded the case for a new rating that incorporates the QME's findings on sleep disturbance. Additionally, the WCJ must correct an identified occupational group number error in future rating calculations.

Workers' Compensation Appeals BoardWayne MooreEast Bay Municipal Utility DistrictAthens Administratorsmachinist maintenance workermachinistmachinist maintenancepermanent disabilityapportionmentQualified Medical Evaluator
References
Case No. ADJ7019734, ADJ7019744
Regular
Dec 21, 2015

WAJID KHAN vs. DAVITA, INC., INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

This Workers' Compensation Appeals Board case involves applicant Wajid Khan's petition for reconsideration of a prior award. The Administrative Law Judge found Khan's occupational group number to be 212, resulting in a 69% permanent disability rating. Khan argued for a higher rating based on his duties also fitting occupational group 340, but the Board denied reconsideration. The Board found insufficient evidence to support Khan's dual occupational classification and noted his procedural violation by attaching inadmissible evidence to his petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAdministrative Law JudgePermanent DisabilityOccupational Group NumberDialysis TechnicianPatient Care TechnicianConsultative Rating DeterminationWCAB Rule 10166(b)
References
Case No. ADJ1357786 (RDG 0126731)
Regular
May 10, 2010

MARK JAMES vs. PACIFIC BELL TELEPHONE COMPANY; PERMISSIBLY SELF-INSURED ADMINISTERED BY SEDGWICK 14627 ONTARIO

The Workers' Compensation Appeals Board denied Pacific Bell's petition for reconsideration of an award to Mark James. The original award found James sustained a 100% permanent disability due to industrial melanoma, and Pacific Bell argued for apportionment to non-industrial causes. The Board affirmed the finding that the Agreed Medical Evaluator, Dr. Blau, was unable to determine the percentage of disability caused by non-industrial factors due to insufficient information. This inability to apportion, not a failure to consult, meant Pacific Bell failed to meet its burden of proof for apportionment.

Workers' Compensation Appeals BoardPacific Bell Telephone CompanyMark JamesMaintenance Splicing TechnicianMelanomaPermanent DisabilityApportionmentLabor Code Section 4663Agreed Medical Evaluator (AME)Dr. Robert Blau
References
Showing 1-10 of 337 results

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