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

Case No. ADJ9979717, ADJ9983551
Regular
Apr 15, 2020

James Wieboldt vs. County of San Diego

The Appeals Board rescinded two WCJ findings of industrial colon and vocal cord cancer, returning the cases for further proceedings. The Board found the medical opinions of Drs. Woolf and Berman lacked substantial evidence due to issues with causation, exposure details, and reliance on incorrect legal presumptions. While the applicant has the burden to prove industrial causation absent the cancer presumption, the Board determined the current medical record requires further development. The Board also noted discrepancies regarding the applicant's job titles and claimed periods of exposure that need clarification.

Workers Compensation Appeals BoardJames WieboldtCounty of San DiegoColon CancerVocal Cord CancerIndustrial InjuryMedical OpinionSubstantial EvidenceLabor Code Section 3212.1Cancer Presumption
References
Case No. ADJ4118575 (MON 0342974)
Regular
May 26, 2010

MANUEL ORTIZ vs. TOWER INDUSTRIES, INC., SCIF INSURED INLAND EMPIRE

This case involves an applicant who sustained severe injuries in a riding accident, including multiple pelvic fractures and urological damage, requiring extensive surgeries. The applicant was awarded 100% permanent disability due to his constant pain, limited mobility, and functional impairments, including urinary incontinence and erectile dysfunction. The defendant appealed, arguing the 100% disability rating was not justified and disputing the findings of sleep disorder and erectile dysfunction. The Workers' Compensation Appeals Board affirmed the applicant's 100% permanent disability, finding the evidence supported total permanent disability based on the facts of his severe injury and ongoing functional limitations. The Board denied the defendant's petitions for reconsideration.

Workers' Compensation Appeals BoardPermanent Total DisabilityPetitions for ReconsiderationFindings and AwardAgreed Medical ExaminersLabor Code Section 4662Pelvis InjuryLower Extremity InjuryUrethra InjuryPsyche Injury
References
Case No. ADJ10256108, ADJ10255968, ADJ10256212, ADJ10256223, ADJ10489875
Regular
Sep 23, 2022

JOSEPH RYAN vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Appeals Board affirmed the finding of permanent and total disability for the applicant, Joseph Ryan, stemming from industrial injuries sustained while employed as a correctional captain. However, the Board remanded the matter for further proceedings to specifically address apportionment of the permanent disability under Labor Code section 4663, considering the Agreed Medical Evaluator's opinion on pre-existing spinal disease. The Board found that the applicant's specific and cumulative trauma injuries to his spine resulted in intertwined disabilities, justifying a combined award, but that Dr. Hasday's apportionment findings require further development and determination at the trial level.

Workers' Compensation Appeals BoardJoseph RyanCalifornia Department of CorrectionsLegally UninsuredState Compensation Insurance FundADJ10256108ADJ10255968ADJ10256212ADJ10256223ADJ10489875
References
Case No. ADJ7037201
Regular
Apr 22, 2013

Eddie Avakian vs. CITY OF BALDWIN PARK, ADMINSURE

This case involves an applicant police officer seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that awarded 72% permanent partial disability. The applicant contended the WCJ erred by excluding sleep disturbances and sexual dysfunction from the disability rating and by apportioning his cardiovascular disability. The WCAB granted reconsideration, rescinded the original award, and found the applicant's sexual dysfunction and sleep disorder compensable. The matter was returned to the trial level for a new decision, with the WCAB stating it would not disturb other findings, including the hypertension apportionment.

Workers' Compensation Appeals BoardEddie AvakianCity of Baldwin ParkPermissibly Self-InsuredAdministered By ADMINSUREADJ7037201Opinion and Order Granting ReconsiderationDecision After ReconsiderationFindings and Award and OrderAdministrative Law Judge
References
Case No. GOL 0088273
Regular
Aug 18, 2008

ROBERT SIEBURG vs. RONALD WOLFE & ASSOCIATES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the original award, and returned the case for further development of the record. The Board found the findings of the administrative law judge regarding $97\%$ permanent disability and apportionment were not supported by substantial medical evidence. Specifically, the opinion of Dr. Kahmann was deemed deficient due to internal inconsistencies, lack of explanation for apportionment, and undefined work restrictions. The Board also found Dr. Basham's report did not meet the standard for substantial medical evidence regarding cognitive dysfunction.

WORKERS' COMPENSATION APPEALS BOARDROBERT SIEBURGRONALD WOLFE & ASSOCIATESSTATE COMPENSATION INSURANCE FUNDGOL 0088273OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONFindings and AwardWCJmaintenance person
References
Case No. ADJ6622799
Regular
Oct 18, 2013

TERRY A. WIRTH vs. STATE OF CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

This case concerns the denial of a Petition for Reconsideration filed by the defendant, the State of California Highway Patrol. The applicant, Terry A. Wirth, suffered a continuous trauma injury (prostate cancer) leading to urinary and erectile dysfunction. The Appeals Board adopted the Workers' Compensation Judge's report, finding that the date of injury was in 2008, determining the applicable permanent disability compensation rate based on that date. The Board also found ample evidence supporting the agreed medical examiner's impairment ratings for the applicant's post-surgical conditions, dismissing the defendant's objections.

Workers' Compensation Appeals BoardState of California Highway PatrolState Compensation Insurance FundPetition for ReconsiderationPermanent disability compensation rateLabor Code section 5412Urinary incontinenceErectile dysfunctionCommon postprostatectomy symptomsWhole person impairment ratings
References
Case No. ADJ486464 (VNO 0557238)
Regular
Jan 25, 2017

Linda Castillo vs. FIRST STUDENT, GALLAGHER BASSETT

The Workers' Compensation Appeals Board granted reconsideration to address the lien of the Employment Development Department (EDD). The Board affirmed the original findings regarding the applicant's injuries and 24% permanent disability, rejecting claims for 100% disability and specific impairments due to lack of substantial evidence. However, the issue of EDD's lien was deferred to allow for a hearing to determine its validity and the defendant's liability.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilityVocational EvaluationSubstantial EvidenceWhole Person ImpairmentVocal Cord DysfunctionSinus TachycardiaEmployment Development Department (EDD)
References
Case No. ADJ3489554 (SFO 0460075), ADJ409657 (SFO 0473579)
Regular
May 10, 2010

REBHI AYESH vs. ARCO/BP AMERICA, Permissibly Self-Insured, Administered By ESIS

The Workers' Compensation Appeals Board reversed an administrative law judge's award, ruling that the applicant is not entitled to industrial workers' compensation benefits for erectile dysfunction. The Board found the erectile dysfunction was caused by non-industrial factors like diabetes and smoking, not the applicant's work-related psychiatric injury. While the psychiatric injury was recognized as a compensable consequence of a prior back injury, medical evidence did not sufficiently demonstrate it contributed to the need for erectile dysfunction treatment. Consequently, the Board rescinded the award for further medical care related to the erectile dysfunction.

Workers Compensation Appeals Boardpsychiatric injuryindustrial injurylow back injuryerectile dysfunctiondiabetessmokingmedical treatmentcausationqualified medical evaluator
References
Case No. ADJ11197293
Regular
Dec 18, 2020

KEVIN TORRES vs. ARCTIC MECHANICAL, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case concerns an applicant's entitlement to an increased impairment rating for sleep dysfunction. The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration. The Board affirmed the Administrative Law Judge's finding that Labor Code Section 4660.1(c)(1) does not preclude an increased impairment rating for sleep dysfunction if it is directly caused by the industrial injury, rather than a consequence of it. Medical evidence from Dr. Jonathan Wang established a direct causal link between the applicant's sleep dysfunction and the industrial injury. The Board found Dr. Wang's report and deposition testimony constituted substantial medical evidence supporting this conclusion and rejected the defendant's arguments.

Labor Code 4660.1(c)(1)sleep dysfunctiondirect causationincreased impairment ratingcompensable consequencepsychiatric disordersubstantial medical evidenceQME reportdeposition testimonyAMA Guides
References
Case No. ADJ7082851
Regular
Jan 30, 2019

HUMBERTO GONZALEZ vs. AMERICAN AUTO WRECKING, STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to amend the original findings, establishing applicant's earnings at $500.00 per week. The Board affirmed the finding of industrial injury to the psyche and right inguinal hernia, but deferred issues of injury to the reproductive system (sexual dysfunction) and sleep disorder. The matter was returned to the WCJ for further development of the record concerning these deferred issues, particularly regarding the specific impact of sleep disorder on impairment and corroboration of sexual dysfunction.

AOE/COEFindings and AwardPetition for ReconsiderationAdministrative Law JudgeAgreed Medical ExaminerQualified Medical ExaminerMaximum Medical ImprovementGeneral LaborerRight inguinal herniaSexual dysfunction
References
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