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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ1950726 (MON 0361748), ADJ6963803, ADJ7198723
Regular
Mar 20, 2012

DANA BURREL vs. LONG BEACH UNIFIED SCHOOL DISTRICT, TRISTAR RISK MANAGEMENT

In three workers' compensation cases, the applicant sustained industrial injuries to her upper extremities on May 21, 2006, March 11, 2008, and July 28, 2008. The Appeals Board granted reconsideration to review the application of Labor Code section 4658(d)(2), which mandates a 15% increase in permanent disability payments when an employer fails to offer suitable work within 60 days of an injury becoming permanent and stationary. The employer stipulated to providing some medical treatment and returning the applicant to work, but failed to offer regular, modified, or alternative work for 12 months post-injury. The Board found the employer's contention of denial unsubstantiated by evidence and, following *Bontempo v. Workers' Comp. Appeals Bd.*, ruled that the 15% increase applies to all three cases.

Labor Code section 4658(d)(2)permanent disability increaseindustrial injuryright upper extremityright handright wristright shoulderright armleft wristleft hand
References
Case No. ADJ19527341
Regular
May 05, 2025

MARIA RAMIREZ vs. ROMAN CATHOLIC BISHOP OF MONTEREY, CALIFORNIA

Applicant Maria Ramirez sought reconsideration of a workers' compensation administrative law judge's order, which found no industrial injury. The Appeals Board granted reconsideration, rescinded the WCJ's decision, and returned the matter to the trial level for further proceedings. The Board determined that the WCJ's credibility finding, based on the delayed worsening of symptoms, required expert medical opinion to ascertain consistency with the claimed injury mechanism, thus necessitating further development of the medical and factual record.

ADJ19527341Petition for ReconsiderationFindings and OrderIndustrial InjuryRight Arm InjuryRight Wrist InjuryRight Hip InjuryRight Leg InjuryRight Foot InjuryWCJ Credibility Determination
References
Case No. ADJ1498961
Regular
Sep 23, 2010

DALE ARNOLD vs. RALPH'S AKA KROGER

This case involves an applicant's claim for workers' compensation benefits for a right shoulder injury. While the initial award recognized industrial injury to the applicant's left shoulder, right elbow, and right forearm, the defendant sought reconsideration, arguing the right shoulder injury was not work-related. The Appeals Board granted reconsideration, finding the applicant failed to meet the burden of proof for the right shoulder injury. They disagreed with the primary treating physician's opinion and found the agreed medical evaluator's opinion more persuasive, ultimately reversing the finding for the right shoulder.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardCumulative TraumaIndustrial InjuryLeft ShoulderRight ElbowRight ForearmRight ShoulderPrimary Treating Physician
References
Case No. ADJ9210498
Regular
Apr 04, 2017

ELEANOR DEFRANCO vs. MONTEREY FISH COMPANY, ENSTAR (US) INC., dba ENSTAR ADMINISTRATORS FOR SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior award that found industrial injury to applicant's right ankle, right shoulder, and back, but not her right knee. The WCAB rescinded the finding of industrial injury to the back, while otherwise affirming the prior decision. Specifically, the WCAB affirmed the finding that the applicant sustained industrial injury to her right ankle and right shoulder, and that medical treatment for her right knee is compensable to relieve the effects of the industrial injuries. The WCAB adopted the WCJ's reasoning for these decisions, including the application of the *Braewood* principle for treating the non-industrial knee condition.

Workers' Compensation Appeals BoardEleanor DefrancoMonterey Fish CompanyEnstarSeabright Insurance CompanyIndustrial InjuryRight AnkleRight ShoulderRight KneeBack Injury
References
Case No. ADJ3947517
Regular
Sep 30, 2009

RUDY GONZALES vs. CELITE CORPORATION, NATIONAL UNION FIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) denied the applicant's petition for reconsideration, upholding the prior ruling that his claim for retroactive vocational rehabilitation maintenance allowance (VRMA) was terminated by the repeal of Labor Code section 139.5 on January 1, 2009. The WCAB granted the defendant's petition, vacating the Rehabilitation Unit's order awarding VRMA because the applicant's right to benefits had not vested in a final order before the effective date of the repeal. The Board clarified that a determination of Qualified Injured Worker status does not constitute a final award of VRMA, and jurisdiction over such claims cannot be conferred by waiver. Therefore, the applicant is not entitled to any further vocational rehabilitation benefits.

Labor Code section 139.5vocational rehabilitationVRMAQIWvested rightinchoate rightfinal orderrepealjurisdictionreconsideration
References
Case No. ADJ7762783 ADJ7752630
Regular
Dec 15, 2018

JAMES MATLOCK vs. STATE OF CALIFORNIA, DEPARTMENT OF TRANSPORTATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The Board affirmed its prior decision that the applicant is permanently and totally disabled due to a July 14, 2004 industrial injury, independent of a subsequent 2005 injury. The defendant's argument that a 100% permanent disability award prevents any further award for shoulder injuries was rejected, as the 2004 award encompassed multiple body regions, not solely the upper extremities. The Board also found no valid waiver of the applicant's right to the 2005 injury award.

Workers' Compensation Appeals Boardpermanent total disabilityindustrial injurylow back injuryneck injuryheadachesleft non-dominant shoulderright dominant shoulderLabor Code section 4664(c)(1)lifetime permanent disability limit
References
Case No. ADJ6581535
Regular
Nov 15, 2017

Angel Mendez vs. Maple Dairy, Zenith Insurance Company

The Workers' Compensation Appeals Board denied Angel Mendez's petition for reconsideration. Mendez sought a finding of $100\%$ permanent disability, arguing total loss of use of his dominant right upper extremity. The Board affirmed the WCJ's prior award of $75\%$ permanent disability, finding no presumption of total disability for the loss of use of only one hand. The evidence did not support a finding of total loss of use of the upper extremity.

Petition for ReconsiderationPermanent Disability ApportionmentVocational EvidenceDominant Upper ExtremityLoss of UsePresumption of Permanent Total DisabilityLabor Code Section 4662(a)(2)Substantial EvidenceLeBoeuf v. Workers' Comp. Appeals Bd.Dairy Worker
References
Case No. ADJ383777
Regular
Apr 04, 2011

Roxanna Ortiz vs. ONE SOURCE, ESIS

The Workers' Compensation Appeals Board denied Roxanna Ortiz's petition for reconsideration of a prior findings and order. The initial ruling determined she sustained industrial injury only to her cervical spine as a janitor, not to other body parts or any resulting temporary/permanent disability or need for further medical treatment. Ortiz argued the judge erred by favoring defense medical reports and discrediting her testimony due to minor inconsistencies in her injury description. The Board adopted the WCJ's report, emphasizing deference to credibility determinations and that admissibility of medical reports should have been challenged at trial, not on reconsideration. A dissenting opinion argued the judge overemphasized minor variations in Ortiz's account and that medical evidence did not sufficiently support denial of other injuries or further treatment.

OrtizOne SourceESISWCABFindings and OrderPetition for ReconsiderationWorkers' Compensation Administrative Law Judgeindustrial injurycervical spineright arm
References
Case No. ADJ7264915
Regular
Jul 15, 2013

ANA GONZALES vs. WAL-MART ASSOCIATES, INC., ACE AMERICAN INSURANCE

This case involves an applicant who sustained industrial psychiatric injury but whose orthopedic claims were denied due to insufficient medical evidence. The Appeals Board denied the applicant's petition for reconsideration, finding the applicant failed to present substantial medical evidence of industrial causation for her orthopedic complaints. A dissenting commissioner argued that the primary medical evaluator's report was deficient and lacked substantial evidence, warranting further development of the record on orthopedic injuries and other claims. The dissent emphasizes the Board's duty to ensure substantial justice, suggesting it should have ordered further investigation on the denied orthopedic issues.

WCABPetition for ReconsiderationFindings and Orderindustrial injurypsychelow backneckright shoulderright wristright elbow
References
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