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

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ8990294
Regular
Oct 26, 2015

VELMA CRUZ vs. TRINITY NURSING HOME MANAGEMENT/SERRANO SOUTH CONVALESCENT HOSPITAL, SEABRIGHT INSURANCE COMPANY

This case involves an applicant seeking workers' compensation for injuries allegedly sustained as a certified nursing assistant. The Workers' Compensation Appeals Board denied reconsideration of the administrative law judge's (WCJ) decision that found no industrial injury, adopting the WCJ's reasoning that the applicant failed to meet her burden of proof regarding causation. While one commissioner dissented, advocating for further record development due to credible testimony of injury mechanisms and potentially insufficient medical evidence, the majority upheld the denial. The majority also noted that, separate from the causation issue, a post-termination provision might also bar the claim.

WCABVelma CruzTrinity Nursing HomeSerrano South ConvalescentSeabright InsuranceADJ8990294Petition for ReconsiderationAdministrative Law JudgeFindings and OrderCertified Nursing Assistant
References
Case No. ADJ226850 (RIV 0064373)
Regular
Oct 31, 2017

DEBRA CHADWELL vs. SCULLY DISTRIBUTION SERVICES, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) overturned a prior decision, ruling that defendants must reinstate home health care and skilled nursing services for the applicant. The defendants had unilaterally terminated these previously authorized services without demonstrating a change in the applicant's condition or circumstances. The WCAB found that once authorized, such services must continue unless the employer proves they are no longer medically necessary. Therefore, the defendants are obligated to provide the services as recommended by the applicant's physician.

Workers' Compensation Appeals BoardUtilization ReviewNon-certificationHome Health CareSkilled Nursing ServicesPrimary Treating PhysicianUnilateral TerminationChange in CircumstancesReconsiderationIndustrial Injury
References
Case No. ADJ2270309 (VNO 0113668) ADJ4503834 (VNO 0113665) ADJ3103605 (VNO 0113666) ADJ2309113 (VNO 0113667)
Regular
Nov 10, 2010

MARIA GARCIA vs. CITY OF LOS ABNGELES, Permissibly Self-Insured

The Workers' Compensation Appeals Board granted reconsideration of a previous award, finding merit in the applicant's contentions regarding denied medical treatments. The Board intends to admit a nurse case manager's report that was previously excluded. This reconsideration aims to further review the factual and legal issues to ensure a just decision regarding the applicant's extensive care needs stemming from long-term quadriplegia. The Board is specifically addressing disputes over various requested services, including nursing care, home modifications, and specific medical treatments.

Workers' Compensation Appeals BoardSupplemental Findings and AwardHomecareNursing ServicesBedsore TreatmentHousekeeping ServicesHospital BedQuadriplegiaInternal InjuryLabor Code §5803
References
Case No. ADJ2184096
Regular
Jun 25, 2009

MANUEL GARCIA vs. PILGRIM CONGREGATIONAL CHURCH

This case involved an applicant injured while performing work for a church. The Workers' Compensation Appeals Board granted reconsideration and reversed the administrative law judge's finding of employment. The Board determined the applicant was an independent contractor based on factors outlined in *S.G. Borello & Sons*, including the church's lack of control over work details, the applicant's distinct occupation, skill requirements, self-supply of tools, and the nature of the payment arrangement. Consequently, the applicant's claim for workers' compensation benefits was denied.

Workers' Compensation Appeals BoardIndependent ContractorEmployee StatusBorello factorsRight to ControlDistinct OccupationSkill RequiredTools and InstrumentalitiesMethod of PaymentIntegral Part of Business
References
Case No. ADJ6772563
Regular
Nov 19, 2013

SHEILA NEWTON vs. CEDARS SINAI HEALTH SYSTEM, TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, upholding the finding that a registered nurse sustained a compensable psychiatric injury AOE/COE. The Board agreed with the Workers' Compensation Judge that the employer's conduct, specifically a meeting concerning coworker complaints and discussions of retirement, was not a lawful, nondiscriminatory, good faith personnel action. While the employer argued the meeting was a routine event based on objective complaints, the Board found the applicant's perception of age discrimination was objectively reasonable given her testimony and performance history. Therefore, the applicant's psychiatric injury claim remained compensable, entitling her to temporary and permanent disability benefits and future medical treatment.

Psychiatric injuryAOE/COElawful personnel actiongood faithobjective reasonablenessLabor Code § 3208.3(h)WCJ findingscredibilityage discriminationco-worker complaints
References
Case No. ADJ10750412
Regular
Jan 05, 2018

CAMERON DRISCOLL vs. VICTOR TREATMENT CENTERS, ATHENS ADMINISTRATORS

This case involves a defendant's petition for removal of an order changing venue to Redding. The Workers' Compensation Appeals Board denied the petition, finding that removal is an extraordinary remedy requiring a showing of substantial prejudice or irreparable harm. The Board adopted the Judge's report, which concluded that the venue change to Redding was proper, considering the applicant's residence and the significant hardship to the applicant if forced to litigate in Sacramento. The inconvenience to the defendant was deemed outweighed by the applicant's circumstances.

Petition for RemovalOrder Changing VenueWorkers' Compensation Appeals BoardAdministrative Law Judgesubstantial prejudiceirreparable harmreconsiderationVictor Treatment CentersAthens AdministratorsCameron Driscoll
References
Case No. ADJ9582137
Regular
Sep 20, 2016

SHERYL FEVOLD MILTON vs. COUNTY OF TULARE

This case involves a worker injured in an industrial accident, sustaining shoulder injuries and bilateral carpal tunnel syndrome. The defendant employer sought to delay mandated home modifications until post-surgery recovery, arguing they weren't medically necessary. However, the court found that the modifications were primarily necessitated by the shoulder injuries, not the carpal tunnel syndrome. Medical experts and an occupational therapist confirmed the need for these modifications to enable the applicant's return to independent living and work. Therefore, the defendant's petition for reconsideration was denied, upholding the order for home modifications.

home modificationspermanent and stationarycarpal tunnel release surgerybilateral shouldersrotator cuff tearT-12 paraplegicoccupational therapistcertified aging-in-place specialistskilled nursing facilityindependent living
References
Case No. ADJ17146948; ADJ17146930; ADJ15040609
Regular
Apr 28, 2025

WAYNE BLOSSER vs. RB SPENCER, INC., INSURANCE COMPANY OF THE WEST

Applicant Wayne Blosser sustained multiple industrial injuries, leading to a WCJ award for home modifications, including a mobile home construction and interim ADA-compliant housing, citing the defendant's failure to timely investigate treatment needs. Defendant sought reconsideration, arguing due process violations, lack of WCJ jurisdiction over home modifications, and insufficient evidentiary support for the award. The Workers' Compensation Appeals Board denied the petition, affirming the WCJ's findings that the defendant had ample notice to investigate and that the issue fell within the WCJ's jurisdiction given the parties' stipulations on medical necessity and the implementation nature of the dispute. The Board emphasized the employer's affirmative duty to investigate and provide benefits upon notice of potential needs.

Workers' Compensation Appeals BoardIndustrial InjuryAC HVAC Commercial InstallerHome ModificationsADA Compliant ApartmentSkilled Nursing FacilityUtilization ReviewIndependent Medical ReviewDue ProcessLabor Code
References
Case No. ADJ3834810 (SRO 0121550)
Regular
Sep 03, 2009

MICHAEL RISCH vs. AT HOME NURSING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's finding of 100% permanent disability for the applicant. The Board found substantial evidence supported the total permanent disability rating and the applicant's average weekly earnings. The 1997 Permanent Disability Rating Schedule was correctly applied due to pre-January 1, 2005 medical reporting indicating permanent disability. The Board also affirmed the WCJ's rejection of apportionment to pre-existing conditions, as the applicant had fully recovered and returned to strenuous work.

Workers' Compensation Appeals BoardMichael RischAt Home NursingState Compensation Insurance FundADJ3834810Opinion and Order Denying Petition for ReconsiderationFindings and Awardadministrative law judgecumulative traumaindustrial injury
References
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