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

Case No. ADJ12305682
Regular
Apr 14, 2023

DAVID REED vs. CSR MANAGEMENT SERVICES, STATE COMPENSATION INSURANCE FUND

This case involves CSR Management Services and their insurer seeking reconsideration of a $71\%$ permanent disability award for David Reed. The defendants argued that the qualified medical evaluator, Dr. Brophy, did not sufficiently explain the applicant's scarring impairment. The Workers' Compensation Appeals Board denied the petition, finding Dr. Brophy adequately explained the scarring impairments as Class 1 under the AMA Guides. The Board noted that defendants could have sought further clarification from the evaluator.

CSR Management ServicesState Compensation Insurance FundADJ12305682Petition for ReconsiderationAmended Findings of FactAward and Orderconstruction laborerindustrial injuryupper extremitiesback
References
Case No. ADJ17937030
Regular
Nov 04, 2025

MARGARET RUSSOTTO vs. PARK MANAGEMENT CORPORATION DBA SIX FLAGS DISCOVERY KINGDOM, PROPERTY AND CASUALTY INSURANCE COMPANY OF HARTFORD

The Workers' Compensation Appeals Board (WCAB) denied the Petition for Reconsideration filed by defendants Park Management Corporation and Property and Casualty Insurance Company of Hartford. The defendants challenged the Findings and Award (F&A) of July 28, 2025, which found applicant Margaret Russotto sustained industrial injuries to her lumbar spine, hips, thigh, and scarring, resulting in 42% disability. The WCAB upheld the F&A, finding that the expert medical opinion of PQME Jagtar Dhesi, D.C., constituted substantial medical evidence supporting the existence and extent of the injuries and impairments. The Board noted the defendants' failure to provide rebuttal medical evidence or undertake further investigation prior to trial, emphasizing the duty to develop the record.

Petition for ReconsiderationFindings and AwardWCJAMA GuidesPermanent ImpairmentSubstantial Medical EvidencePanel Qualified Medical Examiner (PQME)Lumbar SpineHip InjuryScarring
References
Case No. ADJ3100377 (MON 0353282)
Regular
Nov 29, 2010

ANGELA RHYMES vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, Permissibly Self-Insured, Administered By SEDGWICK CMS

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior award due to insufficient medical evidence. The WCAB found that the primary treating physician's impairment ratings were conclusory and lacked a solid basis, particularly regarding lower extremity and skin impairment. Furthermore, the WCAB questioned the inclusion of a digestive system impairment claim, as it was not raised in the original claim or at the initial hearing. The case is remanded for further development of the record, including supplemental reports from both physicians, to properly determine permanent disability and the digestive system injury claim.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilitySubstantial Medical EvidencePrimary Treating PhysicianQualified Medical EvaluatorAMA GuidesWhole Person ImpairmentLeft Ankle InjuryKeloid Scar
References
Case No. ADJ9585461
Regular
Feb 02, 2017

TONY DE LA GARZA vs. ROLL GLOBAL/DEL REY JUICE PLANT dba POM WONDERFUL, Permissibly Self-Insured, Administered by BROADSPIRE

The WCAB dismissed the defendant's Petition for Removal, treating it as a Petition for Reconsideration, and denied it. The Board affirmed the WCJ's order requiring the defendant to authorize surgical treatment. The defendant's initial challenge was based on a prior IMR denial, but the Board found a material change in facts occurred when the treating physician clarified the surgery's non-cosmetic, functional purpose. The Board concluded the subsequent UR certification was valid and the defendant must authorize the treatment.

Workers' Compensation Appeals BoardPetition for RemovalPetition for ReconsiderationFindings and OrderUtilization ReviewIndependent Medical ReviewMedical TreatmentSurgical ProcedureScar DeformityPainful Scar
References
Case No. ADJ6704425
Regular
Apr 02, 2012

MANUEL MENDOZA vs. RACKLEY COMPANY, ZURICH AMERICAN INSURANCE CO.

The Workers' Compensation Appeals Board denied reconsideration of a decision awarding permanent disability benefits to Manuel Mendoza. The Board adopted the administrative law judge's report, which found that the primary treating physician's opinion constituted substantial evidence, even if it differed from other medical opinions. The judge's decision to follow the treating physician's rating, which included consideration of a surgical scar and pain, was upheld. The Board noted that a single physician's relevant and considered opinion can be substantial evidence in workers' compensation cases.

Workers' Compensation Appeals BoardReconsideration DeniedSubstantial EvidencePhysician OpinionAMA GuidesGuzman DecisionPermanent DisabilityPrimary Treating PhysicianPQMESurgical Scar
References
Case No. ADJ4151507 (SFO 0487197)
Regular
Feb 02, 2020

Tracy Sullivan vs. Café Amsterdam, State Compensation Insurance Fund

The Appeals Board granted reconsideration and amended the previous award, finding the applicant's burn injury did not qualify for the "severe burns" exception to the temporary disability indemnity limit under Labor Code section 4656(c)(3)(D). Consequently, temporary disability indemnity is limited to 104 weeks from the commencement of payments on August 10, 2004. The Board affirmed the WCJ's finding that the applicant's psychiatric injury was compensable, meeting the "sudden and extraordinary" employment condition exception. Clerical errors in the original findings were also corrected.

ADJ4151507SFO 0487197Tracy SullivanCafé AmsterdamState Compensation Insurance FundPetition for ReconsiderationFindings Award and OrderWCJindustrial injurycervical spine
References
Case No. ADJ8689638
Regular
Dec 01, 2016

AVI AZOULAY vs. CITY OF ORANGE, YORK SERVICES

The Appeals Board denied the defendant's Petition for Reconsideration, upholding its prior decision that applicant Avi Azoulay sustained an industrial injury. The Board found that Azoulay's bacterial infection, which spread to his bloodstream from his colon, qualified as a "blood-borne infectious disease" under Labor Code section 3212.8. This presumption of industrial causation applied despite the infection originating internally, as the statute's language and purpose encompass such conditions. Consequently, the defendant failed to overcome the presumption and provide evidence that the condition existed prior to employment.

Labor Code section 3212.8presumption of industrial causationblood-borne infectious diseasejuvenile correction officerPetition for Reconsiderationbacterial infectionpathogenic microorganismsanti-attribution clausedivericulitisscar
References
Case No. ADJ1136513
Regular
Feb 13, 2018

FRANCISCO BAUTISTA vs. SMITHS GROUP SERVICES CORPORATION, LIBERTY MUTUAL INSURANCE GROUP

This case concerns applicant's entitlement to extended temporary disability benefits beyond 104 weeks for a severe burn injury under Labor Code § 4656. The Appeals Board rescinded the trial judge's findings, remanding the case for further proceedings. This decision focuses on whether the applicant's burn injury, considering treatment, resulting disability (including psychiatric sequelae), and residual permanent disability, qualifies as "severe" under the statute. The Appeals Board clarified that the severity analysis must encompass the overall impact of the burn, not just the initial injury.

Labor Code Section 4656temporary disabilitysevere burnshigh-velocity eye injuryflash fireburn injurydepth of injurysequelaehyperpigmentationscarring
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. ADJ1966949 (GOL 0095232)
Regular
Mar 19, 2012

ARMANDO OROZCO (ARMANDO OROZCO JUAREZ) vs. PACIFIC VINEYARD COMPANY, STATE COMPENSATION INSURANCE FUND

This case involves a defendant employer's petition for reconsideration of a finding that the applicant sustained an injury arising out of and in the course of employment (AOE/COE). The employer contended the AOE/COE finding lacked substantial evidence, particularly questioning the applicant's account of falling off a tractor and being run over. The Workers' Compensation Appeals Board (WCAB) denied the petition, adopting the WCJ's report which found the applicant's testimony persuasive, supported by employer witnesses attesting to his trustworthiness, and contradicted by unreliable defense expert testimony. The WCJ also noted a prior employer letter disputing the *nature* of the injury, not its occurrence, and the fact the applicant showed scarring.

AOE/COEPetition for ReconsiderationFinding of FactCompromise and Releasesubstantial evidenceWCJdefendant employerapplicantState Compensation Insurance Fundinjury
References
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