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

Case No. SDO 0322942
Regular
Jan 31, 2008

ROBERT WEIS vs. VULCAN MATERIALS COMPANY, ZURICH NORTH AMERICA

The applicant claims an admitted industrial spinal injury caused his umbilical hernia, but the WCJ denied benefits for the hernia, finding it nonindustrial. The applicant argues the Qualified Medical Evaluator's opinion supports industrial causation for the hernia, contradicting the defense. The Appeals Board granted reconsideration to obtain a report from the WCJ regarding this contested issue.

Workers' Compensation Appeals BoardVulcan Materials CompanyZurich North AmericaRobert Weisindustrial injuryspineherniaumbilical herniatruck driverqualified medical evaluator
References
0
Case No. ADJ10222181 (MF) ADJ10222198
Regular
Jan 30, 2019

SAM ALBOUDOOR vs. AMJES, INC. dba K&B FREIGHT SYSTEMS

This case concerns claims for hernias and spine injuries sustained by a truck driver. The Workers' Compensation Appeals Board granted reconsideration to review the finding that hernias were work-related, noting the medical evaluator's conflicting opinions on causation. The Board determined further medical development is required on the hernia issue due to contradictory expert testimony. Additionally, the issue of reimbursement for self-procured medical treatment was deferred pending the resolution of the hernia claims.

Workers' Compensation Appeals BoardAMJES INCK&B Freight SystemsSam Alboudoorherniahiatal herniainguinal hernialumbar spinethoracic spinePQME
References
0
Case No. MISSING
Regular Panel Decision

Cabrera v. Two-Three-Nought-Four Associates

Claimant sustained a back injury and umbilical hernia in September 1994 while performing duties as a building superintendent. An initial Workers’ Compensation Law Judge (WCLJ) decision found the building owner, Two-Three-Nought-Four Associates (2304 Associates), fully liable as the employer and fined them for not maintaining workers' compensation insurance. The Workers’ Compensation Board later modified this, identifying 2304 Associates as the general employer and Property Management Group (PMG) as the special employer, but upheld 2304 Associates' full liability due to its overwhelming control and benefit from the property. 2304 Associates appealed, challenging the employment relationship finding and the full liability assessment. The Appellate Division affirmed the Board's decision, citing substantial evidence that supported the Board’s conclusions regarding 2304 Associates' role as the general employer and its ultimate liability.

Employment RelationshipGeneral EmployerSpecial EmployerEmployer LiabilityWorkers' Compensation InsuranceAppellate ReviewSubstantial EvidenceCredibility AssessmentBuilding SuperintendentBack Injury
References
12
Case No. ADJ300802 (AHM 0109743) ADJ2310921 (AHM 0115931)
Regular
Nov 21, 2008

CHRISTOPHER SHIELDS vs. LAIDLAW TRANSIT; BROADSPIRE

The Appeals Board granted reconsideration, amending the original award to establish a permanent and stationary date of January 3, 2005, for applicant's abdominal hernia injuries. The Board deferred the issues of permanent disability and attorneys' fees, returning the case to the trial level for re-rating based on hernia/abdominal injuries rather than spinal injuries. The Board affirmed the finding of an industrial inguinal hernia injury, while also noting that the defendant did not provide evidence of unreasonable refusal of medical treatment for the hernias.

HerniaUmbilical herniaInguinal herniaLow back painPermanent and stationary dateTemporary total disabilityMedical treatmentAttorney's feesReconsiderationWorkers' Compensation Appeals Board
References
0
Case No. ADJ8109410
Regular
Apr 03, 2015

KRISTINA BROOKS vs. COUNTY OF TULARE

The Workers' Compensation Appeals Board reversed the Administrative Law Judge's decision, finding that the applicant's hiatal hernia and GERD were not industrial injuries. The Board determined that the Labor Code section 3212 presumption for hernias in law enforcement officers was rebutted by medical evidence. Specifically, the Board found that the applicant's hiatal hernia was primarily caused by complications from a prior non-industrial bariatric surgery, not her employment. Therefore, the Board rescinded the award for medical treatment and temporary/permanent disability.

Labor Code section 3212presumptionrebuttalhiatal herniaGERDQualified Medical EvaluatorIra FishmanM.D.deposition testimonybariatric surgery
References
1
Case No. MISSING
Regular Panel Decision
Jul 27, 1978

Claim of Lopez v. New York City Housing Authority

This case involves an appeal from a decision of the Workers’ Compensation Board, which found that the claimant sustained an occupational hernia. The claimant initially filed a claim in 1976 for an injury on July 12, 1973, which was dismissed by a referee due to the two-year limitation under section 28 of the Workers’ Compensation Law. Subsequently, the claimant filed a new claim, and a referee found an occupational disease and causal relationship for an incisional hernia, setting the disablement date as January 19, 1976. The employer and carrier appealed, arguing that the first dismissal was res judicata. The board affirmed the referee's decision, citing its broad powers of continuing jurisdiction under section 123 of the Workers’ Compensation Law. The court affirmed the board's determination, finding substantial medical evidence supporting the conclusion that heavy lifting and bending led to the occupational hernia.

Occupational HerniaWorkers' Compensation LawRes JudicataContinuing JurisdictionTimeliness of ClaimMedical EvidenceBoard DecisionAppealCausal RelationshipIncisional Hernia
References
5
Case No. ADJ9811478
Regular
Aug 14, 2017

MARCOS RAMIREZ vs. HALL MANAGEMENT CORPORATION, NATIONAL UNION FIRE INSURANCE COMPANY/AIG

The applicant sought reconsideration of an order approving a compromise and release (C&R) settlement, claiming there was no agreement to include his hernia claim. The Workers' Compensation Appeals Board (WCAB) dismissed the petition for reconsideration. The WCAB found that the applicant's claim regarding the hernia was a dispute over the C&R, not a final decision on the merits. The matter was remanded to the WCJ for a hearing to create a record on the applicant's allegations before further appeal.

Compromise and ReleasePetition for ReconsiderationWorkers' Compensation Appeals Boardmeeting of the mindshernia claimdefective servicecontinuing jurisdictiongood causemutual mistake of factduress
References
0
Case No. ADJ6475661
Regular
May 11, 2015

ALAN COLGROVE vs. SANTA ROSA PRESS DEMOCRAT, TRAVELERS PROPERTY & CASUALTY COMPANY OF AMERICA

The Appeals Board rescinded the WCJ's decision finding a hernia to be a compensable consequence of a back injury, citing insufficient medical evidence. Dr. Klein’s opinion on causation was found to be inconsistent and not substantial evidence. The Board concluded the medical record requires further development to determine if the hernia is causally related to the industrial injury. Therefore, the case is returned to the trial level for further proceedings and a new decision by the WCJ.

COMPENSABLE CONSEQUENCEPETITION TO REOPENMEDICAL RECORD DEVELOPMENTQUALIFIED MEDICAL EVALUATOR (PQME)OPINIONCAUSAL RELATIONSHIPHERNIABACK INJURYSTIPULATIONSSUBSTANTIAL EVIDENCE
References
3
Case No. POM 0290497
Regular
Feb 22, 2008

WALID THOMAS vs. KAZI FOODS, ST. PAUL TRAVELERS

The Workers' Compensation Appeals Board denied Walid Thomas's petition for reconsideration of a decision that found his alleged back and hernia injuries sustained while employed by Kazi Foods were not industrial. The Board adopted the findings of the administrative law judge, who found Dr. Hajj's opinion to be substantial medical evidence supporting this conclusion. The judge also found Thomas's testimony not credible due to his extensive prior medical history of similar back injuries and a hernia.

Workers' Compensation Appeals BoardReconsideration deniedIndustrial injuryDr. Hajj's opinionSubstantial medical evidenceCredibility findingPlace v. Workers' Comp. Appeals Bd.Garza v. Workmen's Comp. Appeals Bd.Kazi FoodsInc.
References
2
Case No. ADJ1038622
Regular
Nov 19, 2012

PAUL SOTEROPOULOS vs. LOS ANGELES COUNTY FIRE DEPARTMENT

The Workers' Compensation Appeals Board denied the applicant's reconsideration of a prior decision. The Board affirmed the finding that the applicant, a firefighter, did not sustain an injury arising out of and in the course of employment for his testicular cancer. The Board found the agreed medical evaluator's opinion on the latency period provided substantial evidence to rebut the statutory presumption. Furthermore, the Board determined the applicant's hernia was a complication of non-industrial cancer treatment, thus controverting the presumption of compensability for hernias.

Workers' Compensation Appeals BoardPaul SoterepoulosLos Angeles County Fire DepartmentReconsiderationFirefighterRight Testicular CancerHerniaLabor Code Section 3212.1Presumption of CompensabilityLatency Period
References
2
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