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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Pizzo v. Barnhart

Plaintiff Kathleen Pizzo appealed the Commissioner of the Social Security Administration's final determination denying her disability insurance benefits. The District Court reviewed the ALJ's decision, which had assigned no weight to the treating physician's opinion and significant weight to a consulting physician's report. The court found that the ALJ erred by failing to give appropriate weight to the treating physician's opinion, not adequately developing the administrative record to obtain missing medical notes, and giving undue weight to the consulting physician's report which did not explicitly support the capacity for sedentary work. Consequently, the Commissioner's determination was remanded for further administrative proceedings consistent with the District Court's decision, granting the plaintiff's motion for judgment on the pleadings to the extent of the remand and denying the Commissioner's cross-motion.

Social Security ActDisability Insurance BenefitsAdministrative Law JudgeTreating Physician RuleResidual Functional CapacitySedentary WorkMedical EvidenceRemandSubstantial EvidenceRecord Development
References
23
Case No. MISSING
Regular Panel Decision
May 17, 2016

United States v. Nesbeth

Chevelle Nesbeth was convicted by a jury for importation of cocaine and possession with intent to distribute. Senior District Judge Block rendered a non-incarceratory sentence of one-year probation, with special conditions including six months' home confinement and 100 hours of community service. The judge wrote this opinion to emphasize the importance of considering the numerous statutory and regulatory collateral consequences facing Nesbeth as a convicted felon, such as restrictions on employment, housing, and voting. These consequences were extensively balanced against 18 U.S.C. § 3553(a) factors to determine a just punishment. The opinion advocates for legal counsel and the Probation Department to proactively address collateral consequences in all future pre-sentence reports and sentencing proceedings.

Collateral ConsequencesSentencing ReformCriminal JusticeProbationary SentenceDrug Trafficking OffensesFelony ConvictionJudicial DiscretionFederal Sentencing GuidelinesRehabilitationRecidivism
References
55
Case No. ADJ1700793 (SAC 0307437) ADJ3714832 (SAC 0307399)
Regular
Jun 13, 2011

JUANITA BRADLEY (Deceased) vs. COUNTY OF PLACER

This case involves a dispute over liability for a medical-legal report cost. The defendant seeks reconsideration of a prior award holding them responsible for Dr. Adelberg's $4,237.50 report. The defendant argues the judge ignored a prior order for an Agreed Medical Evaluation (AME) and that the applicant's attorney improperly proceeded with Dr. Adelberg's exam. The Board granted reconsideration, preliminarily finding it may be inequitable to place the full cost on the defendant, and intends to split the expense between the defendant and applicant's attorney. A dissenting opinion argues the defendant's own correspondence shows an ongoing dispute regarding the AME, supporting the original award of liability.

Workers' Compensation Appeals BoardReconsiderationMedical-Legal ReportAgreed Medical EvaluationQualified Medical EvaluatorJoint Findings and AwardLabor Code Section 4062(a)Stipulation and OrderEquitable PowersLien Claimant
References
1
Case No. ADJ8657415
Regular
Oct 06, 2017

Oliver Boutte IV (Deceased) vs. U.S. XPRESS ENTERPRISES, LIBERTY MUTUAL INSURANCE COMPANY

This Workers' Compensation Appeals Board case involved a petition for reconsideration filed by U.S. Xpress Enterprises and Liberty Mutual Insurance Company. The defendants argued that the medical report relied upon by the Workers' Compensation Judge (WCJ) was not substantial evidence, specifically regarding the timing of the employee's death from a pulmonary embolus. The Board denied the petition, adopting the WCJ's report which found the physician's opinion to be substantial medical evidence based on adequate examination and reasoning. The Board concluded the WCJ properly found this opinion more persuasive than the opposing medical opinion.

Oliver Boutte IVU.S. Xpress EnterprisesLiberty Mutual Insurance CompanyADJ8657415Petition for ReconsiderationWorkers' Compensation Appeals Boardsubstantial evidencemedical opinionpulmonary embolusreasonable medical probability
References
3
Case No. ADJ7908543
Regular
Nov 13, 2012

JOSE RIVAS vs. CALIFORNIA CARPET, LLC, ICW GROUP

In Rivas v. California Carpet, LLC, the Appeals Board granted the defendant's Petition for Removal, rescinding a prior award of spinal surgery. The WCJ had improperly excluded the second opinion physician's report as untimely. The Board found the applicant waived his objection to the report's untimeliness by not raising it until after the examination. The case was returned to the trial level for reconsideration of the surgery's necessity, including the second opinion report.

Petition for RemovalFindings and AwardSpinal SurgeryPrimary Treating PhysicianSecond Opinion PhysicianLabor Code Section 4062(b)Timeliness ObjectionWaiverExpedited HearingMedical Unit
References
1
Case No. MISSING
Regular Panel Decision

People v. Quinto

The dissenting opinion by Judge Read argues that the second count of indictment against Santos Quinto for second-degree rape, occurring between July and August 2002, is time-barred. This stems from the interpretation of CPL 30.10 (3) (f), which extends the statute of limitations for child sex crimes until the child turns 18 or the offense is reported to law enforcement, whichever occurs earlier. Judge Read contends that a social worker's report to the police in November 2002 regarding 14-year-old Jane's rape and pregnancy claim, even if later retracted by Jane and deemed consensual by the police, qualifies as a "report to a law enforcement agency." The dissent emphasizes that the reporting exception aims to prevent unduly delayed prosecutions and minimize the risk of erroneous convictions. Judge Read concludes that the majority's interpretation effectively writes the reporting exception out of the statute. The overall order of the main decision was affirmed.

Criminal Procedure LawChild Sexual AbuseStatute of LimitationsRape Second DegreeReporting ExceptionPregnancy AllegationPolice InvestigationFalse ProsecutionsEvidence FreshnessVictim Disclosure
References
4
Case No. MISSING
Regular Panel Decision

Ferguson v. Wolkin

Plaintiff was injured in an automobile accident, leading to a disability leave from her employment at Harrison Radiator. Pursuant to a collective bargaining agreement and likely an insurance carrier's request, she was examined by the defendant, an Impartial Medical Opinion Examiner. The defendant reported that the plaintiff was fit to return to work. Plaintiff returned to work and subsequently suffered a back injury, alleging it was caused by her premature return due to the defendant's negligent report, which she claimed failed to adequately consider a myelogram. The defendant moved for summary judgment, arguing a lack of physician-patient duty beyond the examination itself, or immunity. The court granted the defendant's motion, concluding that no physician-patient relationship extended to the reporting of medical findings in this context.

Medical MalpracticePhysician-Patient RelationshipImpartial Medical ExaminerSummary JudgmentDuty of CareDisability ClaimWorkers' CompensationAutomobile AccidentBack InjuryMyelogram
References
3
Case No. ADJ285099 (SFO 0496940) ADJ224856 (SFO 0496941)
Regular
Nov 13, 2008

PATRA NESSETH-STEFFES vs. HAYWARD UNIFIED SCHOOL DISTRICT, SCHOOLS INSURANCE GROUP

The Appeals Board affirmed the WCJ's decision, finding that the applicant's right knee injury did not have an indicated permanent disability in 2004 based on treating physician reports, thus requiring the use of the 2005 Permanent Disability Rating Schedule. The majority concluded that Dr. Lim's MRI report, while showing tears, did not explicitly state the existence of permanent disability from the industrial injury, and the treating physician's report at the time showed no physical evidence of permanent impairment. A dissenting opinion argued that Dr. Lim's MRI report, supported by subsequent medical findings and the applicant's ongoing restrictions, indicated permanent disability in 2004, warranting application of the older 1997 rating schedule.

Workers' Compensation Appeals BoardReconsiderationPermanent Disability Rating ScheduleMedical-Legal EvaluationTreating Physician ReportPermanent and StationaryLabor Code Section 4660(d)American Medical Association GuidesZenith Insurance Co. v. Workers' Comp. Appeals Bd. (Cugini)Genlyte Group v. Workers' Comp. Appeals Bd. (Zavala)
References
2
Case No. ADJ16773219; ADJ16653843
Regular
Jun 03, 2025

LAKEISHA HOWARD vs. OPTUM 360 SERVICES, A UNITED HEALTH GROUP COMPANY; TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The applicant, Lakeisha Howard, sought reconsideration after the WCJ denied her claims for cumulative injury to her left knee and ankle, and deemed Dr. Granado's reports inadmissible. The Appeals Board affirmed the WCJ's decision, finding that Dr. Granado's reports were obtained to rebut the panel QME's opinion rather than for medical treatment and were therefore inadmissible. The Board also upheld the finding that the applicant failed to prove a cumulative injury arising out of her employment, citing Dr. Welborn's opinion that her sedentary job would not cause such trauma. Consequently, the Petition for Reconsideration was denied.

Labor Code Section 5909Petition for ReconsiderationAdmissibility of Medical ReportsCumulative Trauma InjuryCompensable Consequence InjurySubstantial EvidenceCausationPanel Qualified Medical EvaluatorTreating PhysicianMedical-Legal Evaluation
References
10
Case No. ADJ10170465
Regular
May 17, 2018

AMRICK SINGH vs. FOSTER FARMS

This case concerns Amrick Singh's claim for cumulative injury to his work and bilateral lower extremities against Foster Farms. The Workers' Compensation Appeals Board denied Singh's Petition for Reconsideration, upholding the original finding that no cumulative trauma injury occurred. The Board adopted the Workers' Compensation Judge's report, which found that the applicant's arguments regarding the PQME's review of medical records were unpersuasive. The Judge's report highlighted that the PQME's opinion constituted substantial evidence, even if inconsistent with other medical opinions, and that prior awards did not change the lack of substantial evidence for the current claim.

AMRICK SINGHFOSTER FARMSPetition for ReconsiderationDENIEDWCJ Reportsubstantial evidencemedical opinionsQualified Medical Evaluator (PQME)Aubrey SchwartzM.D.
References
1
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