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Case Law Database

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

Case No. ADJ3516579 (VNO 0523127)
Regular
Jan 30, 2012

KELLY WHELIHAN vs. CBS RADIO, MURPHY AND BEANE (TPA)

This case involved a defendant seeking reconsideration of a workers' compensation award for an industrial injury including bilateral wrists, neck, psyche, and complex regional pain syndrome. The defendant argued the administrative law judge erred by relying on one medical opinion over another for temporary disability benefits. However, both the Petition for Reconsideration and the Petition for Removal were dismissed. The Appeals Board found both petitions to be untimely filed based on the dates of service and filing.

Workers' Compensation Appeals BoardReconsiderationRemovalFindings and AwardTemporary DisabilityIndustrial InjuryBilateral WristsNeckPsycheComplex Regional Pain Syndrome
References
2
Case No. ADJ10035615
Regular
Feb 15, 2018

RALPH MARTINEZ vs. PARCO, INC. (psi), CLAIMQUEST (tpa)

This case involves a workers' compensation applicant who suffered a burn injury to his left hand. The defendant sought reconsideration of the WCJ's award, arguing the 104-week limit on temporary disability benefits applied and that the permanent disability rating was incorrect. The Appeals Board denied reconsideration, agreeing that exceptions to the 104-week limit due to amputation or severe burns applied. The Board also found that the WCJ's permanent disability rating was appropriate, treating the Qualified Medical Examiner's discrepancy as a clerical error.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderTemporary Disability BenefitsLabor Code $\S 4656$Permanent Partial DisabilityQualified Medical ExaminerAMA GuidesAmputationSevere Burns
References
2
Case No. ADJ6698870
Regular
Jun 09, 2010

STELLE LEE vs. UNIVERSITY OF CALIFORNIA, DAVIS, (psi) by SEDGWICK CMS (tpa)

The Workers' Compensation Appeals Board denied reconsideration of an order finding that Stella Lee did not sustain an industrial injury. The Board adopted the reasoning of the administrative law judge, who found that the Agreed Medical Examiner's report constituted substantial evidence. The applicant's arguments that the AME was biased and that other medical opinions were ignored were insufficient to overturn this finding. Applicant's excluded exhibits were duplicative or did not meet evidentiary standards.

Workers' Compensation Appeals BoardReconsideration DeniedAgreed Medical ExaminerAMEIndustrial InjuryChemical ExposureDermatitisCausationExpert OpinionMedical Evidence
References
0
Case No. VNO 0504722
Regular
Feb 13, 2008

FRANCK PETER vs. COUNTY OF LOS ANGELES; TPA: CAMBRIDGE INTEGRATED SERVICES

This case concerns a police officer injured in the line of duty, who sought further temporary disability benefits beyond the 104 weeks already paid. The applicant argued that "Injured on Duty" pay should not count towards the statutory limit, and that an exception for high-velocity eye injuries should apply. The Board denied reconsideration, holding that "Injured on Duty" pay is included within the 104-week limit under Labor Code section 4656, citing precedent, and found no evidence of a high-velocity eye injury.

Workers' Compensation Appeals BoardIndustrial InjuryPolice OfficerTemporary Disability IndemnityInjured on Duty (IOD)Los Angeles Administrative Code Section 4.177Labor Code Section 4656Radesky v. City of Los AngelesHigh-Velocity Eye Injury ExceptionMedical Evidence
References
3
Case No. ADJ2140761 (VNO 0544583) ADJ638834 (VNO 0544768)
Regular
May 08, 2018

DENNIS BAJGROWICZ vs. PARAMOUNT PICTURES (psi) administered by MURPHY & BEANE, INC.(tpa)

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, amending the initial award. The Board found the applicant did not sustain a cardiac injury and reduced the permanent disability rating from 76% to 33%. Consequently, the attorney's fee was also reduced from $30,000.00 to $5,244.00, with the decision largely based on substantial medical evidence from Dr. Hirsch, who reviewed extensive records, over conflicting opinions.

Workers' Compensation Appeals BoardParamount PicturesMurphy & BeanePetition for ReconsiderationFindings and Awardcervical spinelumbar spineleft shoulderleft hiplower gastrointestinal system
References
8
Case No. ADJ3055486 (SJO 0260286)
Regular
Nov 17, 2008

MARK BRIDGES vs. CITY OF SUNNYVALE, permissibly Self-insured, GREGORY BRAGG and ASSOCIATES, TPA

The Appeals Board granted reconsideration for both the applicant and defendant due to procedural due process issues, specifically the WCJ's reliance on an unserved rater's letter to determine permanent disability. The Board rescinded the prior award and returned the case for further proceedings, including potential cross-examination of the rater and reconsideration of apportionment. The Board expressed no final opinion on the permanent disability rating or apportionment at this stage.

Workers' Compensation Appeals BoardPolice OfficerIndustrial InjuryPermanent Disability2005 Permanent Disability Rating ScheduleRange-of-Motion (ROM) methodDiagnostic-Related Estimate (DRE) methodAgreed Medical Evaluator (AME)ApportionmentDisability Evaluation Specialist (DES)
References
0
Case No. ADJ823138
Regular
Sep 14, 2009

CHERYL PEET vs. COUNTY OF VENTURA, Permissibly Self-Insured, Administered By CORVEL CORPORATION, TPA

The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration of a June 22, 2009 decision. This reconsideration is necessary to allow the Board further time to thoroughly review the factual and legal issues presented. The Board aims to ensure a complete understanding of the record before issuing a just and reasoned decision. Pending this, all future communications should be directed to the WCAB's Office of the Commissioners.

Workers' Compensation Appeals BoardPetition for ReconsiderationGranting PetitionStatutory Time ConstraintsFactual and Legal IssuesJust and Reasoned DecisionDecision After ReconsiderationOffice of the CommissionersCounty of VenturaCorvel Corporation
References
0
Case No. ADJ3273415 (AHM 0131697) ADJ1190217 (AHM 0131698) ADJ4181066 (AHM 0131699)
Regular
Jan 29, 2010

GINA MENDOZA vs. COUNTY OF LOS ANGELES DEPARTMENT OF CHILDREN AND FAMILY SERVICES, TPA AIMS

This case concerns a lien claimant's petition for reconsideration of a disallowed medical treatment lien. The Workers' Compensation Appeals Board (WCAB) denied the petition, affirming the administrative law judge's finding that the lien lacked evidence of reasonableness. The WCAB found the lien claimant's initial request for authorization deficient under California regulations and its subsequent request, though potentially compliant, was timely denied via utilization review. Furthermore, an agreed medical evaluator had previously opined against the necessity of the treatments in question.

Workers' Compensation Appeals BoardLien claimantPetition for reconsiderationJoint Findings and OrderMedical treatment lienIndustrial injuryStipulated AwardsIntermediate typist clerkPermanent disabilityUtilization review
References
0
Case No. ADJ1781751 (SJO 0264172) ADJ4460330 (SJO 0264178) ADJ3361342 (SJO 0266633)
Regular
Jan 14, 2010

SARA MARTINEZ-RODRIGUEZ vs. TARGET STORES, Permissibly Self-Insured; SEDGWICK CMS, TPA

The Workers' Compensation Appeals Board denied Target Stores' petition for reconsideration, affirming the WCJ's award to Sara Martinez-Rodriguez. The Board found Target's argument that the applicant's 2002 absence from work was for personal reasons unsubstantiated, upholding the temporary disability finding. The Board also affirmed the WCJ's use of the 1997 permanent disability rating schedule for the 1998 and 2002 injuries, primarily because Target failed to issue the required Section 4061 notice due to its own misconduct in not paying temporary disability benefits. The Board disagreed with the WCJ's secondary rationale for applying the older schedule based on the AME's post-2005 report, finding it insufficient on its own.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardTemporary DisabilityPermanent DisabilityRating ScheduleLabor Code Section 4061Agreed Medical Examiner (AME)Pre-2005 Injuries1997 Rating Schedule
References
2
Case No. ADJ6978832
Regular

Mona Dill vs. CITY OF RANCHO PALOS VERDES, PSI, by CJPIA through their TPA, YORK INSURANCE SERVICES GROUP

The Appeals Board granted the defendant's petition for removal, reversing the WCJ's order for a QME evaluation. The Board found the applicant's stipulated zero percent permanent disability and need for further medical treatment to be adequate, given the treating physician's report of no ratable impairment and the applicant's expressed desire to settle. Therefore, the Stipulations with Request for Award were approved, granting the applicant ongoing medical care and zero percent permanent disability.

Petition for RemovalStipulations with Request for AwardPanel Qualified Medical Evaluator (QME)ApportionmentPermanent DisabilityMedical TreatmentIndustrial InjuryRecreation SupervisorPro PerInformation and Assistance Officer (I & A)
References
0
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