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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. ADJ2073428 (VNO 0465400) ADJ1610465 (VNO 0540972) ADJ3247765 (VNO 00384869)
Regular
Apr 04, 2011

JAY ZAVERI vs. STATE COMPENSATION INSURANCE FUND; Legally Uninsured

The applicant sought reconsideration of a workers' compensation award, arguing for a 100% permanent disability rating and challenging the permanent disability start date used for attorney fee commutation. The Appeals Board denied the petition, finding insufficient evidence to establish total permanent disability, as the applicant was currently employed and medical opinions did not definitively support such a rating. The Board also ruled that the applicant waived arguments regarding the rating of specific injuries by failing to properly object, and that even if considered, separate ratings for back, knee, and plantar fasciitis conditions would not result in a higher award due to fibromyalgia being the primary cause and rating higher. Finally, the Board clarified that the July 2, 2000 date was only relevant to the attorney fee commutation calculation and not to the determination of permanent disability indemnity payments.

WCABPetition for ReconsiderationJoint Findings and AwardWorkers' Compensation Judge (WCJ)Industrial InjuryBack InjuryHip InjuryBilateral Knee InjuryBilateral Foot InjuryBilateral Plantar Fasciitis
References
Case No. ADJ10079944
Regular
Feb 26, 2019

Robert Fndkyan vs. Opus One Labs, Employers Compensation Insurance Company

This case concerns an applicant's entitlement to a Supplemental Job Displacement Voucher (SJDV). The original decision denied the SJDV due to the absence of a specific Physician's Return-to-Work form. However, the Appeals Board granted reconsideration, finding that the employer was sufficiently informed of the applicant's permanent disability status and work restrictions through a Qualified Medical Evaluator's report. Therefore, the Board determined that the applicant substantially complied with the requirements and is entitled to the SJDV, prioritizing substance over strict adherence to a particular form.

Supplemental Job Displacement VoucherPhysician's Return-To-Work and Voucher formQualified Medical Evaluation ReportLabor Code section 4658.7(b)permanent and stationary statuspermanent partial disabilityvocational statuswork capacitysubstantial complianceform over substance
References
Case No. ADJ8128282
Regular
Jan 23, 2014

ANGELA EGBIKUADJE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings. The defendant, California Department of Corrections and Rehabilitation, argued that the applicant's psychiatric injury claim was preempted by the ADA and not proven under Labor Code section 3208.3. The Board found the original decision lacked proper analysis regarding predominant industrial causation and the good faith personnel action defense. Therefore, the case was remanded for further development of the record, including expert medical opinion on these issues.

Workers' Compensation Appeals BoardAngela EgbikuadjeCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8128282Van Nuys District OfficeReconsiderationFindings and AwardIndustrial cumulative trauma injury
References
Case No. ADJ6784736
Regular
May 24, 2010

CYNTHIA ARMANDO vs. ENDODONTIC ASSOCIATES CORP., TRUCK INSURANCE EXCHANGE

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration of an order compelling production of claims file documents. However, the Board granted removal, rescinded the original order, and issued a new order. The new order requires the defendant to produce non-privileged portions of the claims file and witness statements, and to describe any privileged documents separately. The Board also clarified that statutory privilege provisions, including attorney work product, are applicable in workers' compensation proceedings.

Petition for RemovalPetition for ReconsiderationClaims Investigation FileAttorney Workproduct PrivilegeWitness StatementsInterim OrderSignificant PrejudiceIrreparable HarmAbsolute Work ProductQualified Work Product
References
Case No. ADJ9123534
Regular
Jul 18, 2015

PHILLIP WARD vs. CITY OF FORT BRAGG, REDWOOD EMPIRE MUNICIPAL INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and amended an award, finding the defendant liable for a 15% increase in permanent disability benefits. This increase is due to the defendant's failure to offer the applicant qualified work within 60 days of his permanent and stationary status, as required by Labor Code section 4658(d)(2). While the applicant had retired, the Board found this did not excuse the employer from making a compliant work offer. The amended order clarifies the increase applies only to payments made 60 days after the Qualified Medical Evaluator's permanent and stationary report.

Labor Code section 4658(d)(2)permanent disability increaseoffer of workmodified workalternative workregular workpermanent and stationary60-day periodretirementCalPERS
References
Case No. ADJ9426494
Regular
Jun 10, 2015

BARBARA SWENSON vs. COMPASS HEALTH, MURPHY AND BEANE, INC.

In this Workers' Compensation Appeals Board case, the applicant sought interview transcripts and statements of defense witnesses. The judge initially ordered the defendant to produce all such materials. The defendant petitioned for removal, arguing the order was overbroad and violated due process by failing to account for work product and attorney-client privilege. The Appeals Board granted the petition for removal, amending the original order. The amended order requires the defendant to provide requested materials, excluding those protected by privilege, for which a privilege log must be filed.

Petition for RemovalInterview TranscriptsWitness StatementsWork ProductAttorney-Client PrivilegePrivilege LogDue ProcessOverbroad OrderAppeals BoardWCJ
References
Case No. VNO 523244
Regular
Aug 04, 2008

ANGIE JAUREGUI vs. MERCY SOUTHWEST HOSPITAL

This case involves an employer seeking reconsideration of a workers' compensation award for an injured nurse. The employer argued their modified work offer should have reduced the permanent disability award, but the Board denied reconsideration. The Board determined the employer's work offer was not a bona fide modified work offer, and thus did not qualify for the statutory reduction.

Permanent and stationaryMedical-legal reportWork restrictionsModified workAlternative workLabor Code Section 4658(d)Permanent disability awardPetition for reconsiderationFindings and AwardWCJ
References
Case No. ADJ12394877
Regular
Dec 14, 2020

SABINA RAMOS vs. GLOBAL FOOD SERVICES, FEDERAL INSURANCE

The applicant was injured and subsequently offered modified work within her restrictions, which she initially performed. However, the applicant then abandoned her employment after suitable modified work was provided by the employer. The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the finding that she was not entitled to temporary disability indemnity due to job abandonment. This denial is based on legal precedent that an employee may be estopped from claiming temporary disability for periods where they refuse or abandon suitable modified work without good cause.

Modified workAbandonment of workTemporary disability indemnityPetition for reconsiderationCredibility determinationsPrimary treating physicianWork restrictionsLabor Code section 4062EstoppelOdd lot doctrine
References
Case No. ADJ6925034
Regular
May 12, 2011

FRANCIS LARA vs. BIMBO BAKERIES USA, ACE AMERICAN INSURANCE COMPANY

The defendant, Bimbo Bakeries USA, sought reconsideration of an award increasing permanent disability payments by 15%, arguing they were entitled to a 15% decrease. This was based on their claim of offering the injured employee, Francis Lara, regular work. However, the Workers' Compensation Appeals Board denied the petition because the defendant's offer of work was fatally flawed, being incomplete, unsigned, and not clearly tied to the employee's specific work restrictions at the time. The Board also noted the offer was made before the employee was declared permanent and stationary, further undermining its validity under Labor Code section 4658(d)(3)(A).

Labor Code section 4658(d)(2)Labor Code section 4658(d)(3)(A)Permanent and Stationary (P&S) reportPetition for ReconsiderationFindings and Awardindustrial injuryright lower extremitypermanent disabilitymodified workalternative work
References
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