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

Case No. ADJ7037201
Regular
Apr 22, 2013

Eddie Avakian vs. CITY OF BALDWIN PARK, ADMINSURE

This case involves an applicant police officer seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that awarded 72% permanent partial disability. The applicant contended the WCJ erred by excluding sleep disturbances and sexual dysfunction from the disability rating and by apportioning his cardiovascular disability. The WCAB granted reconsideration, rescinded the original award, and found the applicant's sexual dysfunction and sleep disorder compensable. The matter was returned to the trial level for a new decision, with the WCAB stating it would not disturb other findings, including the hypertension apportionment.

Workers' Compensation Appeals BoardEddie AvakianCity of Baldwin ParkPermissibly Self-InsuredAdministered By ADMINSUREADJ7037201Opinion and Order Granting ReconsiderationDecision After ReconsiderationFindings and Award and OrderAdministrative Law Judge
References
Case No. ADJ400686 (VNO 0499836)
Regular
Nov 08, 2016

MICHAEL CURZI vs. PHARMAVITE, LLC, TRAVELERS DIAMOND BAR

In *Curzi v. Pharmavite, LLC*, the Workers' Compensation Appeals Board (WCAB) granted reconsideration to further study the case. The WCAB amended the original decision to defer issues of sleep disorder, permanent disability, apportionment, and attorney fees. This action was taken to allow for further development of the record regarding the industrial causation of the sleep disorder. The matter is returned to the trial level for further proceedings and a new decision by the WCJ.

Workers' Compensation Appeals BoardPharmaviteLLCTravelers Diamond BarADJ400686VNO 0499836Opinion and Decision After ReconsiderationFindings and Awardcomputer operatorindustrial injury
References
Case No. ADJ4118575 (MON 0342974)
Regular
May 26, 2010

MANUEL ORTIZ vs. TOWER INDUSTRIES, INC., SCIF INSURED INLAND EMPIRE

This case involves an applicant who sustained severe injuries in a riding accident, including multiple pelvic fractures and urological damage, requiring extensive surgeries. The applicant was awarded 100% permanent disability due to his constant pain, limited mobility, and functional impairments, including urinary incontinence and erectile dysfunction. The defendant appealed, arguing the 100% disability rating was not justified and disputing the findings of sleep disorder and erectile dysfunction. The Workers' Compensation Appeals Board affirmed the applicant's 100% permanent disability, finding the evidence supported total permanent disability based on the facts of his severe injury and ongoing functional limitations. The Board denied the defendant's petitions for reconsideration.

Workers' Compensation Appeals BoardPermanent Total DisabilityPetitions for ReconsiderationFindings and AwardAgreed Medical ExaminersLabor Code Section 4662Pelvis InjuryLower Extremity InjuryUrethra InjuryPsyche Injury
References
Case No. ADJ11197293
Regular
Dec 18, 2020

KEVIN TORRES vs. ARCTIC MECHANICAL, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case concerns an applicant's entitlement to an increased impairment rating for sleep dysfunction. The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration. The Board affirmed the Administrative Law Judge's finding that Labor Code Section 4660.1(c)(1) does not preclude an increased impairment rating for sleep dysfunction if it is directly caused by the industrial injury, rather than a consequence of it. Medical evidence from Dr. Jonathan Wang established a direct causal link between the applicant's sleep dysfunction and the industrial injury. The Board found Dr. Wang's report and deposition testimony constituted substantial medical evidence supporting this conclusion and rejected the defendant's arguments.

Labor Code 4660.1(c)(1)sleep dysfunctiondirect causationincreased impairment ratingcompensable consequencepsychiatric disordersubstantial medical evidenceQME reportdeposition testimonyAMA Guides
References
Case No. ADJ7082851
Regular
Jan 30, 2019

HUMBERTO GONZALEZ vs. AMERICAN AUTO WRECKING, STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to amend the original findings, establishing applicant's earnings at $500.00 per week. The Board affirmed the finding of industrial injury to the psyche and right inguinal hernia, but deferred issues of injury to the reproductive system (sexual dysfunction) and sleep disorder. The matter was returned to the WCJ for further development of the record concerning these deferred issues, particularly regarding the specific impact of sleep disorder on impairment and corroboration of sexual dysfunction.

AOE/COEFindings and AwardPetition for ReconsiderationAdministrative Law JudgeAgreed Medical ExaminerQualified Medical ExaminerMaximum Medical ImprovementGeneral LaborerRight inguinal herniaSexual dysfunction
References
Case No. ADJ6619965 ADJ9843987
Regular
Jul 16, 2018

JESUS ZARAGOZA vs. KOOL KOUNTRY, LLC, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Board granted reconsideration to review the finding of injury to the bladder, sleep disorder, sexual dysfunction, and cognitive disability/headaches, as well as the applicant's earnings. The Board affirmed the finding of injury to the bladder, sleep disorder, and sexual dysfunction but reversed the finding of injury related to cognitive impairment/headaches, finding insufficient medical evidence. Additionally, the Board amended the applicant's earnings to $270.00 per week, based on the parties' stipulation regarding the permanent disability rate, and affirmed the overall award except for these specific modifications.

Workers' Compensation Appeals BoardReconsiderationFindings of FactAwardAdministrative Law JudgePermanent DisabilityAverage Weekly EarningsStipulationAgreed Medical ExaminerQualified Medical Examiner
References
Case No. ADJ7457078
Regular
Jul 03, 2013

MARK GONZALES vs. COCA COLA ENTERPRISES, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Board amended the previous award, reversing the finding of industrial injury to "sleep." The Board found Dr. Navab's report on sleep disorder causation lacked substantial medical evidence due to an inadequate review of medical records and failure to address non-industrial factors. However, the Board upheld the finding of industrial injury for sexual dysfunction, deeming applicant's testimony credible and consistent with medical opinions. The matter was returned to the trial level for a new permanent disability rating excluding the sleep disorder.

WCABReconsiderationCumulative TraumaPsycheHypertensionSexual DysfunctionSleep DisorderSubstantial Medical EvidenceIndustrial CausationDr. Pedram Navab
References
Case No. ADJ2719192 (SFO 0510045)
Regular
Mar 08, 2013

LORI CHIRADIO vs. VOLUME SERVICES AMERICA, INC., AMERICAN HOME ASSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration to review the administrative law judge's (WCJ) award for permanent disability, specifically concerning sleep and sexual dysfunction. The Board found the evidence regarding the extent of impairment for these conditions insufficient and returned the matter to the trial level for further development of the record. This decision acknowledges injury to the sexual system and a sleep disorder but requires more substantial evidence to precisely quantify their impact on permanent disability.

AOE/COEQualified Medical EvaluatorAgreed Medical ExaminerPermanent Disability RatingApportionmentWhole Person ImpairmentActivities of Daily LivingSleep DisorderSexual DysfunctionNocturnal Eating Syndrome
References
Case No. ADJ4118575
Regular
May 26, 2010

MANUEL ORTIZ vs. TOWER INDUSTRIES, INC., SCIF INSURED INLAND EMPIRE

This case involves a worker, Manuel Ortiz, who sustained a severe admitted industrial injury resulting in 100% permanent disability. The defendant, SCIF, sought reconsideration, arguing the WCJ's jump from a 98% to 100% rating lacked sufficient justification and that injury to sleep and erectile dysfunction were erroneously found. However, the Appeals Board denied the petitions, finding the evidence supported the 100% permanent disability rating. The Board emphasized Ortiz's significant injuries, ongoing pain, inability to control bodily functions, and uncorrected erectile dysfunction as establishing total permanent disability.

Workers' Compensation Appeals BoardPetitions for ReconsiderationPermanent DisabilityLabor Code section 4662Agreed Medical ExaminersUrological InjuryErectile DysfunctionSleep DisorderPermanent Total DisabilityFindings and Award
References
Case No. GOL 0088273
Regular
Aug 18, 2008

ROBERT SIEBURG vs. RONALD WOLFE & ASSOCIATES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the original award, and returned the case for further development of the record. The Board found the findings of the administrative law judge regarding $97\%$ permanent disability and apportionment were not supported by substantial medical evidence. Specifically, the opinion of Dr. Kahmann was deemed deficient due to internal inconsistencies, lack of explanation for apportionment, and undefined work restrictions. The Board also found Dr. Basham's report did not meet the standard for substantial medical evidence regarding cognitive dysfunction.

WORKERS' COMPENSATION APPEALS BOARDROBERT SIEBURGRONALD WOLFE & ASSOCIATESSTATE COMPENSATION INSURANCE FUNDGOL 0088273OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONFindings and AwardWCJmaintenance person
References
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