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

Case No. VNO 0349083
Regular
Jul 30, 2007

JUAN MONTERROSO vs. MCALLISTER'S AUTO BODY, INC., CIGA For FREMONT INDEMNITY By CAMBRIDGE INTEGRATED SERVICES

The Workers' Compensation Appeals Board denied reconsideration of an order dismissing Pacific Compensation/CIGA and Reliance Insurance Company/CIGA from applicant Juan Monterroso's claim. The Board adopted the judge's report, which found that other insurance carriers were on the risk during the alleged period of injurious exposure. Therefore, CIGA was not liable for benefits under Insurance Code Section 1063.1(c)(9).

WORKERS' COMPENSATION APPEALS BOARDJUAN MONTERROSOMCALLISTER'S AUTO BODY INC.CIGAFREMONT INDEMNITYCAMBRIDGE INTEGRATED SERVICESORDER DENYING RECONSIDERATIONPetition for ReconsiderationAdministrative Law JudgeLabor Code §5903
References
Case No. ADJ10931214
Regular
Apr 03, 2023

RAUL MAGDALENO (Deceased) PATRICIA MAGDALENO JESUS MAGDALENO vs. A&M FOWER GROWERS, INC., ZENITH INSURANCE COMPANY

This case concerns the denial of a Petition for Reconsideration by A&M Flower Growers, Inc. and Zenith Insurance Company regarding the death of Raul Magdaleno. The defendants contested the finding that Magdaleno sustained an industrial injury to his heart leading to his death on March 9, 2017. The Workers' Compensation Appeals Board (WCAB) adopted the Administrative Law Judge's (ALJ) report, which found that Magdaleno's use of NSAIDs for a work-related back strain, however minimal, was a contributing factor to his fatal heart attack. The WCAB relied on the credible testimony of the surviving spouse and the expert medical opinions of Dr. Weber, who opined that employment was a contributing cause without which the injury would not have occurred, citing relevant California Supreme Court precedent.

AOE/COEPetition for ReconsiderationFindings of FactWCJPanel QMEIndustrial CausationSouth Coast FramingMcAllisterNSAIDsContributing Cause
References
Case No. ADJ9065052
Regular
May 13, 2015

MARK SUAREZ vs. COUNTY OF SANTA BARBARA

This case involves applicant Mark Suarez, a deputy sheriff, who suffered a heart injury on February 4, 2013. Initially, the WCJ found the injury was due to a congenital condition and not work-related. However, the Appeals Board granted reconsideration, finding that Labor Code section 3212.5's "heart trouble" presumption for law enforcement officers applied. The Board determined that while medical evidence indicated a congenital cause, the statute's "anti-attribution" clause prevents rebutting the presumption solely based on a pre-existing condition without evidence of a contemporaneous non-work-related event. Consequently, the Board amended the prior order to find the injury industrially caused, remanding for further proceedings on benefits.

Labor Code section 3212.5heart trouble presumptiondeputy sheriffindustrial injurycongenital conditionaortic stenosisrebuttable presumptionanti-attribution clausenonwork-related eventMuznik
References
Case No. ADJ8714414
Regular
Feb 20, 2018

ALLEN LEAVELL vs. HOUSTON ROCKETS, TIG INSURANCE COMPANY/FAIRMONT SPECIALTY INSURANCE COMPANY, TULSA FAST BREAKERS, COMPSOURCE OKLAHOMA

The applicant, Allen Leavell, sought reconsideration of a prior decision denying California's workers' compensation jurisdiction over his cumulative trauma claim. The Appeals Board denied reconsideration, finding insufficient California-based injury exposure. Applicant's argument that his California games were qualitatively more traumatic was unsupported by medical evidence. The Board affirmed that playing approximately 11% of games in California is insufficient to establish constitutional due process for jurisdiction under the precedent set in *Federal Insurance Co. v. WCAB (Johnson)*.

Workers' Compensation Appeals BoardSubject Matter JurisdictionPersonal JurisdictionCumulative TraumaSpecific InjuryLabor Code Section 3600.5Constitutional Due ProcessFederal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)De MinimisInjurious Exposure
References
Case No. ADJ7946529
Regular
May 15, 2012

FELICIANO ESPINOZA vs. INTERGEM, ARGONAUT INSURANCE COMPANY

The Appeals Board granted reconsideration because the initial award of temporary disability was based on a chiropractor's report deemed not substantial evidence, due to unclear examination methods including a potential phone-only consultation. The Board found this evidence insufficient to support the temporary disability period awarded. Consequently, the Board rescinded the prior award and returned the case to the WCJ to further develop the medical record. This includes potentially obtaining supplemental reports or deposing the agreed medical examiner regarding the applicant's period of total temporary disability.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardTemporary DisabilityIndustrial InjurySubstantial EvidenceMedical OpinionFurther Development of RecordWCJEdward Komberg D.C.
References
Case No. ADJ1244874
Regular
Apr 19, 2010

ENRIQUE ROJAS vs. COSTCO

This case involves a meat cutter/wrapper's claim for an industrial injury to his respiratory system, diagnosed as hypersensitivity pneumonitis. The defendant contested the finding of industrial causation, arguing the medical evidence was insufficient. The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The Board affirmed the administrative law judge's decision, finding that the agreed medical examiner, Dr. Markovitz, established a reasonable medical probability of industrial causation, despite not identifying the precise causative agent. The Board relied on Dr. Markovitz's expert opinion, which utilized a process of elimination and epidemiological considerations to conclude the condition was likely work-related.

Hypersensitivity PneumonitisIndustrial CausationAgreed Medical EvaluatorPulmonologistMeat CutterMeat WrapperRespiratory System InjuryCumulative TraumaProcess of EliminationReasonable Medical Probability
References
Case No. ADJ9895504
Regular
Jan 17, 2020

Elmer Umana vs. West Coast Arborists, Inc., Liberty Mutual Insurance Company

This case involves an employer's petition for reconsideration of a workers' compensation award. The employer argued the award was untimely, and that the Qualified Medical Examiner's (QME) reports were inadmissible as they lacked substantial evidence and proper causation analysis. The Appeals Board denied reconsideration, finding that any delay in issuing the award did not invalidate it. The Board also held that the QME's reports were admissible and constituted substantial evidence, as they detailed causation and reasoning for the impairment ratings.

Workers' Compensation Appeals BoardElmer UmanaWest Coast ArboristsInc.Liberty Mutual Insurance CompanyADJ9895504Opinion and Order Denying Petition for ReconsiderationFindings of Fact Award and OrdersAdministrative Law Judge (WCJ)Injury Arising Out of and Occurring in the Course of Employment (AOE/COE)
References
Case No. ADJ3358392
Regular
Oct 04, 2011

JESUS HERNANDEZ vs. KERN COUNTY SHERIFF'S DEPARTMENT, Permissibly Self-Insured, AIMS

This case involves a deputy sheriff's claim for a left knee injury sustained in August 2005. The defendant employer argued the claim was barred by Labor Code section 3600(a)(10) due to a post-termination filing and insufficient evidence. The Appeals Board affirmed the WCJ's findings, ruling the employer had actual notice of the injury prior to termination, satisfying an exception to section 3600(a)(10)(A). Therefore, the claim was deemed compensable and not barred by the post-termination defense.

Workers' Compensation Appeals Boardindustrial injurydeputy sheriffKern County Sheriff's DepartmentLabor Code section 3600(a)(10)post-termination defensenotice of injurySergeant Goodingqualified medical evaluatorThor Gjerdrum M.D.
References
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. ADJ8501790
Regular
Jul 29, 2015

Kelly Chase vs. St. Louis Blues Hockey Club, Federal Insurance Company

The Workers' Compensation Appeals Board (WCAB) reversed a prior finding of industrial injury for a professional hockey player against the St. Louis Blues. The WCAB found insufficient connection to California for jurisdiction, citing the player's limited games in the state compared to his overall career. This decision followed the precedent set in *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)*, which requires a legitimate and substantial connection to the state for jurisdiction. The WCAB concluded that 21 games out of 485 did not meet this standard for a cumulative injury claim.

WCABSt. Louis Blues Hockey ClubFederal Insurance CompanyADJ8501790Opinion and Decision After Reconsiderationcumulative industrial injuryprofessional hockey playersubject matter jurisdictionstatute of limitationssubstantial medical evidence
References
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