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Case No. ADJ358838 (LBO 0360956) ADJ6781131

Regular

Apr 05, 2013

AUGUSTO DE ANDRADE vs. ITW CIP STAMPING, ZURICH NORTH AMERICA, c/o BROADSPIRE

The Workers' Compensation Appeals Board denied reconsideration of an applicant's claim for injury to his internal systems and psyche. The WCJ's report, adopted by the Board, found that medical opinions from Dr. Jonathan C. Green and Dr. James E. O'Brien were compelling. These opinions concluded that the applicant's internal problems pre-existed the injury and were not industrial, and that no industrial psychiatric injury occurred. The WCJ's credibility findings, based on applicant's inconsistent testimony and a malingering test, were given great weight.

Workers' Compensation Appeals BoardReconsiderationWCJ ReportCredibility FindingIndustrial InjuryPsyche InjuryInternal SystemsLeft Upper ExtremitySteel Mill WorkerRey 5 Item Malingering Test

References

Case No. MISSING

Regular Panel Decision

Marrero v. Apfel

Plaintiff David Davila Marrero, acting pro se, challenged the Commissioner of Social Security's final determination to deny him Supplemental Security Income (SSI) benefits under the Social Security Act. Marrero asserted disability due to a nervous condition, leading to multiple administrative hearings and remands. The District Court reviewed the administrative law judge's (ALJ) decision, which found Marrero not disabled after considering various medical and vocational expert testimonies. The court affirmed the Commissioner's determination, concluding that substantial evidence supported the ALJ's findings, including considerations of potential malingering and Marrero's residual functional capacity. The Commissioner's motion for judgment on the pleadings was therefore granted.

Social Security ActSupplemental Security IncomeDisability BenefitsAdministrative Law JudgeSubstantial Evidence ReviewMedical Expert TestimonyVocational Expert TestimonyParanoid SchizophreniaMalingeringCredibility Assessment

References

Case No. ADJ2079252

Regular

Jan 25, 2010

JON SHINI vs. PACIFIC COAST AUTO BODY & TRUCK, FARMERS SANTA ANA

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the prior award due to the administrative law judge's (WCJ) failure to fully analyze the issues presented in *Ogilvie I* and *Ogilvie II*. Specifically, the WCJ improperly applied the diminished future earning capacity (DFEC) rebuttal formula without sufficient evidentiary development regarding the applicant's post-injury earnings and potential for malingering. The Board remanded the case for further proceedings to conduct a complete *Ogilvie* analysis, including weighing the scheduled rating against the adjusted DFEC factor and considering factors such as the applicant's credibility. The defendant's contention regarding industrial injury to the psyche was not addressed, with the Board allowing it to be raised in further proceedings.

OgilvieDiminished Future Earning CapacityDFECReconsiderationRebuttalPermanent Disability Rating SchedulePost-injury earningsEarning capacityAgreed Medical EvaluatorMalingering

References

Case No. ADJ3167944

Regular

Mar 21, 2011

NEFTALY HEREDIA vs. UNION TRANSPORTATION, INC., SEDGWICK CIAGA GLENDALE

This case involves a claim for workers' compensation benefits for a psychiatric injury allegedly sustained on June 18, 2001. The primary issue is whether the applicant's injury meets the "sudden and extraordinary employment condition" exception to the six-month employment requirement for psychiatric claims under Labor Code section 3208.3(d). The Appeals Board granted reconsideration, rescinded the previous award, and returned the matter for further proceedings. The Board found the Workers' Compensation Judge applied an incorrect "taint of fraud" standard and needs to re-evaluate whether the incident was truly uncommon, unusual, and unexpected. Furthermore, the Board directed the Judge to address issues of symptom magnification and malingering raised by the psychiatric reports.

Sudden and extraordinary employment conditionLabor Code section 3208.3(d)psychiatric injuryQualified Medical Evaluator (QME)symptom magnificationmalingeringpreponderance of the evidenceindustrial injuryamended findings and awardreconsideration

References

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AUGUSTO DE ANDRADE vs. ITW CIP STAMPING, ZURICH NORTH AMERICA, c/o BROADSPIRE

Workers' Compensation Appeals BoardReconsiderationWCJ ReportCredibility FindingIndustrial InjuryPsyche InjuryInternal SystemsLeft Upper ExtremitySteel Mill WorkerRey 5 Item Malingering Test

Marrero v. Apfel

JON SHINI vs. PACIFIC COAST AUTO BODY & TRUCK, FARMERS SANTA ANA

OgilvieDiminished Future Earning CapacityDFECReconsiderationRebuttalPermanent Disability Rating SchedulePost-injury earningsEarning capacityAgreed Medical EvaluatorMalingering

NEFTALY HEREDIA vs. UNION TRANSPORTATION, INC., SEDGWICK CIAGA GLENDALE