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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ8245508 ADJ10745009
Regular
Sep 16, 2019

KHORSHID AGAHI vs. HOAG MEMORIAL HOSPITAL

The WCAB granted reconsideration, affirming the WCJ's decision that the applicant's 2012 award was timely reopened. The Board clarified that a Declaration of Readiness to Proceed filed within five years constituted a timely petition to reopen, despite not being explicitly labeled as such. Additionally, the Board affirmed the applicant's entitlement to a psychiatric QME panel, noting the treating physician's recommendation for such an evaluation superseded any procedural arguments regarding objections to his report. The WCAB determined that a prior interlocutory discovery order did not preclude further development of the record.

Petition to ReopenNew and Further DisabilityDeclaration of Readiness to ProceedQualified Medical EvaluatorPsychiatric MedicineInterlocutory OrderRes JudicataEstoppelTimely ReopeningLabor Code Section 5410
References
Case No. LAO 828699
Regular
May 16, 2008

Corey Booker vs. AUTO ZONE, GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board granted reconsideration to amend a prior award, affirming the need for medical treatment but finding no new temporary disability. The Board determined that the applicant's cessation of work was due to a layoff, not a new or further disability from the injury. Therefore, there was no good cause to reopen the stipulated award for new and further temporary disability.

Workers Compensation Appeals BoardReconsiderationFindings and AwardTemporary Total DisabilityNew and Further DisabilityPetition to ReopenStipulations with Request for AwardMedical TreatmentGood Cause to ReopenLabor Code Sections 5410 and 5803
References
Case No. ADJ2839869 (EUR 0036695)
Regular
Mar 03, 2009

Darlene Counts vs. Sam Kennedy, D.D.S., Zenith Insurance Company

The Workers' Compensation Appeals Board denied Zenith Insurance Company's petition for reconsideration. Zenith argued the WCJ exceeded jurisdiction by awarding benefits beyond the five-year limit without a petition to reopen and challenged medical treatment awards. The Board affirmed the WCJ's decision, finding the original stipulations focused only on medical treatment and did not preclude later determinations on other issues within the statutory timeframe. The WCJ correctly found applicant sustained an industrial injury and ordered appropriate medical treatment, including chronic pain specialist care.

WCABDarlene CountsSam Kennedy DDSZenith Insurance CompanyADJ2839869Supplemental Findings and Awardindustrial injuryright shoulderpsycheleft shoulder
References
Case No. ADJ3383028 (STK 0197218) ADJ8225159 ADJ3094525 (STK 0199499)
Regular
Nov 05, 2018

ARMANDINA MACHUCA vs. STOCKTON UNIFIED SCHOOL DISTRICT, Permissibly Self-Insured, Administered by YORK SERVICES GROUP

The WCAB denied Stockton Unified School District's petition for reconsideration regarding an award of temporary total disability. The defendant argued the award in ADJ3383028 was improper due to the five-year limitation under Labor Code section 4656(b) and insufficient medical evidence. The Board affirmed the WCJ's finding that the March 4, 2004 injury contributed to the 2012 temporary disability period, and that section 4656(b) applies only to temporary partial disability. Furthermore, the Board clarified that the five-year reopening limitation does not apply in cases without a prior award of compensation.

Workers' Compensation Appeals BoardArmandina MachucaStockton Unified School DistrictPetition for ReconsiderationFindings of FactAward and Orderindustrial injuryspineright shoulderpsyche
References
Case No. ADJ870023 (WCK 69873)
Regular
Nov 21, 2008

Denis Mendieta vs. COPENHAGEN HOUSE OF DANISH, MID-CENTURY INSURANCE COMPANY

The Appeals Board reversed an award of attorney's fees, finding that Labor Code section 4064(c) did not apply because the fees were incurred pursuing a petition to reopen, not in connection with the initial stipulated award. The court clarified that a stipulated award, even if treated as an application for certain purposes, does not qualify for the employer-paid attorney's fees under section 4064(c) when the employee later hires counsel to reopen the claim. Therefore, the applicant is responsible for his own attorney's fees for the petition to reopen.

Workers' Compensation Appeals BoardLabor Code section 4064(c)Award of Attorney's FeeWCJstipulated awardcommutationpetition to reopennew and further disabilitycompromise and releaseunrepresented employee
References
Case No. SRO 0112966
Regular
Aug 21, 2007

GABRIEL AGUIRRE, vs. KENDALL JACKSON WINERY, and FIREMAN'S FUND INSURANCE COMPANY,

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The Board found that the applicant demonstrated new and further disability within five years of the date of injury, as evidenced by worsening symptoms and limitations reported by the evaluating physician between 2001 and 2004. Therefore, the applicant's petition to reopen was deemed timely and the original award remained in effect.

Petition for ReconsiderationSupplemental FindingsAward and Orderspermanent disabilitygood cause to reopenmedical treatment awardCompromise and Releasenew and further disabilitydate of injuryLabor Code section 5410
References
Case No. ADJ9865530
Regular
Mar 20, 2015

Baldemar Gonzalez, Jr. vs. Morganite Industries, Gallagher Bassett

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration of a prior award. The petition was dismissed because it was filed untimely and was not properly verified. Although the applicant alleged fraud in obtaining the award, and the stipulations appear to lack a required signature, the Board cannot act on these grounds due to procedural deficiencies and expired timeframes. The applicant may still pursue relief under the Board's continuing jurisdiction concerning rescission, alteration, or amendment of the award within five years of the date of injury.

Petition for ReconsiderationStipulations with Request for Awardfraudmisrepresentationuntimely filingverificationLabor Code Section 5902Labor Code Section 5903continuing jurisdictionLabor Code Sections 5803-5804
References
Case No. ADJ3190591 (SFO 0510866) ADJ9088362 ADJ9524437
Regular
Nov 21, 2014

ISAIAH KACYVENSKI vs. OAKLAND RAIDERS; ACE USA Administered by ESIS; ST. LOUIS RAMS and GREAT DIVIDE INSURANCE COMPANY Administered by BERKLEY SPECIALTY UNDERWRITING MANAGER, LLC

This case concerns a workers' compensation award against the St. Louis Rams and the Oakland Raiders for an injured professional athlete. The Rams petitioned for reconsideration, arguing they were improperly included in a joint award based on stipulations they were not a party to, violating their due process rights. The Appeals Board granted reconsideration, finding the Rams' due process claim had merit. The award was amended to be solely against the Oakland Raiders, as the Rams had elected not to proceed and their employment liability was not established.

Workers' Compensation Appeals BoardJoint AwardPetition for ReconsiderationLabor Code section 5500.5(c)Stipulations with Request for Awardcumulative injuryprofessional athletepermanent disabilitydue processexcess of WCJ's powers
References
Case No. ADJ4092048 (SAC 0315575)
Regular
Feb 03, 2012

CLINTON BAKER vs. TRAYLOR BROTHERS; ST. PAUL FIRE and MARINE UNSURANCE

This case concerns a dispute over temporary disability benefits awarded to applicant Clinton Baker. The Appeals Board granted reconsideration of a prior award finding total temporary disability from May 21, 2007, to the present. The Board determined that while jurisdiction exists to award temporary disability beyond five years post-injury if disability began within that period and a timely petition to reopen was filed, the prior award was rescinded. The matter is returned to the WCJ for further proceedings to clarify the correct commencement date of temporary disability, which applicant argues should be March 19, 2007, a date within the statutory five-year window.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardTemporary Total DisabilityPetition to ReopenFive-Year PeriodJurisdictionIndustrial InjurySpineRight Shoulder
References
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