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

Case No. ADJ7785251
Regular
Nov 14, 2014

Jon Brothers vs. STATE OF CALIFORNIA, DEPARTMENT OF FORESTRY AND FIRE PROTECTION, COASTAL/NORTH REGION; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to clarify that the applicant's cumulative trauma orthopedic injury claim is still under development. The Board agreed with the WCJ that the defense's medical expert, Dr. Baldwin, failed to provide substantial medical evidence due to a misunderstanding of cumulative trauma principles. Dr. Baldwin improperly required documented prior specific injuries to opine on cumulative trauma, thereby failing to adequately assess the applicant's extensive work history. Therefore, the case is affirmed except for the amendment of a finding of fact to reflect that the orthopedic injury claim is contested and requires further medical evaluation.

Cumulative traumaQualified Medical EvaluatorIndependent Medical Evaluatorsubstantial medical evidenceorthopedic injurybinaural hearing losscardiovascular systemBattalion Chiefretired annuitantorthopedic cumulative trauma
References
1
Case No. ADJ 10459549, ADJ 10459544
Regular
Jul 07, 2017

SAUL MEJIA VALLADARES vs. SERVICON SYSTEMS, INCORPORATED

In this case, the Appeals Board affirmed the Arbitrator's denial of the applicant's specific injury claim from March 7, 2016, due to credibility issues and lack of substantial evidence. However, the Board rescinded the denial of the cumulative trauma claim from April 2011 to April 2016. The Board found that medical records indicated prior orthopedic complaints within the cumulative trauma period, necessitating further medical evaluation despite the applicant's credibility issues on other claims. Therefore, the cumulative trauma claim is returned to the Arbitrator for further development of the medical record.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaSpecific InjuryArbitratorCredibility DeterminationMedical EvaluationLabor Code Section 4060Carve-out CaseLabor Code Sections 3201.5
References
7
Case No. ADJ8430146 ADJ7912960 ADJ7914352
Regular
Apr 16, 2019

JULIO BALVANEDA vs. OPTIONS A CHILD CARE AND HUMAN SERVICES, EVEREST NATIONAL INSURANCE COMPANY, SPARTA INSURANCE COMPANY

The Workers' Compensation Appeals Board affirmed a WCJ's award of 95% permanent disability for industrial injuries sustained by Julio Balvaneda while employed as a gardener. The Board clarified that the specific number and dates of cumulative trauma injuries must be re-determined by the WCJ, as the record suggests a single continuous trauma due to ongoing treatment and work activities. The WCJ's finding of combined permanent disability was upheld, particularly concerning intertwined psychiatric and orthopedic impairments, referencing established case law. The matter was returned to the trial level for further proceedings on the cumulative trauma issue.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaApportionmentBensonAustinColtharpCombined Value ChartAgreed Medical EvaluatorPermanent Disability Rating
References
14
Case No. ADJ3758714 [VNO 0553350] ADJ3611380 [ANA 0372874]
Regular
Oct 03, 2008

Herbert J. Ware, Jr. vs. Los Angeles Times

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award, finding no substantial medical evidence supported the applicant's claim of cumulative trauma injury to his psyche. The Board determined that the medical evidence presented only addressed injury to the psyche as a sequela of a specific orthopedic injury, not a cumulative trauma arising from his overall employment. The case was returned to the trial level for further proceedings on all issues, including temporary disability and home health care reimbursement.

Cumulative traumapsychiatric injuryspecific injuryorthopedic injurysequelaepermanent and stationarytemporary disabilityhome health careQualified Medical EvaluatorAgreed Medical Examiner
References
0
Case No. ADJ7332241
Regular
Jun 30, 2011

Jesus Hernandez vs. JCB CLARK ENTERPRISES INC, U.S. FIRE AND GUARANTY

Here's a summary for a lawyer: The Workers' Compensation Appeals Board denied Jesus Hernandez's petition for reconsideration, affirming the WCJ's decision that he failed to meet his burden of proof for a cumulative trauma injury ending March 17, 2007. The applicant argued that prior injuries and a doctor's report supported his claim for a longer period, but the Board found his arguments unpersuasive. A dissenting commissioner believed the case should be returned for further proceedings on orthopedic cumulative trauma claims due to disputed employment periods and available evidence.

Cumulative TraumaPetition for ReconsiderationFindings and AwardWorkers' Compensation Administrative Law Judge (WCJ)Burden of ProofIndustrial Cumulative TraumaPast Industrial InjuryMedical EvidenceSubstantial Medical EvidenceFaulty History
References
10
Case No. ADJ2719991 (VNO 0485134) ADJ1334047 (VNO 0428744)
Regular
Aug 20, 2009

Catalina Barajas vs. WELLPOINT HEALTH NETWORK, INC., ZURICH LOS ANGELES

This case involves an applicant who initially sustained a cumulative trauma injury to her upper extremities during a period covered by one insurer. After returning to work with modified duties, she experienced a recurrence and worsening of symptoms, necessitating further treatment and surgery, which the Board now recognizes as a separate cumulative trauma injury. The Workers' Compensation Appeals Board granted reconsideration, reversing the prior finding of a single cumulative trauma injury. The Board held that distinct periods of compensable temporary or permanent disability, as established by medical evidence and treatment, demarcate separate cumulative trauma injuries, aligning with the *Rodarte* precedent. Consequently, the applicant was found to have sustained two separate cumulative trauma injuries, each attributed to different insurance coverage periods.

cumulative traumaanti-merger doctrineLabor Code sections 3208.25303Rodartecompensable temporary disabilitypermanent disabilitywage lossmodified workbilateral upper extremities
References
3
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
6
Case No. ADJ2630861 (LAO 0880530)
Regular
Nov 16, 2012

MARTHA PONCE vs. ASHLEY & J PHARMACY CORP, dba ROSS MEDICAL PHARMACY, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to amend a prior award, rescinding the permanent disability award for applicant's sleep loss. While the applicant was found to have sustained cumulative trauma injury to her neck, back, and psyche, the Board determined that an additional impairment rating for sleep loss was duplicative of existing orthopedic and psychiatric ratings. The original award of 53% permanent disability was reduced to 47%, and the attorney's fees were adjusted accordingly. The Board also rejected the defendant's argument for apportionment to a specific back injury, as the cumulative trauma finding was already final.

Workers Compensation Appeals BoardAshley & J Pharmacy CorpEmployers Compensation Insurance CompanyMartha PonceOpinion and Order Granting ReconsiderationDecision After Reconsiderationsleep losscumulative trauma injuryneckback
References
0
Case No. ADJ8514073 (MF) ADJ9995510 ADJ2721680 (FRE 0187462)
Regular
Sep 24, 2018

VICTOR VILLA vs. JOE CARDOZA DAIRY, PAULA INS. in receivership by CIGA, INSURANCE COMPANY OF THE WEST, SECURITY NATIONAL administered by RISICO, REPUBLIC INDEMNITY administered by SEDGWICK

This case concerns a dispute over the dates of a cumulative trauma injury to the applicant's left knee, following an admitted 1998 specific injury. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to amend the injury period. The WCAB determined the date of cumulative trauma injury under Labor Code § 5412 was September 4, 2012, the date the applicant retained counsel and gained awareness of the cumulative trauma concept. Consequently, liability for the cumulative trauma injury under Labor Code § 5500.5 was established as September 4, 2011, to September 4, 2012.

WORKERS COMPENSATION APPEALS BOARDJOE CARDOZA DAIRYPAULA INSCIGAINSURANCE COMPANY OF THE WESTSECURITY NATIONALREPUBLIC INDEMNITYSEDGWICKVICTOR VILLASUBSEQUENT CUMULATIVE TRAUMA
References
0
Case No. ADJ8680977
Regular
Apr 28, 2014

Albert Johnson vs. Southwest Airlines, ACE USA Insurance

The Workers' Compensation Appeals Board reversed a judge's decision that barred Albert Johnson's cumulative trauma claim due to the statute of limitations. The Board found that the employer's continued provision of medical treatment for Johnson's injuries tolled the one-year statute of limitations under Labor Code section 5405(c). This treatment, provided after an initial specific injury but before the cumulative trauma claim was filed, was deemed to have also addressed the cumulative trauma elements. Therefore, Johnson's claim for cumulative trauma injury ending August 17, 2009, was found to be timely filed.

Cumulative traumaStatute of LimitationsLabor Code section 5405TollingMedical treatmentSpecific injuryRamp agentSouthwest AirlinesWorkers' Compensation Appeals BoardReconsideration
References
1
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