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

Case No. ADJ3864552 (LAO 0788138)
Regular
Jan 03, 2011

ANTONIETA GUERRERO vs. WELLPOINT HEALTH NETWORK, INC., ZURICH LOS ANGELES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For FREMONT In Liquidation

The Workers' Compensation Appeals Board granted reconsideration of a prior award due to insufficient analysis by the WCJ regarding the date(s) of cumulative trauma. The Board found the WCJ's decision lacked specific reference to evidence, particularly on whether multiple or a single period of cumulative trauma applied. The matter was returned to the trial level for further proceedings, a new decision, and adequate analysis of all contentions, including permanent disability and apportionment.

Cumulative traumaOveruse syndromeFibromyalgiaPsyche injuryPermanent total disabilityApportionmentAttorney feesFindings and AwardReconsiderationWCJ
References
Case No. ADJ7332241
Regular
Jun 30, 2011

Jesus Hernandez vs. JCB CLARK ENTERPRISES INC, U.S. FIRE AND GUARANTY

Here's a summary for a lawyer: The Workers' Compensation Appeals Board denied Jesus Hernandez's petition for reconsideration, affirming the WCJ's decision that he failed to meet his burden of proof for a cumulative trauma injury ending March 17, 2007. The applicant argued that prior injuries and a doctor's report supported his claim for a longer period, but the Board found his arguments unpersuasive. A dissenting commissioner believed the case should be returned for further proceedings on orthopedic cumulative trauma claims due to disputed employment periods and available evidence.

Cumulative TraumaPetition for ReconsiderationFindings and AwardWorkers' Compensation Administrative Law Judge (WCJ)Burden of ProofIndustrial Cumulative TraumaPast Industrial InjuryMedical EvidenceSubstantial Medical EvidenceFaulty History
References
Case No. ADJ6550186
Regular
Mar 18, 2013

KELVIN EDWARDS vs. DALLAS COWBOYS, TRAVELERS INDEMNITY COMPANY AND ITS CASUALTY AFFILIATES AND SUBSIDIARIES, SAN FRANCISCO 49ERS, NATIONAL UNION FIRE INSURANCE COMPANY, CHARTIS CLAIMS, INC.

This case involves a cumulative trauma injury claim by former professional football player Kelvin Edwards. The Workers' Compensation Appeals Board (Appeals Board) affirmed the finding of a single cumulative trauma injury to multiple body parts, rejecting the defendant's argument for apportionment to different employers and dates of injury. The Appeals Board also reversed the award of a Labor Code section 5814 penalty against the San Francisco 49ers, finding their delay in paying benefits was not unreasonable. The applicant's entitlement to permanent disability and future medical treatment, as initially awarded, remains in place.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaPermanent DisabilityLabor Code Section 5500.5Injurious ExposureApportionmentLabor Code Section 5814PenaltyUnreasonable Delay
References
Case No. ADJ7050517
Regular
Jun 16, 2010

Gary Tull vs. YOUNGS MARKET, Permissibly Self-Insured Administered By CANNON COCHRAN MANAGEMENT SERVICES

This case concerns an applicant claiming cumulative trauma injury to his right knee. The WCJ denied the claim, finding the Panel QME's report insufficient to establish cumulative trauma. The Appeals Board granted reconsideration, noting the PQME found an injury and work-related causation but incorrectly characterized it as a specific injury on a particular date. The Board remanded the case to develop the medical record, specifically directing a supplemental report from the PQME on the cumulative trauma aspect of the claim.

Cumulative traumaPanel Qualified Medical EvaluatorPQMEIndustrial injuryRight kneeFindings and OrderReconsiderationTake nothing orderSubstantial medical evidenceBurden of proof
References
Case No. ADJ7785251
Regular
Nov 14, 2014

Jon Brothers vs. STATE OF CALIFORNIA, DEPARTMENT OF FORESTRY AND FIRE PROTECTION, COASTAL/NORTH REGION; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to clarify that the applicant's cumulative trauma orthopedic injury claim is still under development. The Board agreed with the WCJ that the defense's medical expert, Dr. Baldwin, failed to provide substantial medical evidence due to a misunderstanding of cumulative trauma principles. Dr. Baldwin improperly required documented prior specific injuries to opine on cumulative trauma, thereby failing to adequately assess the applicant's extensive work history. Therefore, the case is affirmed except for the amendment of a finding of fact to reflect that the orthopedic injury claim is contested and requires further medical evaluation.

Cumulative traumaQualified Medical EvaluatorIndependent Medical Evaluatorsubstantial medical evidenceorthopedic injurybinaural hearing losscardiovascular systemBattalion Chiefretired annuitantorthopedic cumulative trauma
References
Case No. ADJ2630861 (LAO 0880530)
Regular
Nov 16, 2012

MARTHA PONCE vs. ASHLEY & J PHARMACY CORP, dba ROSS MEDICAL PHARMACY, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to amend a prior award, rescinding the permanent disability award for applicant's sleep loss. While the applicant was found to have sustained cumulative trauma injury to her neck, back, and psyche, the Board determined that an additional impairment rating for sleep loss was duplicative of existing orthopedic and psychiatric ratings. The original award of 53% permanent disability was reduced to 47%, and the attorney's fees were adjusted accordingly. The Board also rejected the defendant's argument for apportionment to a specific back injury, as the cumulative trauma finding was already final.

Workers Compensation Appeals BoardAshley & J Pharmacy CorpEmployers Compensation Insurance CompanyMartha PonceOpinion and Order Granting ReconsiderationDecision After Reconsiderationsleep losscumulative trauma injuryneckback
References
Case No. ADJ624341 (SDO 0320867)
Regular
Jan 21, 2011

MICHAEL LALOR vs. CITY OF SAN DIEGO

This case involves a firefighter who claimed cumulative trauma injury to multiple body parts. The parties stipulated to a single cumulative trauma injury, but the WCJ issued separate permanent disability awards, contrary to the stipulation and the *Benson* precedent regarding individual injury determination. The Appeals Board granted reconsideration, rescinded the WCJ's decision, and returned the matter for further proceedings, emphasizing the binding nature of the parties' stipulation to a single cumulative trauma injury. The Board also directed re-evaluation of causation for hypertension and noted potential impairment from asthma.

Workers' Compensation Appeals BoardCity of San Diegofirefighter/fire captaincumulative traumamultiple body partspermanent disabilityapportionmenthypertensiontuberculosispulmonary/asthma
References
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
Case No. ADJ1576347 (FRE 0235267) ADJ8047239
Regular
Sep 12, 2013

MICHAEL MANFREDI vs. CITY OF FRESNO, AMERICAN ALL-RISK LOSS ADMINISTRATORS

The Workers' Compensation Appeals Board denied Michael Manfredi's petition for reconsideration. Manfredi, a police officer, sought to establish two separate cumulative trauma injuries for his coronary artery disease and hypertension, rather than the single injury found by the WCJ. The Board affirmed the WCJ's finding that the continuous need for medical treatment between periods of exposure constituted a single compensable injury, citing *Western Growers*. Therefore, the original award of 20% permanent disability stands.

Cumulative traumacoronary artery diseasehypertensionpermanent disabilityreconsiderationJoint Findings of Fact and AwardWCJ ReportWestern Growers v. Workers' Comp. Appeals Board (Austin)separate injuriessingle injury
References
Case No. ADJ9172692
Regular
Feb 25, 2016

TIMOTHY FRYE vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION, Legally Uninsured; STATE COMPENSATION INSURANCE FUND

This case involves a correctional lieutenant who claimed a cumulative industrial injury to his heart, knees, hip, cardiovascular system, and hypertension. The defendant sought reconsideration, arguing for separate injury periods for orthopedic and internal conditions. The Board denied the petition, upholding the finding of a single cumulative trauma period ending on the applicant's last day of employment. The Board found no evidence that the applicant knew his disability was work-related prior to consulting an attorney, thus establishing the date of injury as post-employment.

Cumulative traumaDate of injuryIndustrial injuryCardiovascular systemHypertensionOrthopedic claimInternal claimPetition for reconsiderationFindings of Fact and AwardsWCJ
References
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