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

Case No. ADJ4452274 (RIV 0073355)
Regular
Nov 29, 2010

JOHN MCCOY vs. COUNTY OF SAN BERNARDINO, PSD CHILD; COUNTY OF SAN BERNARDINO

The Workers' Compensation Appeals Board granted reconsideration, finding the WCJ erred in applying the good faith personnel action defense to the applicant's migraine headaches. While the WCJ correctly denied the psychiatric injury claim under Labor Code section 3208.3(h), the Board determined this defense does not bar compensation for temporary disability or medical treatment caused by the industrially-related migraines. The case is remanded for further proceedings to award benefits for the applicant's migraines as supported by the Agreed Medical Evaluator's findings.

Workers' Compensation Appeals BoardGood Faith Personnel Action DefenseLabor Code Section 3208.3(h)Agreed Medical EvaluatorMigraine HeadachesPsychiatric InjuryIndustrial RelationTemporary Total DisabilityCompensable PeriodMedical Treatment
References
Case No. ADJ14669607
Regular
Apr 10, 2023

DOUGLAS HERB vs. COUNTY OF LOS ANGELES, SEDGWICK CLAIMS MANAGEMENT SERVICES, INCORPORATED

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the original finding that the applicant sustained industrial injuries to his internal system and head, causing 71% permanent disability. The defendant argued the Agreed Medical Evaluator's (AME) report regarding head injury and sleep issues lacked substantial medical evidence. The Board found the AME's report to be substantial, as it was not speculative, based on adequate examination, and explained its reasoning. Furthermore, the Board found the AME's method of analogizing the applicant's headaches to trigeminal neuralgia for impairment rating was permissible and accurately reflected the applicant's activities of daily living deficits.

GERDirritable bowel syndromehypertensionheadachessleep disturbancepermanent partial disabilityapportionmentmedical treatmentattorney's feeAgreed Medical Evaluator
References
Case No. GRO 0029797
Regular
Dec 21, 2007

MARLENA MOORE vs. ALBERTSONS, SPECIALTY RISK SERVICES

The Appeals Board granted reconsideration to further develop the medical record regarding applicant's headaches. While the applicant's injury to her neck and right shoulder was affirmed, the WCJ's denial of injury to bilateral upper extremities and headaches was modified. The case is remanded for further proceedings specifically on the industrial causation of the applicant's headaches.

Workers' Compensation Appeals BoardMarlena MooreAlbertsonsSpecialty Risk ServicesGRO 0029797Opinion and Order Granting ReconsiderationIndustrial InjuryNeck InjuryRight Shoulder InjuryBilateral Upper Extremities
References
Case No. ADJ6875600
Regular
Aug 11, 2014

SHARON WALTER vs. INTERNATIONAL CAPITAL GROUP, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded the original award, returning the case for further proceedings. Applicant disputed findings regarding psychic injury, headaches, and permanent disability, arguing that post-injury employment should be considered and medical evidence of headaches was overlooked. The WCJ's report recommended granting the petition and further proceedings are now ordered.

Petition for ReconsiderationFindings Award and Orderindustrial injurytemporary disabilitypermanent disabilitypsycheheadachespost injury employmentLabor Code section 4658(d)(2)permanent total disability
References
Case No. ADJ204379 (SBR 0326740)
Regular
Nov 23, 2016

ROBERT DIEHL vs. COUNTY OF SAN BERNARDINO FIRE DEPARTMENT, COUNTY OF SAN BERNARDINO RISK MANAGEMENT

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the finding that the applicant failed to prove injury to his psyche and headaches. The Board found the petition timely due to a substantial amendment to the applicant's permanent disability rating in the original award. However, the medical evidence presented by the applicant was insufficient to establish industrial causation for his headaches. Furthermore, the Board declined to order further development of the record, as discovery had closed prior to the mandatory settlement conference.

Petition for ReconsiderationAmended Findings AwardBurden of ProofIndustrial CausationHeadachesPermanent DisabilityTimeliness of PetitionJudicial FunctionSubstantial Material ChangeLabor Code Section 5903
References
Case No. ADJ218867
Regular
Apr 13, 2011

SANDY FRIZZELL vs. DEPARTMENT OF PARKS AND RECREATION, CHARTIS COSTA MESA, SCIF STATE EMPLOYEES SACRAMENTO

The Workers' Compensation Appeals Board denied reconsideration of a decision regarding Sandy Frizzell's claim against the Department of Parks and Recreation. The petitioner, State Compensation Insurance Fund, contested the 17% disability rating assigned for Ms. Frizzell's headaches, arguing it was improperly calculated. The Board adopted the administrative law judge's report, which found the rating expert's testimony credible and unimpeached. The judge's report explained that the rating appropriately reflected the intermittent nature of the headaches, as testified by the expert.

Workers' Compensation Appeals BoardReconsideration DeniedRating Expert TestimonyUnimpeached TestimonyCredible TestimonyLyme DiseaseContinuing TraumaState Compensation Insurance FundResource EcologistDisability Evaluation Specialist
References
Case No. ADJ9379623
Regular
May 18, 2018

ETHERY AMARI vs. CHILDREN'S HOSPITAL OF LOS ANGELES

The Workers' Compensation Appeals Board granted the applicant's petition for removal, rescinding a prior order that denied her request for an additional neurology Qualified Medical Evaluator (QME). The applicant sustained admitted injuries including to her spine and shoulder, and also claimed headaches. Her treating physician recommended a neurology consult twice, and the applicant testified about worsening headaches post-injury. The Board found that these factors constituted good cause and demonstrated significant prejudice, warranting the appointment of a neurology QME panel.

Petition for RemovalPanel Qualified Medical EvaluatorNeurology QMEWCABFindings and OrderIndustrial InjuryCervical SpineLumbar SpineHeadachesPrimary Treating Physician
References
Case No. ADJ5668010
Regular
Jan 29, 2016

RAGHBIR MAHIL vs. FOSTER FARMS

This case concerns applicant Raghbir Mahil's appeal of a WCJ's decision regarding his 2002 industrial injury. The WCJ found injury to the neck and psyche, awarding 42% permanent disability based on the AMA Guides and denying injury to the right upper extremity and headaches. Applicant argued for total permanent disability, no psychiatric apportionment, and the application of the 1997 rating schedule. The Appeals Board rescinded the WCJ's decision, returning the matter for re-rating permanent disability under the 1997 Schedule due to the timing of temporary disability payments. The Board otherwise affirmed the WCJ's findings, including no injury to the right upper extremity or headaches, and the need for neck treatment only.

Workers' Compensation Appeals BoardRaghbir MahilFoster FarmsOpinion Decision After ReconsiderationFindings and Awardadmitted industrial injuryneck injurypsyche injurypermanent disabilityAMA Guides
References
Case No. ADJ9607300
Regular
Feb 24, 2020

Danielle Manning vs. Conifer Health Solutions

The Workers' Compensation Appeals Board granted reconsideration of a prior decision regarding Danielle Manning's claim. While affirming the original decision, they amended its findings of fact. The Board specifically found that Manning sustained injury arising out of and in the course of employment to psych/stress. The issue of causation for alleged injuries to her right index finger and headaches remains deferred.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ ReportGrant ReconsiderationAmend DecisionAffirm DecisionAccounts Receivable CollectorPsych/Stress InjuryRight Index Finger InjuryHeadaches
References
Case No. VNO 479308, VNO 469079, VNO 496106, VNO 395924, VNO 395925
Regular
Sep 20, 2007

TYRONE PLAYER vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, SEDGWICK CMS

The Workers' Compensation Appeals Board denied Tyrone Player's petition for reconsideration, affirming the previous award. The Board found that the applicant failed to establish a causal link between his employment and claimed injuries of vision and headaches, as the medical evidence presented was not substantial. Furthermore, the Board concluded that reopening the medical record was unwarranted given the applicant's prior opportunities to obtain adequate evidence.

Petition for ReconsiderationJoint Findings and Awardspecific industrial injuriescumulative trauma injurymaintenance workerLos Angeles Unified School Districtvision injuryheadachespermanent disabilityLabor Code section 4664(b)
References
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