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

Case No. ADJ8789952
Regular
Nov 16, 2017

LISA STROTHER vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

This case involves Lisa Strother's claim for psychiatric injury due to cumulative trauma as a correctional officer. The Appeals Board granted reconsideration because the Agreed Medical Evaluator's (AME) report lacked specificity regarding the actual employment events causing the psyche injury and failed to properly apportion permanent disability. The Board found the AME's opinion on causation was not adequately detailed to determine if work events were the predominant cause. Therefore, the matter was returned to the trial level for further development of the record on these critical issues.

Workers' Compensation Appeals BoardLisa StrotherState of California Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8789952Fresno District OfficePetition for ReconsiderationFindings of Fact and AwardCorrectional Officer
References
Case No. ADJ117564
Regular
Oct 05, 2012

Catrina Williams vs. Diversified Photo\/Supply, CIGA by its Servicing Facility CAMBRIDGE INTEGRATED, on behalf of FREMONT INSURANCE, in liquidation

The Workers' Compensation Appeals Board affirmed the WCJ's finding of industrial injury to the applicant's neck and bilateral upper extremities, resulting in 55.75% permanent disability. Applicant's contentions regarding apportionment of neck disability to non-industrial causes, injury to shoulders, internal systems, and psychiatric injury were largely rejected based on lack of substantial medical evidence and credibility issues. The case was remanded for further proceedings solely to address a lien claim for attorney fees filed by the applicant's prior attorney, George Slotnick.

CIGAFremont Insuranceliquidiationreconsiderationcumulative traumabilateral upper extremitiesneck injuryapportionmentnon-industrial causesAgreed Medical Examiner
References
Case No. ADJ7927652
Regular
Oct 25, 2016

Bozenna Kasperowicz vs. Metropolitan State Hospital, State Compensation Insurance Fund

This case involves an industrial injury to the applicant, a psychiatric technician, sustained on June 14, 2011, from a patient strike to the head. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address disputes over psychiatric impairment and a sleep disorder rating. The WCAB affirmed the original award but reduced the permanent disability rating from 76% to 70% by excluding the sleep dysfunction impairment. The WCAB found Dr. O'Brien's opinion on psychiatric impairment more persuasive than conflicting medical evaluations and determined Dr. Matos's opinion on sleep impairment lacked substantial medical evidence due to staleness.

WCABReconsiderationPsychiatric ImpairmentWhole Person ImpairmentGAF ScoreSleep DisorderSubstantial Medical EvidencePermanent DisabilityQualified Medical EvaluatorInsomnia
References
Case No. ADJ8829857 ADJ8829856
Regular
Apr 18, 2016

DULCE ESPINOZA vs. JENCO PRODUCTIONS, INC., FIRST NATIONAL INSURANCE COMPANY OF AMERICA

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration because the appealed finding, deferring development of the record on psychiatric injury, was not a final order. The Board then treated the petition as one for removal, granted it, and rescinded the deferral. Ultimately, the Board found that the applicant failed to prove industrial injury to her psyche, citing a lack of objective evidence and inconsistencies in her reporting, as well as a conflicted medical opinion.

WORKERS' COMPENSATION APPEALS BOARDDULCE ESPINOZAJENCO PRODUCTIONSINC.FIRST NATIONAL INSURANCE COMPANY OF AMERICAADJ8829857ADJ8829856Petition for ReconsiderationPetition for RemovalDecision After Removal
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. ADJ2419502 (MON 0329358) ADJ4501373 (MON 0326365)
Regular
Oct 24, 2011

MACK JARAMILLO vs. COCA COLA BOTTLING CO., Permissibly Self-Insured

This case involves a warehouseman seeking workers' compensation for cumulative and specific injuries resulting in severe physical and psychological impairments. The applicant was awarded 100 percent permanent disability, including further medical treatment, for his specific injury. The defendant sought reconsideration, arguing the 100 percent permanent disability rating was improperly calculated by disregarding the AMA Guides' Combined Values Chart. The Appeals Board denied reconsideration, finding the WCJ properly determined the applicant was totally disabled "in accordance with the fact" under Labor Code Section 4662, supported by substantial evidence of total loss of earning capacity.

WCABPetition for ReconsiderationFindings and OrderFindings and Awardstipulationindustrial injurycervical spinelumbar spinepsycheseizure disorder
References
Case No. ADJ6981320
Regular
Jan 29, 2018

DAVID SCHWEIKERT vs. STATE OF CALIFORNIA - CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed a prior award but amended it to find the applicant sustained injury to his head, neck, and left upper extremity, resulting in 72% permanent disability. The Board clarified that the applicant's lumbar spine injury, previously resolved, was not part of this claim. Furthermore, the Board determined that the applicant is not entitled to future psychiatric treatment. The decision also addressed the rating of headaches as a consciousness disorder and the use of pain add-ons, finding the original evaluations appropriate.

Workers' Compensation Appeals BoardState Compensation Insurance FundAgreed Medical ExaminersWhole Person ImpairmentAMA GuidesDRE Cervical Category IICognitive DisorderConsciousness DisorderVestibular DisorderPeripheral Vascular Disease
References
Case No. ADJ4401003 (OXN 0132344) ADJ8597266
Regular
Feb 27, 2014

Richard Hunt vs. CEMEX, AMERICAN INTERNATIONAL GROUP, INC., GALLAGHER BASSETT SERVICES, INC.

The applicant sought reconsideration of a prior award which found industrial injury to his back, neck, knee, shoulder, psyche, and sleep disorder, but only awarded permanent disability for his back injury. The Appeals Board found that the prior award was not supported by substantial evidence regarding psychiatric permanent disability. Consequently, the Board rescinded the award and returned the case to the trial level for further development of the record regarding psychiatric permanent disability. The applicant may be entitled to additional indemnity benefits upon further proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryTruck DriverPermanent Disability Indemnity BenefitsPsycheSleep DisorderUrological SystemGastrointestinal System
References
Case No. ADJ9549773
Regular
Nov 13, 2015

EDWARD BAUTISTA vs. ARLON GRAPHICS, TRAVELERS

The Appeals Board dismissed the applicant's petition for reconsideration or removal, finding the WCJ's order was not a final determination. The WCJ correctly ordered the applicant to first discuss his anxiety symptoms and need for psychological referral with his primary treating orthopedist. Applicant is not entitled to a second opinion from a psychologist until the primary treating physician has diagnosed the anxiety or determined a referral is unnecessary. Commissioner Sweeney dissented, believing the applicant had an absolute right to an MPN second opinion for his psychiatric condition without first obtaining a referral from his orthopedist.

ADJ9549773Arlon GraphicsTravelersPetition for ReconsiderationPetition for RemovalWorkers' Compensation Appeals BoardWCJLabor Code Section 4616.3Labor Code Section 4616.4Administrative Director Rules
References
Case No. ADJ1047594 (VNO 0549852)
Regular
Dec 22, 2016

Diane De Los Reyes vs. Mediscan, Zurich American Insurance Company

In this case, the applicant, Diane De Los Reyes, sought reimbursement for self-procured medical treatment related to her work-induced Reactive Airway Disease and Anxiety Disorder. The Appeals Board found that some of the applicant's self-procured treatment was likely industrial and reversed the WCJ's finding that all such treatment was non-industrial. The Board therefore rescinded the original order and returned the matter to the WCJ for further proceedings to determine the extent of reimbursable self-procured medical treatment and associated penalties. The applicant's entitlement to reimbursement for medical mileage and penalties thereon was affirmed.

Workers' Compensation Appeals BoardReconsiderationAgreed Medical EvaluatorReactive Airway DiseaseAnxiety DisorderSelf-procured Medical TreatmentReimbursementPenaltiesMedical MileageLabor Code § 4600(a)
References
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