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

Case No. ADJ12182074
Regular
Jan 30, 2023

JUSTIN HAMILTON vs. SACRAMENTO REGIONAL TRANSIT

The Appeals Board rescinded a WCJ's take-nothing order and returned the case to the trial level for further proceedings. The Board found that the Agreed Medical Evaluator (AME), Dr. Campbell, needs to supplement his opinion on industrial injury causation given the WCJ's credibility finding against the applicant. Additionally, the WCJ must consider the applicant's alleged criminal conviction for workers' compensation fraud, if proven, and provide the AME with any conviction details for review. The Board emphasized that it expresses no final opinion on the injury's existence or compensability.

Workers' Compensation Appeals BoardReconsiderationIndustrial InjuryAgreed Medical EvaluatorCriminal ConvictionWorkers' Compensation FraudMedical OpinionCredibilityDiscoveryRescinded
References
3
Case No. ADJ10015666, ADJ12280547
Regular
Oct 31, 2025

YGNACIO PONCE vs. TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA, EARTHBOUND FARMS

Applicant Ygnacio Ponce sought reconsideration of Findings and Orders issued on July 19, 2021, which found that he did not sustain injury to several body parts and was not entitled to additional QME panels for internal medicine and psychology. Ponce specifically contended the workers' compensation administrative law judge (WCJ) erred in denying a QME to determine if he sustained a psyche injury. The Workers' Compensation Appeals Board affirmed the F&O, concluding there was no substantial evidence to support causation for the alleged psyche injury and that the applicant failed to demonstrate due diligence in seeking a QME panel within the mandated discovery period.

Workers' Compensation Appeals BoardReconsiderationFindings and OrdersMaterial HandlerRight Shoulder InjuryPermanent StationaryNew and Further DisabilityQualified Medical Evaluator (QME)Petition to ReopenPsyche Injury
References
2
Case No. ADJ10256108, ADJ10255968, ADJ10256212, ADJ10256223, ADJ10489875
Regular
Sep 23, 2022

JOSEPH RYAN vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Appeals Board affirmed the finding of permanent and total disability for the applicant, Joseph Ryan, stemming from industrial injuries sustained while employed as a correctional captain. However, the Board remanded the matter for further proceedings to specifically address apportionment of the permanent disability under Labor Code section 4663, considering the Agreed Medical Evaluator's opinion on pre-existing spinal disease. The Board found that the applicant's specific and cumulative trauma injuries to his spine resulted in intertwined disabilities, justifying a combined award, but that Dr. Hasday's apportionment findings require further development and determination at the trial level.

Workers' Compensation Appeals BoardJoseph RyanCalifornia Department of CorrectionsLegally UninsuredState Compensation Insurance FundADJ10256108ADJ10255968ADJ10256212ADJ10256223ADJ10489875
References
12
Case No. ADJ14871067
Regular
Feb 13, 2023

EDGAR GAMA vs. XTRACTOR DEPOT, LLC, 2020 LONG BEACH, LLC, THE HARTFORD, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the Petition for Reconsideration, upholding the judge's finding that the applicant was an employee of Xtractor Depot, LLC. The Board gave significant weight to the judge's credibility determination, finding no substantial evidence to warrant overturning it. The Board also noted the petitioner's improper attachment of exhibits to their petition. Ultimately, the applicant's credible testimony and unrebutted exhibits supported the original finding of industrial injury.

Workers' Compensation Appeals BoardPetition for Reconsideration DeniedWCJ Credibility DeterminationGarza v. Workmen's Comp. Appeals Bd.Ostensible AuthorityEmployee StatusXtractor Depot LLCAndrew YoonCannabis IndustryWarehouse Explosion
References
4
Case No. ADJ9016733
Regular
May 03, 2016

TYSON CONGER vs. CARE AMBULANCE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration of a prior award concerning industrial injuries to his low back and psyche. The applicant argues the original findings did not properly weigh evidence and support a higher permanent disability rating. The Board also permitted the applicant to file a supplemental petition to address new information, allowing defendants an opportunity to respond. Reconsideration was granted to ensure a complete review of the record and a just decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationSupplemental PetitionEmergency Medical TechnicianLow Back InjuryPsyche InjuryTemporary DisabilityFuture Medical TreatmentPermanent DisabilityApportionment
References
1
Case No. ADJ1054155 (LAO 0854446) ADJ1247741 (LAO 0854447) ADJ1895803 (LAO 0854448)
Regular
May 03, 2011

HIRITI OKUAMICHAEL vs. PAUL OWENS SHOES INC., STATE FARM FIRE AND CASUALTY COMPANY, STATE COMPENSATION INSURANCE FUND

This amended order clarifies that the Workers' Compensation Appeals Board has granted the applicant's petition for reconsideration of the February 8, 2011 Findings and Awards. This reconsideration aims to allow the Board to thoroughly study the factual and legal issues, including those to be raised in the applicant's supplemental petition. The applicant's request to file a supplemental petition has also been granted and reaffirmed. All future communications regarding these cases should be directed to the Office of the Commissioners of the WCAB.

Supplemental PetitionReconsiderationAppeals Board Rule 10848Findings and AwardsDecision After ReconsiderationOffice of the CommissionersWCABADJ1054155ADJ1247741ADJ1895803
References
0
Case No. ADJ1812731 (LBO 0352930), ADJ4306876 (LBO 0297758)
Regular
Mar 19, 2014

Applicant vs. Defendant

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration. The dismissal was based on the applicant's failure to file proof of service with the petition, a mandatory procedural requirement. Even if the merits were considered, the WCAB would have denied the petition based on the Judge's report. The applicant had sought reconsideration of a denial for a Petition to Reopen and claimed new and further disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition to ReopenFindings and OrderAgreed Medical EvaluatorNew and Further DisabilityTemporary DisabilityBad FaithProof of ServiceDismissal
References
0
Case No. ADJ10239649
Regular
Sep 02, 2016

, Applicant, vs. , Defendants.

The applicant's Petition for Reconsideration was dismissed as untimely because it was filed over twenty days after the Order Approving Compromise and Release. However, the Board returned the case to the trial level to determine if the applicant's claims of fraud regarding his employer's identity and insurance coverage constitute good cause to set aside the original settlement order. The applicant alleged he was misled into settling based on false information about his employer's insurance status. The Board acknowledges these allegations, if proven, could justify setting aside the order.

Petition for ReconsiderationOrder Approving Compromise and ReleaseuntimelyFraudSet Aside OrderJoinderDeclarative JudgmentGood CauseInequitableMistake
References
13
Case No. ADJ6729105
Regular
Sep 16, 2009

, ## Applicant, vs. , ## Defendant(s).

The Workers' Compensation Appeals Board denied reconsideration of a ruling that utilization review for the applicant's shoulder surgery was timely. The applicant argued she did not receive the denial letter within the required timeframe, but the Board found that the denial was properly sent to the treating physician and carbon-copied to the applicant within the statutory period. The Board clarified that WCAB Rule 10505(d) regarding official address records did not apply at the time of the denial because no claim application was yet filed. Therefore, the carrier's obligation was to communicate the denial in writing within the specified time, which they did.

Workers' Compensation Appeals BoardCadbury SchweppesGallagher Bassett ServicesUtilization ReviewPetition for ReconsiderationApplication for Adjudication of ClaimWCAB Rule 10505(d)Labor Code Section 4610ArthroscopyBiceps Tenodesis
References
0
Case No. VNO 0438915
Regular
Oct 23, 2008

Applicant vs. University of Southern California

This case concerns an applicant's Petition for Reconsideration of a WCAB decision denying injury claims against the University of Southern California (USC). The applicant alleged a physical altercation with his supervisor, Mr. Pickering, during a meeting on September 20, 2001, which he claims caused various injuries. However, the WCJ found the applicant lacked credibility due to inconsistencies in his testimony and failure to report the incident promptly. The WCJ relied on testimony from witnesses who stated Mr. Pickering merely touched the applicant's shoulders and noted the applicant's history of prior injuries and medical issues not fully disclosed.

WCABPetition for ReconsiderationUniversity of Southern CaliforniaBiological Safety Specialistspecific injuryanimositycredibility issuesshoulder touchingprior injurieshypertension
References
0
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