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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. ADJ1498961
Regular
Sep 23, 2010

DALE ARNOLD vs. RALPH'S AKA KROGER

This case involves an applicant's claim for workers' compensation benefits for a right shoulder injury. While the initial award recognized industrial injury to the applicant's left shoulder, right elbow, and right forearm, the defendant sought reconsideration, arguing the right shoulder injury was not work-related. The Appeals Board granted reconsideration, finding the applicant failed to meet the burden of proof for the right shoulder injury. They disagreed with the primary treating physician's opinion and found the agreed medical evaluator's opinion more persuasive, ultimately reversing the finding for the right shoulder.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardCumulative TraumaIndustrial InjuryLeft ShoulderRight ElbowRight ForearmRight ShoulderPrimary Treating Physician
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
Case No. MON 0320833 MON 0320834 MON 0320835
Regular
Jul 16, 2007

MICHELLE NORDQUEST-LATTIN vs. ALL CREATURES, FIREMAN'S FUND INSURANCE COMPANY

This Workers' Compensation Appeals Board decision affirms a prior award finding the applicant sustained industrial injuries to her wrist, hand, neck, shoulders, and back across multiple dates. The Board upheld the award of temporary disability indemnity and penalties for unreasonable delay in providing necessary medical treatment and indemnity payments. The defendant's contentions regarding the validity of penalties and attorney's fees were rejected.

Workers' Compensation Appeals BoardMichelle Nordquest-LattinAll CreaturesFireman's Fund Insurance Companyveterinarian nurseright major wrist and handneckshouldersbacktemporary total disability
References
Case No. MON 0325089 MON 0325090
Regular
Oct 05, 2007

NORA MEDEARIS vs. COUNTY OF LOS ANGELES

This case concerns the denial of an applicant's petition for reconsideration of a workers' compensation award. The applicant sought further temporary disability benefits beyond the 104-week limit imposed by Labor Code § 4656(c)(1). The Workers' Compensation Appeals Board denied the petition, finding the applicant failed to prove equitable estoppel against the defendant's application of the statutory limit, despite the defendant's initial refusal to authorize shoulder surgery. The Board adopted the WCJ's reasoning that the applicant did not demonstrate reliance on any conduct by the defendant that prevented her from timely pursuing authorization for the surgery.

Workers' Compensation Appeals BoardNora MedearisCounty of Los AngelesPermissibly Self-InsuredMON 0325089MON 0325090Opinion and Order Denying Petition for ReconsiderationInterim Joint Findings and AwardCentral Services TechnicianIndustrial Injury
References
Case No. ADJ7264915
Regular
Jul 15, 2013

ANA GONZALES vs. WAL-MART ASSOCIATES, INC., ACE AMERICAN INSURANCE

This case involves an applicant who sustained industrial psychiatric injury but whose orthopedic claims were denied due to insufficient medical evidence. The Appeals Board denied the applicant's petition for reconsideration, finding the applicant failed to present substantial medical evidence of industrial causation for her orthopedic complaints. A dissenting commissioner argued that the primary medical evaluator's report was deficient and lacked substantial evidence, warranting further development of the record on orthopedic injuries and other claims. The dissent emphasizes the Board's duty to ensure substantial justice, suggesting it should have ordered further investigation on the denied orthopedic issues.

WCABPetition for ReconsiderationFindings and Orderindustrial injurypsychelow backneckright shoulderright wristright elbow
References
Case No. ADJ7762783
Regular
Jul 24, 2015

JAMES MATLOCK vs. STATE OF CALIFORNIA, DEPARTMENT OF TRANSPORTATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, finding that James Matlock sustained 100% permanent disability solely from his July 14, 2004 injury to his low back, neck, headaches, and left shoulder. This decision overrules the prior finding of 78% permanent disability for that injury. The Board affirmed the separate award for the August 25, 2005 injury to his right shoulder, as separate injuries to different body parts or upper extremities do not violate the 100% combined disability limit. The case is returned to the trial level for a new final award.

Permanent Total DisabilityPetition for ReconsiderationFindings and AwardsIndustrial InjuryPermanent DisabilityLow BackNeckHeadachesLeft Non-Dominant ShoulderRight Dominant Shoulder
References
Case No. ADJ9210498
Regular
Apr 04, 2017

ELEANOR DEFRANCO vs. MONTEREY FISH COMPANY, ENSTAR (US) INC., dba ENSTAR ADMINISTRATORS FOR SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior award that found industrial injury to applicant's right ankle, right shoulder, and back, but not her right knee. The WCAB rescinded the finding of industrial injury to the back, while otherwise affirming the prior decision. Specifically, the WCAB affirmed the finding that the applicant sustained industrial injury to her right ankle and right shoulder, and that medical treatment for her right knee is compensable to relieve the effects of the industrial injuries. The WCAB adopted the WCJ's reasoning for these decisions, including the application of the *Braewood* principle for treating the non-industrial knee condition.

Workers' Compensation Appeals BoardEleanor DefrancoMonterey Fish CompanyEnstarSeabright Insurance CompanyIndustrial InjuryRight AnkleRight ShoulderRight KneeBack Injury
References
Case No. ADJ1904323 (GRO 0034275) ADJ3208896 (GRO 0034276) ADJ649343 (GRO 0034277)
Regular
Nov 01, 2010

SARAH SHIPP vs. GOTTSCHALKS, SPECIALTY RISK SERVICES

The Appeals Board granted reconsideration, rescinding the prior award due to the Workers' Compensation Judge's (WCJ) improper reliance on an Agreed Medical Evaluator's (AME) hernia analogy to rate upper extremity impairment. This analogy violated *Almaraz II* by not adhering to the AMA Guides and potentially incorporating pre-2005 rating schedules. The rater also used an incorrect impairment number and occupational adjustment. The case is remanded for further proceedings and a new decision by the WCJ, ensuring the rating is not based on the flawed hernia analogy.

Workers' Compensation Appeals BoardSarah ShippGottschalksSpecialty Risk ServicesJoint Findings and Awardindustrial injuryright shoulderleft shoulderright elbowthumb
References
Case No. ADJ1756675 (STK 0194632) ADJ2792711 (STK 0194633)
Regular
Sep 21, 2009

Scott Davis vs. RMC PACIFIC MATERIALS, INC., TRAVELERS INDEMNITY OF ILLINOIS

The applicant sought reconsideration of a Joint Findings and Award concerning industrial injuries to his right arm, shoulder, neck, psyche, and right foot/ankle. The WCJ deferred the issue of permanent disability for further medical development. The applicant's petition for reconsideration, which challenged this deferral, was dismissed. This dismissal was based on the principle that reconsideration can only be sought from a final order, and the WCJ's deferral of issues for further development is an interlocutory procedural decision. The applicant may seek reconsideration of a final award once permanent disability is determined.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings and AwardIndustrial InjuryWelder/MechanicRight ArmShoulderNeckPsycheTemporary Disability
References
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