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Case Law Database

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

Case No. ADJ3481462 (OAK 0297878)
Regular
Sep 24, 2009

KATHRYN MILLS vs. BERKELEY UNIFIED SCHOOL DISTRICT, STATE COMPENSATION INSURANCE FUND

The defendant sought reconsideration of an award finding industrial injury to the applicant's left upper extremity and shoulder, causing temporary disability and need for further medical care. The applicant's treating physician, Dr. Nolan, provided opinions regarding her left shoulder and other body parts, while Dr. Cabayan also provided opinions on the left shoulder and other extremities. The Workers' Compensation Appeals Board granted reconsideration and amended the award, clarifying that future medical care is consistent with Dr. Cabayan's opinions for the left shoulder and Dr. Nolan's opinions for other body parts. The Board affirmed the award with this specific amendment.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryInstructional AssistantLeft Upper ExtremityCompensable ConsequenceTemporary DisabilityFurther Medical CareSubstantial Evidence
References
0
Case No. ADJ7730913, ADJ8640698, ADJ8233287, ADJ7881756, ADJ8438104, ADJ7467140, ADJ7467243, ADJ9068351, ADJ9081983
Regular
Dec 02, 2016

HOLLIS COPELAND, JR. vs. DENVER NUGGETS, PINNACOL ASSURANCE

This case involved multiple consolidated workers' compensation claims where the Board initially denied reconsideration of an order dismissing Pinnacol Assurance for lack of personal jurisdiction. The Appeals Board is now granting reconsideration on its own motion to correct clerical errors in its prior opinion. Specifically, the Board failed to list all nine adjudication file numbers and did not serve all affected applicants. The decision after reconsideration affirms the original denial of reconsideration but amends the opinion to include all case numbers.

Appeals BoardGranting ReconsiderationOn MotionDecision After ReconsiderationClerical ErrorsPersonal JurisdictionPinnacol AssuranceConsolidated CasesAdjudication File NumbersAffirm Opinion
References
0
Case No. ADJ10007434
Regular
Sep 23, 2016

RUSSELL RASMUSSEN vs. CITY OF PETALUMA, REDWOOD EMPIRE MUNICIPAL INSURANCE FUND

This case concerns a firefighter's claim for a carotid pseudoaneurysm, which the original judge found work-related based on a QME's opinion. The employer sought reconsideration, arguing the QME's opinion lacked substantial evidence as it was speculative and not based on a history of trauma. The Board granted reconsideration, finding the QME's opinion impermissibly speculative. Ultimately, the Board amended the award to exclude the pseudoaneurysm as an industrial injury, reducing the permanent disability award.

Workers' Compensation Appeals BoardCity of PetalumaRussell RasmussenIndustrial cumulative traumaCardiac palpitationsCarotid pseudoaneurysmBattalion ChiefQualified Medical EvaluatorSubstantial medical evidencePetition for Reconsideration
References
3
Case No. ADJ9466180
Regular
Sep 28, 2017

Erin Inman vs. VENTURA REGIONAL SANITATION DISTRICT

The applicant, Erin Inman, seeks reconsideration of a prior award finding 73% permanent disability due to a cumulative trauma injury to her left wrist resulting in reflex sympathetic dystrophy (RSD). She contends she is totally disabled, citing the Agreed Medical Examiner (AME) Dr. Sohn's opinion that she cannot use either hand and is therefore conclusively presumed totally disabled under Labor Code section 4662(a). The Workers' Compensation Appeals Board granted reconsideration to further develop the medical record. The Board found Dr. Sohn's opinion on total disability was not yet definitive as he repeatedly recommended a pain management evaluation and reserved judgment pending its outcome. Therefore, the determination of permanent disability and attorney fees is deferred pending a pain management evaluation and subsequent opinion from the AME.

Reflex Sympathetic DystrophyCumulative TraumaPermanent Total DisabilityAgreed Medical ExaminerPain Management PhysicianBody Parts AffectedLabor Code Section 4662Permanent Disability RatingMedical Record DevelopmentPetition for Reconsideration
References
3
Case No. ADJ7781989; ADJ8262771
Regular
Oct 03, 2013

MIRIAN GARCIA vs. COOPER COLD FOODS, INC., ILLINOIS MIDWEST INSURANCE AGENCY as administrator for STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) is granting reconsideration of its own prior decision and rescinding a July 23, 2013 decision that had overturned a prior finding of 2% permanent disability for applicant's right knee injury. The WCAB determined that its August 9, 2012 order granting reconsideration was improvidently granted because the applicant had already filed a successive and improper petition for reconsideration. Consequently, the prior order and the subsequent rescinded decision are vacated, and the applicant's petition for reconsideration is dismissed.

WCABReconsiderationPetition for ReconsiderationFindings and AwardAdministrative Law JudgePermanent DisabilityIndustrial InjurySuccessive PetitionImprovidently GrantedVacated
References
4
Case No. ADJ7159953
Regular
Feb 17, 2012

ANTONIO CORONA vs. RANDSTAD NORTH AMERICA, ACE AMERICAN INSURANCE COMPANY

Lien claimants sought reconsideration of an administrative law judge's order disallowing their liens and imposing sanctions. The Appeals Board granted reconsideration, rescinded the order, and returned the matter for a decision on the merits. The Board found the sanctions unjustified due to unclear orders regarding trial briefs and lack of proper notice, and further noted the judge failed to issue a required opinion explaining the basis for disallowing the liens. The case is remanded for a proper decision with an explanatory opinion.

Workers' Compensation Appeals BoardLien ClaimantsReconsiderationWCJ OrderSanctionsTrial BriefsBurden of ProofCompromise and ReleaseIndustrial InjuryUtilization Review
References
2
Case No. ADJ6881051
Regular
Sep 24, 2012

CAMILO LLANEZ vs. DIAMOND HOLDINGS OF CALIFORNIA, ARGONAUT INSURANCE COMPANY

This case involves an applicant seeking workers' compensation benefits for injuries sustained on February 8, 2009. The defendant sought reconsideration of the original award, arguing the permanent disability rating and certain medical opinions were unsupported. The Appeals Board granted reconsideration, finding the orthopedic AME's 12% impairment rating for grip loss unsubstantiated due to lack of proper analysis. However, the Board affirmed the internist's opinions regarding GERD and hypertension, deferred issues of permanent disability and apportionment, and returned the matter for further proceedings.

WCABReconsiderationFindings and AwardAgreed Medical Examiner (AME)Occupational Group NumberApportionmentPermanent DisabilityMedical TreatmentLabor Code Section 4658(d)Substantial Evidence
References
15
Case No. ADJ1242432 (LAO 0810317) ADJ1936406 (LAO 0857303)
Regular
Feb 01, 2011

REYNA MEZA vs. PACPRO MANAGEMENT, Dba COAST SPORTSWEAR, AMERICAN CLAIMS MANAGEMENT for EVEREST NATIONAL INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, By Its Facilitating Agent, INTERCARE INS. SERVICES, for PAULA INSURANCE COMPANY, In Liquidation

Everest National Insurance Company seeks reconsideration of an arbitrator's decision awarding CIGA $\$95,245.36$ in reimbursement for cumulative trauma benefits. Everest argues the arbitrator erred by finding the cumulative trauma extended over the applicant's entire employment, contrary to the Agreed Medical Examiner's (AME) opinion. The Appeals Board granted reconsideration, finding the AME's opinion legally flawed and lacking substantial evidence for the extended cumulative trauma period. The matter is remanded to the arbitrator for further proceedings to develop the medical record and render a new decision.

Workers' Compensation Appeals BoardIndustrial InjuryCumulative TraumaSpecific InjuryAgreed Medical ExaminerPetition for ReimbursementCalifornia Insurance Guarantee AssociationInsurance Coverage PeriodInjurious ExposureSubstantial Evidence
References
9
Case No. ADJ1137286
Regular
Mar 03, 2009

PINAZ KOLAHI vs. GENERAL MOTORS CORP., SEDGWICK CLAIMS MANAGEMENT

Defendant General Motors seeks reconsideration of a Workers' Compensation Appeals Board decision awarding temporary disability, permanent disability, and future medical treatment to applicant Pinaz Kolahi. Defendant argues the cumulative trauma period ending date is unsupported, temporary disability is unsubstantiated, and permanent disability indemnity was calculated at an incorrect rate. The Board granted reconsideration, rescinded the original and amended findings, and remanded the case for further proceedings due to an apparent inconsistency between the amended findings and opinion on decision. The Board expressed no opinion on the merits of the underlying contentions.

WCABADJ1137286VNO 0490167Pinaz KolahiGeneral Motors Corp.Sedgwick Claims ManagementFindings and AwardAmended Findings and AwardPetition for ReconsiderationReport and Recommendation
References
2
Case No. ADJ2979319 (LAO 0864585)
Regular
Nov 21, 2008

PETRA GARCIA vs. BANKERS WEST FUNDING CORPORATION, NATIONAL LIABILITY AND FIRE INSURANCE COMPANY

This case concerns an applicant's entitlement to temporary disability indemnity (TDI) following a right upper extremity injury. The defendant sought reconsideration of an award, arguing TDI should cease earlier based on a QME's opinion and statutory limits. The Appeals Board granted reconsideration, amending the award to find TDI payable from January 3, 2006, through September 2, 2008, and continuing, while establishing the "date of commencement" for the two-year TDI limit as July 1, 2008, the date of first payment. The Board found the treating physician's opinion more persuasive than the QME's regarding the duration of temporary disability.

Workers' Compensation Appeals BoardPetra GarciaBankers West Funding CorporationNational Liability and Fire Insurance CompanyADJ2979319ReconsiderationTemporary Total DisabilityLabor Code section 4656(c)(1)Panel Qualified Medical Evaluator (QME)Ernest Washington M.D.
References
5
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