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

Case No. ADJ7348149
Regular
Mar 18, 2019

CELINE ROUYA vs. SAVE MART SUPERMARKETS, CORVEL CORPORATION

The applicant appeals the WCJ's decision denying injury to psyche and other body parts, arguing the WCJ erred by not addressing her harassment claim and finding the personnel actions were in good faith. The Appeals Board granted reconsideration to further study the issues, noting discrepancies in witness testimony and insufficient medical opinions on causation. The case is returned to the WCJ for further proceedings to develop the record, including obtaining clarified medical opinions on causation and further testimony. The dissenting commissioner would affirm the WCJ's decision, finding the personnel actions were legal and non-discriminatory, and applicant's harassment claims were not supported by objective evidence.

Workers' Compensation Appeals BoardCeline RouyaSave Mart SupermarketsCorvel CorporationADJ7348149ReconsiderationPsychiatric InjuryPharmacy TechnicianHarassmentNational Origin
References
5
Case No. ADJ3844537 (ANA 0379640)
Regular
Apr 21, 2016

RAUL MERCADO CHAVEZ vs. PC INDUSTRIES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board rescinded the WCJ's decision and returned the case for further proceedings. The Board found the WCJ's decision was procedurally flawed for failing to resolve all issues and substantively deficient because the finding of 100% permanent disability was not supported by substantial evidence. Specifically, the vocational expert's opinion was found unreliable as it did not adequately consider the AMEs' medical restrictions. The Board ordered updated medical opinions and further development of the record before a new decision is rendered.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityVocational RehabilitationSubstantial EvidenceBifurcated DecisionDue ProcessLabor CodeMedical OpinionsApportionment
References
8
Case No. ADJ2530222 (MON 0304365)
Regular
Jun 06, 2013

DIANE DAVIS vs. LOS ANGELES COUNTY METROPOLITAN TRANSPORTATION AUTHORITY, TRAVELERS INDEMNITY COMPANY

The Workers' Compensation Appeals Board (WCAB) rescinded a WCJ's decision awarding applicant 58% permanent disability for injuries to her wrists and psyche. The WCAB found that the WCJ's decision lacked substantial evidence because the medical opinions on apportionment and permanent disability were insufficient, particularly Dr. Gilberg's unclear apportionment and the failure to consider Drs. Richman and Furst's opinions. The case is returned to the trial level for further proceedings to obtain clearer medical evidence and address specific contentions from the Subsequent Injuries Benefits Fund regarding apportionment and overall permanent disability.

Subsequent Injuries Benefits Trust FundPermanent Total DisabilityApportionmentCumulative TraumaCognitive DisorderPseudo-dementiaChronic Pain SyndromeNeuropathic Pain SyndromeSubstantial EvidenceMedical Probability
References
8
Case No. ADJ2887862
Regular
Nov 22, 2010

MARIA MEZQUITE vs. AMPCO SYSTEM PARKING, ESIS CHATWORTH

This case involves lien claimants challenging a WCJ's decision denying their claims for medical treatment. The WCJ found most bills inadmissible, citing an agreed medical examiner's opinion that the treatment was unnecessary, and noted that some lien claimants did not even file liens. The Appeals Board granted reconsideration but ultimately affirmed the WCJ's original decision. The Board adopted the WCJ's reasoning and found no error in the exclusion of the medical bills.

Workers' Compensation Appeals Boardreconsiderationlien claimantsFindings and Orderadministrative law judgeburden of proofinadmissible billsAgreed Medical ExaminerMPN regulationsusual and customary fees
References
1
Case No. ADJ10749554
Regular
Nov 06, 2018

APRIL SIMMONS COOK vs. DESERT OASIS HEALTHCARE, GALLAGHER BASSETT SERVICES, INC.

This case involves a dispute over whether defendant's communication with a Qualified Medical Evaluator (QME) violated Labor Code section 4062.3. The Workers' Compensation Appeals Board (WCAB) granted reconsideration and removal, rescinding the original Findings and Award. The WCAB will return the matter to the trial level for further proceedings and a new decision by the WCJ. This action is taken to align the decision with the recent en banc opinion in *Suon v. California Dairies* regarding violations of section 4062.3.

Workers' Compensation Appeals BoardPetition for RemovalEx Parte CommunicationLabor Code Section 4062.3Qualified Medical EvaluatorAttorney's FeesFindings and AwardEn Banc DecisionSuon v. California DairiesRescinded
References
1
Case No. ADJ2765298 (RIV 0026091)
Regular
Aug 13, 2010

PETE SORIA vs. FLEETWOOD ALUMINUM PRODUCTS, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For RELIANCE INSURANCE, In Liquidation

The WCAB granted reconsideration and rescinded a WCJ's order awarding costs to lien claimants. The WCJ's original order lacked a proper evidentiary hearing, a summary of evidence, and an opinion explaining the grounds for the decision, violating due process and Board rules. The Board found the WCJ's subsequent attempt to rescind the order was untimely. The case is returned to the trial level for further proceedings, including an evidentiary hearing and a properly documented decision.

ADJ2765298RIV 0026091ReconsiderationLien ConferenceWCJ OrderStipulated AwardPermanent Total DisabilityRemovalRescinding OrderEvidentiary Hearing
References
1
Case No. ADJ3107843 (MON 0208626)
Regular
Oct 05, 2009

CHRIS DERBOGHOSSIAN vs. ALL TUNE & LUBE, ERIE INSURANCE COMPANY, CRAWFORD & COMPANY

The Board affirmed the WCJ's decision except for the attorney's fees award for the applicant's wife deposition; the contempt order was rescinded as the WCJ lacked authority to address indirect contempt.

WCABremovalreconsiderationdisqualificationcontemptindirect contemptLabor Code section 5814transportation expenseattorney feesmedical treatment
References
11
Case No. ADJ6929350, ADJ7133107, ADJ8881791
Regular
Aug 16, 2019

TIMOTHY RODRIGUEZ vs. DEPARTMENT OF CORRECTIONS, CALIFORNIA MEN'S COLONY, STATE COMPENSATION INSURANCE FUND

The Appeals Board rescinded the WCJ's decision, finding legal error in requiring proof of conspiracy for workers' compensation claims. The WCJ incorrectly applied the burden of proof and failed to adequately consider medical opinions regarding applicant's claims of physical and psychiatric injuries. The case is remanded for further proceedings and a new decision, requiring the WCJ to analyze each claimed injury and body part separately under the correct burden of proof and to further develop the medical record as necessary.

AOE-COEAgreed Medical Evaluatorhostile work environmentconspiracy theoryburden of proofpreponderance of the evidencespecific injurycumulative traumapsychiatric injurygood faith personnel action
References
11
Case No. ADJ10282606, ADJ10283736
Regular
Feb 06, 2019

DARLENE BATTLE vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and rescinded the WCJ's previous findings and awards in both consolidated cases, ADJ10282606 and ADJ10283736. The primary issue concerned the determination of permanent disability for the applicant's right knee injury, specifically whether the medical opinion of Dr. Glousman was substantial evidence. The Board found Dr. Glousman's report lacked sufficient explanation for his impairment ratings according to AMA Guides, and the WCJ improperly supplemented this opinion. Consequently, the matter was returned to the trial level for further proceedings and new decisions by the WCJ.

Workers' Compensation Appeals BoardPermanent DisabilityAMA GuidesQualified Medical EvaluatorSubstantial EvidenceApportionmentReconsiderationFindings and AwardMedical OpinionCorrectional Officer
References
7
Case No. VNO 400907, VNO 400906
Regular
Jan 24, 2008

JORGE ESCOBEDO vs. WESTLAKE INN RESTAURANT & HOTEL, CALIFORNIA INDEMNITY INSURANCE COMPANY, SIERRA INSURANCE GROUP

This Workers' Compensation Appeals Board case involves applicant Jorge Escobedo seeking benefits for injuries presumed compensable under Labor Code section 5402. The Appeals Board affirmed the Administrative Law Judge's (WCJ) decision, finding that the defendant failed to rebut the presumption of injury and that applicant's injuries did not require further medical treatment or result in temporary disability, largely based on the WCJ's adverse credibility finding. A dissenting opinion argued that the WCJ's findings on no treatment or disability improperly abrogated the 5402 presumption and suggested appointing a "regular physician" to resolve conflicting medical opinions.

ReconsiderationRebuttable presumptionCompensabilityLabor Code 5402Medical treatmentTemporary disabilityPermanent disabilityApportionmentAttorney's feesSubstantial evidence
References
4
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