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

Case No. ADJ10127986
Regular
May 28, 2019

SAMANTHA SILVA vs. HILMAR CHEESE, SAFETY NATIONAL INSURANCE

This case concerns the compensability of Voltaren gel prescribed for the applicant's bilateral hand, wrist, and trigger finger injuries. The Workers' Compensation Appeals Board granted reconsideration, rescinding the original findings. The Board found that the critical issue was whether the generic equivalent of Voltaren gel was exempt from utilization review (UR), not solely the brand name's formulary status. The matter was returned for further proceedings to clarify the issues and for a new decision on the eligibility of the generic Voltaren gel.

Workers' Compensation Appeals BoardUtilization ReviewMedical Treatment Utilization ScheduleMTUSDrug FormularyExempt DrugGeneric DrugBrand Name DrugVoltaren GelFindings of Fact
References
Case No. OAK 0318645
Regular
May 23, 2000

FLORENCE ROTTIER vs. LONG'S DRUG STORES, AIG CLAIMS SERVICES

The Workers' Compensation Appeals Board granted reconsideration to review the WCJ's decision regarding applicant Florence Rottier's industrial injury. The Board rescinded the prior order and returned the case to the trial level for further proceedings. This action was primarily due to the WCJ's admission that his decision regarding the applicable rating schedule was based on speculation and a failure to formally admit exhibits into evidence as required by Board precedent.

Workers' Compensation Appeals BoardFlorence RottierLong's Drug StoresAIG Claims ServicesOAK 0318645Opinion and Order Granting ReconsiderationFindings and Orderindustrial injuryright shouldergreeting card clerk
References
Case No. WCK 0067569
Regular
Dec 12, 2007

DELLA D'ETTEL vs. LONGS DRUG STORES CORPORATION, Permissibly Self-Insured, AIG CLAIMS SERVICES

The Appeals Board amended the original award to correctly apportion the applicant's permanent disability, applying the new apportionment law only to the "new and further disability." The Board calculated the applicant's overall industrial permanent disability at 77.25 percent by subtracting the non-industrial factors from the increase in disability and adding it to the original award. This amended calculation, consistent with *Vargas* and *Brodie*, determined the final permanent disability indemnity and life pension.

Della D'EttelLongs Drug Stores CorporationAIG Claims ServicesWCK 0067569ReconsiderationNew and Further DisabilityPermanent Partial DisabilityApportionmentLabor Code section 4663SB 899
References
Case No. ADJ3681337 (VNO 0191233)
Regular
Aug 11, 2015

MARK SAVOIE vs. NATIONAL TECHNICAL SYSTEMS, STATE COMPENSATION INSURANCE FUND

This case involves a worker injured in 1985 who claims his temporary total disability (TTD) rate should be based on significantly higher earnings from 2004, not his 1985 income. The Appeals Board denied reconsideration, agreeing with the WCJ that the applicant failed to provide sufficient evidence of a tangible, reasonably expected wage increase at the time of the 1985 injury. Furthermore, the Board upheld the employer's right to credit from a prior third-party settlement, finding no waiver or laches despite the long delay. The Board adopted the WCJ's reasoning, emphasizing that post-injury earnings require specific, demonstrable proof of anticipation at the time of injury to adjust TTD calculations.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderGrade 3C open crush injurychronic pain syndrometemporary total disabilityearning capacityHoffmeisterstatutory increaseslaches
References
Case No. ADJ7410586
Regular
May 18, 2012

Randall Salcido vs. California Department of Corrections and Rehabilitation, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, affirming the WCJ's finding that the applicant's temporary disability benefits should be based on his earnings as a teacher on the date of injury. The defendant argued that benefits should be based on the applicant's lower subsequent earnings as a warehouse supervisor, as the transfer was anticipated. However, the Board held that the applicant's actual earnings as a teacher reflected his earning capacity and that the lower warehouse supervisor wage was an aberrant basis for calculation. The Board also noted that using the lower wage would incentivize employers to downsize to reduce liability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactDisability BenefitsVocational TeacherEarnings CalculationTemporary DisabilityAverage Weekly EarningsEarning CapacityLabor Code Section 4453
References
Case No. SAC 0191116 SAC 0191126
Regular
Feb 19, 2008

WILLIAM VILLEMAIRE, Deceased, ROBERTA VILLAMAIRE, Widow, Individually and as Guardian ad Litem and Trustee for TIFFANY A. VILLAMAIRE (minor), WILLIAM A. VILLAMAIRE and TRACY A. VILLAMAIRE vs. CAMPBELL SOUP COMPANY; TRAVELERS INSURANCE COMPANY, et. al.

The Workers' Compensation Appeals Board remanded the case for further proceedings to determine the decedent's average weekly earnings capacity, considering union contract wage increases foreseeable at the time of injury, to establish the proper death benefit rate for minor children. The Board clarified that accrued death benefits owed to a deceased dependent are payable to surviving dependents, not their estate. The original award was rescinded, returning the matter to the trial level for a new decision consistent with the opinion.

Workers' Compensation Appeals BoardDeceased EmployeeSurviving WidowGuardian ad LitemTrusteeSurvivor BenefitsCampbell Soup CompanyTravelers Insurance CompanyOpinion and Decision After ReconsiderationAverage Weekly Earnings
References
Case No. ADJ2212690 (RIV 048643)
Regular
Mar 20, 2009

JAMIE WOLDEN (deceased), PATRICIA WOLDEN, individually and as guardian ad litem for DAVID EYLER and ANITA WOLDEN vs. BRIGHT DEVELOPMENT, STATE COMPENSATION INSURANCE FUND

This case involves a widow seeking death benefits for her husband, who died from a multi-drug intoxication more than 240 weeks after his industrial injury. The Workers' Compensation Appeals Board denied reconsideration, upholding the administrative law judge's finding that the death benefit claim was untimely. The Board relied on *Massey v. Workers' Comp. Appeals Bd.*, holding that the 240-week period from the date of injury is a prerequisite for death benefits, which had expired before the decedent's death. Therefore, no death benefit claim could arise, and the applicant's claim was properly disallowed.

Death benefitsLabor Code section 5406(c)240-week limitationdate of injurydate of deathindustrial injurypermanent disabilitymedical treatmentprescription drugsmulti-drug intoxication
References
Case No. ADJ976410 (SDO 0364068)
Regular
Sep 17, 2012

DIANNA BALDWIN vs. ROSS STORES, INC.

This case before the Workers' Compensation Appeals Board involves Dianna Baldwin (Applicant) and Ross Stores, Inc. (Defendant). The Board has issued an order dismissing the Applicant's Petition for Reconsideration. This dismissal is based on the Board's review of the record and incorporates the reasons provided in the administrative law judge's Report and Recommendation.

Petition for ReconsiderationReport and RecommendationWorkers' Compensation Administrative Law JudgeDismissedWorkers' Compensation Appeals BoardRoss StoresInc.Dianna BaldwinCase No. ADJ976410SDO 0364068
References
Case No. ADJ1332416 (WCK 0031685), ADJ3521523 (WCK 0322592), ADJ4017994 (WCK 0029276)
Regular
May 16, 2014

PAMELA ZEILSTRA vs. TARGET STORES, SEDGWICK CMS

This case involves a Petition for Reconsideration filed by Pamela Zeilstra against Target Stores and Sedgwick CMS. The Workers' Compensation Appeals Board dismissed the petition because it was untimely and not filed from a final order, as required by Labor Code section 5900. The Board clarified that interlocutory procedural orders, which do not determine substantive rights, are not subject to reconsideration. Therefore, the petition was dismissed.

Petition for ReconsiderationUntimely PetitionFinal OrderInterlocutory OrderSubstantive RightLiability DeterminationWCABWorkers' Compensation Appeals BoardAdministrative Law JudgeReport and Recommendation
References
Case No. ADJ10892681, ADJ10892685
Regular
Sep 26, 2018

ISABEL VALDEZ vs. ROSS STORES, INC., ARCH INSURANCE COMPANY

This case involves a withdrawn Petition for Reconsideration filed by an unnamed petitioner in the matter of Isabel Valdez v. Ross Stores, Inc. and its insurer. The Workers' Compensation Appeals Board has issued an order dismissing the petition as a result of its withdrawal. No substantive legal issues were decided as the matter was resolved by the petitioner's action. The Board's order is dated September 26, 2018.

Petition for ReconsiderationWithdrawnDismissedWorkers' Compensation Appeals BoardRoss StoresArch Insurance CompanySedgwick Claims Management ServicesADJ10892681ADJ10892685San Diego District Office
References
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