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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. 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. ADJ6779280, ADJ6783287
Regular
Feb 09, 2011

DANA COX vs. FIRST TRANSIT, NEW HAMPSHIRE INSURANCE COMPANY

This case involves an applicant with two distinct industrial injuries to different body parts, leading to concurrent temporary disability. The defendant argued the 104-week limit under Labor Code section 4656(c)(2) should run concurrently for both injuries. The Appeals Board rescinded the prior award, finding the WCJ did not properly apply the statute. The Board remanded the case for a new decision, clarifying that for overlapping periods of temporary disability from multiple injuries, the 104-week limitation runs concurrently.

Labor Code section 4656(c)(2)petition for reconsiderationFindings and Awardparatransit driver104 compensable weeksaggregate disability paymentssuccessive injuriesconcurrent temporary disabilityoverlapping body partsLabor Code section 4656(c)(1)
References
Case No. SFO 0492831
Regular
Jan 23, 2008

ELIAS MONTOYA vs. ASTON BARNES, INC., STATE COMPENSATION INSURANCE FUND

The Board granted reconsideration to clarify the application of Labor Code section 4656 regarding temporary disability indemnity limits. The Board held that "new and further" disability does not extend the 104-week limit under section 4656(c)(1), nor do spinal disc excisions and bone grafts qualify as "amputations" under section 4656(c)(2)(C). Consequently, the applicant is entitled to temporary disability indemnity only up to two years from the date of the first payment.

Workers' Compensation Appeals BoardElias MontoyaAston Barnes Inc.State Compensation Insurance FundSFO 0492831Opinion and Decision After ReconsiderationTemporary Disability IndemnityIndustrial InjuryThoracic SpineChest Injury
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. ADJ6609965, ADJ6827074
Regular
Apr 25, 2013

CHARLES MILLHORN vs. BARRETT BUSINESS SERVICES

Here's a summary for a lawyer: The Workers' Compensation Appeals Board denied reconsideration of an award for temporary disability benefits. The defendant argued that Labor Code Section 4656(c)(2) should apply, but the Board upheld the award under Section 4656(c)(1). This decision was based on the Agreed Medical Evaluator's opinion that both the 2007 and 2008 injuries contributed to the temporary disability. The Board also noted the applicant's attorney was admonished for attaching an exhibit already in evidence.

Workers' Compensation Appeals BoardReconsiderationTemporary DisabilityLabor Code Section 4656(c)(1)Labor Code Section 4656(c)(2)Agreed Medical EvaluatorSpecific InjuryCumulative TraumaApportionmentEDD
References
Case No. ADJ6899666 ADJ6899667
Regular
Jan 25, 2016

KIMBERLY CHAMBERS vs. UCLA MEDICAL CENTER, Permissibly SelfInsured, Administered By SEDGWICK CMS

This case concerns an applicant's industrial injury causing cardiovascular and digestive system damage. The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration as moot due to the judge's rescission of a prior award. The Board granted the defendant's petition, limiting the applicant's total temporary disability to 104 weeks per Labor Code section 4656(c)(2). The issue of a 15% permanent disability increase under Labor Code section 4658(d)(2) was deferred for further proceedings.

Petition for ReconsiderationDismissalFindings of FactOrder and AwardWCJPhlebotomistIndustrial InjuryCardiovascular SystemTemporary DisabilityPermanent Disability
References
Case No. SDO 0354449
Regular
Sep 20, 2007

ADAM PERRY vs. HAMMOND \& MASING CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed a prior award denying additional temporary disability payments beyond the statutory 104-week limit. The applicant sought to extend payments based on his knee surgeries, arguing they constituted "amputations" under Labor Code section 4656(c)(2)(C). The Board held that the term "amputation" in this context refers to the severance of external body parts, not the surgical removal of internal knee fragments or cartilage.

Workers' Compensation Appeals BoardIndustrial InjuryPsyche InjuryTemporary Total DisabilityLabor Code Section 4656(c)(1)Labor Code Section 4656(c)(2)(C)AmputationsOsteochondral FragmentChondroplastyACL Reconstruction
References
Case No. ADJ3328008 (VNO 0517608)
Regular
May 20, 2011

ELIODORO LOPEZ vs. VIRGIL CONVALESCENT HOSPITAL, HEALTHCARE SERVICES GROUP, ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant argued they were denied due process when the Workers' Compensation Judge (WCJ) amended a prior decision to correct a Labor Code section reference concerning temporary disability indemnity. The Board found that the original reference to Labor Code § 4656(c)(2) was a clerical error, as the WCJ clearly intended to apply Labor Code § 4656(c)(1) based on the date of injury. The Board affirmed the WCJ's authority to correct such clerical errors.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary Disability Indemnity104 week capLabor Code section 4656(c)(1)Labor Code section 4656(c)(2)Industrial InjuryNeck InjuryShoulder InjuryCardiovascular System Injury
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
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