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

Case No. ADJ3864552 (LAO 0788138)
Regular
Jan 03, 2011

ANTONIETA GUERRERO vs. WELLPOINT HEALTH NETWORK, INC., ZURICH LOS ANGELES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For FREMONT In Liquidation

The Workers' Compensation Appeals Board granted reconsideration of a prior award due to insufficient analysis by the WCJ regarding the date(s) of cumulative trauma. The Board found the WCJ's decision lacked specific reference to evidence, particularly on whether multiple or a single period of cumulative trauma applied. The matter was returned to the trial level for further proceedings, a new decision, and adequate analysis of all contentions, including permanent disability and apportionment.

Cumulative traumaOveruse syndromeFibromyalgiaPsyche injuryPermanent total disabilityApportionmentAttorney feesFindings and AwardReconsiderationWCJ
References
Case No. ADJ7332241
Regular
Jun 30, 2011

Jesus Hernandez vs. JCB CLARK ENTERPRISES INC, U.S. FIRE AND GUARANTY

Here's a summary for a lawyer: The Workers' Compensation Appeals Board denied Jesus Hernandez's petition for reconsideration, affirming the WCJ's decision that he failed to meet his burden of proof for a cumulative trauma injury ending March 17, 2007. The applicant argued that prior injuries and a doctor's report supported his claim for a longer period, but the Board found his arguments unpersuasive. A dissenting commissioner believed the case should be returned for further proceedings on orthopedic cumulative trauma claims due to disputed employment periods and available evidence.

Cumulative TraumaPetition for ReconsiderationFindings and AwardWorkers' Compensation Administrative Law Judge (WCJ)Burden of ProofIndustrial Cumulative TraumaPast Industrial InjuryMedical EvidenceSubstantial Medical EvidenceFaulty History
References
Case No. ADJ383777
Regular
Apr 04, 2011

Roxanna Ortiz vs. ONE SOURCE, ESIS

The Workers' Compensation Appeals Board denied Roxanna Ortiz's petition for reconsideration of a prior findings and order. The initial ruling determined she sustained industrial injury only to her cervical spine as a janitor, not to other body parts or any resulting temporary/permanent disability or need for further medical treatment. Ortiz argued the judge erred by favoring defense medical reports and discrediting her testimony due to minor inconsistencies in her injury description. The Board adopted the WCJ's report, emphasizing deference to credibility determinations and that admissibility of medical reports should have been challenged at trial, not on reconsideration. A dissenting opinion argued the judge overemphasized minor variations in Ortiz's account and that medical evidence did not sufficiently support denial of other injuries or further treatment.

OrtizOne SourceESISWCABFindings and OrderPetition for ReconsiderationWorkers' Compensation Administrative Law Judgeindustrial injurycervical spineright arm
References
Case No. ADJ7050517
Regular
Jun 16, 2010

Gary Tull vs. YOUNGS MARKET, Permissibly Self-Insured Administered By CANNON COCHRAN MANAGEMENT SERVICES

This case concerns an applicant claiming cumulative trauma injury to his right knee. The WCJ denied the claim, finding the Panel QME's report insufficient to establish cumulative trauma. The Appeals Board granted reconsideration, noting the PQME found an injury and work-related causation but incorrectly characterized it as a specific injury on a particular date. The Board remanded the case to develop the medical record, specifically directing a supplemental report from the PQME on the cumulative trauma aspect of the claim.

Cumulative traumaPanel Qualified Medical EvaluatorPQMEIndustrial injuryRight kneeFindings and OrderReconsiderationTake nothing orderSubstantial medical evidenceBurden of proof
References
Case No. ADJ7785251
Regular
Nov 14, 2014

Jon Brothers vs. STATE OF CALIFORNIA, DEPARTMENT OF FORESTRY AND FIRE PROTECTION, COASTAL/NORTH REGION; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to clarify that the applicant's cumulative trauma orthopedic injury claim is still under development. The Board agreed with the WCJ that the defense's medical expert, Dr. Baldwin, failed to provide substantial medical evidence due to a misunderstanding of cumulative trauma principles. Dr. Baldwin improperly required documented prior specific injuries to opine on cumulative trauma, thereby failing to adequately assess the applicant's extensive work history. Therefore, the case is affirmed except for the amendment of a finding of fact to reflect that the orthopedic injury claim is contested and requires further medical evaluation.

Cumulative traumaQualified Medical EvaluatorIndependent Medical Evaluatorsubstantial medical evidenceorthopedic injurybinaural hearing losscardiovascular systemBattalion Chiefretired annuitantorthopedic cumulative trauma
References
Case No. ADJ1936857
Regular
Jul 08, 2010

Robert Terrazas vs. COMPUSA, Westmont College, Zurich Los Angeles, COMPWEST Newport Beach

The Workers' Compensation Appeals Board (WCAB) amended a prior award concerning Robert Terrazas's cumulative trauma knee injury. The WCAB corrected the cumulative trauma injury date to February 25, 2008, establishing liability for employers during the final year of exposure, specifically Westmont College and COMPUSA. Apportionment of disability was confirmed, but the division of liability and reimbursement between the two employers was deferred pending mandatory arbitration. The WCAB also admonished Westmont's counsel for violating procedural rules in their petition for reconsideration.

Cumulative traumaSpecific injuryApportionmentDate of injuryContinuous traumaLeft kneePermanent disabilityIndustrial exposureEmployer liabilityContribution
References
Case No. ADJ6550186
Regular
Mar 18, 2013

KELVIN EDWARDS vs. DALLAS COWBOYS, TRAVELERS INDEMNITY COMPANY AND ITS CASUALTY AFFILIATES AND SUBSIDIARIES, SAN FRANCISCO 49ERS, NATIONAL UNION FIRE INSURANCE COMPANY, CHARTIS CLAIMS, INC.

This case involves a cumulative trauma injury claim by former professional football player Kelvin Edwards. The Workers' Compensation Appeals Board (Appeals Board) affirmed the finding of a single cumulative trauma injury to multiple body parts, rejecting the defendant's argument for apportionment to different employers and dates of injury. The Appeals Board also reversed the award of a Labor Code section 5814 penalty against the San Francisco 49ers, finding their delay in paying benefits was not unreasonable. The applicant's entitlement to permanent disability and future medical treatment, as initially awarded, remains in place.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaPermanent DisabilityLabor Code Section 5500.5Injurious ExposureApportionmentLabor Code Section 5814PenaltyUnreasonable Delay
References
Case No. ADJ2630861 (LAO 0880530)
Regular
Nov 16, 2012

MARTHA PONCE vs. ASHLEY & J PHARMACY CORP, dba ROSS MEDICAL PHARMACY, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to amend a prior award, rescinding the permanent disability award for applicant's sleep loss. While the applicant was found to have sustained cumulative trauma injury to her neck, back, and psyche, the Board determined that an additional impairment rating for sleep loss was duplicative of existing orthopedic and psychiatric ratings. The original award of 53% permanent disability was reduced to 47%, and the attorney's fees were adjusted accordingly. The Board also rejected the defendant's argument for apportionment to a specific back injury, as the cumulative trauma finding was already final.

Workers Compensation Appeals BoardAshley & J Pharmacy CorpEmployers Compensation Insurance CompanyMartha PonceOpinion and Order Granting ReconsiderationDecision After Reconsiderationsleep losscumulative trauma injuryneckback
References
Case No. ADJ3858587 (ANA 0382822)
Regular
Jul 30, 2009

PEDRO GUERRERO vs. ST. LOUIS CARDINAL BASEBALL CLUB/ ANHEUSER BUSCH COMPANIES, INC; ACE/USA INSURANCE, administered by SPECIALTY RISK SERVICES, INC.

The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for removal. This action rescinded the Administrative Law Judge's (ALJ) order to issue a new decision solely on the period of continuous trauma. The WCAB found the ALJ's prior finding establishing the injury period from 1973 to 1992 was final, as the applicant failed to seek reconsideration within the statutory timeframe. Therefore, further proceedings on this issue are unnecessary, and the case is returned to the trial level for other required proceedings.

RemovalRes JudicataContinuous TraumaFindings of FactPetition for ReconsiderationLabor Code Section 5900Statutory TimeframeIndustrial InjuryPermanent DisabilityCumulative Trauma
References
Case No. ADJ11369088, ADJ11369087
Regular
Mar 24, 2025

Argelia De Luna vs. Valleywide Newspaper, LLC; Twin City Fire Insurance Company

Applicant Argelia De Luna sought reconsideration of the First Amended Findings, Award and Orders issued by the WCJ on December 16, 2024. The WCJ initially found a 68% permanent partial disability for cumulative trauma, which was later amended to 15%. Applicant argued that the WCJ's decision should have been based on unrebutted reports, that the medical record needs further development, and that defendant failed to prove apportionment. The Appeals Board granted the petition, indicating that the medical evidence might be insufficient and further review is necessary, deferring a final decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationFirst Amended Findings Award and OrdersArgelia De LunaValleywide Newspaper LLCTwin City Fire Insurance CompanyADJ11369088ADJ11369087arising out of and in the course of employment (AOE/COE)permanent and stationary
References
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