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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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. ADJ599176 (SAC 0333692) ADJ2396484 (RDG 0122019) ADJ7950339
Regular
Mar 21, 2017

Fernando Muniz Villalpando vs. Doherty Brothers, Martin Dusters, State Compensation Insurance Fund

This case involves an applicant seeking to self-administer his Medical Set-Aside Account (MSA) after previously agreeing to third-party administration by Bridge Pointe/NuQuest. The Appeals Board granted reconsideration, rescinded the prior order, and returned the matter to the trial level. The Board found that the trial judge needs to review the original agreement to determine if it allows for a change of administration or if applicant has contractual rights to pursue this. Further proceedings will assess applicant's competency for self-administration and any opposition from the defendant.

Medical Set-Aside AccountMSAPetition for ReconsiderationJoint Findings and OrderMedical Set-Aside Account administrationself-administrationBridge PointeNuQuestState Compensation Insurance FundCompromise and Release Agreement
References
Case No. OAK 273736, OAK 284934, OAK 331633
Regular
Apr 04, 2008

PAULETTE JOHNSON vs. SAY AREA RAPID TRANSIT

The Workers' Compensation Appeals Board denied BART's Petition for Reconsideration, upholding the finding that BART violated Labor Code Section 132a. The Appeals Board adopted the Administrative Law Judge's report, which determined BART unlawfully placed the applicant on administrative leave due to her assertion of legal rights in her workers' compensation case, not due to legitimate business necessity or medical restrictions. Specifically, BART waited over a year after an agreed medical examiner noted the applicant's inability to climb before placing her on leave, despite no medical opinion prior to the favorable award indicating she could not perform her usual duties.

Workers' Compensation Appeals BoardLabor Code Section 132aAdministrative LeaveAgreed Medical ExaminerPetition for ReconsiderationFindings and AwardTrain OperatorCumulative TraumaLumbar SpineCervical Spine
References
Case No. ADJ8961636, ADJ8961637, ADJ8961639
Regular
Mar 21, 2016

ROBERT ORTEGA vs. CITY OF GUADALUPE, YORK RISK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant sought credit for paid administrative leave (ADL) against temporary disability benefits, arguing the applicant was temporarily totally disabled. However, the Board found that ADL constitutes earned wages, not disability payments, as the applicant was essentially working. Since the defendant failed to prove the applicant was medically unable to work during the ADL period, they could not convert those wages into a credit for disability payments.

Workers Compensation Appeals BoardPaid Administrative LeaveTemporary DisabilityCreditAgreed Medical EvaluatorLabor Code Section 4657Police OfficerIndustrial InjuryBurden of ProofPetition for Reconsideration
References
Case No. ADJ10296423
Regular
Jan 30, 2020

SEYED NAVID MOUSAVIRAD vs. LAFAYETTE PARK HOTEL AND SPA, LIBERTY MUTUAL

The Workers' Compensation Appeals Board affirmed the original decision finding no violation of Labor Code section 132a. The applicant failed to establish a prima facie case of discrimination because there was no evidence the employer knew about a work-related injury or the intent to file a claim. The applicant was on medical leave for an unrelated condition and terminated after exhausting that leave. The Board clarified that the applicant takes nothing on his claim, rather than it being dismissed on procedural grounds.

Labor Code section 132adiscriminationretaliationworkers' compensation claimprima facie caselegal rightemployer dutyindustrial injuryadverse consequencesmedical leave
References
Case No. ADJ1409625 (LBO 0360295) ADJ1382588 (MON 0239533)
Regular
Apr 16, 2015

MELBOURNE BARDOWELL vs. GI TRUCKING COMPANY, GALLAGHER BASSETT SERVICES, ATHENS ADMINISTRATORS

The Workers' Compensation Appeals Board granted reconsideration to clarify the applicant's date of injury for cumulative trauma. The original award found industrial injury to the neck and low back for a trailer mechanic but did not address liability division between two third-party administrators, Athens Administrators and Gallagher Bassett Services. The Board deferred the issue of the period of injurious exposure to the Workers' Compensation Judge. The matter is returned to the WCJ for further proceedings and a new decision on this specific issue.

Petition for ReconsiderationDivision of LiabilityPeriod of Injurious ExposureLabor Code sections 54125500.5Cumulative TraumaDate of InjuryTrailer MechanicPermissibly Self-InsuredThird-Party Administrator
References
Case No. ADJ8509270
Regular
Oct 30, 2015

JAMES HORICK vs. JOHN T. MALLOY, INC., AIG

The Workers' Compensation Appeals Board (WCAB) denied reconsideration of a prior ruling that allowed an injured worker to pursue an Independent Medical Review (IMR). The Administrative Director (AD) had initially denied the IMR request because the injured worker did not personally sign the application, despite their attorney signing it and providing notice of representation. The WCAB found that an attorney, representing an injured worker, is authorized to sign an IMR request as a procedural matter, binding the client. Therefore, the AD's denial was in error, and the matter was properly remanded for IMR.

Independent Medical ReviewPetition for ReconsiderationAdministrative DirectorWorkers' Compensation Appeals BoardFindings and OrderUtilization ReviewLabor Code 4610.5Administrative Rule 9792.10.1Attorney representationMedical authorization
References
Case No. ADJ3715225 (SBE 0341276)
Regular
Dec 08, 2008

MICHAEL COYER vs. COUNTY OF SAN BERNARDINO

Applicant's injury claim denied; while on administrative leave, his injury from a fall off his own roof while repairing storm damage did not arise out of his employment.

Workers' Compensation Appeals Boardfirefighteradministrative leaveindustrial injuryback and spinal cordstorm damageroof repairLabor Code section 3600.4preservation of propertymandatory settlement conference
References
Case No. ADJ4199705
Regular
Oct 28, 2010

JUAN BURCIAGA vs. CONCO COMPANIES, ATHENS ADMINISTRATORS

The Workers' Compensation Appeals Board (WCAB) denied Juan Burciaga's Petition for Reconsideration and Removal. The WCAB adopted the findings and recommendations of the administrative law judge's report in its entirety. Additionally, the WCAB admonished the petitioner for violating WCAB Rule 10842 by attaching irrelevant or already submitted evidence, warning of potential sanctions. This denial means the prior decision in the case remains in effect.

Petition for ReconsiderationRemovalWCAB Rule 10842SanctionsLabor Code Section 5813Administrative Law JudgeWorkers' Compensation Appeals BoardConco CompaniesAthens AdministratorsJuan Burciaga
References
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