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

Case No. ADJ2709955 (MON 0356320)
Regular
Jun 21, 2017

Mario Cocola vs. California Hospital Medical Center

The Workers' Compensation Appeals Board denied Mario Cocola's petition for reconsideration, upholding the finding that he sustained $69\%$ permanent disability from industrial injuries. Cocola argued the administrative judge erred by disregarding the Agreed Medical Examiner's opinion that he was totally disabled from the open labor market due to orthopedic injuries. The Board agreed with the judge's report that the physician's opinion lacked sufficient objective basis for the change in work restrictions. A dissenting opinion argued the medical and vocational evidence supported a $100\%$ permanent disability finding and requested clarification from the medical examiner.

Petition for ReconsiderationFindings of Fact and Awardpermanent disabilitycumulative traumalumbar spinecervical spinepsychecervicogenic headachesEmergency Unit CoordinatorAgreed Medical Examiner
References
1
Case No. ADJ11255525
Regular
Dec 02, 2019

GWENDOLYN JOHNIGAN vs. UC DAVIS MEDICAL CENTER

This case involves an applicant denied workers' compensation benefits for industrial injury to her right leg and knee, with the Workers' Compensation Appeals Board (WCAB) denying her petition for reconsideration. The WCAB adopted the administrative law judge's finding that the applicant did not sustain industrial injury, relying on a panel qualified medical evaluator's opinion that the work duties were insufficient to cause an injury. The applicant argued the medical evidence was not substantial and sought further development of the record. However, the WCAB found the applicant failed to meet her burden of proof with substantial medical evidence. A dissenting opinion argued the medical evidence was insubstantial and required further development.

Petition for ReconsiderationPanel Qualified Medical EvaluatorOrthopedistSubstantial Medical EvidenceFurther DevelopmentSupplemental ReportingDeposition TestimonyIndustrial InjuryRight LegRight Knee
References
4
Case No. ADJ9709726
Regular
Jun 25, 2015

LAURA NUNEZ vs. SUTTER PACIFIC MEDICAL FOUNDATION, SUTTER HEALTH

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant challenged the finding of industrial injury AOE/COE for thoracic outlet syndrome, arguing it wasn't an issue for trial and the medical evidence was insufficient. The Board found that thoracic spine injury was an issue and that Dr. Avery's opinion provided substantial medical evidence to support the thoracic outlet syndrome finding. Any potential defects in the original WCJ opinion were cured by the WCJ's subsequent report.

Thoracic outlet syndromeAOE/COEPetition for Reconsiderationsubstantial medical evidenceG. James Avery M.D.Steven Bratman M.D.industrial injuryapportionmentWCJlabor code 5313
References
1
Case No. ADJ869205 (SAC 0294976) ADJ302322 (SAC 0354178)
Regular
Oct 11, 2010

Patricia Rush vs. The Permanente Medical Group; Athens Administrators Concord

This case involves Patricia Rush claiming cumulative trauma injuries to her knees and back, among other body parts, against The Permanente Medical Group. The Workers' Compensation Appeals Board granted reconsideration because the Administrative Law Judge's findings of industrial causation for knee injuries lacked substantial medical evidence, with conflicting and uncertain Qualified Medical Evaluator opinions. The Board rescinded the prior findings and ordered further development of the medical record, suggesting an Agreed Medical Examiner or a court-appointed physician to resolve the causation issue for the knee injuries. The matter is returned to the trial level for a new final determination after the record is further developed on all issues, including injury causation.

Workers' Compensation Appeals BoardPermanente Medical GroupAthens Administratorscumulative trauma injurykneesbackshouldershandswristsindustrial causation
References
0
Case No. ADJ79 96674
Regular
Mar 24, 2016

ARLZENIA HASLEY vs. EL CENTRO REGIONAL MEDICAL CENTER

The Workers' Compensation Appeals Board (WCAB) denied the defendant's Petition for Removal, which sought to invalidate the medical evidence of the Agreed Medical Examiner (AME), Dr. Luros. The WCAB found that removal is an extraordinary remedy requiring a showing of substantial prejudice or irreparable harm, which the defendant failed to demonstrate. The defendant's arguments regarding flawed medical opinions and the AME's unavailability can be addressed through standard appeal procedures. Furthermore, the defendant filed a supplemental pleading without prior permission, which was disregarded by the Board.

Petition for RemovalArlzenia HasleyEl Centro Regional Medical CenterTriStar Risk ManagementWCABWCJsubstantial prejudiceirreparable harmreconsiderationsupplemental pleading
References
2
Case No. ADJ9826556
Regular
Aug 05, 2016

Spencer Bachus vs. John F. Kennedy Memorial Hospital, Hi-Desert Medical Center

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior decision finding applicant sustained a work-related viral meningitis injury. Defendants argued insufficient medical evidence linked the injury to employment and that the identified virus was not definitively work-acquired. The WCAB determined the existing medical evidence, particularly the Qualified Medical Evaluator's opinions, did not sufficiently establish a special risk of exposure due to the applicant's specific job duties. The case was returned for further development of the record, including a more detailed analysis of the applicant's job tasks and potential exposure risks, and potentially a new medical evaluation by an infectious disease specialist.

Workers' Compensation Appeals BoardViral meningitisIndustrial injuryDual employmentPanel Qualified Medical Evaluator (PQME)Substantial medical evidenceCausationSpecial riskFurther proceedingsRescinded
References
0
Case No. ADJ10870145, ADJ8277957
Regular
Jan 30, 2023

CARLOS LOPEZ vs. PORTERVILLE SHELTERED WORKSHOP, MANUFACTURERS ALLIANCE INSURANCE COMPANY, AMERICAN CLAIMS MGMT., TREE & SIERRA MGMT., SIERRA MGMT., CIGA, INTERCARE HOLDINGS, ULLICO CASUALTY COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a decision finding the applicant sustained cumulative trauma injury while employed by both Sierra Management and Porterville Sheltered Workshop. This decision was based on the WCJ adopting the opinion of Dr. Bernhard, which was found to be substantial evidence despite conflicting medical opinions. The Board affirmed that a single physician's considered opinion can suffice as substantial evidence, even if it contradicts other medical findings. The Petitioner's arguments regarding the WCJ's reasoning and conflicting medical opinions were rejected.

ADJ10870145ADJ8277957Petition for ReconsiderationWorkers' Compensation Appeals BoardWCJ Report and Opinionsubstantial evidencephysician opinioncumulative injuryCIGAManufacturers Alliance Insurance Company
References
2
Case No. MISSING
Regular Panel Decision

MEDICAL ECONOMICS CO. v. Prescribing Reference, Inc.

This memorandum opinion and order addresses Prescribing Reference Incorporated's (PRI) motion for a preliminary injunction against Medical Economics Company and ME Licensing Corporation (MEC). PRI sought to prevent MEC from using the title 'PDR Monthly Prescribing Guide,' alleging trademark infringement and irreparable harm. The Court denied PRI's motion, concluding that PRI did not adequately demonstrate a likelihood of irreparable harm, noting the lack of concrete evidence for shifting advertising revenue or actual consumer confusion. Furthermore, the Court assessed PRI's likelihood of success on the merits of its trademark infringement claim as weak, considering the descriptive nature of PRI's mark, MEC's use of its well-known 'PDR' house mark, and the sophistication of the target audience, medical professionals.

Preliminary InjunctionTrademark InfringementIrreparable HarmLikelihood of ConfusionDescriptive TrademarksHouse MarksConsumer SophisticationHealthcare PublicationsTrademark StrengthInjunctive Relief
References
27
Case No. ADJ3147799 (RIV 0080159)
Regular
Aug 19, 2010

PETER TORCELLINI vs. SATURN ELECTRIC INC.

The Workers' Compensation Appeals Board denied Saturn Electric's petition for reconsideration, affirming the finding that Peter Torcellini sustained an injury arising out of and occurring in the course of his employment. The Board found that the Qualified Medical Evaluator's opinion constituted substantial medical evidence supporting the conclusion that a work-related stressor, even if subjectively experienced by the applicant, triggered the plaque rupture causing his cardiac arrest. The Board reasoned that the applicant's testimony about finding the work stressful and the medical opinion linking the rupture to an immediate stress response provided a reasonable basis for the finding. Defendant failed to provide evidence to contradict this medical opinion.

Workers' Compensation Appeals BoardReconsideration DeniedFinding of FactSaturn Electric Inc.Peter TorcelliniCirculatory System InjuryHeart AttackHypoxic Brain InjuryUnderground Utility TechIndustrial Causation
References
0
Case No. ADJ3371067 (VNO 0458070) ADJ4100976 (VNO 0493655)
Regular
Sep 11, 2013

WILLIAM JOHNSON vs. ENVIRONMENT INDUSTRIES dba VALLEY CREST, Permissibly Self-Insured; Adjusted by ESIS

The Workers' Compensation Appeals Board amended a prior award concerning lien claims for medical treatment by two doctors. The Board allowed Dr. Kottler's medical treatment liens based on a prior agreement, but reduced payment for his medical reports to the Official Medical Fee Schedule rates. Conversely, Dr. Singh's lien for medical treatment was rescinded as he failed to meet his burden of proof to establish the reasonableness and necessity of his treatment. The majority opinion found the agreement with Dr. Kottler enforceable, while a dissenting opinion disagreed with its interpretation and favored the fee schedule amounts.

Workers Compensation Appeals BoardReconsiderationMedical Treatment LiensOfficial Medical Fee ScheduleBurden of ProofCompromise and ReleaseAgreed Medical ExaminerPsychiatric TreatmentCustomary FeeMedical-Legal Reports
References
0
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