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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ8128282
Regular
Jan 23, 2014

ANGELA EGBIKUADJE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings. The defendant, California Department of Corrections and Rehabilitation, argued that the applicant's psychiatric injury claim was preempted by the ADA and not proven under Labor Code section 3208.3. The Board found the original decision lacked proper analysis regarding predominant industrial causation and the good faith personnel action defense. Therefore, the case was remanded for further development of the record, including expert medical opinion on these issues.

Workers' Compensation Appeals BoardAngela EgbikuadjeCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8128282Van Nuys District OfficeReconsiderationFindings and AwardIndustrial cumulative trauma injury
References
Case No. ADJ3925996 (FRE 0180480) ADJ360469 (FRE 0198851)
Regular
Oct 01, 2012

MICHAEL AKINS vs. THE SALVATION ARMY, Permissibly Self-Insured

In this workers' compensation case, the defendant, The Salvation Army, seeks to deny liability for applicant Michael Akins' recommended spinal surgery. While Akins sustained industrial injuries to his neck and back in 1998 and 2001, a subsequent non-industrial car accident in 2008 displaced hardware from his prior industrial surgery. The Board found that the industrial injury was a substantial contributing factor to the need for the current surgery, even though the non-industrial accident was the "most proximate cause." Therefore, the defendant remains liable for the recommended surgical intervention.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrderIndustrial InjurySpinal SurgeryPrimary Treating PhysicianNon-Industrial Motor Vehicle CollisionIntervening EventAgreed Medical ExaminerCausation
References
Case No. ADJ4225526 (GOL 0092072)
Regular
Apr 20, 2017

JESUS ARROYO vs. JOHN CRAVENS PLASTERING, STATE COMPENSATION INSURANCE FUND

This case involves Jesus Arroyo's petition for reconsideration of a Workers' Compensation Appeals Board decision. The Board denied reconsideration, adopting the reasoning of the workers' compensation administrative law judge. Medical evidence from Dr. Markovitz established that Arroyo suffered a total and permanent disability resulting from industrial injuries, including an aortic aneurysm repair and subsequent strokes. The Board found Dr. Markovitz's opinions constituted substantial medical evidence, despite conflicting defense opinions, and affirmed that all necessary medical care and permanent disability were industrially caused.

Workers' Compensation Appeals BoardJesus ArroyoJohn Cravens PlasteringState Compensation Insurance FundPetition for ReconsiderationAgreed Medical ExaminerGerald Markovitzechocardiogramaortic root dilationexpanding aortic aneurysm
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ8144421
Regular
Nov 21, 2016

CLINT JAMES vs. ENTERTAINMENT PARTNERS, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA administered by AIG CLAIMS

The Appeals Board granted reconsideration to find that the prior apportionment of 50% of applicant's lumbar spine impairment to non-industrial causes was not supported by substantial medical evidence. The Board found the PQME's report lacked sufficient detail to explain how non-industrial factors caused the permanent disability. Consequently, the Board rescinded the original award, found no basis for apportionment, and increased the permanent disability to 70%, deferring the issue of attorney fees for trial level determination.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAdministrative Law JudgePermanent DisabilityApportionmentQualified Medical ExaminerSubstantial Medical EvidenceLabor CodeCausation
References
Case No. ADJ1577836
Regular
May 04, 2009

JESUS GAVINO-REMIGIO vs. STRATUS SERVICES GROUP, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant injured when stepping on a metal hook, sustaining an admitted industrial injury to his right foot. The applicant sought reconsideration after the Workers' Compensation Judge (WCJ) denied findings that the injury also affected his internal systems (diabetes), eyes, and psyche, along with associated disability. The Board denied reconsideration, finding the defendant's medical expert's opinion on non-industrial diabetes causation to be substantial evidence, while deeming the applicant's medical experts' opinions insufficient. A dissenting commissioner argued the applicant's medical evidence sufficiently supported industrial causation for diabetes aggravation, warranting reconsideration.

Workers' Compensation Appeals Boardindustrial injuryright footinternal systemseyespsychediabetes mellituspermanent disabilitytemporary disabilityGerald Markovitz M.D.
References
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
Case No. ADJ31300041 (VNO 0552733) ADJ2893120 (VNO 0552734)
Regular
Apr 09, 2009

CESAR RAMIREZ vs. TIME WARNER CABLE, ESIS, INC.

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior award, finding applicant Cesar Ramirez did not sustain an industrial injury. The Board found his ventricular fibrillation, which caused a motor vehicle accident, was a spontaneous, non-industrial medical event. The applicant's claim that a sudden stop in traffic caused "shock" leading to the fibrillation was not credited by the Board. Therefore, the applicant failed to prove his injury arose out of and occurred in the course of employment.

Ventricular fibrillationLone ventricular fibrillationSpontaneous eventNon-industrial medical conditionMotor vehicle accidentIndustrial causationReconsiderationPanel Qualified Medical Evaluator (QME)FrankbackIdiopathic seizure
References
Case No. ADJ3803320 (GOL 0099004)
Regular
Aug 13, 2012

MAURA GARCIA vs. KATHY PACKER, ALLSTATE INSURANCE COMPANY

The applicant sought reconsideration of a WCJ's finding that her psyche injury was not industrially caused. The applicant argued her psychiatric condition was a compensable consequence of her orthopedic injury. The Board granted reconsideration to correct clerical errors in the date of injury. However, the Board affirmed the WCJ's finding, agreeing that the applicant failed to prove industrial causation for her psyche injury, specifically factitious disorder, as required by Labor Code § 3208.3. The matter was returned to the trial level.

Workers' Compensation Appeals BoardPetition for ReconsiderationIndustrial InjuryPsyche InjuryOrthopedic InjuryCompensable ConsequencePredominant CauseLabor Code section 3208.3Factitious DisorderAgreed Medical Evaluator
References
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