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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ10988072
Regular
Jun 24, 2019

JOUZETTE POLK LUSTER vs. RECOLOGY, CORVEL SACRAMENTO

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, rescinded the initial decision, and returned the case for further proceedings. The WCJ had denied the claim based on the applicant's perceived lack of credibility due to discrepancies between her deposition testimony and sub rosa video evidence. However, the Board found that the applicant's credibility issues did not definitively overcome the medical opinions of the Qualified Medical Evaluator. The Board also clarified that the applicant's deposition was properly admitted into evidence as she indicated she would refuse to testify if called.

WCABPetition for ReconsiderationFindings of Fact and Orderindustrial injuryAOE/COEdeposition transcriptsub rosa videomedical evidencePQME reportcredibility
References
Case No. ADJ6970400
Regular
Jun 25, 2019

BETHANY NYBAKKEN vs. LANCASTER SCHOOL DISTRICT

The Appeals Board granted reconsideration to formally admit the defendant's *sub rosa* video and specific exhibits into evidence, as initially intended by the judge. Despite the defendant's arguments regarding fraud, outdated medical evidence, and inadequate vocational testimony, the Board affirmed the judge's finding of permanent total disability. The Board accorded significant weight to the judge's credibility assessment of the applicant. The defendant's supplemental brief was rejected for procedural reasons.

WCABPetition for ReconsiderationFindings and AwardPermanent Total DisabilitySub Rosa VideoAdmissibility of EvidenceCredibility DeterminationObsolete Medical EvidenceApportionmentVocational Expert
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ4617752 (VNO 0390167), ADJ1668605 (VNO 0470519)
Regular
Nov 01, 2010

ROBERT SCHENCK vs. COLIN CLINTON, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, RELIANCE INSURANCE COMPANY, AFFORDABLE QUALITY MOVING & STORAGE, STATE COMPENSATION INSURANCE FUND

This case involves applicant Robert Schenck's petition for reconsideration of a workers' compensation award. Schenck argued the judge erred by admitting sub-rosa video evidence and by not finding total disability based on Dr. Lavi's opinion. The Board denied the petition, finding the sub-rosa evidence was properly admitted and that Dr. Lavi's opinion lacked substantial evidentiary support for total disability. The Board affirmed the WCJ's reliance on defense medical reports finding permanent disability of 29% after apportionment.

SubrogationSub rosa evidenceMandatory Settlement ConferencePermanent DisabilityApportionmentWorkers' Compensation JudgeReconsiderationSubstantial EvidenceQualified Medical ExaminerDoctor-shopping
References
Case No. ADJ10934545
Regular
Aug 23, 2019

Richard Rodriguez vs. CPG FOODS, LLC/GALA FOOD, Cannon Cochran Management Services Inc.

The Appeals Board granted reconsideration and modified the original award, finding that the Qualified Medical Examiner's (QME) apportionment opinion lacked substantial evidence. The Board reversed the original 12% permanent disability finding, awarding 16% based on the QME's impairment rating after reviewing surveillance video evidence. The Board also clarified that treating physician reports from Dr. Mahboubian and Dr. Ahmed are admitted into evidence and may be relied upon. Finally, the Board affirmed the original findings regarding the injured body parts and the permanent and stationary date.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardApplicantDefendantsInjury AOE/COEUpper BackHipsKneesTemporary Total Disability
References
Case No. ADJ1479326 (ANA 0411799) ADJ7233578
Regular
Oct 07, 2014

JONATHAN DUONG vs. AUTOMOBILE CLUB OF SOUTHERN CALIFORNIA, HARTFORD INSURANCE COMPANY OF THE MIDWEST

The Workers' Compensation Appeals Board overturned a WCJ's decision to exclude sub rosa surveillance video. The Board found no legal basis for excluding the video obtained in a mobile home park parking lot and a grocery store, as the applicant lacked a reasonable expectation of privacy in those public areas. The Board determined that the defendant would suffer significant prejudice from the exclusion, justifying removal of the case. Therefore, the sub rosa video was ruled admissible and may be provided to medical evaluators.

Sub rosa videoremovalreconsiderationadmissibilityinvasion of privacyreasonable expectation of privacycivil liabilityworkers' compensation fraudmedical-legal evaluatorworkers' compensation appeals board
References
Case No. ADJ3858007 (SBR 0314079)
Regular
May 26, 2016

RONALD STEFFY vs. H STREET COLLISION CENTER, INC., FARMERS INSURANCE

The Workers' Compensation Appeals Board denied the applicant's Petition for Removal of an Order Vacating Submission. The judge vacated submission to further develop the record due to insufficient evidence, finding the Agreed Medical Examiner's opinions unpersuasive after reviewing medical records and sub rosa video evidence. The Board found the order did not cause significant prejudice or irreparable harm, as it allows for a complete adjudication of issues, including medication usage and permanent disability. Further medical-legal examinations were ordered to develop a record capable of supporting findings on impairment and causation.

Petition for RemovalOrder Vacating SubmissionAgreed Medical Examiner (AME)McDuffieLabor Code section 5701sub rosa videoinsubstantial evidencepermanent disabilitycausationvocational rehabilitation
References
Case No. ADJ8725567
Regular
Feb 07, 2017

MARTHA ROMERO vs. DEPARTMENT OF SOCIAL SERVICES, INHOME SUPPORTIVE SERVICES; Permissibly Self-Insured; YORK RISK SERVICES GROUP

The Workers' Compensation Appeals Board denied Martha Romero's petition for reconsideration. The Board affirmed the finding that Romero sustained industrial cumulative trauma to her knees, shoulders, neck, trunk, ankles, and low back, but not to her head, arms, wrists, extremities, feet, psyche (hypertension, sleep disorder), or gastritis. This denial was based on the WCJ's report, which found Romero failed to meet her burden of proof regarding additional injuries and that her medical evidence was unsubstantial due to an inaccurate history and her failure to demonstrate due diligence in developing the record. The Board also noted the QME's opinion that Romero exaggerated her symptoms, supported by sub rosa video evidence.

Workers' Compensation Appeals BoardCumulative Trauma InjuryIndustrial InjuryPetition for ReconsiderationFindings and OrderAdministrative Law JudgeQualified Medical EvaluatorSub Rosa VideoMagnifying SymptomsDue Diligence
References
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