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

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In this case, the Appeals Board partially rescinded the WCJ's award for psychiatric injury due to inconsistencies in the medical opinion regarding predominant causation.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
3
Case No. MISSING
Regular Panel Decision

Kurz v. St. Francis Hospital

The defendants moved to preclude plaintiffs' expert testimony on causation or, alternatively, for a pretrial hearing regarding the plaintiff's vision loss. The plaintiff developed visual disturbances shortly after receiving Amiodarone intravenously following cardiac bypass surgery in 2008. Defendants argued a lack of scientific evidence linking short-term Amiodarone use to optic neuropathy, while the plaintiff's expert contended that rapid drug absorption could cause optic disc edema, a known side effect. Furthermore, the plaintiff highlighted medical records where defendant physicians themselves initially attributed the vision loss to the medication. The court, applying the Frye standard, determined that general causation—Amiodarone causing vision loss—is an established medical theory. It further ruled that the specific causation tests from Parker and Cornell, typically applied to toxic tort cases, were not strictly applicable here due to the distinct nature of medical malpractice. Consequently, the court denied the defendants' motion, finding an adequate foundation for the admissibility of the plaintiff's expert testimony, with any disputes regarding specific timing affecting only the weight of the evidence, not its admissibility.

Medical MalpracticeExpert TestimonyCausationAmiodaroneOptic NeuropathyVision LossMotion in LimineFrye StandardParker StandardCornell Standard
References
9
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
5
Case No. ADJ8645491
Regular
Apr 28, 2015

LEOPOLD VASQUEZ vs. G&K MANAGEMENT COMPANY, CHUBB INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior order, and returned the case for further proceedings because the Agreed Medical Examiner's psychiatric opinion regarding the predominant cause of the applicant's injury was unclear, contradictory, and lacked substantial evidence. The AME confused causation of injury with apportionment of disability, and did not definitively state that industrial factors were the predominant cause of the psychiatric injury. The Board determined the medical record required further development to properly adjudicate the claim.

Workers' Compensation Appeals BoardIndustrial InjuryPsyche InjuryAgreed Medical ExaminerCausationApportionmentPersonnel Action DefenseLabor Code Section 3208.3Liberal ConstructionPreponderance of Evidence
References
13
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
1
Case No. ADJ8550821, ADJ9443562
Regular
Feb 06, 2017

ESMERALDA REYNOSO vs. COUNTY OF VENTURA

This case concerns a worker's compensation claim for psychiatric injury due to continuous trauma from 1998-2012. The defendant sought to overturn the finding that the injury arose out of employment, arguing the medical expert's reports lacked substantial evidence due to alleged inconsistencies and incomplete history. The Appeals Board affirmed the original award, finding the expert's opinions on industrial causation were sufficiently consistent and based on an adequate medical history. The Board found the defendant's arguments failed to undermine the expert's conclusions regarding predominant industrial causation.

Workers' Compensation Appeals BoardJoint Findings and AwardReconsiderationPanel Qualified Medical Examiner (PQME)Substantial Medical EvidenceContinuous Trauma InjuryPsychiatric InjuryCausationIndustrial FactorsPersonnel Actions
References
0
Case No. ADJ8935673
Regular
Jun 08, 2015

ANGEL URRUTIA vs. CARDENAS MARKETS, INC.

The Workers' Compensation Appeals Board granted reconsideration of a decision denying applicant's claim for psychological injury. The Board found that while the applicant's alleged work events occurred, the medical evidence regarding predominant causation was unclear. Therefore, the matter was returned to the trial level for further development of the medical record, specifically requesting clarification from Dr. Surapaneni on whether actual employment events were the predominant cause of the applicant's injury. The Board emphasized the need for clear medical evidence establishing work-related causes as more than 50% of all causal factors.

Labor Code section 3208.3psychiatric injurypredominant causationindustrial cumulative traumagender transitionrestroom usediscriminationactual events of employmentsubstantial medical evidencefurther development of the record
References
6
Case No. ADJ3189130 (STK 0188538)
Regular
Dec 08, 2010

DAVID DYKES vs. E. & J. GALLO WINERY

The Workers' Compensation Appeals Board granted reconsideration of a prior decision that found the applicant sustained a compensable industrial injury to his psyche. The Board found that the applicant failed to meet the burden of proof under Labor Code section 3208.3(b)(1) that actual employment events were the predominant cause of his psychiatric injury. Medical evidence submitted by the applicant's own psychologist was deemed insufficient due to lack of clear reasoning and an inability to establish predominant causation. Therefore, the Board amended the findings to reflect that no compensable industrial injury to the psyche was proven.

Workers' Compensation Appeals BoardE. & J. Gallo WineryDavid Dykesindustrial injurypsyche injurycompensable consequenceLabor Code section 3208.3(b)(1)predominant causesubstantial medical evidenceDr. Robert Schneider
References
4
Case No. ADJ8339114
Regular
Sep 10, 2014

SHEENA KOREIE vs. LOS ANGELES COUNTY OFFICE OF EDUCATION

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of a finding of no compensable psyche injury. The Board admonished applicant's attorney for disrespectful and procedurally improper filings, citing multiple violations of the Labor Code and Board rules. The WCJ's report, adopted by the Board, found the applicant's testimony lacked credibility and that actual events of employment did not predominantly cause the alleged psychiatric injury, as required by Labor Code section 3208.3. The WCJ also noted the lack of corroborating evidence for the hostile work environment claim and the PQME's opinion was not sufficiently clear on predominant causation by actual events.

PSYCHE INJURYCONTINUOUS TRAUMAHOSTILE WORK ENVIRONMENTVERGAOBJECTIVE EVIDENCESUBJECTIVE EVIDENCEACTUAL EVENTS OF EMPLOYMENTPREDOMINANT CAUSEPQMELABOR CODE 3208.3
References
12
Case No. ADJ10560768
Regular
Nov 15, 2018

JOHN BROADFOOT vs. COUNTY OF EL DORADO

The Workers' Compensation Appeals Board denied reconsideration of a denial for a deputy sheriff's psyche injury claim. The applicant argued the Qualified Medical Evaluator's (QME) opinion was not substantial evidence. However, the Board found the QME thoroughly evaluated the applicant and concluded employment was not the predominant cause of any mental disorder. The Board affirmed that lay opinion cannot override expert medical testimony on complex medical causation issues.

Workers' Compensation Appeals BoardDeputy SheriffCumulative InjuryPsychePanel Qualified Medical EvaluatorVladimir BokariusSubstantial Medical EvidencePetition for ReconsiderationLabor Code § 3208.3Predominant Cause
References
2
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