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

Case No. ADJ2570690 (BAK 0136703) ADJ2091641 (BAK 0136704) ADJ2368957 (BAK 0136705)
Regular
Feb 01, 2016

WESLEY CHAMBERS vs. SCHLUMBERGER DOWELL, TRAVELERS INDEMNITY COMPANY OF ILLINOIS, TRAVELERS INSURANCE COMPANY

In this Workers' Compensation Appeals Board decision, the applicant sustained a 100% permanent disability award due to orthopedic and psychiatric injuries. The Board granted reconsideration, agreeing with the applicant's total permanent disability but finding the prior apportionment to non-industrial factors was insufficient. The Board amended the award to incorporate a 15% apportionment to non-industrial factors based on medical opinion, reducing the compensable permanent disability to 85%, and returned the case for a new rating. This adjustment stems from the applicant's pre-existing "family problems" which contributed to his psychiatric condition, independent of his industrial injuries.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityApportionmentCumulative TraumaPsychiatric InjuryOrthopedic InjuryAgreed Medical ExaminerQualified Medical EvaluatorMedical Evidence
References
1
Case No. ADJ7037475
Regular
Oct 04, 2018

JESUS ROJAS vs. GAY AND LESBIAN COMMUNITY CENTER, INC.; STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Jesus Rojas's petition for reconsideration, affirming the administrative law judge's award of 81% permanent disability for his admitted industrial spine injury. Rojas argued for 100% permanent disability based on an Agreed Medical Examiner's opinion of inability to return to the labor market and contended apportionment to non-industrial factors was unsubstantiated. The Board found the apportionment to pre-existing congenital stenosis was supported by medical evidence and that the *Hikida* case did not apply as Rojas's disability was not directly caused by the effects of medical treatment necessitated by both industrial and non-industrial factors. Furthermore, the Board held that Labor Code section 4662(b) does not create an independent pathway to permanent total disability.

Petition for ReconsiderationFindings of Fact and AwardPermanent DisabilityApportionmentAgreed Medical Examiner (AME)Labor Code section 4656Labor Code section 4658Labor Code section 4662(b)Hikida v. Workers' Comp. Appeals. Bd.non-industrial factors
References
2
Case No. 03-cv-4134
Regular Panel Decision

Infantolino v. Joint Industry Board of the Electrical Industry

Anthony Infantolino sued the Joint Industry Board of the Electrical Industry (JIB) and Thomas Bush, alleging unlawful retaliation under the Americans with Disabilities Act (ADA) and New York State/City laws. JIB moved for summary judgment, arguing procedural defects and substantive failures, including that it was not Infantolino's employer. The court found JIB to be a 'joint labor-management committee' and thus a 'covered entity' under the ADA, refuting the employer argument. The court denied summary judgment regarding the retaliation claims, finding genuine issues of fact as to whether JIB's stated reasons for its actions were pretexts for impermissible retaliation. However, the motion for summary judgment was granted in part, denying punitive and compensatory damages for the ADA retaliation claim and punitive damages for the New York State Human Rights Law claim, but allowing punitive damages for the New York City Human Rights Law claim.

ADA RetaliationDisability DiscriminationSummary JudgmentBurden-Shifting FrameworkCausal ConnectionPretextPunitive DamagesCompensatory DamagesNew York City Human Rights LawNew York State Human Rights Law
References
36
Case No. ADJ9971016
Regular
Aug 27, 2019

BALDEMAR GONZALEZ, JR. vs. MORGANITE INDUSTRIES, GALLAGHER BASSETT SERVICES, INC.

This case involves a dispute over the apportionment of permanent disability benefits for an applicant's hearing loss. The Workers' Compensation Appeals Board (WCAB) rescinded the original award because the administrative law judge (WCJ) failed to provide the formula used to calculate the 16% permanent disability rating. Additionally, the WCAB found that the medical evaluator's report lacked sufficient reasoning to explain how the applicant's asymmetrical hearing loss was apportioned between industrial and non-industrial causes. The matter was returned to the WCJ for further proceedings, potentially including a new medical report and deposition.

Workers' Compensation Appeals BoardReconsiderationPermanent Disability RatingApportionmentIndustrial InjuryNon-IndustrialOccupational Noise ExposureAsymmetrical Hearing LossQualified Medical EvaluatorOtology Report
References
10
Case No. ADJ1861602 (NOR 0180537) ADJ509009 (NOR 0190111)
Regular
Aug 23, 2010

MARIO VAZQUEZ vs. SOUTHERN CALIFORNIA GAS COMPANY, ALEXIS RISK MANAGEMENT SERVICES, INC.

The defendant sought reconsideration of a Workers' Compensation Appeals Board (WCAB) award of 100% permanent disability and lifetime benefits to the applicant for psychological and physical injuries. The defendant argued for apportionment to non-industrial factors, citing a medical evaluator's opinion that the applicant had pre-existing personality disorders. However, the WCAB denied reconsideration, finding the defendant failed to meet its burden of proof on apportionment, as the medical expert could not medically quantify the non-industrial contribution to the disability. Furthermore, the WCAB upheld the finding that the applicant's two industrial injuries were intertwined, preventing separate apportionment between them.

Petition for ReconsiderationJoint Findings of Fact and AwardIndustrial InjuryPsycheHeadachesSeizuresPermanent DisabilityApportionmentNon-Industrial FactorsSubstantial Evidence
References
12
Case No. ADJ268422 (MON 0326162-MF) ADJ1140304 (MON 0329012)
Regular
Jul 06, 2016

DAWN LEAH GURITZKY vs. REGENTS OF THE UNIVERSITY OF CALIFORNIA, SANTA MONICA UCLA MEDICAL CENTER

The Workers' Compensation Appeals Board granted reconsideration of a previous award finding the applicant 100% permanently disabled due to two industrial injuries. The defendant argued the judge erred by not properly applying apportionment to non-industrial factors, as required by law and supported by medical opinions. The Board found the medical evidence, particularly Dr. Friedman's, lacked sufficient apportionment analysis and the vocational evaluator's reasoning on total disability needed further clarification. The case was returned to the trial level for further development of the record on these issues.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings and AwardPermanent DisabilityApportionmentLabor Code section 4663Benson v. The Permanente Medical GroupDr. David FriedmanLuis Mas Ph.D.vocational evaluator
References
2
Case No. ADJ2590975 (STK 0190237)
Regular
Sep 12, 2011

RAFAEL DELEON vs. STATE OF CALIFORNIA, CDCR, MULE CREEK PRISON, adjusted by STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the Appeals Board affirmed a prior award granting medical treatment for applicant's diabetes. Despite the defendant's argument that diabetes treatment was for a non-industrial condition, the Board found it necessary to prevent worsening of the applicant's industrially caused heart disease. Medical evaluators concluded that controlling diabetes is an essential component of treating industrial heart conditions, making the treatment compensable. The decision hinges on the principle that treatment for non-industrial conditions is covered when essential to cure or relieve the effects of an industrial injury.

Workers' Compensation Appeals BoardIndustrial InjuryHeart ConditionDiabetesGastrointestinal DifficultiesAgreed Medical EvaluatorTreating PhysicianCardiologistMedical TreatmentLabor Code Section 4600
References
9
Case No. ADJ6591842
Regular
Jan 28, 2013

FRANCISCO LUJAN vs. MAXON INDUSTRIES, INC., CHARTIS COSTA MESA, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

This case involves a worker's compensation claim by Francisco Lujan against Maxon Industries, Inc. The defendant, Maxon Industries, filed a Petition for Reconsideration arguing that the Administrative Law Judge (ALJ) erred by relying on the medical opinions of Dr. Diane Weiss. The defendant contended Dr. Weiss's reports were not substantial evidence due to perceived discrepancies in symptom severity, lack of psychological testing, alleged ex parte communication, contradiction by another doctor, disregard of videotape evidence, and non-conformity with AMA Guides. The Workers' Compensation Appeals Board (WCAB) denied reconsideration, adopting the ALJ's report which found Dr. Weiss's opinions credible and well-reasoned, supported by the applicant's testimony and corroborated by another medical expert on the critical issue of work capacity. The WCAB also upheld the ALJ's reliance on the vocational expert's report, finding it unrebutted, and found no error in the award of attorney's fees.

Petition for ReconsiderationAgreed Medical ExaminerElectric shockSub rosa videoGAF scorePsychological testingEx parte communicationAMA GuidesVocational expertUniform Reduction Method
References
1
Case No. MISSING
Regular Panel Decision
Feb 10, 2017

Mitchell v. SUNY Upstate Medical University

Plaintiff Robbie Mitchell sued SUNY Upstate Medical Center for alleged Title VII violations, including race discrimination and retaliation, after experiencing a series of adverse employment actions. These actions included reassignment, disciplinary notices (NODs), a mandatory medical examination, a formal counseling memorandum, a verbal dispute, and eventual termination. The defendant moved for summary judgment, arguing the plaintiff failed to establish a prima facie case for most claims and that their actions were based on legitimate, non-discriminatory reasons. The court granted summary judgment in favor of SUNY Upstate Medical Center, concluding that the plaintiff failed to provide sufficient evidence of discrimination or that retaliation was the but-for cause of the challenged employment actions, and consequently, the case was closed.

Title VIICivil Rights ActEmployment DiscriminationRetaliationSummary JudgmentAdverse Employment ActionMcDonnell Douglas FrameworkWorkplace ConductDisciplinary ActionPaid Administrative Leave
References
49
Case No. ADJ11030955
Regular
Jan 06, 2020

JOSE RIVAS ESCALANTE vs. WEST ANAHEIM MEDICAL CENTER, SAFETY NATIONAL INSURANCE

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's finding of industrial injury. The Board agreed that the claim was not barred by post-termination provisions because the applicant's date of injury, defined by disability and knowledge of its industrial cause, occurred after notice of termination. Evidence showed the applicant did not suffer a compensable disability or ratable permanent disability until after he was terminated. Furthermore, the Board found that medical evaluators adequately considered non-industrial conditions in their findings of industrial causation.

Labor Code section 3600(a)(10)post-termination provisionsexception 3600(a)(10)(D)date of injurynotice of terminationcertified nurse's assistantindustrial injurycervical spinelumbar spineleft wrist
References
7
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