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

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. VNO 452114, VNO 452108
Regular
Aug 17, 2007

AURELIA SANCHEZ vs. PARACELSUS HEALTH CORP.

The Appeals Board granted reconsideration of the WCJ's decision, finding that the Agreed Medical Examiner's (AME) opinion regarding the applicant's neck injury was not substantial evidence. This was due to the AME's failure to review relevant medical records and consider the applicant's subsequent neck surgery. The case is returned to the trial level for further development of the record, including potentially obtaining a supplemental opinion from the AME or appointing a new medical examiner.

Workers Compensation Appeals BoardAurelia SanchezParacelsus Health Corp.industrial injurybilateral handswristsneck injuryorthopedic agreed medical examinerAMEDr. Jeffrey A. Berman
References
Case No. SFO 0495098
Regular
Jan 14, 2008

SALVADOR GARCIA vs. ABLE BUILDING MAINTENANCE, ZURICH NORTH AMERICA INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and amended the original award, reducing the applicant's permanent disability rating from 29% to 17%. This decision was based on the persuasive opinion of one medical evaluator who found minimal neck complaints, deeming a prior report stale and lacking substantial evidence regarding neck impairment. Consequently, the applicant's permanent disability indemnity was reduced to $15,023.64.

Salvador GarciaAble Building MaintenanceZurich North America Insurance CompanySFO 0495098Opinion and Order Granting ReconsiderationFindings and Awardindustrial injuryshouldersneckjanitor
References
Case No. ADJ3566412 (OAK 0340812)
Regular
Oct 04, 2010

JESUS RAMIREZ vs. NILES MACHINE & TOOL WORKS, INC., PACIFIC COMPENSATION INSURANCE COMPANY

The Appeals Board granted reconsideration to address the defendant's claim that the WCJ erred in awarding permanent disability without a specific finding on injury to the applicant's neck. The Board noted that the WCJ's permanent disability rating appeared to incorporate factors related to the cervical spine, despite no finding of industrial injury to that body part. Consequently, the Board rescinded the Amended Findings and Award and returned the case to the trial level for further proceedings and a decision on industrial injury to the neck and the proper permanent disability rating. The Board did not rule on the defendant's other arguments regarding the AMA Guides and the appropriateness of the rating.

AMENDED FINDINGS AND AWARDINDUSTRIAL INJURYUPPER EXTREMITIESSHOULDERPERMANENT DISABILITY51%RECONSIDERATIONWCJALMARAZAMA GUIDES
References
Case No. ADJ843658 (LBO 0359099)
Regular
May 05, 2010

NANCY MOLL vs. RALPH'S GROCERY COMPANY, SEDGWICK CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board denied Ralph's Grocery Company's petition for reconsideration. The defendant argued the administrative law judge erred in finding a cumulative industrial injury to the applicant's neck, citing a lack of substantial medical evidence and the WCJ's failure to consider a report from Dr. Kim. The Board adopted the WCJ's report, finding that Dr. Schiffman's reports adequately explained the delayed onset of cervical spine complaints, thus supporting the applicant's claim for the neck injury. The Board also admonished the applicant's counsel for improperly attaching an exhibit not previously entered into evidence.

Workers' Compensation Appeals BoardRalph's Grocery CompanySedgwick Claims ManagementNancy MollFindings and Awardindustrial injurybilateral shoulderselbowswristsneck
References
Case No. ADJ3957329 (OAK 0162600) ADJ621097 (OAK 0183630)
Regular
Jan 27, 2017

JUDITH KRAFT vs. CORREY JAMESTOWN, HARTFORD INSURANCE COMPANY, FACILITY SYSTEMS, INC., BROADSPIRE CONCORD

Here's a summary for a lawyer in maximum four sentences: Hartford Insurance sought removal of an order requiring it to administer the applicant's future medical award for all body parts. Hartford argued this would cause irreparable harm by potentially barring reimbursement from CIGA for neck injury treatment, for which Hartford claims no current liability. The Workers' Compensation Appeals Board denied removal, adopting the judge's reasoning that potential prejudice to Hartford was outweighed by applicant's need for a single administrator and the judge's discretion to assign administration pending adjudication of neck injury liability. Commissioner Lowe dissented, arguing Hartford faces substantial prejudice and potential liability for an injury it did not insure.

Workers' Compensation Appeals BoardPetition for RemovalFindings of FactAdministrative Law JudgeIndustrial InjuryLow BackLeft AnkleNeckDistrict ManagerAccount Executive
References
Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ2905370 (LAO 0869494)
Regular
Dec 31, 2008

JENNIFER ANN MCCLASKEY vs. POLLY'S BAKERY CAFÉ; EMPLOYERS DIRECT THOUSAND OAKS

The Workers' Compensation Appeals Board granted reconsideration to review the WCJ's award of medical treatment expenses for the applicant's neck. The Board found that the lien claimants failed to prove an industrial injury to the applicant's neck, a condition not included in the original compromise and release. Consequently, the Board reversed the WCJ's decision, disallowing the liens for treatment related to the neck.

WCABFindings and AwardReconsiderationLabor Code Section 5313Order Approving Compromise and ReleaseBilateral Carpal TunnelLien ClaimantsIndustrial InjuryNeck SymptomsAgreed Medical Evaluator (AME)
References
Case No. ADJ4399741 (LBO 0115442)
Regular
Nov 02, 2017

RONNIE BARNES vs. STATE OF CALIFORNIA/EMPLOYMENT DEVELOPMENT DEPARTMENT, STATE COMPENSATION INSURANCE FUND, STATE EMPLOYEES SANTA ANA

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The applicant sought to include a neck injury as part of a 1982 back injury award, arguing a medical definition of "back" encompassed the neck. However, the Board found no evidence of a neck injury contemporaneous to the original award and noted the claim was time-barred due to lack of a timely petition to reopen. Therefore, the Board lacked jurisdiction to amend the original findings.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderWorkers' Compensation Judge (WCJ)Permanent Disability Rating Schedule (PDRS)Date of InjuryPetition to ReopenContinuing JurisdictionLabor Code Section 5804Medical Treatment
References
Case No. ADJ576600 (VNO 0507700)
Regular
Nov 09, 2009

KAREN MAGILL vs. TUESDAY MORNING, ARROWOOD INDEMNITY COMPANY

The WCJ found industrial injury to applicant's right shoulder, neck, right upper extremity, and back, but not to other body parts. Applicant's petition for reconsideration is denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryRight ShoulderNeckRight Upper ExtremityBackTemporary DisabilityPermanent Disability
References
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