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

Case No. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
Case No. ADJ9625407
Regular
Sep 12, 2018

KEITH FIELD vs. CITY OF PINOLE

This case involves a firefighter who sustained bilateral carpal tunnel syndrome after retirement. The Appeals Board reversed the trial judge, holding that Labor Code section 4458.5 applies, entitling the applicant to permanent disability benefits calculated at the maximum indemnity rate. This applies regardless of the applicant's actual earnings or the fact that carpal tunnel syndrome is not a specifically enumerated presumptive injury. The case is remanded for determination of the precise date of injury to calculate the benefit rate.

Workers' Compensation Appeals BoardKeith FieldCity of PinolePermissibly Self-InsuredMunicipal Pooling AuthorityADJ9625407Opinion and Decision After Reconsiderationindustrial injuryfirefighterbilateral upper extremities
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. ADJ6766619 (MF) ADJ6766620
Regular
Feb 28, 2018

MARIA DURAN vs. FOREVER 21 RETAIL, INC., CHUBB GROUP

This case involves Maria Duran's request for home health care services, which was initially denied by utilization review (UR) and upheld by Independent Medical Review (IMR). The applicant argued that her need for assistance with household chores and personal hygiene fell outside the scope of the Medical Treatment Utilization Schedule (MTUS) guidelines as applied. While the Board acknowledges that the specific MTUS guideline used in this case was later found to be an invalid regulation in a related case, it affirmed the original decision. This affirmance was based on the finding that the initial request for services was too vague, lacking specific details on the type, frequency, and duration of care, and that a revised request could be made.

Workers' Compensation Appeals BoardMaria DuranForever 21 RetailInc.Chubb GroupOpinion and Decision After ReconsiderationIndependent Medical ReviewIMRUtilization ReviewUR
References
Case No. ADJ6743994
Regular
Jan 24, 2011

STANLEY HOLDER vs. COUNTY OF NEVADA

The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for reconsideration and denied the defendant's. The WCAB found the applicant's heart condition to be industrially caused based on the presumption under Labor Code section 3212.5, overriding the AME's fluctuating opinion. Permanent disability was increased from 4% to 20% and apportionment was disallowed under Labor Code section 4663(e). Finally, the defendant was denied a 15% reduction in permanent disability payments under Labor Code section 4658 because they failed to strictly prove an offer of regular work in the statutorily prescribed form and manner.

Industrial injuryDeputy SheriffCirculatory systemHeart diseasePermanent disabilityApportionmentAgreed Medical Evaluator (AME)ReconsiderationLabor Code section 3212.5Heart trouble presumption
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ11415215
Regular
Oct 05, 2020

Kenneth Hazelbaker vs. California Highway Patrol, STATE COMPENSATION INSURANCE FUND

The Appeals Board denied the defendant's petition for reconsideration, upholding a prior award for applicant Kenneth Hazelbaker's industrial prostate cancer. The Board affirmed the finding that the cancer is presumed compensable under Labor Code section 3212.1, as medical evidence supported its development within the statutory period. The WCJ's reservation of jurisdiction was also upheld, as prostate cancer was correctly deemed an insidious and progressive disease. Finally, the Board confirmed the applicant's entitlement to permanent disability indemnity based on maximum earnings under Labor Code section 4458.5.

Workers' Compensation Appeals BoardCalifornia Highway PatrolState Compensation Insurance FundKenneth HazelbakerPetition for ReconsiderationFindings and Awardindustrial cumulative traumaprostate cancerLabor Code section 3212.1presumed compensable
References
Case No. ADJ1179569 (AHM 0099178)
Regular
Jun 10, 2011

JERRY CHASTAIN vs. COUNTY OF ORANGE, ORANGE COUNTY FIRE AUTHORITY, STATE COMPENSATION INSURANCE FUND, AMERICAN HOME ASSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, USF&G

In this workers' compensation case, the Appeals Board granted reconsideration to address USF&G's challenge to liability for an applicant's prostate cancer, who died after a prolonged period following exposure. The Board rescinded the prior decision, finding the WCJ erred by not fully addressing liability under Labor Code section 5500.5, specifically regarding the latency period and last date of injurious exposure. The matter was returned to the trial level for further proceedings and a new decision on liability, while affirming the presumption under Labor Code section 3212.1.

Workers' Compensation Appeals BoardFire Apparatus EngineerProstate CancerContinuous Trauma InjuryLabor Code Section 5412Labor Code Section 5500.5Labor Code Section 3212.1 PresumptionLatency PeriodInjurious ExposureCumulative Injury
References
Case No. ADJ2046608 (VNO 0502368)
Regular
Mar 07, 2012

NOE PEREZ vs. HERRICK CORPORATION

The Workers' Compensation Appeals Board granted Herrick Corporation's Petition for Removal, rescinding a WCJ order. The Board is now intending to dismiss Herrick's Petition for Contribution against SCIF. This is because Herrick's contribution claim is barred by the one-year statute of limitations under Labor Code section 5500.5(e). The Order Approving Compromise and Release was dated August 31, 2006, and Herrick's petition was filed over two and a half years later.

Petition for RemovalContributionCarve-out JurisdictionLabor Code Sections 3201.53201.7State Compensation Insurance Fund (SCIF)Alexander BuggyCompromise and ReleaseArbitratorJoint and Several Award
References
Case No. ADJ7555409
Regular
Mar 04, 2014

JESUS ESCANUELA vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the defendant's Petition for Reconsideration and dismissed the applicant's untimely petition. The WCAB found that the Agreed Medical Examiner's (AME) opinion regarding psychiatric permanent disability was not supported by substantial evidence, as it did not properly address causation under the current PDRS. Consequently, the case is remanded to the trial level for further development of the record concerning psychiatric permanent disability. The WCAB deferred the issue of permanent disability and attorney's fees pending this further development.

Workers' Compensation Appeals BoardJesus EscanuelaCalifornia Department of Correctionslegally uninsuredState Compensation Insurance FundADJ7555409Fresno District OfficeOpinion and OrderPetition for ReconsiderationFindings and Award
References
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