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

Case No. ADJ823138 (OXN 0142604)
Regular
Oct 25, 2010

CHERYL PEET vs. COUNTY OF VENTURA, Permissibly SelfInsured, Administered By CORVEL CORPORATION

The Workers' Compensation Appeals Board is reconsidering a prior decision that found a deputy probation officer sustained industrial injuries resulting in 78% permanent disability. The defendant sought reconsideration, arguing the Qualified Medical Examiner's (QME) opinion, which formed the basis of the award, was ambiguous and unsubstantiated. The Board agrees that the QME's assessment of 60% whole person impairment is not adequately supported by the record, particularly in light of the applicant's own testimony regarding her daily activities. Therefore, the case is returned to the trial level for further evidence development and a new decision, with consideration for cost of living adjustments if a life pension is awarded.

Workers Compensation Appeals BoardCheryl PeetCounty of VenturaCORVEL CORPORATIONADJ823138OXN 0142604Opinion and Decision After Reconsiderationdeputy probation officerindustrial injuryright upper extremity
References
Case No. ADJ1528752 (FRE 0238108) ADJ2715270 (FRE 0238107) ADJ4356655 (FRE 0238106)
Regular
Mar 10, 2014

JUANITA GUZMAN vs. BEST BUY, GALLAHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board found that the applicant's orthopedic injuries were established, resulting in a $29\%$ permanent disability rating. However, the applicant failed to provide substantial medical evidence that her industrial injuries caused or contributed to her alleged cardiovascular system issues, sleep apnea, GERD, or hypertension. Specifically, the opinion of the applicant's expert, Dr. Cayton, was deemed not substantial evidence due to reliance on an inaccurate and unverified history of the applicant's weight.

Workers' Compensation Appeals BoardJoint Findings of Fact and AwardPetition for ReconsiderationAdministrative Law JudgeBest BuyGallaher Bassett ServicesInc.Permanent DisabilityIndustrial InjuriesOrthopedics
References
Case No. ADJ6996303
Regular
Mar 23, 2023

JOHN DAVIES vs. COUNTY OF SAN DIEGO PROBATION DEPT., COUNTY OF SAN DIEGO

The Workers' Compensation Appeals Board affirmed a prior award of 84% permanent disability for a Probation Officer with heart/hypertension and hip injuries. The Board found that Labor Code section 3212.10's heart presumption and section 4663(e)'s non-attribution clause prohibit apportionment of the applicant's new and further disability. The defendant's contention that prior stipulations required apportionment was rejected, citing precedent that such presumptions take precedence. The Board clarified that the 84% represents the applicant's total permanent disability, not solely the new and further disability.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPetition for ReconsiderationPermanent DisabilityApportionmentHeart PresumptionLabor Code Section 3212.10Non-Attribution ClauseLabor Code Section 4663(e)
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. ADJ7258268
Regular
Dec 20, 2013

PATRICIA SMITH vs. WELLPOINT HEALTH NETWORKS, INC.; and ZURICH NORTH AMERICA INSURANCE CO.

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the original award. The Board found substantial evidence supported the necessity of a Jenny Craig weight loss program, including special diet food products, as reasonably necessary treatment. This was based on the applicant's need to lose weight for industrial back surgery and the program's proven success, evidenced by the applicant's 54-pound weight loss. The Board adopted the administrative law judge's report and recommendation in its entirety.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationDENIEDJenny Craigweight loss programspecial diet food productsreasonably necessary treatmentindustrial back surgerysubstantial evidencemedical treatment
References
Case No. ADJ9803664
Regular
Dec 04, 2015

JUAN GONZALEZ (Deceased), DEPARTMENT OF INDUSTRIAL RELATIONS, DEATH WITHOUT DEPENDENTS UNIT vs. CALIFORNIA HIGHWAY PATROL DISABILITY & RETIREMENT, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted removal and rescinded a judge's order that stayed proceedings pending the outcome of a probate case. The WCAB determined that probate court findings have limited relevance to determining workers' compensation death benefits and that the WCAB has sole jurisdiction over dependency issues. By staying the proceedings, the judge's order caused significant prejudice to the defendant, SCIF, by hindering discovery and resolution of a potential partial dependency claim. The matter was reset for further proceedings, with parties urged to attempt informal settlement.

Death benefitsDependencyWorkers' Compensation Appeals BoardPetition for RemovalMandatory Settlement ConferenceProbate proceedingsLabor CodeCalifornia Highway PatrolState Compensation Insurance FundDeath Without Dependents Unit
References
Case No. ADJ11295277
Regular
Mar 30, 2020

MARIA PARTIDA vs. ST. JOHN KNITS, INC., THE HARTFORD

The WCAB granted reconsideration to further review the exclusion of QME Dr. Amory's reports. Defendant argues applicant failed to prove injury arising out of and in the course of employment and that the exclusion of Dr. Amory's reports was an error. The Board will rescind the prior order and return the matter for further proceedings, specifically focusing on whether defense counsel violated Labor Code Section 4062.3 regarding communication with the QME and service of sub rosa DVD. The Board directs the WCJ to analyze these issues consistent with the precedent set in *Suon v. California Dairies*.

Workers' Compensation Appeals BoardReconsiderationFindings of Fact and OrderQualified Medical EvaluatorEx Parte CommunicationLabor Code Section 4062.3Sub Rosa DVDSubstantial Medical EvidenceArising Out of and in the Course of EmploymentAdmissibility of Evidence
References
Case No. ADJ8223604
Regular
Nov 14, 2013

DEEANNA FOBBS vs. UC DAVIS MEDICAL CENTER

The Workers' Compensation Appeals Board denied Dee Anna Fobbs' petition for reconsideration. The Board adopted the Workers' Compensation Administrative Law Judge's report and recommendations, finding that the applicant did not sustain an injury to her right knee arising out of and in the course of employment. The Board gave great weight to the WCJ's credibility findings and concluded that the overwhelming weight of the evidence supported the WCJ's decision. Applicant's claims of impeachment errors, improper denial of testimony, and adverse inference for destroyed evidence were rejected.

DEEANNA FOBBSUC DAVIS MEDICAL CENTERSEDGWICK CMSPETITION FOR RECONSIDERATIONDENIEDWCJ REPORTGARZA V. WORKMEN'S COMP. APPEALS BD.WITNESS STATEMENTSIMPEACHMENTADMISSIBILITY
References
Case No. ADJ2117331 (OAK 0261803)
Regular
May 31, 2017

Janice Payne vs. Federal Express, BROADSPIRE

This case involves Janice Payne seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision denying her weight loss program extension. The WCJ initially ruled he lacked jurisdiction due to prior Utilization Review (UR) and Independent Medical Review (IMR) denials, which were not appealed. However, the applicant argued a 2003 Compromise and Release agreement designated Dr. Mandel as the ultimate medical arbiter for treatment disputes, superseding UR/IMR. The WCAB granted reconsideration, finding the contractual agreement to use Dr. Mandel remains enforceable despite subsequent UR/IMR legislation. The case is remanded to the trial level to consider Dr. Mandel's opinions on the weight loss program's medical necessity.

Compromise and ReleaseMedical ArbiterUtilization ReviewIndependent Medical ReviewWeight Loss ProgramContractual AgreementJurisdictionSubstantial JusticeStipulationMedical Treatment Dispute
References
Case No. ADJ621872 (BAK0145447) ADJ4407215 (BAK 0151114)
Regular
Nov 13, 2012

FRANK TORRES vs. COUNTY OF KERN; PROBATION DEPARTMENT

The Workers' Compensation Appeals Board granted reconsideration to award further medical treatment for Frank Torres' cumulative trauma injury to his left knee. The Board found that the Agreed Medical Examiner's opinion provided sufficient evidence for this award, despite the judge's initial denial. This decision overturns the prior finding that no further treatment was necessary for the left knee. The award of further medical treatment clarifies and prevents potential future delays in care for the industrial injury.

Workers' Compensation Appeals BoardFrank TorresCounty of KernProbation DepartmentADJ621872ADJ4407215ReconsiderationFindings and AwardCumulative TraumaLeft Knee Injury
References
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