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

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings.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. OAK 216926 OAK 207971
Regular
Jun 27, 2008

JAMES SHERRY vs. CONNELLEY'S FINE FURNITURE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a finding of 100% permanent disability for applicant James Sherry. Although the Board found the presumption of total disability under Labor Code section 4662(d) inapplicable, they affirmed the 100% permanent disability award based on vocational evidence and medical opinions regarding the applicant's severe psychological impairments and constant headaches. The Board also determined that the defendant failed to establish apportionment to a prior disability award, as the current psychological impairments were solely attributed to the industrial injuries.

Workers' Compensation Appeals BoardConnelley's Fine FurnitureState Compensation Insurance FundOAK 216926OAK 207971Opinion and Order Denying Reconsiderationindustrial injurieskneesnecklow back
References
Case No. ADJ8700541
Regular
Oct 17, 2019

ZAHRA STEPHENS vs. COX ENTERPRISES, INC.

The Appeals Board granted reconsideration to review the WCJ's finding of permanent and total disability based on the opinions of a psychologist, Dr. Windman, and a vocational expert, Mr. Wilkinson. The Board found that Dr. Windman's opinion lacked substantial evidence due to inconsistencies, inadequate record review, and conflicts with other medical opinions. Consequently, Mr. Wilkinson's vocational opinion, which relied heavily on Dr. Windman's findings, was also deemed not substantial evidence. The case is remanded to the trial level for further proceedings and a new determination of permanent disability.

Workers' Compensation Appeals BoardReconsiderationPermanent Total DisabilityMedical OpinionVocational ExpertSubstantial EvidencePQMENeurologistPsychologistOrthopedist
References
Case No. LAO 0793819
Regular
Oct 05, 2007

REYNA SAAVEDRA vs. LILLIAN MILLER, THE HARTFORD INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior decision denying a lien claim for homecare services. The Board found that the record was unclear regarding the necessity and type of homecare provided by the applicant's mother. The case is remanded for further development of the medical record, specifically requiring a supplemental opinion from the applicant's treating psychologist on the reasonableness of the homecare.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationIndustrial InjuryLow Back InjuryPsychiatric InjuryHomecare ServicesReasonably RequiredCure or RelieveMedical Treatment
References
Case No. ADJ3810369
Regular
Apr 08, 2009

NANCY PHILLIPS vs. SAN JACINTO UNIFIED SCHOOL DISTRICT, ACE/USA, KEENAN & ASSOCIATES

The Workers' Compensation Appeals Board denied Nancy Phillips' petition for reconsideration of an administrative law judge's award of $7,500 in attorney's fees to her former counsel, Jeffrey S. Segal. Phillips argued her prior counsel was only worth $1,500 and that she secured a better settlement on her own. The Board found Segal's $7,500 fee justified, considering the case's complexity, the significant responsibility he assumed, and the settlement he generated prior to being substituted out. Therefore, the Board upheld the original award, denying Phillips' request for reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardCompromise and ReleaseAttorney's FeesLien ClaimAdministrative Law JudgeIndustrial InjuryBack InjuryPsyche Injury
References
Case No. ADJ7574646
Regular
Jan 25, 2012

HEATHER YARBOROUGH vs. JENNY CRAIG, AIG INSURANCE c/o SEDGWICK CMS

The Workers' Compensation Appeals Board dismissed the defendant's petition for removal and reconsideration as untimely, as it was filed 34 days after the order was served. The petition argued the administrative law judge erred by ordering treatment outside the Medical Provider Network, but the board found the petition was filed beyond the jurisdictional time limits. Furthermore, the board noted that the order compelling the defendant to arrange for a PQME evaluation and other examinations was not a final order, which is required for reconsideration. Therefore, both petitions were dismissed.

WCABPetition for RemovalPetition for ReconsiderationUntimely FilingMPNMedical Provider NetworkNeurosurgeonOrthopedistNeurologistTreating Doctor
References
Case No. ADJ7820546
Regular
May 06, 2013

GONZALO GONZALEZ vs. LUCIO FAMILY ENTERPRISES, INC., IMPERIUM INSURANCE COMPANY

This case involves an applicant's petition for reconsideration which the Board dismissed as improperly filed, as it was not from a "final" order determining substantive rights or liabilities. The Board also denied the applicant's petition for removal, finding no showing of substantial prejudice or irreparable harm. The underlying issue concerns whether the applicant's alleged head injury from a paintball incident caused a subsequent aneurysm. The judge recommended further discovery by an appropriate medical specialist to determine causation, as the existing QME's report was deemed insufficient on this complex medical issue.

Petition for ReconsiderationPetition for RemovalInterlocutory OrderFinal OrderSubstantive RightAOE/COELabor Code §3209.3(c)Medical CollaborationQMEPsychologist
References
Case No. ADJ10278736
Regular
Nov 15, 2019

UFRACINA CERVANTES vs. STRATEGIC RESTAURANT COMPANY II, LLC, NEW HAMPSHIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of a finding of $75\%$ permanent disability. The applicant argued for $100\%$ permanent disability based on vocational and medical expert opinions. The Board found the applicant failed to meet her burden of proof for total disability due to insufficient substantial medical evidence. A dissenting commissioner believed the record was undeveloped, particularly regarding a requested functional capacity evaluation and a psychiatric evaluation, and that further development was necessary for substantial justice.

WCABPetition for ReconsiderationFindings and AwardPermanent DisabilityVocational ExpertFunctional Capacity EvaluationQualified Medical EvaluatorResidual Functional CapacityPain Management SpecialistPsychologist
References
Case No. ADJ6904193
Regular
Oct 25, 2019

SHEILA FRANK vs. DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration to address the applicant's contentions regarding apportionment of permanent disability and the denial of permanent and total disability. The Board found that the defendant failed to meet its burden of proof for apportionment, as the medical expert's opinion lacked substantial evidence and detail. Consequently, the applicant is entitled to an unapportioned award of permanent and total disability. The case is returned to the trial level for further proceedings to determine the award and attorney's fees.

Workers Compensation Appeals BoardPermanent DisabilityApportionmentLabor Code Section 4663(c)ReconsiderationMedical TreatmentCumulative TraumaPsychologistDepartment of CorrectionsState Compensation Insurance Fund
References
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