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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. ADJ4151507 (SFO 0487197)
Regular
Feb 02, 2020

Tracy Sullivan vs. Café Amsterdam, State Compensation Insurance Fund

The Appeals Board granted reconsideration and amended the previous award, finding the applicant's burn injury did not qualify for the "severe burns" exception to the temporary disability indemnity limit under Labor Code section 4656(c)(3)(D). Consequently, temporary disability indemnity is limited to 104 weeks from the commencement of payments on August 10, 2004. The Board affirmed the WCJ's finding that the applicant's psychiatric injury was compensable, meeting the "sudden and extraordinary" employment condition exception. Clerical errors in the original findings were also corrected.

ADJ4151507SFO 0487197Tracy SullivanCafé AmsterdamState Compensation Insurance FundPetition for ReconsiderationFindings Award and OrderWCJindustrial injurycervical spine
References
Case No. ADJ1566624 (MON 0329177) ADJ4125360 (MON 0329180)
Regular
Jul 19, 2011

LAURA LINDQUIST vs. SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE; CORVEL CORPORATION

This case concerns the correct permanent disability rating schedule to apply for an injury occurring before January 1, 2005. The Board affirmed the WCJ's decision to use the 1997 PDRS, finding an exception applied due to prior medical reporting indicating permanent disability. However, the Board amended the permanent disability indemnity award and attorney's fee amount based on the WCJ's correction of a mathematical error. The case is returned to the trial level for further proceedings reflecting this corrected award.

WORKERS' COMPENSATION APPEALS BOARDFindings and AwardPetition for ReconsiderationFindings of Factpermanent disabilitypermanent disability indemnity2005 Permanent Disability Rating Schedule1997 Permanent Disability Rating ScheduleLabor Code section 4660(d)treating physician
References
Case No. ADJ352088 (MON 0360366)
Regular
Apr 12, 2011

NANCY MONTOYA vs. AUGUST CONSTRUCTION, INC., SEABRIGHT INSURANCE

This case concerns a clerical error in a workers' compensation award where the weekly temporary disability indemnity rate was inconsistently stated. The applicant, Nancy Montoya, incurred an industrial injury while employed by August Construction, Inc. The defendant petitioned for reconsideration to correct the typographical error in the Findings and Award, specifically regarding the stipulated temporary disability indemnity rate. The Workers' Compensation Appeals Board granted reconsideration, amended the award to reflect the agreed-upon rate of $833.33 per week, and returned the case for further proceedings.

Workers' Compensation Appeals BoardAugust ConstructionSeabright InsuranceFindings and AwardPetition for ReconsiderationTypographical ErrorTemporary Disability Indemnity RatePermanent Disability Indemnity RateStipulationReport and Recommendation
References
Case No. GRO 0027359 GRO 0031626
Regular
May 14, 2008

TERESA FOSTER-KENNEDY vs. SANSUM SANTA BARBARA MEDICAL FOUNDATION, ARROWOOD INDEMNITY COMPANY, DYNAMIC CLAIM SERVICE

The Appeals Board granted reconsideration, affirming only the initial penalty and attorney's fee for the unreasonable delay in authorizing follow-up care with Dr. Billy. However, the Board reversed all other penalties and attorney's fees related to the payment of prior attorney's fees, finding those issues either rescinded, not properly presented, or mooted by settlement agreements. The employer is now liable for the initial penalty and associated attorney's fee regarding Dr. Billy, but not for any subsequent penalties or fees concerning attorney fee disputes.

Labor Code section 5814Labor Code section 5814.5unreasonable delayfollow-up careattorney's feespenalty petitionreconsiderationawardFindings of FactReport and Recommendation
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. ADJ2748573
Regular
May 11, 2009

THOMAS HERNON vs. COUNTY OF SANTA CLARA

The Appeals Board granted reconsideration, reversing the prior finding on the applicant's occupational group number from 560 to 380 (painter), based on evidence of the applicant's actual job duties. The Board also modified the decision regarding apportionment, accepting the Agreed Medical Evaluator's opinion that 10% of the disability should be apportioned to pre-existing degenerative disease. However, the Board affirmed the application of the 1997 Permanent Disability Rating Schedule, as temporary disability payments were terminated before January 1, 2005, triggering notice requirements. Ultimately, the applicant's permanent disability was reduced to 63% after apportionment.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardApplicantDefendantPublic Service WorkerOccupational Group NumberIndustrial InjuryLow BackNeck
References
Case No. ADJ10008098
Regular
Feb 06, 2017

YVETTE SALDIVAR vs. STATE OF CALIFORNIA-DEPARTMENT OF GENERAL SERVICES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to review the judge's findings of fact and award. While the defendant argued against the applicant's burden of proof, the WCJ's credibility finding, and the award of temporary disability instead of Industrial Disability Leave, the Board ultimately amended the findings. The Board found that the applicant sustained a cumulative trauma injury to her psyche through January 28, 2014, arising out of and in the course of employment, affirming the rest of the original award.

PSYCHE INJURYCUMULATIVE TRAUMASPECIFIC INJURYTEMPORARY DISABILITY INDEMNITYINDUSTRIAL DISABILITY LEAVERECONSIDERATIONFINDINGS AND AWARDWORKERS' COMPENSATION ADMINISTRATIVE JUDGEAPPEALS BOARDBURDEN OF PROOF
References
Case No. ADJ4522362
Regular
Sep 26, 2008

CELESTE LILJEBLAD-THOMAS vs. BARONE'S RESTAURANT, STATE COMPENSATION INSURANCE FUND

The WCAB reversed the Supplemental Findings and Award granting reconsideration to the defendant, State Compensation Insurance Fund. The WCJ lacked jurisdiction to award temporary disability more than five years after the injury date.

WORKERS' COMPENSATION APPEALS BOARDCeleste Liljeblad-ThomasBarone's RestaurantState Compensation Insurance FundSupplemental Findings and Awardtemporary disability indemnityactual earnings25% penaltiesfurther medical treatmentreimbursement for mileage
References
Case No. ADJ9956461
Regular
Jul 11, 2016

ROBIN GOEBEL vs. MCDONALD'S, EMPLOYERS COMPENSATION INSURANCE COMPANY

In this workers' compensation case, the defendant, McDonald's, sought reconsideration of a prior award finding applicant Robin Goebel sustained an industrial injury to her back and left knee. The administrative law judge had found the defendant failed to timely complete utilization review (UR) for requested medical treatment. The Appeals Board granted reconsideration, affirming the finding of untimely UR. However, the Board deferred the issue of medical necessity for the requested treatment, allowing for further development of the record on that point.

Utilization ReviewTimelinessMedical TreatmentAuthorization RequestIndustrial InjuryBack InjuryKnee InjuryPetition for ReconsiderationFindings and AwardDeferred Issue
References
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