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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
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. ADJ9887809
Regular
Jan 29, 2019

JOSEPH CAGLIA vs. CALIFORNIA DEPARTMENT OF REHABILITATION, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration of a finding of five percent permanent partial disability. The Board adopted the Administrative Law Judge's (WCJ) report, which found the opinion of Dr. Pelton more persuasive than that of Dr. Purcell. The WCJ explained that Dr. Pelton's use of a Station and Gait Disorder rating was appropriate given the applicant's objective ligament tear and resulting subjective limitations, even if a conventional application of the AMA Guides yielded zero impairment. The WCJ's detailed report cured any potential defect under Labor Code § 5313, and the reliance on Dr. Pelton's report constituted substantial evidence.

WCABPetition for Reconsiderationsubstantial evidencemedical opinionsWCJ reportpermanent disabilityprimary treating physicianAMA GuidesAlmaraz-GuzmanStation & Gait Disorder
References
Case No. ADJ2241828
Regular
Dec 05, 2008

LISA MANZO vs. WHITE MEMORIAL MEDICAL CENTER

The Workers' Compensation Appeals Board dismissed the employer's petition for reconsideration as it was not a final order but granted removal to rescind the WCJ's disapproval of the Stipulations. The Board found the Stipulations might be adequate despite the WCJ's concerns and ordered the matter returned to the trial level with missing documents to be filed. The employer must provide Dr. Knight's December 2006 report, its investigator's report, and the proposed Stipulations for a new decision on their adequacy.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalStipulations with Request for AwardWCJ disapprovalinadequate Stipulationsunsigned Stipulationsindustrial injuryright wristright elbow
References
Case No. ADJ9292791
Regular
Sep 29, 2015

HIEP LE NGOC NGUYEN vs. OAKS CLUB ROOM, NATIONAL CASUALTY COMPANY, NATIONWIDE AGRIBUSINESS INSURANCE COMPANY

This case concerns applicant's petition for removal after the WCJ denied their request for a new Qualified Medical Examiner (QME) panel. The denial was based on the original QME's failure to issue a timely supplemental report despite two requests. Although the QME claimed non-receipt of the requests, the supplemental report has now been provided. The Appeals Board denied removal, finding that issuing a new panel would only cause further delay given the report is now available.

Petition for RemovalQualified Medical ExaminerSupplemental ReportRule 38(i)Administrative Law JudgeWCJ ReportPrejudiceIrreparable HarmUntimely ReportPanel Qualified Medical Examiner
References
Case No. LAO 838220
Regular
May 14, 2007

MARIA SERAFIN vs. LANSCO DIE CASTING, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the previous award, and remanded the case to determine permanent disability using the 1997 Schedule. This decision stems from the Board's finding that the applicant's treating physician's December 20, 2004, report indicated the existence of permanent disability, triggering an exception under Labor Code section 4660(d). Consequently, the outdated 1997 Schedule, not the 2005 Schedule, must be applied to calculate the applicant's permanent disability benefits.

Workers' Compensation Appeals BoardMaria SerafinLansco Die CastingState Compensation Insurance FundLAO 838220ReconsiderationFindings and AwardWCJIndustrial InjuryRight Shoulder
References
Case No. ADJ7237157
Regular
Aug 15, 2013

JUAN ESTRADA vs. R&L BROSAMER, INC.; CHARTIS/AIG

The Workers' Compensation Appeals Board (WCAB) granted removal, rescinded an administrative law judge's (WCJ) order, and otherwise affirmed the WCJ's decision. The rescinded order compelled the applicant, Juan Estrada, to attend a medical examination on July 19, 2013. The WCAB adopted and incorporated the WCJ's report outlining the reasons for this action.

RemovalRescindedMedical ExaminationCompelling AttendanceWCJ OrderPetition for RemovalWorkers' Compensation Appeals BoardAdministrative Law JudgeReport of WCJDecision After Removal
References
Case No. ADJ1029045 (LAO 0790607)
Regular
Sep 21, 2012

ELVIRA CABRAL vs. ACCURIDE INTERNATIONAL, INC., SEDGWICK CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration because the administrative law judge's (WCJ) order striking Dr. Windler's reports was an evidentiary ruling, not a final order dispositive of substantive rights. The WCAB also denied the applicant's Petition for Removal, finding no evidence of significant prejudice or irreparable harm required for this extraordinary remedy. The WCAB concluded the WCJ's report sufficiently explained the bases for striking the reports, curing any technical defect regarding Labor Code section 5313. Therefore, the applicant's request to overturn the ruling on Dr. Windler's reports was denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for Removalsubstantial evidenceDr. Windler's reportsstricken from the recordnon-industrial personal injuryLabor Code section 5313final orderadmissibility of evidence
References
Case No. ADJ7242422
Regular
Sep 24, 2013

TRACIE WHITE vs. COUNTY OF SACRAMENTO, DEPARTMENT OF FINANCE

The Workers' Compensation Appeals Board denied the County of Sacramento's Petition for Removal. The County sought to replace a Qualified Medical Evaluator (QME) due to an allegedly untimely supplemental report. The Board affirmed the administrative law judge's denial, interpreting Administrative Director Rule 38(h) to grant QMEs sixty days for supplemental reports. The Board also noted the County objected to the report before receiving it.

Petition for RemovalQualified Medical EvaluatorQME panelsupplemental reportuntimely reportAdministrative Director Rule 38Report and RecommendationFajardo v. Workers' Comp. Appeals Bd.WCJoff calendar
References
Case No. ADJ9163440
Regular
Oct 05, 2015

INOCENCIO PEDROSA vs. KAISER FOUNDATION HEALTH PLAN

This case concerns a workers' compensation claim where the applicant alleged injury to his right ankle and cervical spine from operating a pallet jack. The defendant disputed the injury AOE/COE, primarily citing surveillance footage and alleged inconsistencies in applicant's testimony. The WCJ found injury AOE/COE based on Dr. Sadler's report, which interpreted the surveillance video as confirming applicant's head hitting a wall, despite the WCJ finding Dr. Sadler's report not substantial due to his failure to consider prior injuries. The Appeals Board granted reconsideration, rescinded the WCJ's decision, and returned the matter for further development of the record, finding no substantial evidence to support the injury finding. Additionally, defense counsel was admonished for improperly submitting extraneous documents with the Petition for Reconsideration.

AOE/COEPetition for ReconsiderationWCJsubstantial evidencecredible witnesssurveillance footagedeposition testimonyprimary treating physicianpanel qualified medical examinersupplemental report
References
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