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

Case No. ADJ1232764
Regular
Mar 24, 2009

ALEXANDRA CULLEN-WRIGHT vs. CUMMINS & WHITE, LLP, STATE COMPENSATION INSURANCE FUND

Applicant sought reconsideration of a WCAB decision denying jurisdiction to amend a prior award, arguing her RSD constitutes an insidious, progressive disease exempting it from the five-year statute of limitations. The Board denied reconsideration, finding the applicant failed to demonstrate her RSD met the criteria for an insidious, progressive disease as defined in *General Foundry Service v. WCAB*. Furthermore, the Board noted the original decision did not reserve jurisdiction and no timely petition to reopen was filed to address this possibility. Therefore, the WCAB lacked jurisdiction to amend the award over five years post-injury.

Workers' Compensation Appeals BoardLabor Code Section 5804cumulative injurycomplex regional pain syndromeRSDagreed medical examinersubstantial evidencepermanent and stationarysympathetic ganglion blockpetition to set aside
References
Case No. ADJ1837482
Regular
Jun 09, 2011

RANDALL ROGERS vs. CLAREMONT FORD, STATE COMPENSATION INSURANCE FUND

The applicant sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that apportioned 80% of his left lower extremity and psyche disability to a November 8, 2002 injury, and 20% to pre-existing factors. The applicant argued the Agreed Medical Examiner's opinion was flawed, the record should have included an RSD expert, and a sub-rosa video was inadmissible. The WCAB denied the petition, adopting the judge's report and admonishing applicant's counsel for citing an unpublished opinion. Defendant's untimely request to change the apportionment was also not considered.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings Award OrderAdministrative Law JudgePermanent DisabilityLife PensionAttorney FeesLienSub Rosa VideoAME
References
Case No. LAO 0798702
Regular
Jun 19, 2008

ENRIQUE HERNANDEZ vs. EL TORITO RESTAURANT, KEMPER PRIMARY WORK COMP PRG, GALLAGHER BASSETT SERVICES, INC.

This case involves applicant Enrique Hernandez's second petition for reconsideration of a Workers' Compensation Appeals Board decision. The Board dismissed the petition because it was a successive filing, as the initial petition had already been denied on the merits without new evidence. Applicant's arguments regarding a repetitive stress disorder (RSD) diagnosis were not considered due to the successive nature of the petition and his failure to properly present new evidence.

Petition for ReconsiderationWCJIndustrial InjuryNeckLeft ShoulderLeft Upper ExtremityRepetitive Stress Disorder (RSD)Agreed Medical Evaluator (AME)Successive PetitionWrit of Review
References
Case No. ADJ2500785 (MON 0261411)
Regular
Jan 30, 2009

Starr Olson vs. HACIENDA BRIDES INTERNATIONAL, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the original award, and remanded the case for a new permanent disability rating. The Board found the original judge erred by relying on a QME's opinion of total permanent disability that was not based on an accurate history. Instead, the Board directed the new rating be based on the opinions of the Agreed Medical Examiners (AMEs), who found significant but less restrictive permanent disability. Additionally, the Board reinstated the AME psychiatrist's apportionment of 30% of the psychological disability to non-industrial factors.

Workers' Compensation Appeals BoardStarr OlsonHacienda Brides InternationalState Compensation Insurance Fundindustrial injurybilateral upper extremitiesRSDleft shoulderright kneepsyche
References
Case No. ADJ6487753
Regular
Aug 21, 2014

NATHANIEL SIMS, II vs. VALLEY EXPRESS, INC., STATE FARM CALIFORNIA WORKERS' COMPENSATION CLAIMS

This case concerns an applicant injured in 2007 who sought reimbursement for home health care services provided by his spouse. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address the impact of new Labor Code section 4600(h), enacted in 2013. The WCAB determined that the statute applies to this case as no final decision had been reached before its effective date. While acknowledging the employer's liability began on December 26, 2011, the WCAB deferred the issue of whether liability commenced earlier, pending further development of the record on the prescription date.

Workers Compensation Appeals BoardReconsiderationAmended Findings of FactOrderIndustrial InjuryRight ArmPsycheRSDAgreed Medical EvaluatorHome Support
References
Case No. ADJ2891866 (SFO 0502133)
Regular
Jan 18, 2013

JULIO PAIZ vs. SAN RAMON MARRIOTT HOTEL

The Workers' Compensation Appeals Board granted reconsideration and affirmed the original award for industrial injury to the applicant's right hand, psyche, and internal system, resulting in 45% permanent disability. The Board amended the decision to allow attorney's fees, awarding $6,142.00 to the applicant's former attorney and $2,000.00 to his current attorney for their respective services. The original award of 45% permanent disability was maintained as substantial evidence supported the agreed medical examiners' opinions.

Workers' Compensation Appeals BoardSan Ramon Marriott HotelJulio Paizindustrial injuryright hand injurypsyche injuryinternal system injurypermanent disabilitymedical treatmentagreed medical examiners
References
Case No. ADJ3179043
Regular
Nov 12, 2008

TINA PERRY vs. LYONS OF CALIFORNIA, FIREMAN'S FUND INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Tina Perry's petition for reconsideration. The Board upheld the Administrative Law Judge's finding that Perry sustained an industrial injury only to her neck and upper extremities, not her lower body. This decision was based on the independent medical examiner's opinion, which the Board found to be substantial evidence despite applicant's contrary contentions.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryWaitressNeck InjuryUpper ExtremitiesLow Back InjuryHips InjuryKnees Injury
References
Case No. ADJ4166849 (ANA 0339834)
Regular
Apr 02, 2012

CYNTHIA HARDEMAN vs. INTERMODAL TRANSPORTATION SERVICES; CNA

This case involves an applicant alleging new and further permanent total disability stemming from a 1999 industrial injury. The defendant sought reconsideration, arguing the administrative law judge erred in finding the injury caused $100\%$ permanent disability. The Workers' Compensation Appeals Board denied reconsideration, adopting the judge's report. The Board found substantial medical evidence supported the $100\%$ disability rating based on a primary treating physician's opinion that the applicant was unable to compete in the open labor market due to severe orthopedic restrictions.

New and further disabilityPetition for reconsiderationPermanent total disabilityLabor Code § 5410Open labor marketSubstantial evidenceMedical opinionOrthopedistPrimary treating physicianReflex sympathetic dystrophy (RSD)
References
Case No. ADJ757155
Regular
Mar 21, 2013

FRANK KEY vs. TORRANCE MEMORIAL MEDICAL CENTER, MATRIX ABSENCE MANAGEMENT, INC.

The Workers' Compensation Appeals Board denied the Defendant's Petition for Reconsideration. The Defendant argued that the applicant's condition had improved post-surgery, necessitating reevaluation by medical and vocational experts. However, the Board upheld the WCJ's finding that the applicant's testimony was credible and that his chronic pain and unemployability were well-established. The Board agreed with the WCJ that further evaluations were unnecessary as pain management was ongoing and did not alter the applicant's permanent total disability status.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeCredibilityGarza v. Workers' Comp. Appeals Bd.PhlebotomistLumbar spineCervical spineLeft lower extremityPsyche
References
Case No. SBR 0299490
Regular
Feb 25, 2008

DELILAH AVILA vs. DYNCORP, AMERICAN HOME ASSURANCE, AIG CLAIM SERVICES

The Workers' Compensation Appeals Board granted reconsideration and awarded applicant home health care services based on a diagnosis of industrially-related reflex sympathetic dystrophy (RSD), reversing a prior ruling. The Board affirmed the denial of attorney's fees under Labor Code § 5814.5, finding no unreasonable delay in compensation payment. Issues regarding the duration, provider, and rate of home health care were deferred for further determination.

Reflex sympathetic dystrophyComplex regional pain syndromeHome health careExpedited hearingPetition to reopenQualified medical evaluatorTreating physicianActivities of daily livingLabor Code § 5814.5Attorney's fees
References
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