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

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ2012970
Regular
Feb 18, 2010

GARY BAUMGARTNER vs. MCFARLAND AIR CONDITIONING, STATE COMPENSATION INSURANCE FUND, SUBSEQUENT INJURIES BENEFITS TRUST FUND OF THE STATE OF CALIFORNIA

This case involves a Subsequent Injuries Benefits Trust Fund (SIBTF) appeal regarding an applicant's entitlement to benefits for a 100% permanent disability due to combined pre-existing and subsequent industrial injuries. The SIBTF argued the applicant's claim was barred by the statute of limitations due to filing delays and an incorrect case number on an initial application. However, the Board affirmed the WCJ's finding that the claim was timely, considering the applicant's ignorance of his SIBTF rights and the death of his prior attorney. The Board found the amended application related back to the initial filing and that the SIBTF suffered no prejudice from the procedural error.

Subsequent Injuries Benefits Trust FundSIBTFstatute of limitationspermanent disabilityWCJFindings and Awardapportionmentamended applicationpetition for reconsiderationLabor Code section 4751
References
Case No. ADJ7485185, ADJ9885267
Regular
Sep 18, 2017

LAURA ORTIZ vs. FARMERS INSURANCE GROUP, MID CENTURY INSURANCE

This Workers' Compensation Appeals Board decision denies a petition for reconsideration, affirming the applicant's timely invocation of jurisdiction to seek additional benefits. The Board adopted the WCJ's reasoning that the applicant's filings of an Application for Adjudication of Claim and an Amended Application, along with documented medical evidence of worsening condition, satisfied the requirements for reopening and seeking further compensation. These actions put the defendants on notice of the applicant's intent to pursue increased benefits, even without a formal petition to reopen.

Petition for ReconsiderationLabor Code section 5410Application for Adjudication of ClaimRiel v. State of CaliforniaBeaida v. Workers' Comp. Appeals Bd.stipulated awardpro perfuture medical treatmentincreased symptomsworsening condition
References
Case No. ADJ3388364 (VNO 0526713) ADJ2633182 (VNO 0342427)
Regular
Oct 24, 2014

RICHARD FROMKNECHT vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND

The applicant sought reconsideration of a decision denying him benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). The applicant claimed a pre-existing disability from a 1996 spinal injury caused further permanent disability with a subsequent 1998 spinal injury. However, both injuries became permanent and stationary concurrently, meaning there was no distinct pre-existing ratable disability at the time of the second injury. Therefore, the applicant did not meet the criteria for SIBTF benefits under Labor Code section 4751, and his petition for reconsideration was denied.

Subsequent Injuries Benefits Trust FundLabor Code section 4751Petition for ReconsiderationFindings and OrderStipulations with Requests for AwardsAgreed Medical Evaluatorapportionmentpermanent and stationarypreexisting disabilityindustrial injury
References
Case No. ADJ1982986 (MON 0317718)
Regular
Jan 04, 2019

JAMES O’DONNELL vs. SOUTHERN CALIFORNIA GAS COMPANY

The Workers' Compensation Appeals Board affirmed a prior finding that applicant's claim for Subsequent Injuries Benefits Trust Fund (SIBTF) benefits is not barred. The Board clarified that there is no statute of limitations for SIBTF applications, establishing timeliness based on a reasonable period after the Board's finding of likely eligibility. The Board found the applicant's 1991 stipulated award established a prior labor-disabling injury sufficient for SIBTF eligibility. Applicant's SIBTF application was deemed timely filed within 21 days of the January 4, 2011 award determining combined permanent disability.

SIBTFStatute of LimitationsSubsequent Injuries Benefits Trust FundPermanent DisabilityReconsiderationFindings of FactWCJAgreed Medical EvaluatorStipulation and Request for AwardCumulative Trauma
References
Case No. ADJ4219530 (SJO 0221066)
Regular
May 10, 2010

Dawn May vs. West Valley/Mission College, California Insurance Guarantee Association for Fremont Compensation Insurance in liquidation, Subsequent Injuries Benefits Trust Fund

The applicant sought reconsideration of a WCJ's finding that her claim for Subsequent Injuries Benefits Trust Fund (SIBTF) benefits was untimely. The WCJ based this on the applicant's knowledge of potential SIBTF liability by July 2004 and her filing in December 2008. The Appeals Board granted reconsideration, finding the claim was filed within a "reasonable time" as per *Talcott*. The Board determined that an award of permanent disability had not issued before the applicant filed her SIBTF claim and found no prejudice to the SIBTF, thus rescinding the WCJ's order.

Subsequent Injuries Benefits Trust FundSIBTFTalcottBacareasonable timesubstantial likelihoodpermanent disabilitydate of injurycausationapportionment
References
Case No. ADJ2651648 (MON 0342704)
Regular
Jul 18, 2017

TERESA SANCHEZ vs. HAWTHORNE UNIFIED SCHOOL DISTRICT, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of an award granting applicant benefits for a 2006 industrial injury, arguing the prior disability rating was insufficient. The applicant had two industrial injuries: a 1997-2002 cumulative trauma and the 2006 specific injury, both causing fibromyalgia. The WCJ found the combined disability from both injuries exceeded the threshold for SIBTF benefits, based on her primary treating physician's rating. The Appeals Board affirmed the WCJ's decision, adopting the judge's report which found the applicant met the criteria for SIBTF benefits, and denied the SIBTF's petition.

Subsequent Injuries Benefits Trust FundSIBTFcumulative traumacompensable consequencefibromyalgiapermanent and stationaryAgreed Medical ExaminerAMA Guides1997 rating scheduleprimary treating physician
References
Case No. ADJ1620559 (ANA 0373462)
Regular
Feb 09, 2015

WAYNE JOHNSON vs. TENNANT COMPANY, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of a workers' compensation award finding the applicant entitled to SIBTF benefits due to a permanent total disability resulting from the combination of two injuries. The SIBTF argued the applicant was not eligible as he claimed to have fully recovered from his prior injury before the second one. The Board denied the petition, holding that medical evidence established prophylactic work restrictions after the first injury which constituted a labor-disabling condition. The applicant's lay opinion of recovery was insufficient to negate the physician-imposed restrictions, which remained valid for SIBTF eligibility purposes.

Subsequent Injuries Benefits Trust FundSIBTFlabor disabling disabilityprophylactic work restrictionpermanent and stationarycompromise and releaseapportionmentratable permanent disabilitylay opinionmedical evidence
References
Case No. ADJ3953602 (SRO 0260827) ADJ2646453 (SRO 0133845)
Regular
Nov 14, 2012

ROBERTO HERNANDEZ vs. MILL VALLEY SCHOOL DISTRICT, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) seeks reconsideration of an award finding the applicant totally permanently disabled due to industrial injuries sustained in 2004. The WCJ found the combined injuries greater than 70% and the second injury itself greater than 35%, entitling the applicant to SIBTF benefits. SIBTF argues the applicant's disability is solely due to the subsequent injury, thus disqualifying them from SIBTF benefits. The Appeals Board granted reconsideration to review the admissibility of two vocational reports and deposition transcripts, Exhibits M and N, which were previously marked for identification only. The Board intends to receive these documents into evidence unless timely objections are filed.

SIBTFPetition for ReconsiderationFindings and AwardPermanent DisabilityIndustrial InjuryVocational Rehabilitation EvaluationDiminished Future Earning CapacityDeposition TranscriptExhibits M and NWCJ Report
References
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