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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ8990294
Regular
Oct 26, 2015

VELMA CRUZ vs. TRINITY NURSING HOME MANAGEMENT/SERRANO SOUTH CONVALESCENT HOSPITAL, SEABRIGHT INSURANCE COMPANY

This case involves an applicant seeking workers' compensation for injuries allegedly sustained as a certified nursing assistant. The Workers' Compensation Appeals Board denied reconsideration of the administrative law judge's (WCJ) decision that found no industrial injury, adopting the WCJ's reasoning that the applicant failed to meet her burden of proof regarding causation. While one commissioner dissented, advocating for further record development due to credible testimony of injury mechanisms and potentially insufficient medical evidence, the majority upheld the denial. The majority also noted that, separate from the causation issue, a post-termination provision might also bar the claim.

WCABVelma CruzTrinity Nursing HomeSerrano South ConvalescentSeabright InsuranceADJ8990294Petition for ReconsiderationAdministrative Law JudgeFindings and OrderCertified Nursing Assistant
References
Case No. ADJ2270309 (VNO 0113668) ADJ4503834 (VNO 0113665) ADJ3103605 (VNO 0113666) ADJ2309113 (VNO 0113667)
Regular
Nov 10, 2010

MARIA GARCIA vs. CITY OF LOS ABNGELES, Permissibly Self-Insured

The Workers' Compensation Appeals Board granted reconsideration of a previous award, finding merit in the applicant's contentions regarding denied medical treatments. The Board intends to admit a nurse case manager's report that was previously excluded. This reconsideration aims to further review the factual and legal issues to ensure a just decision regarding the applicant's extensive care needs stemming from long-term quadriplegia. The Board is specifically addressing disputes over various requested services, including nursing care, home modifications, and specific medical treatments.

Workers' Compensation Appeals BoardSupplemental Findings and AwardHomecareNursing ServicesBedsore TreatmentHousekeeping ServicesHospital BedQuadriplegiaInternal InjuryLabor Code §5803
References
Case No. ADJ6772563
Regular
Nov 19, 2013

SHEILA NEWTON vs. CEDARS SINAI HEALTH SYSTEM, TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, upholding the finding that a registered nurse sustained a compensable psychiatric injury AOE/COE. The Board agreed with the Workers' Compensation Judge that the employer's conduct, specifically a meeting concerning coworker complaints and discussions of retirement, was not a lawful, nondiscriminatory, good faith personnel action. While the employer argued the meeting was a routine event based on objective complaints, the Board found the applicant's perception of age discrimination was objectively reasonable given her testimony and performance history. Therefore, the applicant's psychiatric injury claim remained compensable, entitling her to temporary and permanent disability benefits and future medical treatment.

Psychiatric injuryAOE/COElawful personnel actiongood faithobjective reasonablenessLabor Code § 3208.3(h)WCJ findingscredibilityage discriminationco-worker complaints
References
Case No. ADJ3834810 (SRO 0121550)
Regular
Sep 03, 2009

MICHAEL RISCH vs. AT HOME NURSING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's finding of 100% permanent disability for the applicant. The Board found substantial evidence supported the total permanent disability rating and the applicant's average weekly earnings. The 1997 Permanent Disability Rating Schedule was correctly applied due to pre-January 1, 2005 medical reporting indicating permanent disability. The Board also affirmed the WCJ's rejection of apportionment to pre-existing conditions, as the applicant had fully recovered and returned to strenuous work.

Workers' Compensation Appeals BoardMichael RischAt Home NursingState Compensation Insurance FundADJ3834810Opinion and Order Denying Petition for ReconsiderationFindings and Awardadministrative law judgecumulative traumaindustrial injury
References
Case No. ADJ8546489
Regular
Oct 13, 2016

THEMAS PRUETT vs. ASCO INC., STATE COMPENSATION INSURANCE FUND

The applicant seeks reconsideration of a decision denying further nurse case manager services. The WCAB granted reconsideration, holding that an employer cannot unilaterally terminate long-term, voluntarily provided nurse case manager services without medical evidence of changed circumstances. The Board found the applicant's treating physician recommended continued services, and the defendant bears the burden to prove services are no longer medically necessary. Therefore, the defendant must reinstate nurse case manager services until such medical evidence is presented.

Nurse Case ManagerUnilateral TerminationMedical NecessityBurden of ProofVoluntary ProvisionSubstantial Medical EvidencePetition for ReconsiderationLabor Code Section 4600Industrial InjuryFindings and Order
References
Case No. SBR 0326533
Regular
Sep 10, 2007

RODNEY HORTON vs. US NURSING CORPORATION

The Workers' Compensation Appeals Board granted reconsideration and rescinded the previous award, finding that the defendant's evidence regarding the applicant's intoxication, including expert testimony and a doctor's report, should not have been excluded. The exclusion was based on discovery closure rules which the Board determined were not properly applied given subsequent reopenings and disclosures. The case is returned to the trial level for admission of the controverted evidence and a new decision.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardMandatory Settlement ConferenceDiscoveryDue ProcessIndustrial InjuryNurseIntoxicationExpert Witness
References
Case No. ADJ2145551 (LAO 0846616)
Regular
Apr 14, 2009

MANUEL TORRES vs. NATIONAL DECK STAIR CORPORATION, STATE COMPENSATION INSURANCE FUND

This case involves a lien claimant, California Affordable Care, seeking reconsideration or removal of an order approving a stipulation between the defendant and another provider, West Coast Nursing. The petitioner argued the WCJ erred by ordering payment without West Coast Nursing complying with specific board rules and questioned its standing. The Appeals Board dismissed the reconsideration petition, finding the petitioner was not aggrieved by the order as their lien was not yet determined. Removal was denied, as the petitioner failed to show irreparable harm and their due process rights were preserved via a scheduled status conference. Furthermore, the petition would have been dismissed for failing to serve West Coast Nursing, a party with a competing interest, on the Board.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalLien ClaimantStipulationWest Coast NursingState Compensation Insurance FundWCJ OrderBoard RulesStanding
References
Case No. ADJ3015289 (FRE 0242633)
Regular
Jan 06, 2012

SHARON LONG vs. KAISER FOUNDATION HOSPITALS administered by KAISER PERMANENTE

This case involves applicant Sharon Long's claim for workers' compensation benefits due to cumulative trauma sustained as a registered nurse for Kaiser Foundation Hospitals. The Workers' Compensation Appeals Board granted reconsideration, reversing the initial denial of industrial injury. The Board found that Dr. Dureza's opinion, which attributed 33% of applicant's injuries to cumulative trauma from her nursing duties, constituted substantial evidence of industrial causation. The Board remanded the case for further proceedings on orthopedic benefits and the psychiatric injury claim, deferring the EDD lien.

Workers' Compensation Appeals BoardKaiser Foundation HospitalsSharon LongIndustrial InjuryCumulative TraumaRegistered NurseNeck InjuryLow Back InjurySpine InjuryPsyche Injury
References
Case No. ADJ2238226
Regular
Mar 04, 2013

JUDINE JACOBS vs. RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC.

The Workers' Compensation Appeals Board affirmed the dismissal of an applicant's claim, finding it lacked jurisdiction due to Indian tribal sovereign immunity. The applicant, a nurse, claimed a psyche injury while employed by Riverside-San Bernardino County Indian Health, Inc. (RSB). RSB, despite being incorporated under California law, was deemed a governmental entity linked to tribes and serving federal policy, thus entitled to sovereign immunity. The Board found no evidence of an explicit waiver of this immunity.

Tribal sovereign immunityWorkers' Compensation Appeals BoardIndian Healthpsyche injurynursefindings and orderjurisdictionpetition for reconsiderationreport and recommendationadministrative law judge
References
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