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

Case No. ADJ6900339
Regular
Nov 13, 2017

Gloria Frialde vs. TJ Ward, Truck Insurance Exchange, Subsequent Injuries Benefit Trust Fund

This Workers' Compensation Appeals Board decision amends a prior award, primarily by removing a finding of industrial injury related to a sleep disorder. The Board found that the applicant's sleep issues stemmed from pain from her physical injuries, not a separate sleep disorder, and thus not separately compensable. The matter is returned to the trial level to re-determine the applicant's permanent disability, considering the corrected findings and specific instructions regarding life pension and permanent disability indemnity rates. The applicant's claim for benefits from the Subsequent Injuries Benefit Trust Fund was denied.

Workers Compensation Appeals BoardReconsiderationOpinion and DecisionFindings Orders and AwardCumulative TraumaPermanent DisabilityApportionmentSubsequent Injuries Benefit Trust FundVocational ExpertAlmaraz/Guzman
References
10
Case No. OXN 0128150, OXN 0128151, OXN 0128152
Regular
Sep 17, 2007

PEGGY A. RICO vs. AQUARIA, INC., CHUBB GROUP OF INSURANCE COMPANIES, CIGA, For RELIANCE INSURANCE, In Liquidation

The Workers' Compensation Appeals Board granted reconsideration to determine if applicant Peggy Rico sustained separate cumulative trauma injuries. The WCAB found that the applicant's return to work with a different insurer, involving distinct injurious exposures and new medical symptoms, constituted a separate industrial injury from her earlier cumulative trauma. Consequently, the case was remanded for a new determination of liability for benefits based on these separate injuries.

Workers' Compensation Appeals BoardCIGAReliance InsuranceChubb GroupCumulative Trauma InjurySeparate Industrial InjuryMedical EvidenceDate of InjuryLabor Code Section 5412Labor Code Section 5500.5
References
9
Case No. ADJ2719991 (VNO 0485134) ADJ1334047 (VNO 0428744)
Regular
Aug 20, 2009

Catalina Barajas vs. WELLPOINT HEALTH NETWORK, INC., ZURICH LOS ANGELES

This case involves an applicant who initially sustained a cumulative trauma injury to her upper extremities during a period covered by one insurer. After returning to work with modified duties, she experienced a recurrence and worsening of symptoms, necessitating further treatment and surgery, which the Board now recognizes as a separate cumulative trauma injury. The Workers' Compensation Appeals Board granted reconsideration, reversing the prior finding of a single cumulative trauma injury. The Board held that distinct periods of compensable temporary or permanent disability, as established by medical evidence and treatment, demarcate separate cumulative trauma injuries, aligning with the *Rodarte* precedent. Consequently, the applicant was found to have sustained two separate cumulative trauma injuries, each attributed to different insurance coverage periods.

cumulative traumaanti-merger doctrineLabor Code sections 3208.25303Rodartecompensable temporary disabilitypermanent disabilitywage lossmodified workbilateral upper extremities
References
3
Case No. ADJ2307991 (VNO 0427797) (MF) ADJ3536405 (VNO 0336819) ADJ487962 (VNO 0533632)
Regular
Jun 14, 2018

JACQUELINE AUSTIN vs. FIRST FOURSQUARE CHURCH OF VAN NUYS, GUIDE ONE MUTUAL INSURANCE COMPANY, FREMONT, CIGA, CYPRESS INSURANCE COMPANY, FOREST LAWN MEMORIAL PARK, SAFECO INSURANCE, TRAVELERS PROPERTY CASUALTY COMPANY

This case involves an applicant who sustained two separate cumulative trauma injuries to her neck, back, and gastrointestinal system, including GERD and fibromyalgia. The Workers' Compensation Appeals Board (WCAB) affirmed the findings that the applicant suffered distinct industrial injuries during employment with First Foursquare Church (insured by Cypress) and Forest Lawn Memorial Park (insured by Travelers). Defendant Cypress contested the dating of the injury and the finding of two separate cumulative trauma periods, while Travelers challenged the sufficiency of medical evidence for one injury. The WCAB found Cypress waived the issue of one versus two cumulative trauma injuries by failing to raise it timely. Ultimately, the WCAB adopted the WCJ's findings, confirming the two separate cumulative trauma periods and the respective carrier liabilities.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaDate of InjuryLabor Code Section 5412Labor Code Section 5500.5Findings of FactAward and OrderAdministrative Law JudgeCypress Insurance Company
References
9
Case No. ADJ8702052 ADJ8954034
Regular
Sep 13, 2018

James McClendon vs. Home Pest Defense (Rollins Inc), National Union First Insurance Company, Sedgwick Claims Management Services, Inc.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to review an award of 100% permanent disability for two industrial injuries. The defendant argued for separate disability awards based on apportionment between the two injuries, citing the *Benson* case, and challenged the Agreed Medical Examiner's (AME) opinion. The WCAB rescinded the original award and returned the case for further development of the medical record, specifically to clarify the AME's ability to separately rate the two injuries. The majority found the AME's reasoning for not separately rating the injuries was not consistent with applicable standards, while a dissenting commissioner believed the AME's determination was within his expertise and that the defendant failed to meet its apportionment burden.

Workers Compensation Appeals BoardReconsiderationPermanent Total DisabilityJoint AwardApportionmentBensonAgreed Medical ExaminerFunctional Capacity EvaluationVocational ExpertDate of Injury
References
7
Case No. ADJ3304517 (VNO 0558755), ADJ8042777
Regular
Sep 17, 2012

STEPHEN McLAUGHLIN vs. AMERICAN INTERNATIONAL GROUP, CHARTIS

The Workers' Compensation Appeals Board granted reconsideration, reversing a prior award that found the applicant's right shoulder injury to be a separate industrial injury. The Board determined the shoulder injury was a "compensable consequence" of the applicant's original bilateral hand and wrist injury, occurring while receiving treatment. Therefore, the applicant is not entitled to an additional 104 weeks of temporary disability beyond the statutory limit for the initial injury. The applicant takes nothing by way of his claim for the right shoulder injury as a separate event.

Compensable consequenceCumulative traumaBilateral handsCarpal tunnel syndromeRight shoulder injuryTemporary disabilitySection 4656(c)(1)Petition for reconsiderationFindings and awardWorkers' compensation administrative law judge
References
10
Case No. CV-23-1229
Regular Panel Decision
Dec 12, 2024

Matter of Webster v. Office of Children & Family Servs.

Claimant Percival Webster, who previously received a 50% schedule loss of use (SLU) award for his right leg due to a 2018 knee injury, sustained a second compensable injury to his right hip in March 2020. An independent medical examination by John Ioia, credited by the Workers' Compensation Law Judge (WCLJ), assessed a 50% SLU of the right leg solely attributable to the hip injury. The employer's carrier contended that the new award should be offset by the prior knee injury award, citing *Matter of Genduso*. However, the Workers' Compensation Board affirmed the WCLJ's decision, relying on *Matter of Johnson v City of New York*, which permits separate SLU awards for distinct injuries to the same body member if the claimant proves the second injury caused an increased loss of use independently. The Board found sufficient medical evidence to support the finding that the hip injury was a separate pathology warranting a distinct 50% SLU award, a decision which the Appellate Division affirmed.

Schedule Loss of UseWorkers' Compensation Board DecisionRight Hip InjuryRight Knee InjuryIncreased Loss of UseMedical Expert TestimonyIndependent Medical ExaminationOffsetting Disability AwardsStatutory InterpretationPrior Injury
References
6
Case No. ADJ8401036
Regular
May 04, 2016

STEVE RYDER vs. CITY OF LOS ANGELES, TRISTAR RISK MANAGEMENT, SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case concerns an applicant seeking benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). The core issue is whether the applicant's subsequent industrial injury, when considered alone, results in a permanent disability of at least 35%. The Appeals Board reversed the WCJ, finding the applicant's permanent disability is 35% after adjusting for diminished future earning capacity and adding the separate impairments, thereby qualifying him for SIBTF benefits. The Board's decision hinges on interpreting Labor Code section 4751 to allow DFEC adjustments and mandate addition of impairments, not combination via the Combined Values Chart, for SIBTF qualification.

Subsequent Injuries Benefits Trust FundLabor Code section 4751permanent disabilitywhole-person impairmentdiminished future earning capacityCombined Values ChartAMA Guidesfirefighterprostate cancersexual dysfunction
References
6
Case No. MISSING
Regular Panel Decision

McGurran v. DiCanio Planned Development Corp.

DiCanio Planned Development Corp. (DPD) appealed an order dismissing its third-party complaint against DiCanio Residential Communities Corp. (DRC) in a personal injury action. Both DPD and DRC were additional named insureds under a multi-peril general liability policy issued by General Accident Insurance Company. An employee of DRC was injured at a DPD construction site, and General Accident paid the settlement for DPD. The central issue was whether the common-law antisubrogation rule precluded General Accident from seeking indemnification from DRC. The court determined that the antisubrogation rule did not apply because the General Accident policy contained an employee exclusion, meaning DRC was not covered by General Accident for the specific claims related to its employee's injury. DRC was separately covered by the State Insurance Fund for workers' compensation. Consequently, the appellate court reversed the Supreme Court's order, denied DRC's motion to dismiss, and reinstated the third-party complaint.

Antisubrogation RuleIndemnificationInsurance Policy ExclusionThird-Party ComplaintPersonal Injury DamagesAppellate ReviewWorkers' Compensation CoverageCommon Law PrinciplesCoverage DisputeSubrogation Rights
References
7
Case No. ADJ6693720
Regular
Mar 15, 2010

KERRY NECHODOM vs. CITY OF GROVER BEACH

The Workers' Compensation Appeals Board granted reconsideration to amend the date of injury for Kerry Nechodom's right shoulder injury in case ADJ6693720 from February 3, 2007 - September 10, 2009 to August 12, 2008 - September 10, 2009. This amendment acknowledges a separate cumulative trauma injury due to distinct periods of disability and lack of continuous treatment between injuries. The Board affirmed the original award, finding that the applicant sustained two separate cumulative trauma injuries causing distinct periods of temporary disability. The employer's arguments regarding the cumulative trauma period and Labor Code $\S 4656$ limitations were addressed and resolved by this clarification.

Workers' Compensation Appeals BoardKerry NechodomCity of Grover BeachADJ6693720ADJ5791464ReconsiderationJoint Findings and AwardIndustrial InjuryRight ShoulderCumulative Injury
References
11
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