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

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
Case No. POM 0245397
Regular
Mar 10, 2008

RUDOLPH FIERRO vs. J. O. STILES, INC., CONTINENTAL CASUALTY COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the original finding of 100% permanent disability for industrial injuries to the applicant's knees, hips, feet, spine, right upper extremity, and reflex sympathetic dystrophy. The Board found that the treating physician's extensive medical opinions and the vocational rehabilitation expert's testimony adequately supported the 100% disability finding, despite the defendant's reliance on an Agreed Medical Evaluator's opinion. The Board emphasized that it is not bound by an AME's opinion and can give it less weight if other evidence is more persuasive.

Reflex sympathetic dystrophyAgreed Medical EvaluatorPetition for reconsiderationPermanent disabilityVocational rehabilitationIndustrial injuryTreating physicianMultiple diagnosesLumbar radiculopathySpinal cord stimulator
References
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
Case No. ADJ2148650
Regular
Sep 30, 2011

BRET ROSS vs. ALLERGAN, INC., AMERICAN HOME ASSURANCE

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior decision because the judge failed to make findings on all issues presented. The applicant sought reconsideration of a ruling requiring all medical treatment disputes to go through utilization review (UR), arguing this was unnecessary for chronic conditions. While UR is generally required per Labor Code §4610, the Board found the judge's decision was deficient by not addressing issues like liability for self-procured treatment or treatment outside the MPN. The case was returned to the trial level for a new decision that addresses all disputed issues.

Utilization ReviewPeroneal Nerve BlocksReflex Sympathetic DystrophySelf-Procured TreatmentLabor Code Section 4600Labor Code Section 4610Medical Treatment NecessityChief of SecurityPermanent DisabilityPrimary Treating Physician
References
Case No. SBR 0283205, SBR 0267402
Regular
Dec 11, 2007

PHILLIP F. GARCIA vs. LOCKHEED MARTIN AIRCRAFT SERVICES, Permissibly Self-Insured, ESIS, TRAVELERS INSURANCE (ADM./ADJ. AGT.)

The Workers' Compensation Appeals Board granted reconsideration of an award for total permanent disability, which combined the effects of a 1995 shoulder/arm/hand injury and a 1998 bilateral shoulder/upper extremity injury. The defendant, Lockheed Martin, argued that separate awards were required as the injuries became permanent and stationary at different times and affected different body parts. The Board rescinded the award and returned the case to the trial level to await a forthcoming en banc decision on the applicability of the Wilkinson doctrine regarding combined permanent disability awards.

Workers' Compensation Appeals BoardLockheed Martin Aircraft ServicesPermissibly Self-InsuredESISTravelers InsurancePhillip F. GarciaFurther Supplemental Findings and AwardTotally Permanently Disabled1995 injury1998 injury
References
Case No. ADJ823138 (OXN 0142604)
Regular
Oct 25, 2010

CHERYL PEET vs. COUNTY OF VENTURA, Permissibly SelfInsured, Administered By CORVEL CORPORATION

The Workers' Compensation Appeals Board is reconsidering a prior decision that found a deputy probation officer sustained industrial injuries resulting in 78% permanent disability. The defendant sought reconsideration, arguing the Qualified Medical Examiner's (QME) opinion, which formed the basis of the award, was ambiguous and unsubstantiated. The Board agrees that the QME's assessment of 60% whole person impairment is not adequately supported by the record, particularly in light of the applicant's own testimony regarding her daily activities. Therefore, the case is returned to the trial level for further evidence development and a new decision, with consideration for cost of living adjustments if a life pension is awarded.

Workers Compensation Appeals BoardCheryl PeetCounty of VenturaCORVEL CORPORATIONADJ823138OXN 0142604Opinion and Decision After Reconsiderationdeputy probation officerindustrial injuryright upper extremity
References
Case No. ADJ2689132 (POM 0259201)
Regular
May 22, 2012

Daphne Dewey vs. THE LIMITED/LERNER, SPECIALTY RISK SERVICES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and amended a prior decision to find the applicant 100% totally permanently disabled. This reversal was based on the persuasive analysis of the applicant's vocational expert, who considered both the physical and psychological impacts of the applicant's complex regional pain syndrome. The Board found that the applicant's impairments rendered her unable to compete in the open labor market, even if she could perform limited work in a sheltered environment. Consequently, the applicant is entitled to permanent disability indemnity for life.

Complex Regional Pain SyndromeReflex Sympathetic DystrophyVocational ExpertPermanent DisabilityReconsiderationAgreed Medical ExaminerWork Function ImpairmentsOverlap of DisabilitySheltered WorkshopOpen Labor Market
References
Case No. ADJ3946969
Regular
Nov 28, 2011

GARY GLASGOW vs. RAM CON CO., INC., CIGA

The Workers' Compensation Appeals Board denied reconsideration of a decision awarding the applicant 47% permanent disability. The applicant's petition for removal was dismissed as reconsideration was the proper remedy for challenging the final award. The decision affirmed findings that the applicant was not a credible historian and that his claimed neurocognitive deficits were not work-related. The Board adopted the Workers' Compensation Judge's report, which found substantial evidence supported the disability rating based on conflicting medical opinions and video evidence contradicting the applicant's claimed limitations.

WCABReconsiderationRemovalRamcon Co.Inc.CIGALegion InsuranceLiquidationSedgwick CMSPlumbing Foreman
References
Case No. ADJ2198671 (MON 0357212)
Regular
Dec 12, 2012

DANALEE FOWLER vs. WOLFGANG PUCK CATERING EVENTS, AMERICAN HOME ASSURANCE

This case involves an applicant who sustained an admitted industrial injury to her left ankle and other body parts. The Workers' Compensation Appeals Board granted reconsideration to further develop the record. The Board found the trial judge's reliance on a vocational expert's opinion for 100% permanent disability was improper. Specifically, the expert based his conclusion on medical information outside his expertise and an unsubstantiated history of seizures. The matter is returned to the trial level for further development regarding vocational rehabilitation and gainful employment.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilityVocational ExpertAgreed Medical ExaminerChronic Regional Pain SyndromeReflex Sympathetic DystrophyLumbar Epidural CatheterSpinal Stimulator
References
Case No. ADJ790852
Regular
Apr 05, 2016

LAURA BREITIGAN vs. COUNTY OF RIVERSIDE

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, amending the award to include attorney fees on accrued unpaid permanent disability benefits and correcting clerical errors. The Board denied the defendant's petition for reconsideration, upholding the finding of 100% permanent disability and injury to the lumbar spine. The defendant was also admonished for filing a document exceeding the page limit without prior permission. The applicant, a nurse, sustained industrial injuries to her thoracic spine, lumbar spine, and psyche.

Workers' Compensation Appeals BoardLaura BreitiganCounty of RiversideFindings and Awardindustrial injurythoracic spinelumbar spinepsychepermanent disabilityapportionment
References
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