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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. 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The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings.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
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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ10788598
Regular
Jul 19, 2019

Shanai King vs. Food 4 Less

This case involves a claimant alleging a psychiatric injury due to workplace stress. The administrative law judge (WCJ) denied the claim, finding the applicant's testimony not credible and the medical evaluations insufficient. The Appeals Board granted reconsideration, rescinded the WCJ's findings, and returned the case for further proceedings. This decision stems from deficiencies in the medical evaluator's analysis of causation, conflating injury causation with permanent disability causation, and the need to develop the medical record.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrderPsyche InjuryQualified Medical EvaluatorIndustrial CausationPredominant CauseGood Faith Personnel ActionSubstantial EvidenceMedical Opinion
References
Case No. ADJ8276769
Regular
Jun 25, 2015

JAMES ROBINSON vs. REBAS, INC dba TOYOTA LIFT, ACE USA, administered by SEDGWICK CMS

The Workers' Compensation Appeals Board granted reconsideration to allow further development of the medical record regarding applicant's psychiatric injury. While affirming the finding of no neck or back injury, the Board deferred the issue of psychiatric injury causation. This decision stems from the Qualified Medical Evaluator's need for additional records and applicant's testimony to provide a definitive opinion on whether employment events predominantly caused the alleged psychiatric harm. The case is returned to the trial level for further proceedings on this specific issue.

Workers' Compensation Appeals BoardPSYCHIATRIC INJURYLABOR CODE SECTION 3208.3ACTUAL EVENTS OF EMPLOYMENTPREDOMINANT CAUSATIONMEDICAL RECORD DEVELOPMENTQUALIFIED MEDICAL EVALUATOROPINIONCAUSATIONRECONSIDERATION
References
Case No. ADJ10715455
Regular
Mar 18, 2019

MICHAEL KAMM vs. COUNTY OF MONTEREY, P.S.I., administered by INTERCARE HOLDINGS INSURANCE SERVICES, INC.

In this case, the Appeals Board partially rescinded the WCJ's award for psychiatric injury due to inconsistencies in the medical opinion regarding predominant causation. While the Board affirmed the rejection of the good faith personnel action defense, it found Dr. Lopez's opinion lacked clarity on whether employment events were the predominant cause of the applicant's overall psychiatric disability. Therefore, the matter is returned to the WCJ for further development of the medical record to clarify predominant causation before a new decision can be issued.

Workers' Compensation Appeals BoardReconsiderationPsychiatric InjuryPredominant CausationLabor Code Section 3208.3(h)Good Faith Personnel Action DefensePanel Qualified Medical Evaluator (PQME)Dr. LopezAnxiety DisorderMajor Depression
References
Case No. ADJ8789952
Regular
Nov 16, 2017

LISA STROTHER vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

This case involves Lisa Strother's claim for psychiatric injury due to cumulative trauma as a correctional officer. The Appeals Board granted reconsideration because the Agreed Medical Evaluator's (AME) report lacked specificity regarding the actual employment events causing the psyche injury and failed to properly apportion permanent disability. The Board found the AME's opinion on causation was not adequately detailed to determine if work events were the predominant cause. Therefore, the matter was returned to the trial level for further development of the record on these critical issues.

Workers' Compensation Appeals BoardLisa StrotherState of California Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8789952Fresno District OfficePetition for ReconsiderationFindings of Fact and AwardCorrectional Officer
References
Case No. ADJ10301846 ADJ8235335
Regular
Feb 07, 2019

Jack Kessler vs. E. \u0026 J. Gallo Winery

Defendant E. & J. Gallo Winery sought reconsideration of a Workers' Compensation Appeals Board decision that found applicant Jack Kessler sustained a compensable psychiatric injury. The Board denied reconsideration, affirming the administrative law judge's finding that industrial factors were the predominant cause of the applicant's psyche injury. The defendant argued the applicant failed to meet the "predominant cause" standard for psychiatric injuries and that combining two separate injuries was impermissible. The Board clarified that the issue of injury causation is distinct from the apportionment of permanent disability, and the applicant's medical evidence met the predominant cause standard.

Workers' Compensation Appeals BoardPetition for ReconsiderationNew and Further DisabilityPsyche InjuryPredominant CauseLabor Code section 3208.2Labor Code section 3208.3Cumulative TraumaSpecific InjuryApportionment
References
Case No. ADJ16528931
Regular
Apr 25, 2025

Marisa Kelly vs. Sacramento County Child Protective Services, PSI, County of Sacramento

Defendant sought reconsideration of a Findings of Fact, Awards and Orders (F&O) issued on February 5, 2025, which found that the applicant, Marisa Kelly, sustained a work-related psychiatric injury. The defendant contended that the medical evidence supporting this finding, specifically from the Panel Qualified Medical Examiner (PQME), was not substantial. The Workers' Compensation Appeals Board, after reviewing the petition and the WCJ's report, determined that the PQME's reasoning clearly supported the causation of the applicant's temporary disability and need for medical treatment. The Board concluded that the PQME's use of 'exacerbation' instead of 'aggravation' was immaterial, and therefore, the petition for reconsideration was denied.

Workers' Compensation Appeals BoardSacramento County Child Protective ServicesMarisa KellyPetition for ReconsiderationFindings of Fact Awards and OrdersInjury Arising Out of and Occurring in the Course of EmploymentAOE/COEPsycheMedical EvidencePanel Qualified Medical Examiner
References
Case No. ADJ8984416
Regular
Nov 08, 2016

MARIA GARIBAY vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration and rescinded the WCJ's decision, which had denied an applicant's claim for psychiatric injury based on the good faith personnel action defense. The Board found that the Agreed Medical Evaluator's reports were deficient regarding causation percentages. The case is returned to the trial level for further development of the record, specifically to obtain a report from the AME addressing the percentage of causation for each workplace incident. This is to allow for a meaningful review of the WCJ's future decision on predominant and substantial cause.

Good faith personnel actionLabor Code section 3208.3psyche injurypredominant causesubstantial causeAgreed Medical Evaluatorpsychiatric disabilitycausation percentagesWorkers' Compensation Appeals Boardindustrial injury
References
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