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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ7948651
Regular
May 09, 2016

Barbara Tom vs. CITY OF OAKLAND, JT2 INTEGRATED

This case involves a petition for reconsideration by the defendant, City of Oakland, following an award of permanent disability to applicant Barbara Tom. The defendant argued the Workers' Compensation Judge (WCJ) erred by not deferring to the Agreed Medical Evaluator's (AME) opinion and by not developing the record with the AME. The WCAB denied reconsideration, adopting the WCJ's report which found the AME's opinion deficient. The WCJ's report detailed how the primary treating physician's report was more persuasive and thoroughly reasoned, supporting the WCJ's findings over the AME's.

Workers' Compensation Appeals BoardPetition for ReconsiderationAgreed Medical Evaluator (AME)Primary Treating Physician (PTP)AMA GuidesPermanent Disability RatingCarpal Tunnel SyndromeSubstantial EvidenceWCJ OpinionMedical Opinion Deference
References
Case No. ADJ10975151
Regular
Jan 06, 2020

RUSSELL CAMARA vs. TESLA, INC., AMERICAN ZURICH INSURANCE COMPANY

In this workers' compensation case, the Applicant sustained an admitted industrial injury to the lumbar spine. The Applicant's primary treating physician (PTP) designated a secondary physician to evaluate permanent and stationary status and impairment, whose report the PTP adopted. The defense challenged the validity of this secondary physician's report, arguing only the Panel Qualified Medical Examiner's (PQME) report was properly obtained. The Workers' Compensation Appeals Board denied the Petition for Reconsideration, affirming that the PTP, or a physician designated by the PTP, is authorized to render opinions on medical issues, provided proper notice and procedural requirements are met. The Board found the designation and subsequent report were compliant with Labor Code and Administrative Director Regulations.

Workers' Compensation Appeals BoardPetition for ReconsiderationPrimary Treating PhysicianQualified Medical ExaminerLabor Code Section 4061.5Permanent and Stationary ReportMedical-Legal EvaluationSecondary PhysicianAdministrative Director Rule 9785Designation of Physician
References
Case No. ADJ3918602 (SAC 0330507) ADJ272371 (SAC 0354775)
Regular
Apr 05, 2010

THOMAS MELTON vs. COUNTY OF SACRAMENTO, SHERIFF'S DEPARTMENT

In this workers' compensation case, the defendant sought reconsideration of an award for spinal surgery recommended by the applicant's treating physician, Dr. Montesano. The defendant argued the administrative law judge should have favored the opinion of Dr. Reynolds, an agreed medical examiner. The Appeals Board denied reconsideration, finding Dr. Montesano's opinion constituted substantial evidence supporting the award. The Board affirmed the judge's discretion to choose among conflicting medical reports.

Workers' Compensation Appeals BoardJoint Findings and AwardPermissibly Self-InsuredDeputy SheriffIndustrial InjuryLow BackSpinal SurgeryTreating PhysicianAgreed Medical ExaminerSecond Opinion Physician
References
Case No. GOL 96757
Regular
Jun 10, 2008

SA YANG LO vs. CUSTOM SENSORS & TECHNOLOGIES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a prior award, upholding the application of the 2005 Permanent Disability Rating Schedule. The Board found that exceptions allowing for the 1997 Schedule did not apply, as the applicant's temporary disability indemnity extended beyond January 1, 2005, and no qualifying pre-2005 reports indicated permanent disability. Furthermore, the Board found the applicant's vocational expert's opinion regarding diminished future earning capacity unpersuasive, thus affirming the initial 9% permanent disability rating.

Workers' Compensation Appeals BoardSA Yang LoCustom Sensors & TechnologiesInc.State Compensation Insurance FundGOL 96757Opinion and Order Denying ReconsiderationFindings and AwardWorkers' Compensation Administrative Law JudgeWCJ
References
Case No. VNO 431741
Regular
Feb 22, 2008

PAULETTE FOX vs. ENTERTAINMENT PARTNERS, CNA

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The Board found the administrative law judge did not err in increasing the applicant's permanent disability rating based on the credible testimony of the applicant and the opinion of her treating physician. Any procedural defects in the original decision were cured by the judge's subsequent report.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardCumulative InjuryNew and Further Permanent DisabilityStipulated AwardPetition to ReopenWCJ Report and RecommendationMinutes of HearingOpinion on Decision
References
Case No. ADJ10033793
Regular
Aug 14, 2017

MARIA BARRERA vs. PRESTIGE CLEANERS, INC., PROCENTURY INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Maria Barrera's petition for reconsideration. The Board affirmed the Administrative Law Judge's (WCALJ) decision that Barrera failed to prove her claimed injuries arose out of and occurred in the course of employment (AOE/COE). The WCALJ properly weighed the medical evidence, finding the opinion of QME Dr. Lipson, who found no evidence of industrial injury, to be more persuasive than the treating physicians' reports. Barrera's petition did not meet procedural requirements and lacked substantial evidence to overturn the WCALJ's findings.

Petition for ReconsiderationDeniedOpinion and OrderWorkers' Compensation Appeals BoardAdministrative Law JudgeReport of Workers' Compensation Administrative Law JudgeSubstantial EvidencePhysician's OpinionCausationInjury AOE/COE
References
Case No. ADJ6704425
Regular
Apr 02, 2012

MANUEL MENDOZA vs. RACKLEY COMPANY, ZURICH AMERICAN INSURANCE CO.

The Workers' Compensation Appeals Board denied reconsideration of a decision awarding permanent disability benefits to Manuel Mendoza. The Board adopted the administrative law judge's report, which found that the primary treating physician's opinion constituted substantial evidence, even if it differed from other medical opinions. The judge's decision to follow the treating physician's rating, which included consideration of a surgical scar and pain, was upheld. The Board noted that a single physician's relevant and considered opinion can be substantial evidence in workers' compensation cases.

Workers' Compensation Appeals BoardReconsideration DeniedSubstantial EvidencePhysician OpinionAMA GuidesGuzman DecisionPermanent DisabilityPrimary Treating PhysicianPQMESurgical Scar
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
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