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

Case No. ADJ9210498
Regular
Apr 04, 2017

ELEANOR DEFRANCO vs. MONTEREY FISH COMPANY, ENSTAR (US) INC., dba ENSTAR ADMINISTRATORS FOR SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior award that found industrial injury to applicant's right ankle, right shoulder, and back, but not her right knee. The WCAB rescinded the finding of industrial injury to the back, while otherwise affirming the prior decision. Specifically, the WCAB affirmed the finding that the applicant sustained industrial injury to her right ankle and right shoulder, and that medical treatment for her right knee is compensable to relieve the effects of the industrial injuries. The WCAB adopted the WCJ's reasoning for these decisions, including the application of the *Braewood* principle for treating the non-industrial knee condition.

Workers' Compensation Appeals BoardEleanor DefrancoMonterey Fish CompanyEnstarSeabright Insurance CompanyIndustrial InjuryRight AnkleRight ShoulderRight KneeBack Injury
References
Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ1406771 (LAO 0726969) ADJ1468176 (LAO 0727001) ADJ555495 (LAO 0746656)
Regular
Feb 01, 2013

CARMEN SANCHEZ vs. CROWN CITY PLATING, LIBERTY MUTUAL INSURANCE COMPANY, HIH INSURANCE by CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, INTERCARE INSURANCE SERVICES, Wausau Underwriters Insurance Company

The Workers' Compensation Appeals Board granted reconsideration and rescinded a previous award, returning the case to the trial level for further proceedings. The Board found the judge erred by considering specific injuries as part of a cumulative trauma, as this issue was already determined by res judicata. The Board also directed that benefits be awarded against either CIGA or Wausau, and any decision on reimbursement must conform to specific case law regarding CIGA's liability. The current administrator is to continue paying uncontested benefits pending further proceedings.

Workers' Compensation Appeals BoardReconsiderationJoint Findings Award OrderIndustrial InjurySpinePsycheHeartRight LegRight FootRight Ankle
References
Case No. SDO 0323941
Regular
Aug 20, 2007

CAPRICE SMITH vs. KINDERCARE LEARNING CENTER, SPECIALTY RISK SERVICES, AIG

This case concerns whether the old or new workers' compensation permanent disability rating schedule applies to an injury predating the 2005 schedule changes. The Board affirmed the WCJ's prior determination that the 1997 schedule applies due to a final, unchallenged finding on the matter. However, the Board granted reconsideration to amend the award, deferring the issue of permanent disability and attorney's fees for further proceedings at the trial level due to the WCJ's insufficient explanation of the disability rating and apportionment.

Workers' Compensation Appeals BoardKindercare Learning CenterSpecialty Risk ServicesAIGCaprice SmithSDO 0323941Petition for ReconsiderationAmended Findings and AwardPreschool TeacherIndustrial Injury
References
Case No. ADJ1950726 (MON 0361748), ADJ6963803, ADJ7198723
Regular
Mar 20, 2012

DANA BURREL vs. LONG BEACH UNIFIED SCHOOL DISTRICT, TRISTAR RISK MANAGEMENT

In three workers' compensation cases, the applicant sustained industrial injuries to her upper extremities on May 21, 2006, March 11, 2008, and July 28, 2008. The Appeals Board granted reconsideration to review the application of Labor Code section 4658(d)(2), which mandates a 15% increase in permanent disability payments when an employer fails to offer suitable work within 60 days of an injury becoming permanent and stationary. The employer stipulated to providing some medical treatment and returning the applicant to work, but failed to offer regular, modified, or alternative work for 12 months post-injury. The Board found the employer's contention of denial unsubstantiated by evidence and, following *Bontempo v. Workers' Comp. Appeals Bd.*, ruled that the 15% increase applies to all three cases.

Labor Code section 4658(d)(2)permanent disability increaseindustrial injuryright upper extremityright handright wristright shoulderright armleft wristleft hand
References
Case No. ADJ2679141 (VNO 0452598) ADJ2658608 (VNO 0490822)
Regular
Jul 09, 2009

ELIZABETH ALVAREZ vs. UNICO AMERICAN CORPORATION; EXPLORER INSURANCE COMPANY/ICW GROUP

The Appeals Board denied defendant's petition for reconsideration of the July 9, 2009 Joint Findings of Fact and Award. The WCJ found that applicant sustained an industrial injury to her low back, right knee and right ankle and that the treatment was reasonable and necessary.

Workers' Compensation Appeals BoardJoint Findings of Fact and AwardPetition for ReconsiderationIndustrial InjuryLow BackCoccyxRight KneeRight AnkleCompensable Consequence InjuryLien Claimants
References
Case No. ADJ8160941
Regular
Apr 13, 2015

DANIEL BROWN vs. GOLDEN GATE BRIDGE\/HIGHWAY AND TRANSPORTATION DISTRICT

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The Board adopted the Administrative Law Judge's (WCJ) report, which found the applicant's right ankle fracture to be a compensable consequence of his prior industrial right knee injury. The WCJ's credibility determination regarding the applicant's testimony that his knee buckled before his fall was given great weight, as is standard practice. The Board found no substantial evidence to overturn this determination, despite minor inconsistencies in testimony regarding the exact surface of the fall.

Compensable consequenceCredibility determinationWorkers' Compensation Appeals BoardWCJPetition for ReconsiderationIndustrial injuryRight kneeRight ankleCausation of injuryMedical treatment
References
Case No. ADJ6509769
Regular
Aug 16, 2010

JOAN VALENTINE vs. CB RICHARD ELLIS, INC., ZURICH NORTH AMERICA

The applicant sought reconsideration of a WCJ decision that awarded $4\%$ permanent disability for a low back injury but denied claims for right knee, right ankle, and sleep disorder injuries. The applicant contended the WCJ erred by not finding an industrial injury to her right knee, arguing her attorney failed to enter relevant medical reports into evidence. The Appeals Board granted reconsideration, rescinded the original award, and returned the matter to the trial level. This action was based on the potential insufficiency of the PQME's review, as the applicant's testimony regarding her knee injury was corroborated by contemporaneous medical reports that may not have been fully considered.

Petition for reconsiderationPro perFindings and AwardIndustrial injuryLow back injuryPermanent disabilityRight knee injuryRight ankle injurySleep disorderVerified petition
References
Case No. ADJ19527341
Regular
May 05, 2025

MARIA RAMIREZ vs. ROMAN CATHOLIC BISHOP OF MONTEREY, CALIFORNIA

Applicant Maria Ramirez sought reconsideration of a workers' compensation administrative law judge's order, which found no industrial injury. The Appeals Board granted reconsideration, rescinded the WCJ's decision, and returned the matter to the trial level for further proceedings. The Board determined that the WCJ's credibility finding, based on the delayed worsening of symptoms, required expert medical opinion to ascertain consistency with the claimed injury mechanism, thus necessitating further development of the medical and factual record.

ADJ19527341Petition for ReconsiderationFindings and OrderIndustrial InjuryRight Arm InjuryRight Wrist InjuryRight Hip InjuryRight Leg InjuryRight Foot InjuryWCJ Credibility Determination
References
Case No. ADJ1498961
Regular
Sep 23, 2010

DALE ARNOLD vs. RALPH'S AKA KROGER

This case involves an applicant's claim for workers' compensation benefits for a right shoulder injury. While the initial award recognized industrial injury to the applicant's left shoulder, right elbow, and right forearm, the defendant sought reconsideration, arguing the right shoulder injury was not work-related. The Appeals Board granted reconsideration, finding the applicant failed to meet the burden of proof for the right shoulder injury. They disagreed with the primary treating physician's opinion and found the agreed medical evaluator's opinion more persuasive, ultimately reversing the finding for the right shoulder.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardCumulative TraumaIndustrial InjuryLeft ShoulderRight ElbowRight ForearmRight ShoulderPrimary Treating Physician
References
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