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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. ADJ7948651
Regular
May 09, 2016

Barbara Tom vs. CITY OF OAKLAND, JT2 INTEGRATED

This case involves a petition for reconsideration by the defendant, City of Oakland, following an award of permanent disability to applicant Barbara Tom. The defendant argued the Workers' Compensation Judge (WCJ) erred by not deferring to the Agreed Medical Evaluator's (AME) opinion and by not developing the record with the AME. The WCAB denied reconsideration, adopting the WCJ's report which found the AME's opinion deficient. The WCJ's report detailed how the primary treating physician's report was more persuasive and thoroughly reasoned, supporting the WCJ's findings over the AME's.

Workers' Compensation Appeals BoardPetition for ReconsiderationAgreed Medical Evaluator (AME)Primary Treating Physician (PTP)AMA GuidesPermanent Disability RatingCarpal Tunnel SyndromeSubstantial EvidenceWCJ OpinionMedical Opinion Deference
References
Case No. GOL 96757
Regular
Jun 10, 2008

SA YANG LO vs. CUSTOM SENSORS & TECHNOLOGIES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a prior award, upholding the application of the 2005 Permanent Disability Rating Schedule. The Board found that exceptions allowing for the 1997 Schedule did not apply, as the applicant's temporary disability indemnity extended beyond January 1, 2005, and no qualifying pre-2005 reports indicated permanent disability. Furthermore, the Board found the applicant's vocational expert's opinion regarding diminished future earning capacity unpersuasive, thus affirming the initial 9% permanent disability rating.

Workers' Compensation Appeals BoardSA Yang LoCustom Sensors & TechnologiesInc.State Compensation Insurance FundGOL 96757Opinion and Order Denying ReconsiderationFindings and AwardWorkers' Compensation Administrative Law JudgeWCJ
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. ADJ8657415
Regular
Oct 06, 2017

Oliver Boutte IV (Deceased) vs. U.S. XPRESS ENTERPRISES, LIBERTY MUTUAL INSURANCE COMPANY

This Workers' Compensation Appeals Board case involved a petition for reconsideration filed by U.S. Xpress Enterprises and Liberty Mutual Insurance Company. The defendants argued that the medical report relied upon by the Workers' Compensation Judge (WCJ) was not substantial evidence, specifically regarding the timing of the employee's death from a pulmonary embolus. The Board denied the petition, adopting the WCJ's report which found the physician's opinion to be substantial medical evidence based on adequate examination and reasoning. The Board concluded the WCJ properly found this opinion more persuasive than the opposing medical opinion.

Oliver Boutte IVU.S. Xpress EnterprisesLiberty Mutual Insurance CompanyADJ8657415Petition for ReconsiderationWorkers' Compensation Appeals Boardsubstantial evidencemedical opinionpulmonary embolusreasonable medical probability
References
Case No. ADJ9810030 ADJ9810028
Regular
Feb 01, 2019

ESTEBAN HERNANDEZ, vs. BIDART BROTHERS; ZENITH INSURANCE COMPANY,

The Workers' Compensation Appeals Board (WCAB) denied Esteban Hernandez's petition for reconsideration. The WCAB adopted and incorporated the report and opinion of the workers' compensation administrative law judge (WCJ). Therefore, the WCJ's original decision, whatever it was, remains in effect.

WORKERS' COMPENSATION APPEALS BOARDPETITION FOR RECONSIDERATIONDENYING RECONSIDERATIONWCJ REPORTWCJ OPINIONESTEBAN HERNANDEZBIDART BROTHERSZENITH INSURANCE COMPANYADJ9810030ADJ9810028
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ9744877
Regular
Sep 13, 2019

DALJEET HEERA vs. BANK OF AMERICA, CORVEL CORPORATION

Here's a summary of the case for a lawyer: The Workers' Compensation Appeals Board denied reconsideration of an applicant's claim for industrial injury to her right shoulder, left shoulder, and cervical spine. The Board affirmed the Workers' Compensation Judge's (WCJ) credibility determination, finding it supported by substantial evidence, and gave it great weight. The WCJ's report, adopted by the Board, found that the applicant's treating physicians' opinions constituted substantial evidence, outweighing the defense medical evaluator's conflicting conclusions. The Board emphasized that a single physician's opinion can be sufficient if it is well-reasoned and consistent with the record, even if other opinions differ.

Petition for ReconsiderationWCJ credibility determinationsubstantial evidencemedical opinionsapplicantdefendantindustrial injuryright shoulderleft shouldercervical spine
References
Case No. ADJ8067157
Regular
Nov 30, 2012

MARISOL PERALTA vs. FROZEN YOGURT OF VALLEY VILLAGE, INC., STAR INSURANCE CO.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to further develop the record regarding applicant Marisol Peralta's alleged industrial injury. The WCAB rescinded the prior decision finding an injury, citing that the medical opinions were not substantial evidence as they lacked definitive causation findings and weren't based on complete medical histories. Crucially, neither physician reviewed applicant's full medical records, and one deferred causation due to pregnancy while the other awaited X-ray results. The case is returned to the trial level for further proceedings and a new decision by the WCJ.

Workers' Compensation Appeals BoardMarisol PeraltaFrozen Yogurt of Valley VillageInc.Star Insurance Co.Illinois Midwest Insurance AgencyLLCADJ8067157Opinion and Order Granting ReconsiderationDecision After Reconsideration
References
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