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

Case No. ADJ1220987 (SJO 0262634)
Regular
Nov 17, 2010

RICHARD GILLISPIE vs. PLASTECH, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) appealed an award of benefits to an applicant with a pre-existing disability, arguing a subsequent industrial back injury did not cause pathology in the opposite leg as required by statute. The Appeals Board affirmed the award, finding that Labor Code section 4751 only requires the subsequent injury to "affect" the opposite member, not necessarily cause direct pathology. Evidence showed the applicant's low back injury caused verified radiculopathy and impaired leg function, meeting the statutory requirement. The Board found SIBTF's legal arguments unpersuasive and the WCJ's findings supported by substantial evidence.

Subsequent Injuries Benefits Trust FundLabor Code section 4751industrial injurylow backradiculopathypermanent disabilityopposite and corresponding memberpathologyAMA GuidesDRE category III
References
Case No. ADJ9655057, ADJ10399527
Regular
Jun 18, 2018

BELEN AGUILAR vs. PRECISION HAY COMPANY, CALIFORNIA FARM MANAGEMENT SELF INSURED GROUP

The Workers' Compensation Appeals Board granted reconsideration to applicant Belen Aguilar because the administrative law judge's findings were not supported by substantial evidence. Specifically, the medical opinions regarding permanent disability and apportionment from QME Dr. Santaniello were deemed insufficient due to lack of information about the applicant's work duties across various employers. The case is returned to the judge for further proceedings to develop the medical record on injury and apportionment.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactAward & OrderPanel Qualified Medical EvaluatorPermanent DisabilityApportionmentSubstantial EvidenceMedical OpinionLumbar Spine Injury
References
Case No. ADJ18058034
Regular
Sep 23, 2025

ROBERT MERRIWEATHER vs. HP HOOD, LLC, ACE AMERICAN INSURANCE COMPANY

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
Case No. GRO 0029816, GRO 0029817
Significant

Marlene Escobedo vs. Marshalls, CNA Insurance Co.

The Appeals Board affirmed the WCJ's decision to apportion 50% of the applicant's permanent disability to a preexisting degenerative arthritis, holding that Labor Code section 4663, as amended by SB 899, permits apportionment based on causation from non-industrial factors supported by substantial medical evidence.

SB 899apportionmentcausationpermanent disabilitypreexisting arthritismedical evidencesubstantial evidenceLabor Code section 4663compensable consequenceQME
References
Case No. ADJ2329367 (OAK 0323054)
Regular
May 06, 2013

JOSEPH VALTIERRA vs. TCB INDUSTRIAL, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and rescinded the WCJ's award due to inadequate medical evidence regarding the applicant's left shoulder injury. Both the applicant's and defendant's medical evaluators provided opinions that were found to be speculative, incomplete, and not based on a full understanding of the underlying pathology. The Board determined that substantial evidence was lacking on the apportionment of disability and the precise nature of the left shoulder condition. The case is returned to the trial level for further development of the medical record.

Compensable consequenceApportionmentSubstantial evidenceMedical opinionReasonable medical probabilityUnderlying pathologyLeft shoulder injuryRight shoulder injuryMillwrightCumulative trauma
References
Case No. ADJ10455142
Regular
Oct 19, 2017

RUBEN CELEDON vs. ADVANCED STRUCTURAL ALLOYS, LLC, ENSTAR NORTH AMERICA

The Workers' Compensation Appeals Board denied a defendant's petition to disqualify the administrative law judge (WCJ). The defendant alleged bias due to a purported "preexisting relationship" with applicant's attorney and the WCJ's rulings. However, the defendant provided no specific facts to support the relationship claim, and the WCJ denied it. Erroneous rulings, even if numerous, do not automatically establish judicial bias, and the WCJ had previously corrected an order at the defendant's request. The Board found no evidence of bias and denied the petition for disqualification.

Petition for DisqualificationWCAB Rule 10452WCJ biaspreexisting relationshiperroneous rulingsaffidavitCode of Civil Procedure Section 641declaration under penalty of perjurysubjective perception of biasWorkers' Compensation Appeals Board
References
Case No. ADJ10387978
Regular
Aug 13, 2019

MELE LATU vs. HEWLETT PACKARD ENTERPRISE SERVICES, SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case involves a denied petition for reconsideration regarding Subsequent Injuries Benefits Trust Fund (SIBTF) benefits. The applicant settled her industrial injury claim for $937,166, then sought SIBTF benefits. The Board denied the petition because the applicant failed to prove a pre-existing "labor disabling" condition, which is a requirement for SIBTF eligibility even after statutory changes. Medical evidence indicated the applicant was asymptomatic and functional prior to her industrial injury, and any apportionment was to asymptomatic pathology, not a labor-disabling condition.

Subsequent Injuries Benefits Trust FundSIBTFLabor Code section 4751labor disablingpermanent partial disabilityapportionmentSenate Bill 899SB 899asymptomatic pathologyEscobedo v. Marshalls
References
Case No. SJO 243795
Regular
Sep 17, 2007

BAIRO SISIC vs. VASONA MANAGEMENT, INC., UNITED STATES FIRE INSURANCE COMPANY

The Appeals Board granted reconsideration because the administrative law judge (WCJ) incorrectly applied the 1997 Permanent Disability Rating Schedule. The WCJ's reasoning for using the older schedule, based on pre-existing pathology and unadmitted medical reports, was flawed. The case is remanded for a new decision on which rating schedule applies, considering Labor Code § 4660(d) and whether specific reports or prior temporary disability payments trigger the 1997 schedule.

Workers' Compensation Appeals BoardVasona ManagementInc.United States Fire Insurance CompanyCrum & Forsterpermanent disability rating1997 Schedule2005 Schedulepre-existing pathologydegenerative disc disease
References
Case No. ADJ3705124 (VNO 0496493)
Regular
Jul 09, 2015

Dusty Glenn Garman vs. California Department of Corrections, California Substance Abuse Treatment Facility; Subsequent Injuries Benefits Trust Fund

The Appeals Board reversed a WCJ's decision, finding that applicant Dusty Glenn Garman had preexisting permanent disability or impairment prior to his industrial injury. This finding was based on substantial medical evidence, including deposition testimony from Dr. Markovitz and cardiac catheterization lab results, indicating significant coronary artery stenosis. Consequently, the Board determined that the Subsequent Injuries Benefits Trust Fund (SIF) is liable for benefits as the applicant met the statutory thresholds for such liability.

Subsequent Injuries Benefits Trust FundPreexisting permanent disabilityRetroactive prophylactic work restrictionCoronary artery diseaseApportionmentHeart troubleLabor Code § 4751Labor Code § 3212.2Medical evidenceStenosis
References
Case No. ADJ8423386
Regular
Nov 14, 2016

CARLOS FIGUEROA vs. PERFORMANCE AUTO CARE, AMTRUST NORTH AMERICA

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's decision that apportioned 50% of the applicant's left knee disability to non-industrial factors. The Board found that the agreed medical evaluator's opinion on apportionment lacked sufficient detail and clarity to constitute substantial evidence. Consequently, the Board deferred the issues of permanent disability and apportionment, remanding the case for further development of the record. This will involve obtaining clarification from the medical evaluator regarding how prior injuries and pathology specifically contributed to the applicant's current impairment and the success of his knee replacement surgery.

Workers' Compensation Appeals BoardPetition for ReconsiderationApportionmentAgreed Medical EvaluatorOrthopedistSubstantial Medical EvidenceAMA GuidesWhole Person ImpairmentTotal Knee ReplacementPre-existing Pathology
References
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