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

Case No. GRO 0020213
Regular
May 28, 2008

Sandra K. Carnahan vs. Albertsons Stores, Inc., Specialty Risk Services

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration as it was not a final order, but granted removal. The Board found substantial evidence, including the primary treating physician's report and a utilization review certification, supported the applicant's need for a urological consultation due to urinary problems secondary to her industrial back injury. Therefore, the Board rescinded the WCJ's decision and ordered the defendant to provide the applicant with a urological consultation.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalWCJFindings of FactUrological consultationLumbar injuryNeural innervationUrinary tract infectionsUtilization review
References
10
Case No. ADJ4317262 (ANA 0327568)
Regular
Apr 13, 2009

JOSE GONZALEZ vs. BURR ROOFING, INC., SCIF INSURED SANTA ANA

The applicant sought reconsideration of a workers' compensation award, primarily arguing the permanent disability rating undervalued his urological condition and the WCJ erred in not crediting vocational rehabilitation expert opinion. The Appeals Board granted reconsideration solely to award additional attorney fees for temporary disability benefits. While the majority affirmed the WCJ's original findings on permanent disability, a dissenting commissioner argued the urological condition was significantly underestimated and requested a new rating.

Workers Compensation Appeals BoardJose GonzalezBurr RoofingSCIF Insured Santa Anapermanent disabilityapportionmentrooferupper back injurymid back injurylow back injury
References
0
Case No. ADJ11451772
Regular
Apr 03, 2023

EDUARDO CASELIN HUERTA vs. MONTIE WAYNE SHEET METAL, CALIFORNIA INSURANCE COMPANY, APPLIED RISK SERVICES, INC.

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration and deferred the issue of permanent disability. The Board affirmed the finding of temporary disability through August 9, 2020, based on medical opinions stating the applicant remained unable to work due to his urological condition. However, the Board requires the Administrative Law Judge to clarify how permanent disability ratings were calculated (addition versus combination) and to further analyze the applicability of Labor Code section 4660.1(c) to the applicant's sexual dysfunction and urological impairments. The Board took no position on the ultimate resolution of these permanent disability issues.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary DisabilityPermanent DisabilityLumbar SpineSexual DysfunctionUrological ImpairmentCombined Values ChartLabor Code Section 4660.1(c)Qualified Medical Evaluator
References
3
Case No. ANA 0385835 ANA 0385836
Regular
Nov 09, 2007

HERMILO RINCON vs. PETERSON HARDWARE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of an order that refused to authorize a urological consultation. The denial was based on the judge's report, which found no immediate medical need for the consultation and noted the applicant's stated complaints were back pain, with the urethral stricture possibly being non-industrial. Additionally, the petition for reconsideration contained improperly filed documents.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ ReportFuture Medical CareExpedited HearingPrimary Treating PhysicianUtilization ReviewUrological ConsultationUrethral StrictureNon-Industrial
References
0
Case No. ADJ3880125
Regular
Nov 01, 2014

SOKPHEAP PEN vs. THE ENSIGN GROUP, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to amend a prior finding. The Board found that the applicant sustained industrial injury to her spine only, deferring the issue of injury to the psyche, uterus, and urological system. This was because the applicant's claims for these latter body parts were not properly raised as trial issues, thus denying the defendant due process. The Board otherwise affirmed the original decision.

Petition for ReconsiderationFindings and OrderCertified Nursing AssistantSpine InjuryPsyche InjuryUterus InjuryUrological System InjuryQualified Medical EvaluatorDr. CremataDr. Brandeis
References
4
Case No. ADJ8166088
Regular
Apr 10, 2015

GUILLERMO GARCIA vs. QUETICO LOGISTICS, LLC, TOKIO MARINE MANAGEMENT, INC.

Applicant sought removal from an order continuing his workers' compensation case to trial, arguing his condition was not permanent and stationary and required further medical development on urological, sexual, and sleep issues. The Appeals Board denied the petition for removal. They adopted the WCJ's reasoning but noted discrepancies regarding applicant's ongoing treatment. Therefore, the applicant's request to rescind the order and continue the case was denied.

Petition for Removalrescinding Ordercontinued to trialpermanent and stationarymedical record developmenturological complaintssexual dysfunctionsleep disordermedical treatment reportsMandatory Settlement Conference
References
0
Case No. ADJ1644999 (LAO0880435)
Regular
Dec 11, 2012

, MANUEL FERNIZA, vs. , RENT A CENTER, INC.; FIREMAN'S FUND INSURANCE COMPANY/ASSOCIATED INDEMNITY,

The Workers' Compensation Appeals Board (WCAB) vacated its prior order granting reconsideration and dismissed the applicant's petition. The WCAB determined that the applicant's petition sought reconsideration of an interim procedural order, not a final decision, which is not appealable. Even if the merits were considered, the WCAB would have affirmed the judge's decision, finding the QME report timely and deferring a decision on treatment authorization until a PQME urological report was issued.

Workers' Compensation Appeals BoardReconsiderationFinal OrderInterim OrdersPanel Qualified Medical ExaminerMedical Provider NetworkUrological ConditionIndustrial InjuryAdministrative DirectorWCJ Report
References
1
Case No. ADJ8094546
Regular
Dec 16, 2014

Jesse Martinez vs. Linda Vista Farms, Zenith Insurance Company

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award. The applicant, Jesse Martinez, claims 100% permanent disability due to back and urologic injuries, but the trial judge awarded 45%. The Board found insufficient evidence to fully address whether the applicant's diminished future earning capacity rebutted the scheduled permanent disability rating. The matter was returned to the trial level for further development of the record concerning this specific issue.

Permanent disabilityLeBoeufvocational expertsubstantial evidencediminished future earning capacityWCJpanel Qualified Medical Evaluatorsorthopedicurologicpermanent disability rating
References
2
Case No. MON 0320089 MON 0297024
Regular
Oct 24, 2007

, \DONALD LEE (Deceased), CARRIE LEE (Widow)\, Carrie Lee vs. NORRIS INDUSTRIES, Permissibly SelfInsured, Administered by S.R.S.; THE TRAVELERS; CALIFORNIA CASUALTY INSURANCE COMPANY

This case involves a widow's petition for reconsideration of a finding that her deceased husband's death was not industrially caused by bladder/urological issues. The applicant argued she was denied due process due to new evidence presented at the final hearing, requesting the record be reopened. The majority denied the petition, adopting the WCJ's report. However, one commissioner dissented, believing the applicant should have had the opportunity for further discovery based on changed testimony from a defendant's witness and newly presented information.

Workers' Compensation Appeals BoardDonald LeeCarrie LeeNorris IndustriesThe TravelersCalifornia Casualty Insurance CompanyPetition for ReconsiderationJoint Findings and OrdersIndustrial InjuryBladder
References
1
Case No. ADJ9455268
Regular
Sep 07, 2018

MICHAEL HOLT vs. CONTRACTORS WARDROBE, TRAVELERS, YORK RISK SERVIES

The Workers' Compensation Appeals Board granted reconsideration to address an alleged injury to the applicant's kidneys and urological system. The Board found the original judge failed to clarify if this issue was submitted for decision or make a specific finding, necessitating a remand for clarification. The Board also dismissed the applicant's petition for removal as premature, but left the judge's notice of intent to sanction the applicant's attorney undisturbed. The prior award of temporary disability and future medical treatment was preserved, with other issues deferred.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFindings Award and OrdersSanctionsAgreed Medical EvaluatorQualified Medical EvaluatorCumulative TraumaCardiovascular SystemCirculatory System
References
0
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