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

Case No. ADJ4 227596 (POM 0281890) MF ADJ3 720208 (POM 0281889)
Regular
Apr 06, 2016

What Happened in Felix vs. Weber Metals Reconsideration?

The applicant sought reconsideration of a denied authorization for Synvisc knee injections. The original Independent Medical Review (IMR) denied the request, finding no documentation of the applicant's osteoarthritis failing to respond to conservative treatment. The Appeals Board found this IMR determination was based on a plainly erroneous finding of fact, as medical records in the file directly contradicted this assertion. Therefore, the Board granted the applicant's appeal, rescinded the WCJ's decision, and remanded the case for a new IMR.

Workers' Compensation Appeals BoardIndependent Medical ReviewSynvisc injectionsOsteoarthritisLabor Code section 4610.6(h)Plainly erroneous finding of factOrdinary knowledgeExcess of powersUtilization reviewTreating physician
References
1
Case No. ADJ9329099
Regular
Jan 27, 2016

How Did the WCAB Rule in Hardgrove vs. Intercon Security?

The Appeals Board rescinded the original award due to an insufficient apportionment of permanent disability. The Board found that the QME's opinion, which attributed 75% of the applicant's left knee disability to pre-existing osteoarthritis, lacked adequate reasoning and was not substantial evidence. Therefore, the case was returned for further development of the record regarding apportionment, specifically concerning the QME's rationale. The Board clarified that while the applicant sustained an admitted injury to her left knee, the extent of permanent disability and its causation require further medical evaluation.

Workers' Compensation Appeals BoardReconsiderationFindings Award OrderQualified Medical EvaluatorQMEApportionmentPreexisting OsteoarthritisPermanent DisabilitySubstantial EvidenceMedical Opinion
References
8
Case No. MISSING
Regular Panel Decision

What Did the WCAB Decide in Cuadra vs. Community Home Care?

This case involves an appeal from a Workers’ Compensation Board decision denying benefits to a claimant who experienced knee pain during employment. The Board had reversed a WCLJ’s decision, finding no accidental injury or occupational disease causally related to work, crediting medical opinions that found no causal link between the claimant's osteoarthritis and meniscus tear and his work duties. The appellate court affirmed the Board’s decision, holding that the Board's resolution of conflicting medical opinions was supported by substantial evidence.

Workers' Compensation LawAccidental InjuryOccupational DiseaseCausal RelationshipMedical Opinion ConflictSubstantial EvidenceKnee InjuryOsteoarthritisMeniscus TearEmployment-related Injury
References
9
Case No. ADJ3584476 (RIV 0084688)
Regular
Feb 03, 2012

How Were Death Benefits Handled in Bocanegra vs. Sun-Gro Commodities?

The Appeals Board affirmed the WCJ's decision, finding applicant reached permanent and stationary status on October 3, 2008, based on Agreed Medical Evaluator (AME) Dr. Chun's substantial evidence. The Board also upheld the 90% apportionment of permanent disability to applicant's pre-existing degenerative osteoarthritis, finding Dr. Chun's opinion supported by Dr. Rimoldi's report. The applicant's arguments regarding the P&S date and apportionment were rejected as misplaced or not supported by substantial evidence.

Workers' Compensation Appeals BoardOpinion and Decision After ReconsiderationIndustrial InjuryPermanent and Stationary DateAgreed Medical Evaluator (AME)Temporary Total Disability (TTD)ApportionmentDegenerative OsteoarthritisPre-existing ConditionSubstantial Evidence
References
7
Case No. MISSING
Regular Panel Decision
Apr 21, 1978

Can a WCJ Be Disqualified for Appearance of Bias?

The case involves an appeal by a claimant from a Workers' Compensation Board decision, filed November 21, 1977, and corrected April 21, 1978. The Board concluded that the claimant did not have a causally related disability after December 4, 1972, stemming from an accident on November 8, 1972. This finding was based on Dr. Bastable's report, which found no causally related disability for the injury, and the testimony of Dr. Gruman and Dr. Naumann, who reported underlying osteoarthritis. The Appellate Division affirmed the Board's decision, stating it was supported by substantial evidence.

Disability ClaimCausationMedical OpinionOsteoarthritisWorkers' Compensation AppealBoard DecisionSubstantial EvidenceAppellate AffirmationMedical Expert TestimonyInjury Date
References
0
Case No. MISSING
Regular Panel Decision
Jun 10, 1991

What Were the Key Rulings in Torrez vs. SuperShuttle?

Jerrold L. Cunningham appealed the denial of worker's compensation benefits from the Obion Chancery Court, which found no compensable injury during his employment with Goodyear. Cunningham argued his pre-existing osteoarthritis was aggravated by strenuous work. The Supreme Court of Tennessee affirmed the lower court's decision, stating that an increase in pain from a pre-existing condition, without advancement in its severity or a specific industrial accident, does not constitute a compensable injury. The dissenting opinion contended that the evidence demonstrated an advancement in the severity of Cunningham's condition, warranting benefits for permanent disability.

Workers' CompensationOsteoarthritis AggravationPre-existing Medical ConditionCompensability StandardsMedical Expert TestimonyRheumatology FindingsEmployment-related DisabilityTennessee Supreme CourtAppellate Review of FactsMaterial Evidence Rule
References
6
Case No. ADJ18058034
Regular
Sep 23, 2025

Why Was Removal Denied in Rush vs. California Correctional Institution?

Applicant sought reconsideration of a $23\%$ permanent disability award, arguing the $40\%$ apportionment to non-industrial factors lacked substantial medical evidence. The Workers' Compensation Appeals Board denied reconsideration, adopting the trial judge's report. The Board found the Qualified Medical Evaluator's apportionment was based on substantial medical evidence, including applicant's pre-existing osteoarthritis and a prior knee replacement, which explained the causation for the permanent disability. The Board also confirmed timely action on the petition within the statutory 60-day period.

Workers' Compensation Appeals BoardPetition for ReconsiderationPermanent Partial DisabilityApportionmentSubstantial Medical EvidenceLabor Code Section 5909Electronic Adjudication Management SystemPanel Qualified Medical EvaluatorWhole Person ImpairmentAMA Guides
References
7
Case No. 2025-60-2109
Regular Panel Decision
Aug 12, 2025

What Did the WCAB Clarify in Ontiveros vs. Savers Stores?

Patricia Evans, an employee of Kroger Company, requested medical benefits for a left-knee injury, which Kroger denied. The employer's denial was based on the authorized treating physician's opinion that the injury was not work-related. Dr. William Kurtz diagnosed severe osteoarthritis and a Baker's cyst, attributing these conditions to pre-existing issues rather than the alleged workplace incident. The Court agreed with the physician's findings, noting the employee failed to provide a contrary medical opinion. Consequently, the Court denied Ms. Evans's claim for medical benefits, determining she was unlikely to prevail at a final hearing.

Workers' CompensationMedical BenefitsLeft Knee InjuryOsteoarthritisBaker's CystCausationPre-existing ConditionExpedited HearingMedical OpinionPanel Physician
References
1
Case No. 2016-06-2007
Regular Panel Decision
Apr 13, 2017

Why Was Reconsideration Denied in Gomez vs. Dorothy Stevens?

Ms. Keyes sought an expedited hearing for her workers' compensation claim after Bridgestone Americas denied it, asserting her left knee injury did not primarily arise from employment. Medical evaluations by Dr. Lane Tippens and Dr. Michael Reid indicated chronic osteoarthritis and a degenerative meniscal tear, with Dr. Reid explicitly stating the injury was not work-related. The court, noting the lack of contrary medical evidence, denied Ms. Keyes' requested relief, concluding she was unlikely to prevail on causation. The employer also faced a referral to the Penalty Unit for failing to file a wage statement as required.

Knee InjuryDegenerative ConditionCausation DisputeMedical EvidenceExpedited HearingPreexisting ConditionBurden of ProofTennessee Workers Compensation LawEmployer Non-ComplianceWage Statement Violation
References
2
Case No. 2020-06-0716
Regular Panel Decision
Sep 02, 2021

Why Was Reconsideration Dismissed in Sabino vs. Johnson Pump Company?

Jimmy Dix, Jr. alleged a right hamstring injury in April 2019 while employed by Nyrstar Clarksville, Inc. He claimed the authorized treating physician, Dr. Kurtis Kowalski, focused solely on his preexisting osteoarthritis, neglecting the hamstring tear. The Court, agreeing with Mr. Dix and supported by Dr. Philip Karpos's assessment of a significant hamstring tear, ruled that Nyrstar must authorize additional medical treatment for the hamstring injury with Dr. Kowalski. However, the request for temporary disability benefits was denied due to insufficient evidence regarding disability duration and work restrictions from Dr. Kowalski.

Hamstring TearOsteoarthritisMedical Treatment DisputeTemporary Disability BenefitsAuthorized Treating PhysicianEmployer's ResponsibilityCausation of InjuryMaximum Medical Improvement (MMI)Expedited HearingTennessee Workers' Compensation
References
5
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