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

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. ADJ7527781; ADJ7527786
Regular
Feb 05, 2016

OCTAVIO ESPINOZA vs. TORRES FARM LABOR, SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, amending the original award to defer the finding of permanent disability and attorney's fees. The Board denied the defendant's petition for reconsideration, affirming the original award regarding future medical treatment for internal injuries. The case is returned to the WCJ for further proceedings, including consideration of a sleep study report and development of the record concerning permanent disability. The Board agreed that substantial evidence supported the finding of industrial injury to internal organs and the need for future medical treatment.

Workers' Compensation Appeals BoardIndustrial InjuryPermanent DisabilityTemporary Total DisabilityFuture Medical TreatmentPetition for ReconsiderationFindings of FactJoint AwardWCJSubstantial Evidence
References
Case No. ADJ1371205 (VNO 0557310)
Regular
Mar 10, 2011

VICTOR LOPEZ vs. GREYSTONE MANAGEMENT, ZENITH INSURANCE COMPANY

This case concerns a lien claimant, Unicare Diagnostic Center, seeking payment for sleep studies related to an applicant's claimed industrial injuries. The applicant settled their primary claim via Compromise and Release, but Unicare's lien remained unresolved. The trial judge ruled against the lien claimant, finding the insomnia claim non-industrial and the sleep studies medically unnecessary. The Appeals Board affirmed this decision after reconsideration, adopting the trial judge's reasoning.

Compromise and ReleaseLien ClaimantUnicare Diagnostic CenterIndustrial InjuryChestEarNoseHandsWristsHeadaches
References
Case No. ADJ6550105; ADJ6777358 ADJ6777361; ADJ6976802
Regular
Jun 24, 2014

ESTHER GARCIA vs. ANTELOPE VALLEY UNION HIGH SCHOOL DISTRICT, YORK INSURANCE SERVICES GROUP

This case involves an applicant with multiple workers' compensation claims. At a mandatory settlement conference, the judge ordered a sleep study, which the defendant challenged. The Appeals Board granted the defendant's petition for removal, finding the order for the sleep study premature. The Board rescinded the sleep study order, stating that such an order cannot be made before the case is tried or submitted, and before it's established that specific medical opinions are deficient.

Petition for RemovalDecision After RemovalMandatory Settlement ConferenceSleep StudyDiscovery OrderMedical Record AugmentationPanel Qualified Medical EvaluatorThreshold MatterDevelop the RecordAdmission of Evidence
References
Case No. ADJ6772869
Regular
Jan 17, 2012

Michelle Jones vs. CITY OF LONG BEACH

This case involves a worker seeking compensation for a sleep disorder in addition to her admitted industrial shoulder injury. The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award. The Board found that the applicant's hypersomnia was not a separate ratable sleep disorder, but rather a consequence of pain from her industrial shoulder injury. Therefore, the case was returned for a new permanent disability rating that excludes the sleep disorder.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjurySleep DisorderPermanent DisabilityRight ShoulderHypersomniaAMA GuidesPain Questionnaire
References
Case No. ADJ3896064 (SAL 0121108)
Regular
Aug 08, 2012

BRUCE AYERS vs. GRANITE ROCK COMPANY, ZURICH AMERICAN INSURANCE COMPANY

This Workers' Compensation Appeals Board order denies reconsideration of a prior award finding permanent and total disability. The applicant's treating physician and vocational experts opined that the applicant's multiple impairments, including chronic pain, medication side effects, and sleep disturbances, render him unemployable. The Board found the defendant failed to present a fair and complete picture of the medical evidence regarding the applicant's employability, specifically omitting key portions of the physician's opinion. The Board also noted the defendant's attempt to reopen discovery regarding sleep medication was without merit, as the applicant's testimony was credible and the existing evidence supported his ongoing disability.

Workers' Compensation Appeals BoardGranite Rock CompanyZurich American Insurance CompanyPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeSleep StudySleep MedicationEarning CapacitySuitable and Gainful EmploymentVocational Experts
References
Case No. MON 0340665
Regular
Jul 02, 2008

DANIEL EARL PETERSON vs. STATE OF CALIFORNIA, DEPARTMENT OF MENTAL HEALTH, legally uninsured and adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to further develop the record, specifically ordering a formal sleep study. This action rescinded the previous award because the medical evidence presented regarding the applicant's sleep disturbance was deemed unsubstantial, lacking a formal sleep laboratory diagnosis as required by AMA Guides. The Board also noted potential correct contentions by the defendant regarding indemnity rates and overlapping temporary and permanent disability payments.

Workers' Compensation Appeals BoardAgreed Medical EvaluatorAMESleep StudyPermanent DisabilityFindings and AwardReconsiderationSubstantial Medical EvidenceEpworth Sleepiness ScaleAMA Guides
References
Case No. ADJ70 84052
Regular
Mar 23, 2015

Edwin Martinez vs. Coca-Cola Enterprises, Inc.

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The Board adopted the Workers' Compensation Judge's report, which found a compensable sleep disorder and awarded additional permanent disability. The Board also found that the judge's order regarding the Employment Development Department (EDD) lien was a non-final order and denied the defendant's related contention.

Sleep disordercompensable sleep disorderpermanent disabilityWCJ discretionEDD lienreimbursementpetition for reconsiderationabuse of discretionWPIpsychiatric injury
References
Case No. ADJ655912 (SDO 0342137) ADJ677760 (SDO 0342143)
Regular
Feb 11, 2009

MARIA E. GARCIA vs. SAN DIEGO UNIFIED PORT DISTRICT, AMERICAN HOME ASSURANCE COMPANY, AIG DOMESTIC CLAIMS

The Workers' Compensation Appeals Board denied both the applicant's and defendant's petitions for reconsideration. The Board upheld the trial judge's decision to deny massage therapy, finding it not medically necessary per ACOEM guidelines and not supported by the treating physician's reports. Conversely, the Board affirmed the need for a sleep study and orthopedic/psychiatric consults based on the primary treating physician's consistent recommendations, rejecting the defendant's challenges to the exclusion of PQME reports and admission of other evidence. Ultimately, the Board found substantial medical evidence supported the original award and denied both parties' requests for review.

Workers' Compensation Appeals BoardIndustrial InjuryRight ShoulderNeckFurther Medical TreatmentSleep StudyOrthopedic ConsultPsychiatric ConsultMassage TherapyPanel Qualified Medical Examiner
References
Case No. ADJ8782360
Regular
Jun 01, 2018

Eldridge Taylor vs. California Department of Corrections and Rehabilitation, STATE COMPENSATION INSURANCE FUND

The California Workers' Compensation Appeals Board denied a petition for reconsideration, affirming a prior award to Eldridge Taylor. The award included permanent disability for cumulative trauma injuries, sleep disorder, and hearing loss. The employer argued the sleep disorder rating was subsumed by orthopedic pain, the hearing loss lacked substantial evidence, and the WCJ failed to properly apportion non-industrial factors. The Board adopted the WCJ's report, finding sufficient medical evidence for the sleep disorder and hearing loss. The dissenting opinion argued the sleep disorder award should be rescinded as it stemmed solely from industrial pain already rated.

Workers' Compensation Appeals BoardEldridge TaylorCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8782360Cumulative TraumaCorrectional OfficerParole OfficerSleep Disorder
References
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