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Case Law Database

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

Case No. ADJ7365256

Regular

Dec 12, 2011

DONALD McDUFFIE vs. VERIZON WIRELESS INC, SEDGWICK

This case involves a petition for reconsideration filed by Donald McDuffie against Verizon Wireless Inc. and Sedgwick. The Workers' Compensation Appeals Board dismissed McDuffie's petition because it was untimely, filed more than 25 days after the administrative law judge's September 15, 2011 decision. The Board also noted that even if timely, the petition would have been denied on the merits based on the judge's report.

Petition for ReconsiderationUntimely FilingLabor Code § 5903Code of Civil Procedure § 1013Workers' Compensation Appeals BoardWCJ ReportDismissalDeidra E. LoweJoseph M. MillerSusan V. Hamilton

References

Case No. ADJ3412693

Regular

Oct 13, 2010

COLINE ANTOURI vs. WARNER BROTHERS STUDIO, PSI, WARNER BROTHERS WORKERS' COMPENSATION

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, which sought to deny reimbursement for applicant's medication costs. The Board granted the applicant's petition for removal, amending the order to further develop the record. This amendment requires parties to select an Agreed Medical Evaluator (AME) within ten days, or the WCJ will appoint a regular physician to address new and further disability and apportionment, following the procedure outlined in *McDuffie*. The Board affirmed the WCJ's original findings and orders otherwise.

Workers' Compensation Appeals BoardReconsiderationRemovalAgreed Medical EvaluatorRegular PhysicianLabor Code Section 5701Labor Code Section 4062.2(c)Utilization ReviewOut-of-Pocket ExpensesNew and Further Disability

References

Case No. ADJ7762146, ADJ9640376

Regular

Aug 06, 2019

STEVEN ESTAVILLO vs. CITY OF BURBANK

The Appeals Board granted reconsideration to rescind and substitute the WCJ's May 13, 2019 decision, remanding the case for further proceedings to develop the record according to *McDuffie*. The Board specifically admonished defense counsel for disrespectful and inappropriate language in pleadings, cautioning that future non-compliance may result in sanctions. The matter is returned to the WCJ to determine the applicant's entitlement to a combined award, permanent disability, further medical treatment, and attorney fees. The employer's liability for stipulated injuries to the spine, cardiovascular system, hernia, sleep, and psyche is acknowledged.

Petition for ReconsiderationWorkers' Compensation Appeals BoardOpinion and OrderJoint Findings and AwardOrder for CommutationFindings of FactMcDuffie v. Los Angeles County Metropolitan Transit AuthorityLab. Code§ 5813Cal. Code Regs.

References

Case No. ADJ7898288

Regular

Nov 19, 2012

vs. LAMPS PLUS, OLD REPUBLIC INSURANCE

The Workers' Compensation Appeals Board denied reconsideration of a "take nothing" award for an applicant claiming cumulative trauma injury. The Board adopted the WCJ's report, which found the applicant failed to meet his burden of proof due to inconsistent testimony and unreliable medical evidence. The WCJ's credibility findings, based on the applicant's demeanor and conflicting statements regarding his medical history and work absences, were given great weight. Consequently, the Board concluded that the evidence did not demonstrate a cumulative trauma injury arising out of and in the course of employment, and further development of the medical record was not warranted.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedGarza v. Workers' Comp. Appeals Bd.Old Republic Insurance CompanyMilestone Insurance CompanyColdiron v. Compuwave Corp.cumulative trauma injuryAOE/COEtake nothing

References

Case No. ADJ1649220

Regular

Aug 19, 2009

ERIC LUND vs. CALIFORNIA DEPARTMENT OF FORESTRY (STATE COMPENSATION INSURANCE FUND) LAKEPORT FIRE PROTECTION DISTRICT (FASIS), CLEARLAKE OAKS FIRE PROTECTION DISTRICT (FASIS)

This case involves a firefighter claiming industrial injury to his jaw and tonsil cancer, with the initial finding supporting the presumption of injury. The defendant sought reconsideration, arguing that the WCJ improperly relied on medical opinions obtained after discovery closure and in violation of physician selection procedures. The Appeals Board granted reconsideration, rescinded the initial findings, and returned the matter for further proceedings due to procedural errors in admitting key medical evidence. The Board emphasized that evidence obtained after discovery closure and potentially exceeding applicant's rights under Labor Code section 4062.1(e) should not have been admitted.

Labor Code section 3212.1squamous cell carcinomatonsil cancerlymph node cancerfirefighter injurycumulative injurypresumption of injuryrebutted presumptionLabor Code section 4062.1panel QME

References

Case No. ADJ6820138, ADJ6820197

Regular

Oct 03, 2011

AMELIA MENDOZA vs. HUNTINGTON HOSPITAL, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

This case involves Amelia Mendoza's deceased applicant seeking reconsideration of a prior Workers' Compensation Appeals Board (WCAB) decision. The WCAB had previously overturned an administrative law judge's finding of death benefits due to an industrial injury, instead finding only an industrial injury to the applicant's left arm on a specific date, not resulting in death. The applicant argued the prior decision was erroneous, citing WCJ credibility, objective medical evidence of internal injury, and the treating physician's reports. The WCAB denied the petition for reconsideration, reaffirming its prior decision that the applicant's industrial injury did not result in death and that no attorney's fees could be awarded from available funds.

AMELIA MENDOZAHUNTINGTON HOSPITALSEDGWICK CLAIMS MANAGEMENT SERVICESINC.ADJ6820138ADJ6820197Petition for ReconsiderationOpinion and OrderWCJindustrial injury

References

Case No. ADJ4238414

Regular

Jul 22, 2011

CINDY HEWITT vs. THE KROGER CO. dba RALPHS, SEDGWICK CLAIMS

This case involves a Petition for Removal filed by the defendant, The Kroger Co. dba Ralphs, seeking to rescind an order continuing the applicant's case to trial. The defendant argued that inconsistencies in the agreed medical evaluator's reports required further discovery, such as interrogatories or a second deposition, before proceeding. The Appeals Board denied the petition, adopting the WCJ's reasoning that the adequacy of the medical record cannot be determined until the matter is submitted for trial. The Board emphasized that it is more expeditious to proceed to trial and allow the WCJ to assess the record's completeness then.

Petition for RemovalAgreed Medical EvaluatorInconsistenciesDiscoveryOff CalendarWCJReport and RecommendationMcDuffieMedical Record AugmentationCase Development

References

Case No. VNO 0492098

Regular

Feb 07, 2008

LAILA BOUCHER vs. 21ST CENTURY INSURANCE COMPANY, NATIONAL UNION FIRE INSURANCE COMPANY, AIG Claim Services, Inc.

The Appeals Board granted reconsideration on its own motion due to a lack of substantial evidence supporting the Workers' Compensation Judge's (WCJ) findings on permanent disability and apportionment. The WCJ declared the medical reports regarding the applicant's back problems not credible, yet issued rating instructions not based on medical evidence. The case is returned to the trial level for further proceedings, including the potential appointment of an Agreed Medical Evaluator to supplement the record.

Workers' Compensation Appeals BoardReconsiderationApportionmentPermanent DisabilitySubstantial EvidenceMedical TreatmentQualified Medical EvaluatorPrimary Treating PhysicianWCJAgreed Medical Evaluator

References

Case No. ADJ7673925

Regular

Jul 02, 2015

MICHELLE ROEHRIG vs. CHILD DEVELOPMENT, INC., UNITED STATES FIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to address the defendant's challenges to the previous award. The Board found the existing medical evidence insufficient to support the awarded permanent disability rating and injury in the form of a sleep disorder. Consequently, these issues, along with attorney fees, are deferred for further development of the record at the trial level. The decision emphasizes the need for a formal sleep study and admonishes defense counsel for procedural and citation deficiencies.

Complex Regional Pain SyndromeCRPSAlmaraz-Guzmanagreed medical examinerAMEqualified medical examinerPQMEAMA Guides5th Editionsleep disorder

References

Case No. SAL 097348

Regular

Jun 16, 2008

SHERRI BUSA vs. WILLIAM G. ANDERSON, D.D.S., ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded a previous award because the judge improperly relied on a medical expert's report that exceeded the scope of his retention. The expert was retained solely to assess the need for surgery, not to determine permanent disability or a permanent and stationary date. The case is remanded for further development of the record regarding permanent disability and the permanent and stationary date.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityPermanent and Stationary DateAgreed Medical EvaluatorQualified Medical EvaluatorSurgical ConsultMedical-Legal ProcedureFurther Medical TreatmentIndustrial Injury

References

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Updated Daily

Case Law Database

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

Case No. ADJ7365256

Regular

Dec 12, 2011

DONALD McDUFFIE vs. VERIZON WIRELESS INC, SEDGWICK

Petition for ReconsiderationUntimely FilingLabor Code § 5903Code of Civil Procedure § 1013Workers' Compensation Appeals BoardWCJ ReportDismissalDeidra E. LoweJoseph M. MillerSusan V. Hamilton

References

Case No. ADJ3412693

Regular

Oct 13, 2010

COLINE ANTOURI vs. WARNER BROTHERS STUDIO, PSI, WARNER BROTHERS WORKERS' COMPENSATION

References

Case No. ADJ7762146, ADJ9640376

Regular

Aug 06, 2019

STEVEN ESTAVILLO vs. CITY OF BURBANK

References

Case No. ADJ7898288

Regular

Nov 19, 2012

vs. LAMPS PLUS, OLD REPUBLIC INSURANCE

References

Case No. ADJ1649220

Regular

Aug 19, 2009

ERIC LUND vs. CALIFORNIA DEPARTMENT OF FORESTRY (STATE COMPENSATION INSURANCE FUND) LAKEPORT FIRE PROTECTION DISTRICT (FASIS), CLEARLAKE OAKS FIRE PROTECTION DISTRICT (FASIS)

Labor Code section 3212.1squamous cell carcinomatonsil cancerlymph node cancerfirefighter injurycumulative injurypresumption of injuryrebutted presumptionLabor Code section 4062.1panel QME

References

Case No. ADJ6820138, ADJ6820197

Regular

Oct 03, 2011

AMELIA MENDOZA vs. HUNTINGTON HOSPITAL, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

AMELIA MENDOZAHUNTINGTON HOSPITALSEDGWICK CLAIMS MANAGEMENT SERVICESINC.ADJ6820138ADJ6820197Petition for ReconsiderationOpinion and OrderWCJindustrial injury

References

Case No. ADJ4238414

Regular

Jul 22, 2011

CINDY HEWITT vs. THE KROGER CO. dba RALPHS, SEDGWICK CLAIMS

Petition for RemovalAgreed Medical EvaluatorInconsistenciesDiscoveryOff CalendarWCJReport and RecommendationMcDuffieMedical Record AugmentationCase Development

References

Case No. VNO 0492098

Regular

Feb 07, 2008

LAILA BOUCHER vs. 21ST CENTURY INSURANCE COMPANY, NATIONAL UNION FIRE INSURANCE COMPANY, AIG Claim Services, Inc.

References

Case No. ADJ7673925

Regular

Jul 02, 2015

MICHELLE ROEHRIG vs. CHILD DEVELOPMENT, INC., UNITED STATES FIRE INSURANCE COMPANY

Complex Regional Pain SyndromeCRPSAlmaraz-Guzmanagreed medical examinerAMEqualified medical examinerPQMEAMA Guides5th Editionsleep disorder

References

Case No. SAL 097348

Regular

Jun 16, 2008

SHERRI BUSA vs. WILLIAM G. ANDERSON, D.D.S., ZENITH INSURANCE COMPANY

References

Showing 1-10 of 81 results

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