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

Case No. ADJ7946529
Regular
May 15, 2012

FELICIANO ESPINOZA vs. INTERGEM, ARGONAUT INSURANCE COMPANY

The Appeals Board granted reconsideration because the initial award of temporary disability was based on a chiropractor's report deemed not substantial evidence, due to unclear examination methods including a potential phone-only consultation. The Board found this evidence insufficient to support the temporary disability period awarded. Consequently, the Board rescinded the prior award and returned the case to the WCJ to further develop the medical record. This includes potentially obtaining supplemental reports or deposing the agreed medical examiner regarding the applicant's period of total temporary disability.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardTemporary DisabilityIndustrial InjurySubstantial EvidenceMedical OpinionFurther Development of RecordWCJEdward Komberg D.C.
References
Case No. ADJ11428234
Regular
Oct 17, 2025

RAMON COLLADO vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, CENTINELA STATE PRISON

The Workers' Compensation Appeals Board granted reconsideration to study the factual and legal issues in Ramon Collado's case against the California Department of Corrections and Centinela State Prison. Collado sought reconsideration of a WCJ's Findings and Order from July 28, 2021, which concluded he failed to prove an industrially caused heart/hypertension injury between December 20, 2012, and August 14, 2018. The Board found the Qualified Medical Evaluator's opinion on whether Collado's condition was an aggravation or mere exacerbation of prior injuries was unclear and contradictory, failing to constitute substantial medical evidence. Consequently, the Board rescinded the WCJ's decision and returned the matter to the trial level for further proceedings, including the development of the medical record and a determination on the applicability of Labor Code section 3212 presumptions.

Workers Compensation Appeals BoardRamon ColladoCalifornia Department of CorrectionsCentinela State PrisonState Compensation Insurance FundOpinion and Decision After ReconsiderationFindings and Orderworkers' compensation administrative law judgeindustrially caused injuryexacerbation
References
Case No. ADJ1455856
Regular
Aug 24, 2012

GUILLERMO HERNANDEZ vs. SPIESS CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of a finding of 79% permanent disability. The Board found the applicant's vocational expert's opinions regarding diminished future earning capacity unsubstantiated. Consequently, the Board amended the award to reflect 37% permanent disability based on a prior stipulation, and removed any apportionment to non-industrial factors due to lack of substantial medical evidence from the defendant.

WCABSpiess ConstructionState Compensation Insurance FundGuillermo HernandezADJ1455856GRO 0032468ReconsiderationPermanent DisabilityDiminished Future Earning CapacityDFEC
References
Case No. ADJ9431348 ADJ9439654
Regular
May 13, 2015

BLADIMIRO MEJIA JUAREZ vs. CAVALIER LANDSCAPE & DESIGN, FLORISTS' MUTUAL INSURANCE COMPANY D/B/A HORTICA

The Workers' Compensation Appeals Board granted applicant's petition for reconsideration, rescinding its prior order that dismissed the applicant's petition as untimely. The Board found the applicant's initial petition for reconsideration was timely filed. However, upon reviewing the merits, the Board affirmed the original decision denying the applicant's claim, finding the applicant lacked credibility and the medical reports were not substantial evidence due to reliance on the applicant's self-reporting and lack of objective findings.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and AwardWCJsubstantial evidencemedical causationcredibilitytimelinessLabor CodeGarza v. Workers' Comp. Appeals Bd.
References
Case No. ADJ6408456
Regular
May 17, 2010

KENNETH M. HOOVER vs. CITY OF POMONA

The Appeals Board granted reconsideration of the WCJ's award of 100% permanent total disability. The Board found that the WCJ's decision was not supported by substantial evidence, primarily due to deficiencies in Dr. Grodan's medical reporting regarding the applicant's skin and cardiovascular conditions. The matter was returned to the trial level for further development of the record and a new decision. The Board confirmed the application of the 1997 Permanent Disability Rating Schedule and the admission of Dr. Shirman's report.

WORKERS' COMPENSATION APPEALS BOARDADJ6408456KENNETH M. HOOVERCITY OF POMONAreconsiderationFindings and Award and Orderworkers' compensation administrative law judgeWCJMay 172010
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
Case No. ADJ4653074 (BAK 0152415)
Regular
Oct 11, 2013

ROBERT HUFF vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to review the administrative law judge's decision regarding applicant Robert Huff's workers' compensation claim against the California Department of Corrections. The Board amended the findings to deny temporary total disability benefits for the period December 9, 2009, to March 7, 2011, as the applicant had exhausted his 104-week limit. The Board also deferred the issues of permanent disability and attorney's fees, remanding the matter for a new rating based on the orthopedic Agreed Medical Evaluator's March 5, 2012 report, while affirming the rejection of the psychiatric AME's apportionment. Finally, the Board corrected a clerical error regarding the weekly rate for permanent disability benefits.

WORKERS' COMPENSATION APPEALS BOARDROBERT HUFFCALIFORNIA DEPARTMENT OF CORRECTIONSPermissibly UninsuredSTATE COMPENSATION INSURANCE FUNDOpinion and Decision After ReconsiderationFindings of Fact Award and OpinionWCJAgreed Medical EvaluatorsAME
References
Case No. GOL 0088273
Regular
Aug 18, 2008

ROBERT SIEBURG vs. RONALD WOLFE & ASSOCIATES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the original award, and returned the case for further development of the record. The Board found the findings of the administrative law judge regarding $97\%$ permanent disability and apportionment were not supported by substantial medical evidence. Specifically, the opinion of Dr. Kahmann was deemed deficient due to internal inconsistencies, lack of explanation for apportionment, and undefined work restrictions. The Board also found Dr. Basham's report did not meet the standard for substantial medical evidence regarding cognitive dysfunction.

WORKERS' COMPENSATION APPEALS BOARDROBERT SIEBURGRONALD WOLFE & ASSOCIATESSTATE COMPENSATION INSURANCE FUNDGOL 0088273OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONFindings and AwardWCJmaintenance person
References
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