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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. 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. 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. ADJ1666303 LAO 0885884
Regular
Feb 07, 2011

ALTHEA RUSSELL vs. SECURITAS SECURITY SERVICES, BROADSPIRE

This case concerns a defendant's petition for reconsideration of a workers' compensation award finding the applicant sustained back, leg, and psyche injuries resulting in 65% permanent disability. The defendant argued that psychiatric medical reports were not substantial evidence and inadmissible. The Appeals Board denied reconsideration, finding the defendant waived objections to the psychiatric reports by failing to object at the mandatory settlement conference where discovery closed. Furthermore, the Board found the defendant's assertion regarding the content of the reports was factually inaccurate, and the reports did constitute substantial medical evidence.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilitySubstantial Medical EvidenceAdmissibleDiscoveryMandatory Settlement ConferenceLabor Code Section 5502Invited Error
References
Case No. ADJ3817836 (SJO 0250881)
Regular
May 31, 2012

ZUFAN A. REDA vs. FRY'S ELECTRONICS, INC., ZURICH NORTH AMERICAN INSURANCE

This case concerns applicant Zufan A. Reda's claim for permanent total disability due to a psychiatric injury. The Workers' Compensation Appeals Board (WCAB) is ordering the development of the record because neither the applicant's QME, Dr. Sidle, nor the defendant's QME, Dr. Keins, provided substantial evidence regarding the apportionment of psychiatric permanent disability. The WCAB found that Dr. Sidle's report incorrectly addressed causation of injury rather than apportionment of disability, and Dr. Keins' report was rejected as non-substantial due to prior rulings on industrial causation. Therefore, the WCAB has appointed Dr. Roy Curry as a "regular physician" to conduct a new evaluation on the issue of psychiatric permanent disability.

Petition for ReconsiderationDevelopment of RecordLabor Code section 5701Industrial InjuryPsychiatric InjuryCompensable ConsequenceSection 5803Section 5804Section 5410Permanent Total Disability
References
Case No. ADJ6535347, ADJ6534384
Regular
Nov 02, 2015

CHRISTINE KNAPP vs. COUNTY OF FRESNO

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration. The applicant sought to overturn findings of $53\%$ permanent disability and disputed the exclusion of vocational expert reports and a claim of $100\%$ disability. The Board found the petition contained numerous factual misrepresentations and violations of WCAB rules and professional conduct by the applicant's attorney. The Board adopted the WCJ's report, which recommended denial due to the petition's legal defects and factual inaccuracies.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardOccupational Group NumberIndustrial InjuryRight ShoulderMigraine HeadachesPermanent DisabilityAgreed Medical ExaminerQualified Medical Examiner
References
Case No. ADJ2653629 (LAO 0826099)
Regular
Dec 02, 2011

, Applicant, vs. HERITAGE PRINTING AND FINISHING CORP.; CHARTIS,

This case concerns the application of the 1997 or 2005 permanent disability rating schedule for a 2003 injury. The applicant's psychiatric permanent disability was found to exist as of November 1, 2004, based on a comprehensive medical-legal report. The Appeals Board affirmed the WCJ's decision to use the 1997 schedule, as the pre-2005 report triggered an exception under Labor Code section 4660(d). The defendant's arguments regarding the report's qualifications and separate rating for body parts were rejected.

Permanent disability rating scheduleLabor Code section 4660(d)1997 rating schedule2005 rating scheduleComprehensive medical-legal reportTreating physician reportAldi v. CarrMcClellanIngersollThompson & Horn
References
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