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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ7555409
Regular
Mar 04, 2014

JESUS ESCANUELA vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the defendant's Petition for Reconsideration and dismissed the applicant's untimely petition. The WCAB found that the Agreed Medical Examiner's (AME) opinion regarding psychiatric permanent disability was not supported by substantial evidence, as it did not properly address causation under the current PDRS. Consequently, the case is remanded to the trial level for further development of the record concerning psychiatric permanent disability. The WCAB deferred the issue of permanent disability and attorney's fees pending this further development.

Workers' Compensation Appeals BoardJesus EscanuelaCalifornia Department of Correctionslegally uninsuredState Compensation Insurance FundADJ7555409Fresno District OfficeOpinion and OrderPetition for ReconsiderationFindings and Award
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. ADJ8668832
Regular

BACILIO ANGEL SALAZAR vs. SAN DIEGO PERSONNEL AND EMPLOYMENT AGENCY, INC., AMTRUST NORTH AMERICA for CASTLEPOINT NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for removal, rescinding a prior order that deemed a QME report timely. The Board found Dr. Tahami's psychiatric evaluation report was untimely served on the defendant. As the defendant objected prior to receiving the report, they are entitled to a replacement QME panel in psychiatry.

Petition for RemovalQualified Medical EvaluatorQME paneluntimely reportreplacement QMEAdministrative Director RuleLabor Codepsychiatric injurymedical-legal evaluationsubstantial prejudice
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. ADJ7219585
Regular
Jul 06, 2015

Barbara Miljkovic vs. Southern California Edison

The Workers' Compensation Appeals Board denied Barbara Miljkovic's petition for reconsideration, affirming the Administrative Law Judge's (ALJ) decision. The Board found no industrial injury from alleged asbestos exposure, based on medical reports showing no evidence of asbestos-induced lung disease. Furthermore, the Board determined that Miljkovic's psychiatric injury was barred by Labor Code Section 3208.3(h) because the employer's personnel actions, while potentially harsh, were lawful, non-discriminatory, and conducted in good faith. The Board clarified that good faith personnel actions constituted 50% of the cause of the psychiatric injury, consistent with case law.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ reportSan Francisco Unified School District v. Workers' Comp. Appeals Bd. (Cardozo)psychiatric injurygood faith personnel actionsLabor Code Section 3208.3(h)asbestosisreactive airways diseaseRolda v. Pitnew Bowles
References
Case No. SAC 355392
Regular
Jan 29, 2008

JANELL J. HASTINGS vs. GEORGE VISMAN dba HIGH HILL RANCH, ZENITH INSURANCE COMPANY

The Appeals Board denied the applicant's Petition for Removal, which sought to compel a psychiatric or psychological consultation. The Board adopted the Workers' Compensation Judge's reasoning that a panel for psychological issues is provided by the Division of Workers' Compensation if parties do not agree on a Qualified Medical Evaluator. Therefore, the applicant's request for removal to obtain this specific consultation was denied.

Petition for RemovalPsychiatric consultationPsychological consultationQualified Medical EvaluatorAdministrative Director Rule 32(c)Agreed Medical EvaluatorDivision of Workers' CompensationMedical UnitPanelWorkers' Compensation Appeals Board
References
Case No. ADJ6892359
Regular
Feb 06, 2012

JORGE GARCIA vs. AEROSPACE DYNAMICS, INC, TRAVELERS INSURANCE

The Workers' Compensation Appeals Board denied a petition for removal filed by Travelers Insurance. The petition sought to exclude a psychiatric report and have a new QME appointed, arguing the original report lacked substantial medical evidence. The Board found that the substantiality of medical evidence is best determined at trial. Therefore, they denied removal, allowing the trial to proceed and deferring the evidentiary dispute to the trial judge.

Petition for RemovalMandatory Settlement ConferencePanel Qualified Medical EvaluatorSubstantial Medical EvidencePsychiatric ReportIndustrial Cumulative TraumaAdmissibility of Medical ReportPre-trial ArgumentsDiscretionary PowerExtraordinary Remedy
References
Case No. ADJ655912 (SDO 0342137) ADJ677760 (SDO 0342143)
Regular
Feb 11, 2009

MARIA E. GARCIA vs. SAN DIEGO UNIFIED PORT DISTRICT, AMERICAN HOME ASSURANCE COMPANY, AIG DOMESTIC CLAIMS

The Workers' Compensation Appeals Board denied both the applicant's and defendant's petitions for reconsideration. The Board upheld the trial judge's decision to deny massage therapy, finding it not medically necessary per ACOEM guidelines and not supported by the treating physician's reports. Conversely, the Board affirmed the need for a sleep study and orthopedic/psychiatric consults based on the primary treating physician's consistent recommendations, rejecting the defendant's challenges to the exclusion of PQME reports and admission of other evidence. Ultimately, the Board found substantial medical evidence supported the original award and denied both parties' requests for review.

Workers' Compensation Appeals BoardIndustrial InjuryRight ShoulderNeckFurther Medical TreatmentSleep StudyOrthopedic ConsultPsychiatric ConsultMassage TherapyPanel Qualified Medical Examiner
References
Case No. ADJ6671882
Regular
Jul 31, 2009

ANGELICA ALMANZA vs. VOLER TEAM APPAREL, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

In this case, the defendant sought reconsideration of an award requiring neurological and psychiatric consultations for the applicant. The defendant argued that a psychiatric consultation was barred by Labor Code section 3208.3(d) as the applicant had less than six months of employment. However, the Appeals Board found the record inadequate to determine if a psychiatric injury was actually claimed. Therefore, the Board granted reconsideration, rescinded the award, and returned the matter for further proceedings to establish a proper record.

Workers' Compensation Appeals BoardAngelica AlmanzaVoler Team ApparelBerkshire Hathaway Homestate CompaniesADJ6671882ReconsiderationFindings and AwardNeurological consultationsPsychiatric consultationsIndustrial injury
References
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