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

Case No. ADJ3135090 (SAC 0355157) ADJ6834808
Regular
Sep 12, 2019

GUY LEE vs. UOP/MCGEORGE SCHOOL OF LAW, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board affirmed the WCJ's decision denying benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). Applicant's prior stipulation dismissing claims for sleep disturbance, sexual dysfunction, and psychiatric injury bound him from pursuing these for SIBTF benefits. Even without those dismissals, applicant's permanent disability rating for the subsequent injury, after adjustments, did not meet the 35% threshold required for SIBTF eligibility. The WCJ's finding that the industrial injury was not the predominant cause of the claimed psychiatric injury also contributed to the denial.

Subsequent Injuries Benefits Trust FundLabor Code section 4751permanent partial disabilitystipulated dismissalpredominant causepsychiatric injurybilateral carpal tunneldiminished future earning capacityWCJWorkers' Compensation Appeals Board
References
4
Case No. ADJ5621413
Regular
Sep 15, 2016

LORI RENFRO vs. SUMMIT COUNSELING AND EDUCATION, STATE COMPENSATION INSURANCE FUND, SUBSEQUENT INJURIES BENEFIT TRUST FUND

This case involves applicant Lori Renfro's claim for Subsequent Injuries Benefit Trust Fund (SIBTF) benefits following a work injury. The WCJ initially awarded benefits, finding the industrial injury's standalone disability exceeded the 35% threshold. The SIBTF appealed, arguing the injury's standalone disability was below 35% and the prior disability should be measured at the time of the subsequent injury. The Appeals Board rescinded the award, finding the WCJ erred by not properly applying the 35% threshold for the subsequent injury alone. The matter is remanded to determine the applicability of Labor Code section 4751(a) and to re-evaluate the 70% combined disability threshold, measuring prior disability as it existed before the subsequent injury.

Subsequent Injuries Benefit Trust FundSIBTFpermanent disability thresholdapportionmentLabor Code section 4751combined disabilityprior disabilitysubsequent injuryvocational expertQME
References
4
Case No. ADJ5779347, ADJ6812428, ADJ6812429
Regular
Nov 16, 2012

RICHARD RAMIREZ vs. GEORGIA-PACIFIC, LLC

This case involves an applicant claiming psychiatric injury along with physical injuries. The Workers' Compensation Appeals Board granted reconsideration to address the defendant's contention that the applicant failed to meet the statutory threshold for psychiatric injury. Ultimately, the Board found no industrial psychiatric injury, rescinded the previous award, and issued a new award for physical injuries, permanent disability, and necessary future medical treatment for those injuries. The Board also clarified that while the applicant needs treatment for depression and sleep issues, these were not found to be industrially caused.

WCABGeorgia-PacificLLCESISFindings and OrderReconsiderationFindings and Awardpsychiatric injurycumulative traumapermanent disability
References
0
Case No. ADJ3552048 (LAO 0795520)
Regular
Feb 28, 2011

JAVIER GALINDO vs. MEAT EXPORTE CORPORATION, STATE COMPENSATION INSURANCE FUND

This case involves a lien claimant's appeal challenging the disallowance of psychiatric treatment costs. The Workers' Compensation Appeals Board (WCAB) affirmed the original decision, finding the applicant did not meet the six-month actual work requirement under Labor Code section 3208.3(d) for psychiatric injury claims. The applicant's extensive absences due to an admitted orthopedic injury meant he did not perform six months of actual service. The WCAB clarified that this six-month threshold applies even to psychiatric injuries stemming from admitted physical injuries. The lien claimant's arguments regarding detrimental reliance and the necessity of treatment for the orthopedic injury were also rejected.

Labor Code Section 3208.3(d)psychiatric injurysix months actual worklien claimantindustrial orthopedic injurydetrimentally reliedimplied authorizationWorkers' Compensation Appeals BoardFindings and OrderPetition for Reconsideration
References
6
Case No. MISSING
Regular Panel Decision

Claim of Kessler v. Fairmont Theater, Inc.

Claimant, employed for two days in 1986 as a projectionist, sought workers' compensation benefits for psychiatric injury and eye injury. He alleged harassment from his employer and supervisor caused a nervous breakdown, and projector light injured his eyes. The Workers’ Compensation Law Judge dismissed the psychiatric injury claim but found prima facie evidence for vision impairment, remitting that part for further development. The Workers’ Compensation Board subsequently ruled against the psychiatric trauma claim, a decision supported by employer and supervisor testimony denying harassment and claimant's psychiatrist confirming prior psychiatric issues. The appellate court affirmed the Board's decision, concluding that it was based on substantial evidence and that issues of credibility are within the Board's purview.

Psychiatric InjuryNervous BreakdownEye InjuryEmployment TerminationIntoxicationHarassmentCredibilitySubstantial EvidenceWorkers' Compensation BenefitsAppellate Review
References
2
Case No. ADJ6438312
Regular
Apr 06, 2009

BRANDON MOORE vs. MARINER HEALTH CARE, INC., STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's claim for psychiatric injury as a consequence of an admitted lumbar spine injury. The primary issue is whether the applicant met the six-month employment requirement under Labor Code § 3208.3(d) for compensable psychiatric injury claims. The applicant was hired on August 6, 2007, and last worked on January 29, 2008, falling short of the six-month threshold. The Appeals Board found that "employment" under the statute requires the performance of actual services, rejecting the argument that simply remaining on payroll suffices, citing precedent. Therefore, the Board granted reconsideration, rescinded the prior finding, and held the applicant did not sustain a compensable psychiatric injury.

Workers' Compensation Appeals BoardLabor Code Section 3208.3(d)compensable consequencepsychiatric injurysix-month employment requirementactual serviceWal-Mart Stores v. Workers' Comp. Appeals Bd. (Garcia)obiter dictumMillsAtalla
References
5
Case No. ADJ1279352
Regular
Nov 18, 2010

WARREN BARNA vs. PACIFIC TUBE, ST. PAUL TRAVELERS, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of an award finding them liable for an applicant's psychiatric injury. The applicant had previously settled orthopedic claims and a cumulative trauma claim. The Appeals Board granted reconsideration to amend the original decision, adding specific findings required by Labor Code section 4751 regarding the applicant's pre-existing psychiatric disability and the compensable industrial psychiatric injury. The Board affirmed the original finding of liability against the SIBTF, while clarifying the applicant's eligibility for SIBTF benefits and addressing the issue of potential offsets.

Subsequent Injuries Benefits Trust Fundpsychiatric disabilitypre-existing disabilityindustrial injurypermanent partial disabilityLabor Code section 4751Workers' Compensation Appeals Boardreconsiderationcumulative traumaspecific injury
References
0
Case No. MISSING
Regular Panel Decision

Poblet v. Parisi

Plaintiff, Mrs. Poblet, suffered alleged "post-traumatic neurosis syndrome" after a car collision on February 20, 1981, claiming serious injury requiring psychiatric care. Defendants moved for summary judgment, asserting the plaintiff failed to establish "serious injury" under New York's No-Fault Law (Insurance Law § 5102 [d]). Judge Alan LeVine evaluated whether a solely psychiatric injury could meet the "serious injury" threshold, including whether it constituted a "significant limitation of use of a body function or system" or a non-permanent injury preventing substantially all daily activities for 90 days. The court, citing legislative intent to limit minor injury lawsuits, held that while medically determined, Mrs. Poblet's condition did not prevent her from performing substantially all daily activities for the statutory period. Consequently, the defendants' motion for summary judgment was granted, dismissing the complaint.

Summary JudgmentNo-Fault LawSerious Injury ThresholdPsychiatric InjuryPost-Traumatic Neurosis SyndromeAutomobile AccidentInsurance LawCPLR 3212 MotionMedical EvidenceMental Health Impact
References
4
Case No. ADJ3207910 (SJO 0257814)
Regular
Jul 20, 2010

BARTON LEWIS vs. COUNTY OF SANTA CLARA, SUBSEQUENT INJURIES BENEFITS TRUST FUND (SIBTF)

This case concerns the Subsequent Injuries Benefits Trust Fund (SIBF) liability for applicant Barton Lewis, who suffered multiple industrial injuries. The SIBF contested the applicant's eligibility, arguing he did not meet the statutory thresholds for benefits. The Board affirmed the Administrative Law Judge's decision, finding the applicant met the 35% permanent disability threshold under Labor Code section 4751 based on the February 5, 2003 injury alone, without apportionment. This decision allows the applicant to receive benefits from the SIBF.

Workers' Compensation Appeals BoardSubsequent Injuries Benefits Trust FundSIBTFdistrict attorney investigatorindustrial injurylow backbrainheartright armcumulative injury
References
1
Case No. ADJ7832100
Regular
Jan 09, 2017

William Reid vs. Subsequent Injuries Benefits Trust Fund

This case involves a Subsequent Injuries Benefits Trust Fund (SIBTF) claim where the applicant, William Reid, sought benefits due to a cumulative injury to his feet and back. The SIBTF petitioned for reconsideration, arguing the applicant's subsequent injury alone did not meet the statutory threshold for benefits and that prior impairments were asymptomatic or improperly assessed. The Workers' Compensation Appeals Board denied the petition, adopting the WCJ's report. The WCJ found the applicant met the 5% opposite and corresponding impairment threshold with a combined permanent disability rating of 10% from his feet and back, and that pre-existing conditions like hypertension and gout qualified as disabling impairments. Ultimately, the WCJ concluded the applicant was rendered totally permanently disabled, establishing SIBTF liability.

Subsequent Injuries Benefits Trust FundLabor Code section 4751opposite and corresponding thresholdpermanent disabilitycumulative traumaasymptomatic impairmentvocational rehabilitation consultantOrthopedic AMEDr. DevorDr. Panting
References
1
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