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Case Law Database

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

Case No. ADJ649373
Regular
Aug 01, 2014

TRENA GIBNEY vs. GLENDALE ADVENTIST HOSPITAL, ADVENTIST HEALTH

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration, upholding the judge's findings. The judge ruled that the applicant was entitled to referrals to a pulmonologist, nephrologist, and hematologist, as well as an AFO brace. The Board rejected the defendant's supplemental pleading and admonished their counsel for misstating facts, noting potential future sanctions. The applicant sustained a catastrophic injury as a registered nurse in 2008 and has undergone multiple surgeries, with the current dispute revolving around the medical necessity of further consultations and an AFO brace.

WCABPetition for ReconsiderationWCJ reportsupplemental pleadingmisstating factssanctionsFindings and Awardpulmonologistnephrologisthematologist
References
Case No. ADJ522872 (FRE 0245612) ADJ4049318 (FRE 0247705)
Regular
Sep 02, 2016

GINGER THAYER vs. OMNI HOTEL, ARCH INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) rescinded the trial judge's decision denying the applicant's claims for industrial injury. The WCAB found insufficient clarification from the Qualified Medical Evaluator, Dr. Levine, regarding the applicant's pulmonary issues and any resulting temporary or permanent disability. The case is remanded for further proceedings to obtain these clarifications and subsequently re-evaluate the derivative psychological injury claim.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and Orderindustrial injurypsychepulmonary systemorganic brain damageseizure disorderqualified medical evaluatorpulmonologist
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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ10455970
Regular
Jul 15, 2019

CRESENCIO BENITEZ (Deceased); BEATRIZ GAONA (Widow) vs. AZITEX TRADING; EMPLOYERS COMPENSATION

Applicant sought death benefits for her husband's fatal pneumonia, alleging it resulted from cumulative industrial exposure. The Workers' Compensation Appeals Board denied her petition for reconsideration, upholding the trial judge's finding that the decedent did not sustain industrial injury. This denial was based on the exclusion of applicant's medical evidence and adherence to the trial judge's report. One commissioner dissented, arguing the record was underdeveloped and further investigation into the decedent's workplace exposures was necessary for substantial justice.

Workers' Compensation Appeals BoardBeatriz GaonaCresencio BenitezAzitex TradingEmployers CompensationADJ10455970Petition for ReconsiderationFindings and OrderMachine OperatorCumulative Injury
References
Case No. ADJ1244874
Regular
Apr 19, 2010

ENRIQUE ROJAS vs. COSTCO

This case involves a meat cutter/wrapper's claim for an industrial injury to his respiratory system, diagnosed as hypersensitivity pneumonitis. The defendant contested the finding of industrial causation, arguing the medical evidence was insufficient. The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The Board affirmed the administrative law judge's decision, finding that the agreed medical examiner, Dr. Markovitz, established a reasonable medical probability of industrial causation, despite not identifying the precise causative agent. The Board relied on Dr. Markovitz's expert opinion, which utilized a process of elimination and epidemiological considerations to conclude the condition was likely work-related.

Hypersensitivity PneumonitisIndustrial CausationAgreed Medical EvaluatorPulmonologistMeat CutterMeat WrapperRespiratory System InjuryCumulative TraumaProcess of EliminationReasonable Medical Probability
References
Case No. ADJ18210611
Regular
May 08, 2025

ELENITA JOVER vs. COUNTY OF SAN BERNARDINO DEPARTMENT OF PUBLIC HEALTH

Elenita Jover, a licensed vocational nurse, sought reconsideration of a Findings and Award that denied her request for additional Qualified Medical Evaluation (QME) panels. The initial F&A found injuries to her cervical and lumbar spine, shoulders, and right thumb, but not to other claimed body parts like stress, psyche, or internal systems. The Appeals Board granted the petition, rescinded the original F&A, and ordered additional QME panels for pulmonology, internal medicine (diabetes), ophthalmology, ENT, and neurology, returning the case to the trial level for further proceedings. This decision was based on the original QME's recommendation for further evaluations and the need to develop the evidentiary record to ensure substantial justice.

Petition for ReconsiderationQualified Medical EvaluationLicensed Vocational NurseArising out of and in the course of employmentPermanent DisabilityDue ProcessPulmonologistInternistOphthalmologistOtolaryngologist
References
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