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

Case No. ADJ10065069
Regular
May 16, 2018

MARCIA FARRAR vs. STATE OF CALIFORNIA, UNEMPLOYMENT INSURANCE APPEALS BOARD, legally uninsured, administered by STATE COMPENSATION INSURANCE FUND

This case concerns defendant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) finding of injury arising out of and occurring in the course of employment (AOE/COE) to the applicant's right upper extremity. Defendant argued that no evidence supported injury to other alleged body parts and that the WCJ should have made findings on those parts instead of deferring the issue. The WCAB denied reconsideration, affirming the WCJ's decision to limit the trial to the threshold issue of right upper extremity injury AOE/COE. The WCAB found Dr. Amster's opinion constituted substantial evidence for the right upper extremity injury and that the WCJ acted within their authority by deferring other issues.

Workers' Compensation Appeals BoardAOE/COEQualified Medical ExaminerReconsiderationCumulative TraumaRepetitive Strain InjuryPreexisting ConditionAggravationContributing CauseMandatory Settlement Conference
References
7
Case No. ADJ5668010
Regular
Jan 29, 2016

RAGHBIR MAHIL vs. FOSTER FARMS

This case concerns applicant Raghbir Mahil's appeal of a WCJ's decision regarding his 2002 industrial injury. The WCJ found injury to the neck and psyche, awarding 42% permanent disability based on the AMA Guides and denying injury to the right upper extremity and headaches. Applicant argued for total permanent disability, no psychiatric apportionment, and the application of the 1997 rating schedule. The Appeals Board rescinded the WCJ's decision, returning the matter for re-rating permanent disability under the 1997 Schedule due to the timing of temporary disability payments. The Board otherwise affirmed the WCJ's findings, including no injury to the right upper extremity or headaches, and the need for neck treatment only.

Workers' Compensation Appeals BoardRaghbir MahilFoster FarmsOpinion Decision After ReconsiderationFindings and Awardadmitted industrial injuryneck injurypsyche injurypermanent disabilityAMA Guides
References
2
Case No. MISSING
Regular Panel Decision

Johnson v. Second Injury Fund

Walter Johnson, who had previously lost vision in his right eye, suffered an injury at work resulting in the loss of vision in his left eye, leaving him totally and permanently disabled. He received benefits from Texas Employer’s Insurance Association and the Second Injury Fund. Johnson and his wife then sued Texas Industries, Inc. for negligence. Both TEIA and the Second Injury Fund intervened, seeking subrogation rights. The trial court denied the Second Injury Fund's claim to subrogation, but the court of appeals reversed. The Texas Supreme Court reviewed whether the Second Injury Fund is subrogated to Walter Johnson's rights in his personal injury suit. The Court concluded that subrogation is a legislative creation and the statute funding the Second Injury Fund explicitly enumerates funding methods without including subrogation. Therefore, the Supreme Court reversed the court of appeals' judgment and affirmed the trial court's decision, denying subrogation for the Second Injury Fund.

SubrogationSecond Injury FundWorkers' CompensationStatutory InterpretationExpressio Unius Est Exclusio AlteriusTotal DisabilityPersonal InjuryTexas Supreme CourtFunding MechanismsLegislative Intent
References
9
Case No. 534955
Regular Panel Decision
Feb 16, 2023

In the Matter of the Claim of Victor Martinez

Victor Martinez, a construction worker, was injured on November 11, 2020, when his right hand was caught between a cantilever pin and a concrete post. He filed a claim for workers' compensation benefits, including injuries to his neck and back, in addition to his right upper extremity. A Workers' Compensation Law Judge (WCLJ) initially established the claim only for injuries to his right forearm and wrist, disallowing the neck and back claims. However, the Workers' Compensation Board modified this determination, amending the claim to include the neck and back injuries. The employer and its workers' compensation carrier appealed the Board's decision, arguing against the causal relationship of the neck and back injuries. The Supreme Court, Appellate Division, Third Judicial Department, affirmed the Board's decision, finding it supported by substantial evidence and deferring to the Board's assessment of medical witness credibility and its factual findings.

Construction InjuryWorkers' Compensation BenefitsCausality DeterminationNeck and Back InjuriesSubstantial EvidenceMedical Opinion CredibilityAppellate ReviewWork AccidentBoard Decision AffirmationOrthopedist Testimony
References
8
Case No. ADJ602790 (STK 0179563)
Regular
Jul 17, 2012

TRACEE MAWYER vs. GALLO GLASS COMPANY

This case involves Tracee Mawyer's workers' compensation claim against Gallo Glass Company for cumulative trauma injuries. The Appeals Board granted reconsideration, reversing the trial judge's denial of injury to applicant's bilateral upper extremities, specifically carpal tunnel syndrome. The Board found Dr. Clayman's reports sufficiently supported an industrial injury to the upper extremities and awarded additional temporary disability for the period following carpal tunnel surgery. The case was returned for a new permanent disability rating for the upper extremity injuries.

Cumulative traumabilateral upper extremitiescarpal tunnel release surgerytemporary disabilitypermanent disability ratingreconsiderationDr. Claymanneck injuryshoulder injuryspine injury
References
0
Case No. 2016-07-0264
Regular Panel Decision
Nov 18, 2016

Beene, Marshall v. Metro Services, Inc.

Marshall Beene, an employee of Metro Services, Inc., suffered an injury after falling from a ladder. Metro Services accepted compensability for right elbow, rotator cuff, and shoulder injuries, but challenged a cervical spine injury. The Court of Workers' Compensation Claims held an expedited hearing to address Mr. Beene's requests for additional medical benefits and temporary disability benefits. The court granted authorization for Mr. Beene to receive treatment from Dr. Gregory Ball for his compensable right-upper extremity injury and also awarded temporary partial disability benefits starting March 4, 2016. However, the request for authorized treatment by Dr. Todd Bonvallet for his cervical spine injury was denied, as medical evidence indicated it was not primarily work-related.

Workers' CompensationMedical BenefitsTemporary DisabilityExpedited HearingCervical Spine InjuryRight Elbow InjuryRotator Cuff InjuryComplex Regional Pain SyndromeMaximum Medical ImprovementAuthorized Treating Physician
References
4
Case No. 2015-02-0155, 2015-02-0156, 40357-2015, 31700-2015
Regular Panel Decision
Apr 13, 2018

Muse, Estel Blackie v. Campbell County

Estel "Blackie" Muse, an employee of Campbell County, filed claims for multiple injuries, including his back, hearing loss, right shoulder, bilateral upper extremities, and occupational lung disease. The employer accepted the back and hearing-loss claims but denied the others. The Court of Workers’ Compensation Claims at Knoxville, presided by Judge Lisa A. Lowe, denied Mr. Muse's claims for his right shoulder, bilateral upper extremity, and occupational lung disease, finding he failed to establish compensability. However, the court granted permanent partial disability benefits for his back and hearing loss based on accepted medical opinions, incorporating increased benefits and applying a social security offset. The total award for permanent partial disability benefits was $79,073.37, and future medical benefits for his back and hearing loss were also awarded.

Workers' CompensationPermanent Partial DisabilityBack InjuryHearing LossOccupational Lung DiseaseRight Shoulder InjuryBilateral Upper Extremities InjuryMedical CausationPreponderance of EvidenceIndependent Medical Evaluation (IME)
References
5
Case No. ADJ8835660
Regular
Jan 19, 2018

JOE CASILLAS vs. GRAYD A PRECISION METAL FABRICATORS; STATE COMPENSATION INSURANCE FUND

This case concerns a petition for reconsideration by the defendant regarding a permanent total disability award for Joe Casillas. The defendant argued against the total disability finding, questioned injury to the left upper extremity, and contested the basis for vocational rehabilitation findings. The Board granted reconsideration to amend the findings, rescinding the finding of injury to the left upper extremity due to the applicant unilaterally withdrawing that issue. However, the Board affirmed the permanent total disability finding based on substantial medical and vocational evidence, including the applicant's significant limitations in daily living and unsuitability for vocational rehabilitation, despite the absence of left upper extremity injury.

Permanent total disabilityvocational rehabilitationindustrial injurybilateral upper extremitiescervical spinepsychefabricatorState Compensation Insurance Fundpetition for reconsiderationadministrative law judge
References
3
Case No. ADJ4111589, ADJ2809505, ADJ4372783, ADJ1391390, ADJ2081394, ADJ8992669
Regular
Oct 09, 2015

GUILLERMO CORNEJO vs. SOLAR TURBINES, INC.

This case involves a worker who sustained multiple admitted industrial injuries to his right foot, back, right thigh, psyche, right lower extremity, and hands. The applicant alleged a subsequent left shoulder condition arose as a compensable consequence of these prior injuries due to a fall. Initially, an administrative law judge found the fall was not industrial, ruling the applicant merely tripped. However, the Workers' Compensation Appeals Board granted reconsideration, finding that medical evidence established the applicant's admitted industrial injuries caused weakness in his right lower extremity and balance issues, which contributed to his fall. Therefore, the Board reversed the prior ruling, determining the left shoulder condition was a compensable consequence of the original industrial injuries.

compensable consequenceadmitted industrial injuriesleft shoulder conditionright footright lower extremitybalanceweaknessfallL4-L5 fusionradiculopathy
References
4
Case No. ADJ9841969
Regular
Jul 23, 2019

MARIA ALBERTO vs. GUARDIAN HOME CARE, ZURICH AMERICAN INSURANCE COMPANY

This case involves a workers' compensation applicant who sustained injuries to her left elbow, left upper extremity, lumbar spine, and right knee. The WCAB granted reconsideration of an administrative law judge's decision to re-evaluate specific injuries and permanent disability. The Board found that further development of the medical record was necessary concerning alleged injuries to the right wrist, thoracic spine, and cervical spine. Consequently, the decision defers these issues and the determination of permanent disability pending further medical evidence.

WCABReconsiderationPanel Qualified Medical EvaluatorAdministrative Law JudgePermanent DisabilityIndustrial InjuryCervical SpineThoracic SpineRight WristMedical Opinion
References
3
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