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

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. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ10148520
Regular
Jun 01, 2018

Fernando Lopez Chang vs. JLS Environmental Services, ACE American Insurance Company, BARRETT BUSINESS BUREAU

The Workers' Compensation Appeals Board affirmed a judge's decision that the applicant is barred from compensation for a right shoulder injury. The applicant failed to report the injury to his employer prior to his termination, which is a requirement under Labor Code section 3600(a)(10) for post-termination claims. The Board found insufficient evidence that the employer had notice of the injury before termination or that medical records predated termination with evidence of the injury. Therefore, the applicant did not meet any of the statutory exceptions to have his claim considered.

Workers' Compensation Appeals BoardLabor Code section 3600(a)(10)industrial injuryplastererright shoulder injuryreporting injuryterminationpost-termination claimpreponderance of evidenceemployer notice
References
Case No. ADJ383777
Regular
Apr 04, 2011

Roxanna Ortiz vs. ONE SOURCE, ESIS

The Workers' Compensation Appeals Board denied Roxanna Ortiz's petition for reconsideration of a prior findings and order. The initial ruling determined she sustained industrial injury only to her cervical spine as a janitor, not to other body parts or any resulting temporary/permanent disability or need for further medical treatment. Ortiz argued the judge erred by favoring defense medical reports and discrediting her testimony due to minor inconsistencies in her injury description. The Board adopted the WCJ's report, emphasizing deference to credibility determinations and that admissibility of medical reports should have been challenged at trial, not on reconsideration. A dissenting opinion argued the judge overemphasized minor variations in Ortiz's account and that medical evidence did not sufficiently support denial of other injuries or further treatment.

OrtizOne SourceESISWCABFindings and OrderPetition for ReconsiderationWorkers' Compensation Administrative Law Judgeindustrial injurycervical spineright arm
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the finding that his injury claims were filed after notice of termination. The Board agreed that the applicant's claims were barred under Labor Code sections 3600(a)(10) and 3208.3(e) as they were filed after notice of termination and no exceptions applied. The Board also determined that the defendant's denial letter encompassed both the specific and cumulative trauma claims, thus negating the presumption of compensability under Labor Code section 5402(b).

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and OrderWCJRalphs Grocery Companyindustrial injurypsycheheadright shoulderneck
References
Case No. ADJ666750 ( AHM 0139351)
Regular
Mar 05, 2009

ROBERT FELTER vs. SERVICEMASTER, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted Servicemaster's petition for removal, allowing them to list witnesses and exhibits despite waiving this right by failing to object to the Declaration of Readiness to Proceed. This decision aims to decide the case on its merits, specifically concerning the applicant's claim of wrongful termination due to an industrial injury. The Board affirmed the prior order closing discovery but amended it to permit Servicemaster's evidence presentation. The matter was returned to the trial judge for further proceedings, with a warning to attorney Evans regarding his conduct during the hearing.

Petition for removalLabor Code § 132aIndustrial injuryRight shoulder injuryRight arm injuryRight hand injuryNeck injuryBack injuryViolation of Labor Code § 132aTermination due to injury
References
Case No. ADJ1950726 (MON 0361748), ADJ6963803, ADJ7198723
Regular
Mar 20, 2012

DANA BURREL vs. LONG BEACH UNIFIED SCHOOL DISTRICT, TRISTAR RISK MANAGEMENT

In three workers' compensation cases, the applicant sustained industrial injuries to her upper extremities on May 21, 2006, March 11, 2008, and July 28, 2008. The Appeals Board granted reconsideration to review the application of Labor Code section 4658(d)(2), which mandates a 15% increase in permanent disability payments when an employer fails to offer suitable work within 60 days of an injury becoming permanent and stationary. The employer stipulated to providing some medical treatment and returning the applicant to work, but failed to offer regular, modified, or alternative work for 12 months post-injury. The Board found the employer's contention of denial unsubstantiated by evidence and, following *Bontempo v. Workers' Comp. Appeals Bd.*, ruled that the 15% increase applies to all three cases.

Labor Code section 4658(d)(2)permanent disability increaseindustrial injuryright upper extremityright handright wristright shoulderright armleft wristleft hand
References
Case No. ADJ6910802
Regular
Jul 30, 2010

JORGE ESCALANTE vs. CINTAS CORPORATION, EXCEL SPECIALTY INSURANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to determine if the applicant's claim for industrial injury to his right shoulder and cervical spine is barred by Labor Code section 3600(a)(10). The initial finding of injury AOE/COE by the WCJ is supported by evidence, but the WCAB rescinded this decision to allow the parties to fully litigate the post-termination defense. The matter is returned to the trial level for the WCJ to hear evidence on whether the applicant's claim is barred or if any exceptions under section 3600(a)(10) apply. This ensures due process for both applicant and defendant regarding the application of the post-termination statute.

Workers' Compensation Appeals BoardJorge EscalanteCintas CorporationExcel Specialty InsuranceReconsiderationFindings of Fact and AwardIndustrial InjuryRight ShoulderCervical SpineLabor Code Section 3600(a)(10)
References
Case No. ADJ7784334
Regular
Jul 17, 2013

ESTEBAN ESCOBAR vs. UCLA MEDICAL CENTER

The Appeals Board granted reconsideration and reversed the trial judge's finding of no industrial injury. The Board found that the applicant sustained a cumulative injury to his right upper extremity, supported by the unrebutted medical opinion of a Qualified Medical Examiner. Compensation is not barred by the post-termination defense as the date of injury, per Labor Code Section 5412, occurred after the applicant's termination date. The case is returned to the trial level for further proceedings.

Post-termination defenseLabor Code section 3600(a)(10)Section 5412Cumulative injuryRight upper extremityIndustrial injuryPQMEKenneth ScheffelsM.D.Reconsideration
References
Case No. ADJ12672803, ADJ12979844, ADJ12673709
Regular
Apr 24, 2023

FREDDIE BANUELOS vs. ROBERT BERCU, STATE FARM FIRE AND CASUALTY COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Workers' Compensation Appeals Board granted reconsideration of three prior decisions, affirming the dismissal of the post-termination defense for a right knee injury (ADJ12979844) and a cumulative trauma psychiatric injury claim (ADJ12673709), finding employer knowledge prior to termination. However, the Board amended the decision for a cumulative orthopedic injury claim (ADJ12672803), deferring the finding of industrial injury pending further development of the record regarding specific body parts and treatment needs. The Board also clarified that no psychiatric injury was found to date in ADJ12673709, and arguments regarding medical evidence for that claim were premature.

Post-termination defenseLabor Code 3600(a)(10)Labor Code 3208.3(e)Employer knowledgeIndustrial injuryOrthopedic injuryPsychiatric injuryCumulative traumaSpecific injuryRight knee injury
References
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