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Case Law Database

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

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The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings.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. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ6465992
Regular
Apr 04, 2023

WILLIAM HUFFORD vs. HOWELL'S FOREST HARVESTING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board reversed a prior decision that denied applicant William Hufford's claim for benefits. The Board found that the defendants failed to prove either that Hufford was intoxicated at the time of his accident or that any potential intoxication was a proximate cause of the injury. Furthermore, the Board determined that even if the "going and coming rule" would normally apply, an exception exists because the employer provided the vehicle and it was used as an incident of employment. Consequently, Hufford's injury was found to have arisen out of and in the course of employment.

Workers' Compensation Appeals BoardADJ6465992Opinion and Decision After ReconsiderationCompensable InjuryArising Out of and in the Course of Employment (AOE/COE)Intoxication DefenseProximate CauseGoing and Coming RuleVehicle-Use ExceptionBlood Alcohol Level
References
Case No. ADJ1635860 (ANA 0371188) ADJ3803325 (ANA 0371189)
Regular
Feb 20, 2018

SHERRY HOUGH vs. COOPERVISION, EMPLOYERS INSURANCE OF WAUSAU

This case involves an applicant seeking workers' compensation benefits for medical treatment recommended by her physician. The defendant contested responsibility, arguing a 2016 motor vehicle accident was the sole proximate cause of the need for treatment, not the applicant's 2002 industrial injury. The Board affirmed the finding that the treatment was at least partially related to the industrial injury but amended the order. This amendment defers the determination of medical necessity for the requested treatment pending further development of the record. Crucially, the defendant was precluded from utilizing the utilization review process due to their failure to properly notify the applicant and her attorney of their deferral decision.

Workers' Compensation Appeals BoardReconsiderationJoint Findings and OrderRequest for Authorization (RFA)Utilization Review (UR)Intervening CauseProximate CauseAgreed Medical Examiner (AME)Causally RelatedCumulative Trauma
References
Case No. ADJ3925996 (FRE 0180480) ADJ360469 (FRE 0198851)
Regular
Oct 01, 2012

MICHAEL AKINS vs. THE SALVATION ARMY, Permissibly Self-Insured

In this workers' compensation case, the defendant, The Salvation Army, seeks to deny liability for applicant Michael Akins' recommended spinal surgery. While Akins sustained industrial injuries to his neck and back in 1998 and 2001, a subsequent non-industrial car accident in 2008 displaced hardware from his prior industrial surgery. The Board found that the industrial injury was a substantial contributing factor to the need for the current surgery, even though the non-industrial accident was the "most proximate cause." Therefore, the defendant remains liable for the recommended surgical intervention.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrderIndustrial InjurySpinal SurgeryPrimary Treating PhysicianNon-Industrial Motor Vehicle CollisionIntervening EventAgreed Medical ExaminerCausation
References
Case No. BAK 0141141
Regular
Mar 07, 2008

Briant Certuche vs. TRANS-SYSTEMS, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board rescinded the previous decision, finding insufficient consideration of whether the applicant's Valley Fever infection was industrially caused or solely due to living in the San Joaquin Valley. The case is returned to the trial level for further development of the medical record, specifically to address the relative likelihood of environmental versus occupational exposure. This decision acknowledges that employment need only be a contributory cause for injury compensability.

Workers' Compensation Appeals Boardindustrial injuryValley Fevercoccidiomycosisproximate causeoccupational exposuregeographic endemicmedical-legal expertsubstantial evidencecontributing cause
References
Case No. ADJ10950502
Regular
Mar 10, 2020

ROBERT HANSEN (Deceased), DIANA HANSEN, MAYA HANSEN, CALLIE HANSEN, ROBERT GENE REINHARDT, Guardian Ad Litem For MATTHEW HANSEN and TAYLOR HANSEN vs. FREIGHT HANDLERS, LLC., LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding that the deceased sustained a compensable industrial injury causing death. The Board agreed with the WCJ that the defendant failed to prove the decedent's intoxication proximately caused the injury, despite acknowledging the decedent was intoxicated. Furthermore, the Board found substantial evidence supported the WCJ's conclusion that the death was not a suicide and that the decedent remained within the course of employment under the commercial traveler rule, even with his intoxication and the employer's zero-tolerance policy.

Compensable Industrial InjurySuicide DefenseIntoxication DefenseCourse of EmploymentCommercial Traveler RuleProximate CauseBurden of ProofSubstantial Evidence RuleCredibility DeterminationsZero Tolerance Policy
References
Case No. ADJ2393396 (VNO 0518987) ADJ1912573 (VNO 0518986)
Regular
May 05, 2015

CHRISTOPHER COLON vs. MILES CHEMICAL COMPANY, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation claim where the applicant alleged serious and willful misconduct by his employer, Miles Chemical Company. The applicant claimed the employer failed to provide adequate safety equipment, specifically respiratory filters, leading to injuries from chemical exposure. The Workers' Compensation Appeals Board denied reconsideration, affirming the trial judge's finding that the employer's actions did not constitute serious and willful misconduct. The Board found the applicant's injuries were caused by third-party forklift drivers and lacked sufficient evidence that the alleged inadequate respiratory filters were the proximate cause of the injury or that the employer acted with the requisite intent or recklessness.

Workers' Compensation Appeals BoardSerious and willful misconductLabor Code section 4553Industrial injuryChemical exposureRespiratory filtersNegligenceProximate causeSubstantial evidenceManaging officer
References
Case No. ADJ8661529
Regular
Dec 23, 2016

PETER HANSEN vs. PAR ELECTRICAL CONTRACTORS, INC.; GALLAGHER BASSETT SERVICES

This case involves a workers' compensation claim by Peter Hansen for injuries sustained on October 1, 2012. The administrative law judge initially found the injury not compensable, concluding applicant's intoxication was the substantial and proximate cause. On reconsideration, the Board affirmed this decision, finding the employer met its burden of proof. Medical evidence, including a toxicologist's opinion, established that applicant's blood alcohol level at the time of the fall, estimated to be 0.165 or higher, caused significant impairments leading to the injury.

Workers' Compensation Appeals BoardPar Electrical ContractorsGallagher Bassett ServicesPeter Hansenlinemanintoxicationsubstantial and proximate causeblood alcohol testQualified Medical EvaluatorDr. Mummaneni
References
Case No. ADJ9510323
Regular
Mar 02, 2018

JONATHON SCOTT MCCARTNEY vs. COUNTY OF SACRAMENTO CONTRACTS, YORK RISK SERVICES GROUP

This case involves Jonathon Scott McCartney's claim for workers' compensation benefits due to actinic keratosis. The Administrative Law Judge initially denied the claim, finding insufficient evidence of industrial causation, despite McCartney's significant sun exposure as a deputy sheriff. The Workers' Compensation Appeals Board granted reconsideration, finding that McCartney's cumulative sun exposure during employment was a contributing proximate cause of his condition. Relying on *South Coast Framing, Inc. v. Workers' Comp. Appeals Bd.*, the Board held that employment only needs to be a contributing factor, not the sole or primary cause, for an injury to be deemed industrial.

Actinic keratosisDeputy SheriffCumulative traumaIndustrial causationContributing proximate causeSouth Coast FramingPanel Qualified Medical EvaluatorMedical causationSun exposureWork-related injury
References
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