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

Case No. ADJ7781989; ADJ8262771
Regular
Oct 03, 2013

MIRIAN GARCIA vs. COOPER COLD FOODS, INC., ILLINOIS MIDWEST INSURANCE AGENCY as administrator for STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) is granting reconsideration of its own prior decision and rescinding a July 23, 2013 decision that had overturned a prior finding of 2% permanent disability for applicant's right knee injury. The WCAB determined that its August 9, 2012 order granting reconsideration was improvidently granted because the applicant had already filed a successive and improper petition for reconsideration. Consequently, the prior order and the subsequent rescinded decision are vacated, and the applicant's petition for reconsideration is dismissed.

WCABReconsiderationPetition for ReconsiderationFindings and AwardAdministrative Law JudgePermanent DisabilityIndustrial InjurySuccessive PetitionImprovidently GrantedVacated
References
4
Case No. ADJ1576468 (OXN 0133481)
Regular
Apr 20, 2009

ELAINE BREA ULT vs. LONG'S DRUG STORE, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

Defendant seeks reconsideration of a decision finding applicant temporarily totally disabled from a neck and shoulder injury. Defendant argues the judge erred by finding ongoing temporary disability when evidence suggests permanent stationary status, and by awarding temporary disability beyond statutory limits, citing *Nickelsberg*. The Appeals Board granted reconsideration due to procedural deficiencies, specifically the lack of a proper opinion by the judge and a required report on reconsideration. Therefore, the Board rescinded the original decision and returned the case for a proper record and new decision.

Workers' Compensation Appeals BoardReconsiderationTemporary Total DisabilityPermanent and StationaryLabor Code Section 4656Nickelsberg v. Workers' Comp. Appeals BoardOpinion on DecisionReport and RecommendationFindings and AwardRescinded
References
2
Case No. ADJ3615708 (BAK 0147668) ADJ2881957 (BAK 0147353) ADJ1664277 (BAK 0147354)
Regular
Oct 27, 2015

FRANCISCO JAVIER CASILLAS vs. SAN JOAQUIN VALLEY TRANSPORTATION, STATE COMPENSATION INSURANCE FUND, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The applicant sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision, arguing that a key psychiatric AME report was unreliable and that the WCJ failed to address this in the opinion. The WCAB denied the reconsideration, finding that the WCJ properly relied on the reports of a different psychiatric AME, thus rendering the applicant's argument regarding the disputed report irrelevant. However, the WCAB granted reconsideration on its own motion to correct clerical errors in the original decision identified by the parties. The matter was then remanded to the WCJ to reissue a corrected decision.

California Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact Awards and OrdersAgreed Medical Evaluator (AME)Dr. John StalbergDr. Carl Marusaksubstantial medical evidencepsychiatric claimspermanent disabilitylabor code section 132a
References
4
Case No. ADJ7159953
Regular
Feb 17, 2012

ANTONIO CORONA vs. RANDSTAD NORTH AMERICA, ACE AMERICAN INSURANCE COMPANY

Lien claimants sought reconsideration of an administrative law judge's order disallowing their liens and imposing sanctions. The Appeals Board granted reconsideration, rescinded the order, and returned the matter for a decision on the merits. The Board found the sanctions unjustified due to unclear orders regarding trial briefs and lack of proper notice, and further noted the judge failed to issue a required opinion explaining the basis for disallowing the liens. The case is remanded for a proper decision with an explanatory opinion.

Workers' Compensation Appeals BoardLien ClaimantsReconsiderationWCJ OrderSanctionsTrial BriefsBurden of ProofCompromise and ReleaseIndustrial InjuryUtilization Review
References
2
Case No. ADJ1242432 (LAO 0810317) ADJ1936406 (LAO 0857303)
Regular
Feb 01, 2011

REYNA MEZA vs. PACPRO MANAGEMENT, Dba COAST SPORTSWEAR, AMERICAN CLAIMS MANAGEMENT for EVEREST NATIONAL INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, By Its Facilitating Agent, INTERCARE INS. SERVICES, for PAULA INSURANCE COMPANY, In Liquidation

Everest National Insurance Company seeks reconsideration of an arbitrator's decision awarding CIGA $\$95,245.36$ in reimbursement for cumulative trauma benefits. Everest argues the arbitrator erred by finding the cumulative trauma extended over the applicant's entire employment, contrary to the Agreed Medical Examiner's (AME) opinion. The Appeals Board granted reconsideration, finding the AME's opinion legally flawed and lacking substantial evidence for the extended cumulative trauma period. The matter is remanded to the arbitrator for further proceedings to develop the medical record and render a new decision.

Workers' Compensation Appeals BoardIndustrial InjuryCumulative TraumaSpecific InjuryAgreed Medical ExaminerPetition for ReimbursementCalifornia Insurance Guarantee AssociationInsurance Coverage PeriodInjurious ExposureSubstantial Evidence
References
9
Case No. ADJ1137286
Regular
Mar 03, 2009

PINAZ KOLAHI vs. GENERAL MOTORS CORP., SEDGWICK CLAIMS MANAGEMENT

Defendant General Motors seeks reconsideration of a Workers' Compensation Appeals Board decision awarding temporary disability, permanent disability, and future medical treatment to applicant Pinaz Kolahi. Defendant argues the cumulative trauma period ending date is unsupported, temporary disability is unsubstantiated, and permanent disability indemnity was calculated at an incorrect rate. The Board granted reconsideration, rescinded the original and amended findings, and remanded the case for further proceedings due to an apparent inconsistency between the amended findings and opinion on decision. The Board expressed no opinion on the merits of the underlying contentions.

WCABADJ1137286VNO 0490167Pinaz KolahiGeneral Motors Corp.Sedgwick Claims ManagementFindings and AwardAmended Findings and AwardPetition for ReconsiderationReport and Recommendation
References
2
Case No. ADJ7730913, ADJ8640698, ADJ8233287, ADJ7881756, ADJ8438104, ADJ7467140, ADJ7467243, ADJ9068351, ADJ9081983
Regular
Dec 02, 2016

HOLLIS COPELAND, JR. vs. DENVER NUGGETS, PINNACOL ASSURANCE

This case involved multiple consolidated workers' compensation claims where the Board initially denied reconsideration of an order dismissing Pinnacol Assurance for lack of personal jurisdiction. The Appeals Board is now granting reconsideration on its own motion to correct clerical errors in its prior opinion. Specifically, the Board failed to list all nine adjudication file numbers and did not serve all affected applicants. The decision after reconsideration affirms the original denial of reconsideration but amends the opinion to include all case numbers.

Appeals BoardGranting ReconsiderationOn MotionDecision After ReconsiderationClerical ErrorsPersonal JurisdictionPinnacol AssuranceConsolidated CasesAdjudication File NumbersAffirm Opinion
References
0
Case No. ADJ6958585 ADJ6958588
Regular
Mar 26, 2012

Christian Ferro vs. Edgewater Motel, Inc., Compwest Insurance Company

The applicant, Christian Ferro, sought reconsideration of a WCJ's decision denying psychiatric temporary disability benefits. The Appeals Board granted reconsideration, finding that the applicant's admitted industrial injuries caused temporary partial psychiatric disability from September 16, 2011, continuing. This decision was based on an agreed medical evaluator's opinion and the defendant's failure to demonstrate the availability of suitable modified work. The penalty issue was deferred, and applicant's attorney was awarded a 12% fee.

Workers Compensation Appeals BoardPsychiatric temporary disabilityAdmitted industrial injuryCumulative injuryCrohn's DiseasePsoriasisLabor Code section 5814Agreed medical evaluatorTemporarily partially disabledOdd lot doctrine
References
4
Case No. ADJ7523216
Regular
Sep 28, 2012

MARTIN GARCIA vs. MCKITTRICK RANCH, ZENITH INSURANCE COMPANY

Applicant Martin Garcia sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision finding 2% permanent disability for a left shoulder injury. The applicant argued the Qualified Medical Examiner's (QME) opinion was insubstantial and lacked proper evaluation time. The WCAB granted reconsideration, affirming the initial findings regarding the admitted injury and temporary disability. However, the WCAB deferred the issue of permanent disability, returning the case to the trial level to address causation, permanent and stationary date, and permanent disability for other body parts (back and psyche) to avoid piecemeal decisions.

Workers' Compensation Appeals BoardReconsiderationQualified Medical ExaminerPermanent DisabilityTemporary DisabilityApportionmentLaborerIndustrial InjuryFindings of FactAward
References
0
Case No. ADJ7356433
Regular
Apr 25, 2014

TANYA PERDUE vs. COMMUNITY SYSTEMS CORPORATION, STATE COMPENSATION INSURANCE FUND

The defendant sought reconsideration of a finding of 100% permanent disability, arguing for apportionment based on the PQME's opinion. The Appeals Board granted reconsideration, finding the decedent sustained 80% permanent disability after apportionment. This decision was based on Dr. Blum's opinion, which the Board considered substantial evidence for apportionment. The dissenting commissioner argued Dr. Blum's apportionment was speculative and not substantial evidence due to his deposition testimony.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityApportionmentQualified Medical EvaluatorWhole Person ImpairmentCervical StenosisOssification of Posterior Longitudinal LigamentCentral Cord SyndromeFuture Earning Capacity
References
4
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