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

Case No. ADJ588686 (SDO 0309857) ADJ2275487 (SDO 0311854) ADJ1079800 (SDO 0309856)
Regular
Mar 12, 2014

GRAZYNA KOZAK vs. QUIDEL CORPORATION, CNA INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the petition for reconsideration, affirming the WCJ's decision. The Board found the defense exhibits, including surveillance videos and vocational expert reports, were properly admitted. They also upheld the use of the AMA schedule for permanent disability, finding the applicant's earlier reports did not qualify for the prior rating schedule. Finally, the Board gave great weight to the WCJ's credibility findings regarding the applicant and found the opinions of some expert witnesses to be unsubstantial.

Petition for ReconsiderationWorkers' Compensation Appeals BoardWCJ credibility findingvocational expert reportssubrosa filmscustodian of recordspermanent disability rating schedulePDRSpermanent and stationary statussubstantial evidence
References
Case No. ADJ3923408
Regular
Apr 20, 2009

Andrea Seyfried vs. Compass Films, Inc., National Surety Company/Fireman's Fund, Power Payroll, Inc., California Insurance Guarantee Association for Legion Insurance Company

The Workers' Compensation Appeals Board found that the applicant sustained an industrial injury while employed by both Power Payroll (general employer) and Compass Films (special employer). Power Payroll was insured by Legion Insurance, whose obligations are now handled by CIGA. Compass Films was insured by Fireman's Fund. The Board rescinded the prior order finding Power Payroll as the sole employer and returned the case for proceedings to determine the respective liabilities of CIGA and Fireman's Fund. CIGA is not liable if Fireman's Fund policy constitutes "other insurance" available to the applicant.

General employerSpecial employerDual employmentPayroll servicesFilm industryInsurance Guarantee AssociationInsurer insolvencySpecial employer controlPayroll companyProduction manager
References
Case No. VNO 0426480
Regular
Dec 14, 2007

IRMA SCOTT vs. BERGEN BRUNSWIG DRUG COMPANY, SPECIALTY RISK SERVICES

The Appeals Board granted reconsideration to allow the defendant to introduce newly discovered surveillance footage of the applicant. The Board found the defendant demonstrated reasonable diligence in attempting to obtain this evidence, and the footage is relevant to the applicant's permanent disability. The case is remanded to the trial level for further proceedings, including consideration of the new evidence and potential re-evaluation of the applicant's disability rating and attorney fees.

Workers' Compensation Appeals BoardIndustrial cumulative traumaBilateral upper extremitiesNeckBackPermanent disability ratingReconsiderationSurveillance filmsNewly discovered evidenceDue diligence
References
Case No. ADJ3835932
Regular
Dec 17, 2010

BEVERLY SMITH vs. CEDARS SINAI MEDICAL CENTER, TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of a prior award. The applicant sought to reopen the case due to the retirement of an Agreed Medical Evaluator and alleged worsening of her condition. However, the Board found the applicant failed to demonstrate good cause, as her claims were unsubstantiated, contradicted by surveillance evidence, and she did not exercise due diligence in seeking further evaluation. Consequently, the prior findings of industrial injury to the psyche and achilles tendon, with 24% permanent disability after apportionment, were upheld.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryPsycheAchilles TendonOrthopedic Agreed Medical Evaluator (AME)Permanent DisabilityApportionmentPetition to Reopen
References
Case No. ADJ518435
Regular
Apr 20, 2010

Alphonso Durazo vs. PPG INDUSTRIES

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board affirmed the findings of the Workers' Compensation Judge, particularly regarding the applicant's credibility. Sub-rosa surveillance films and medical evaluations by QMEs demonstrated that the applicant made multiple false statements about his disability and complaints, leading to a plea of no contest to workers' compensation fraud. The applicant's award of future medical treatment for his heel was based on a finding of bruising, not the extent of disability he claimed.

Workers' Compensation Appeals BoardReconsiderationWCJ credibilitysub-rosa filmsdisabilitysubjective complaintsindustrial injurywarehouse workerPAK truckTemporary Total Disability
References
Case No. ADJ3787731 (OAK 0332481)
Regular
Oct 17, 2008

LINDA ALCUTT vs. VOLT SERVICES GROUP, GALLAGHER BASSETT SERVICES

The Board granted reconsideration to allow the WCJ to consider surveillance videos and the medical reports of Dr. Morris, which were initially excluded. The WCJ erred by not admitting Dr. Morris' reports, who opined the applicant's condition was permanent and stationary, and by failing to discuss the surveillance evidence. The case is remanded for further proceedings to admit Dr. Morris' reports and consider all evidence.

Workers' Compensation Appeals BoardReconsiderationTemporary DisabilityPermanent and StationaryQualified Medical EvaluatorTreating PhysicianSub Rosa InvestigationMedical ReportsLabor Code § 4062Admissibility of Evidence
References
Case No. ADJ7028178
Regular
Mar 18, 2013

LEOBARDO CHAVEZ vs. VAN ACKER CONSTRUCTION ASSOCIATES, SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the applicant's Petition for Removal, upholding the Administrative Law Judge's (ALJ) order quashing subpoenas duces tecum. The Board found the subpoenas overly broad, duplicative, and burdensome, requesting extensive records related to surveillance beyond what had already been provided. While acknowledging the applicant was not afforded sufficient opportunity to respond to the initial motion to quash, the Board determined no substantial prejudice occurred as the applicant could issue a more narrowly drawn subpoena. The denial ensures the applicant must refashion a reasonable request for surveillance records.

Petition for RemovalQuashed Subpoenas Duces TecumOverbroadDuplicativeBurdensomeSurveillance RecordsPrivileged DocumentsInvestigator's Field NotesOpportunity to be HeardSubstantial Prejudice
References
Case No. ADJ9163440
Regular
Oct 05, 2015

INOCENCIO PEDROSA vs. KAISER FOUNDATION HEALTH PLAN

This case concerns a workers' compensation claim where the applicant alleged injury to his right ankle and cervical spine from operating a pallet jack. The defendant disputed the injury AOE/COE, primarily citing surveillance footage and alleged inconsistencies in applicant's testimony. The WCJ found injury AOE/COE based on Dr. Sadler's report, which interpreted the surveillance video as confirming applicant's head hitting a wall, despite the WCJ finding Dr. Sadler's report not substantial due to his failure to consider prior injuries. The Appeals Board granted reconsideration, rescinded the WCJ's decision, and returned the matter for further development of the record, finding no substantial evidence to support the injury finding. Additionally, defense counsel was admonished for improperly submitting extraneous documents with the Petition for Reconsideration.

AOE/COEPetition for ReconsiderationWCJsubstantial evidencecredible witnesssurveillance footagedeposition testimonyprimary treating physicianpanel qualified medical examinersupplemental report
References
Case No. ADJ144976 (MON 0262584)
Regular
Dec 01, 2014

RAJAN ROY vs. SIEMENS BUILDING TECH-LANIS, ST. PAUL TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a prior award finding the applicant sustained industrial injury to his back and psyche, but not to his heart and internal system. The applicant argued the medical opinions regarding the lack of internal injury and the apportionment of permanent disability were not substantial evidence. The Board found the medical opinions, particularly from Dr. Arora regarding internal injuries, were well-reasoned and supported by the record. The Board also upheld the apportionment of permanent disability by Drs. Sohn and Miles, finding it based on correct legal theory and substantial evidence, considering prior documented injuries.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact & AwardIndustrial InjuryPermanent DisabilityApportionmentQualified Medical EvaluatorAgreed Medical EvaluatorSubstantial EvidenceLabor Code Sections 4663 and 4664
References
Case No. ADJ7113676; ADJ7331802
Regular
May 27, 2011

Alicia Prado vs. FOODSCO; dba RALPHS GROCERY COMPANY, SEDGWICK CLAIM

This case involves a worker claiming industrial injuries on two dates, December 24, 2009, and June 3, 2010, both of which were initially denied by the WCJ. The applicant sought reconsideration, arguing substantial evidence supported her claims and highlighting issues with evidence evaluation and potential defendant misconduct. The Appeals Board granted reconsideration, adopted the WCJ's reasoning for affirming the original decision, but ordered corrections to clerical errors in the Minutes of Hearing concerning the applicant's date of hire and marital status.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderIndustrial InjuryWCJClerical ErrorsMinutes of HearingDate of HireLight DutyStore Film
References
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