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

Case No. ADJ10443669
Regular
Oct 04, 2017

Donna Carter vs. Rose International Group, OneBeacon Insurance Group

The Appeals Board affirmed the Workers' Compensation Judge's finding that Donna Carter sustained an industrial injury to her right knee and left wrist on May 18, 2016. Despite inconsistencies in the applicant's testimony regarding a slip and fall incident, her account was corroborated by a witness who found her on the floor. Medical records from the day of the incident also supported the applicant's claim, establishing a clear mechanism of injury. The Board found that the common sense nature of a slip and fall does not require expert medical opinion to establish industrial causation for the incident itself.

ADJ10443669Rose International GroupOneBeacon Insurance GroupDonna CarterWorkers' Compensation Appeals BoardOpinion and Decision After Reconsiderationslip and fallindustrial injuryright kneeleft wrist
References
Case No. SFO 0499272
Regular
Jul 07, 2008

Helen Miller vs. Green Gulch Farm and Zen Center, EVEREST NATIONAL INSURANCE

The Workers' Compensation Appeals Board affirmed the administrative law judge's finding that Helen Miller was an employee of Green Gulch Farm and Zen Center and sustained an industrial injury to her left ankle. The Board found Miller was not a volunteer due to the extensive benefits received and the employer's control, and her jogging injury during a lunch break was a reasonable expectancy of employment, not barred by Labor Code section 3600(a)(9). Therefore, her injury arose out of and occurred in the course of her employment.

Workers' Compensation Appeals BoardHelen MillerGreen Gulch Farm and Zen CenterEverest National InsuranceGallagher BassettSFO 0499272Opinion and Decision After ReconsiderationLabor Code Section 3351Labor Code Section 3352(i)Employee definition
References
Case No. ADJ218867
Regular
Apr 13, 2011

SANDY FRIZZELL vs. DEPARTMENT OF PARKS AND RECREATION, CHARTIS COSTA MESA, SCIF STATE EMPLOYEES SACRAMENTO

The Workers' Compensation Appeals Board denied reconsideration of a decision regarding Sandy Frizzell's claim against the Department of Parks and Recreation. The petitioner, State Compensation Insurance Fund, contested the 17% disability rating assigned for Ms. Frizzell's headaches, arguing it was improperly calculated. The Board adopted the administrative law judge's report, which found the rating expert's testimony credible and unimpeached. The judge's report explained that the rating appropriately reflected the intermittent nature of the headaches, as testified by the expert.

Workers' Compensation Appeals BoardReconsideration DeniedRating Expert TestimonyUnimpeached TestimonyCredible TestimonyLyme DiseaseContinuing TraumaState Compensation Insurance FundResource EcologistDisability Evaluation Specialist
References
Case No. ADJ7486243
Regular
May 23, 2011

WALTER ROSS III vs. SOUTHGATE PARKS AND RECREATION DISTRICT, YORK INSURANCE SERVICES GROUP, INC.

This case involves a Petition for Removal filed by Applicant Walter Ross III against Southgate Parks and Recreation District and York Insurance Services Group. The Workers' Compensation Appeals Board (WCAB) reviewed the petition and the WCJ's report. Finding no grounds for removal, the WCAB adopted the WCJ's reasoning and denied the petition. The order officially denies Walter Ross III's petition for removal.

Petition for RemovalWorkers' Compensation Appeals BoardWCJ ReportDeny RemovalSouthgate Parks and Recreation DistrictYork Insurance Services GroupADJ7486243Oakland District OfficeDecision and OrderAdministrative Law Judge
References
Case No. ADJ3057068
Regular
Nov 01, 2010

Cecilio Torres vs. Holbrook Construction, Inc., Lincoln General Insurance Company, American Claims Management, State Compensation Insurance Fund

The Workers' Compensation Appeals Board granted reconsideration, rescinded a prior decision, and returned the case for further proceedings. The applicant claimed a back and other injuries, alleging he notified his supervisor of the incident and subsequent pain before termination. The Board found the applicant met his burden to prove he provided sufficient notice of injury to his supervisor prior to termination, fulfilling the notice requirement of Labor Code section 3600(a)(10). Defendants failed to rebut the applicant's evidence that he reported the injury and requested medical treatment from his supervisor.

Workers' Compensation Appeals BoardReconsiderationLabor Code Section 3600(a)(10)Notice of InjuryTerminationPreponderance of EvidenceSupervisor NoticeActual NoticeEmployer KnowledgeWCJ Decision
References
Case No. ADJ7500739
Regular
May 25, 2012

SAMIRA HASAN vs. AMERICAN SHIELD PRIVATE SECURITY, GALLAGHER BASSETT

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior finding, ruling that Samira Hasan, a security guard, sustained an industrial injury. Hasan was struck by a car while crossing the street for coffee shortly before her shift began, having signed in and received implied approval from her supervisor. The Board found this to be a compensated coffee break exception to the "going and coming" rule, thus arising out of and in the course of employment. One Board member dissented, giving greater weight to the administrative law judge's credibility findings regarding the supervisor's testimony.

Workers' Compensation Appeals Boardindustrial injurycourse of employmentarising out of employmentgoing and coming rulecompensated lunch breaksign-in sheetsupervisor approvalcredibility findingsdissenting opinion
References
Case No. ADJ176329 (VNO 0542064)
Regular
Jun 15, 2009

Jesse W. Pratt vs. Lancaster Healthcare Center, Zurich America Insurance Company

This case involved a maintenance supervisor who claimed industrial injury to his psyche and various physical ailments due to alleged stress and harassment by his supervisor. The Appeals Board granted reconsideration, reversing the initial award. The Board found that the applicant's psychiatric injury was substantially caused by lawful, nondiscriminatory, good-faith personnel actions, specifically workplace critiques and job modifications by management. Consequently, compensability for the psychiatric injury was barred under Labor Code section 3208.3(h). The issue of whether the applicant's non-psychiatric conditions were industrially caused was deferred for further development of the record at the trial level.

Workers' Compensation Appeals BoardLabor Code section 3208.3(h)good faith personnel actionpsychiatric injuryindustrial injurycompensabilitymaintenance supervisorreconsiderationFindings and Awardactual events of employment
References
Case No. ADJ6603653
Regular
Mar 29, 2010

PEGGY MILLER vs. STATE OF CALIFORNIA, DEPARTMENT OF MENTAL HEALTH, Legally Uninsured, STATE COMPENSATION INSURANCE FUND

This case concerns applicant Peggy Miller's claim for a psychiatric injury allegedly arising from a verbal dispute with her supervisor over medication administration. The Workers' Compensation Appeals Board (WCAB) denied her petition for reconsideration of a prior finding that her injury was not compensable. The WCAB majority adopted the judge's report concluding the incident was a lawful, non-discriminatory, good faith personnel action and not a compensable industrial injury. However, one commissioner dissented, arguing the supervisor's directive to administer medication contrary to physician's orders was unlawful, thus not a "lawful, nondiscriminatory, good faith personnel action" under Labor Code section 3208.3(h).

Workers' Compensation Appeals BoardPsychiatric injuryVerbal exchange24 hour clockMedication administrationShift supervisorPersonnel actionLawfulNondiscriminatoryBad faith
References
Case No. ADJ6978832
Regular

Mona Dill vs. CITY OF RANCHO PALOS VERDES, PSI, by CJPIA through their TPA, YORK INSURANCE SERVICES GROUP

The Appeals Board granted the defendant's petition for removal, reversing the WCJ's order for a QME evaluation. The Board found the applicant's stipulated zero percent permanent disability and need for further medical treatment to be adequate, given the treating physician's report of no ratable impairment and the applicant's expressed desire to settle. Therefore, the Stipulations with Request for Award were approved, granting the applicant ongoing medical care and zero percent permanent disability.

Petition for RemovalStipulations with Request for AwardPanel Qualified Medical Evaluator (QME)ApportionmentPermanent DisabilityMedical TreatmentIndustrial InjuryRecreation SupervisorPro PerInformation and Assistance Officer (I & A)
References
Case No. ADJ7597809
Regular
Oct 28, 2013

VICKI GREGORY vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board denied the County of Los Angeles' petition for reconsideration. The Board adopted the judge's report, which found that applicant Vicki Gregory's injuries sustained when thrown from a horse at an annual trail ride arose out of and occurred in the course of her employment. The judge determined that Gregory reasonably and subjectively believed her participation was required as part of her training for the Sheriff's Department Mounted Enforcement Unit. Credible MED Unit witnesses corroborated that such participation was essential for certification and duty readiness.

Workers' Compensation Appeals BoardPetition for ReconsiderationInjury AOE/COEMounted Enforcement DetailDeputy SheriffTrail RideTraining ExerciseMED Unit CertificationSubjective BeliefReasonable Belief
References
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