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

Case No. ADJ2786471 (AHM 0131083) ADJ1723308 (AHM 0131186) ADJ1776217 (AHM 0131184)
Regular
Jul 12, 2011

RENE GARCIA vs. CITY OF ANAHEIM

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior decision regarding applicant Rene Garcia's industrial injury to his low back and knees. The Board found that the treating physician's impairment rating was not substantial evidence because it impermissibly considered the applicant's ability to compete in the open labor market, in addition to Activities of Daily Living (ADLs), deviating from *Almaraz/Guzman* guidelines. The matter was returned to the trial level for further proceedings, including a supplemental report or deposition from the physician, to clarify the *Almaraz/Guzman* analysis solely on ADLs.

Workers Compensation Appeals BoardCity of Anaheimfirefightercumulative traumapermanent disability awardapportionmentAMA GuidesAlmaraz v. Environmental Recovery ServicesMilpitas Unified School Dist. v. Workers' Comp. Appeals Bd.Whole Person Impairment
References
7
Case No. ADJ7507358
Regular
Apr 03, 2023

KENNETH HARLAN vs. RENE M. CASAREZ aka RENE CASAREZ aka RENE BASAREZ aka RENE CAESAREZ dba AFFORDABLE PLUMBING AND ROOTER, HIROSHI CHARLES TANGE, FARMERS INSURANCE

This case concerns a worker injured while performing plumbing services at a new construction project. The Workers' Compensation Appeals Board denied a petition for reconsideration, upholding the finding that the homeowner, Hiroshi Tange, was the applicant's employer. The Board gave significant weight to the Workers' Compensation Judge's credibility determination of witnesses. Ultimately, the Board found no substantial evidence to overturn the judge's conclusion that the applicant was an employee working for the benefit of the homeowner, who exercised control over the project.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJcredibility determinationhomeownerunlicensed contractorindependent contractorpresumption of employmentLabor Code Section 3700Business and Professions Code Section 7125.2
References
12
Case No. ADJ9572711
Regular
May 20, 2019

RENE HINOJOSA vs. NORTH KERN STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the employer's petition and granted the applicant's petition for reconsideration. The Board affirmed the original finding of injury to the psyche and cardiovascular system, including hypertension, but amended the award. Crucially, the Board found that Labor Code section 3212.2 applied due to the applicant's custodial duties, thus precluding apportionment of permanent disability for hypertension and cardiovascular disease under Labor Code section 4663(e). This resulted in an increased permanent disability rating of 73% and entitlement to a life pension.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Orders and Awardstationary engineerpsyche injurycardiovascular systemhypertensionheart trouble presumptionLabor Code Section 3212.2Labor Code Section 4663(e)
References
1
Case No. ADJ9831208
Regular
Sep 09, 2016

MANUEL ESQUIVEL vs. MJH DESIGN BUILDERS, INC, TOWER INSURANCE CO. OF NEW YORK

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior decision, finding insufficient evidence to bar Manuel Esquivel's claim by the statute of limitations. The employer had knowledge of the industrial injury claim around February 15, 2013, but failed to provide required written notice of workers' compensation rights to the applicant. The Board also noted that the employer's stipulation to providing some medical treatment could estop them from asserting the statute of limitations defense. The case is returned for further proceedings to determine the applicability of the statute of limitations.

Workers Compensation Appeals BoardManuel EsquivelMJH Design BuildersTower Insurance Co.AmtrustStatute of LimitationsLabor Code section 5410Labor Code section 5405Petition for ReconsiderationFindings and Order
References
14
Case No. ADJ1054155 (LAO 0854446) ADJ1247741 (LAO 0854447) ADJ1895803 (LAO 0854448)
Regular
May 03, 2011

HIRITI OKUAMICHAEL vs. PAUL OWENS SHOES INC., STATE FARM FIRE AND CASUALTY COMPANY, STATE COMPENSATION INSURANCE FUND

This amended order clarifies that the Workers' Compensation Appeals Board has granted the applicant's petition for reconsideration of the February 8, 2011 Findings and Awards. This reconsideration aims to allow the Board to thoroughly study the factual and legal issues, including those to be raised in the applicant's supplemental petition. The applicant's request to file a supplemental petition has also been granted and reaffirmed. All future communications regarding these cases should be directed to the Office of the Commissioners of the WCAB.

Supplemental PetitionReconsiderationAppeals Board Rule 10848Findings and AwardsDecision After ReconsiderationOffice of the CommissionersWCABADJ1054155ADJ1247741ADJ1895803
References
0
Case No. ADJ9016733
Regular
May 03, 2016

TYSON CONGER vs. CARE AMBULANCE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration of a prior award concerning industrial injuries to his low back and psyche. The applicant argues the original findings did not properly weigh evidence and support a higher permanent disability rating. The Board also permitted the applicant to file a supplemental petition to address new information, allowing defendants an opportunity to respond. Reconsideration was granted to ensure a complete review of the record and a just decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationSupplemental PetitionEmergency Medical TechnicianLow Back InjuryPsyche InjuryTemporary DisabilityFuture Medical TreatmentPermanent DisabilityApportionment
References
1
Case No. VNO 0438915
Regular
Oct 23, 2008

Applicant vs. University of Southern California

This case concerns an applicant's Petition for Reconsideration of a WCAB decision denying injury claims against the University of Southern California (USC). The applicant alleged a physical altercation with his supervisor, Mr. Pickering, during a meeting on September 20, 2001, which he claims caused various injuries. However, the WCJ found the applicant lacked credibility due to inconsistencies in his testimony and failure to report the incident promptly. The WCJ relied on testimony from witnesses who stated Mr. Pickering merely touched the applicant's shoulders and noted the applicant's history of prior injuries and medical issues not fully disclosed.

WCABPetition for ReconsiderationUniversity of Southern CaliforniaBiological Safety Specialistspecific injuryanimositycredibility issuesshoulder touchingprior injurieshypertension
References
0
Case No. ADJ6958416
Regular
May 19, 2011

Norma Zell vs. ALAMEDA COUNTY, SEDGWICK CMS

The Workers' Compensation Appeals Board granted the applicant's first petition for reconsideration, amending the original award to increase her permanent disability rating from 20% to 24% based on corrected medical calculations. The Board denied the applicant's second petition for reconsideration regarding her left wrist injury, adopting the judge's reasoning that it was not a compensable industrial injury. The original finding of a cumulative industrial injury to the right wrist during her employment as a deputy sheriff was affirmed. The award was amended to reflect the 24% permanent disability rating and adjusted attorney fees.

Workers' Compensation Appeals BoardCumulative Industrial InjuryRight Wrist InjuryDeputy SheriffPermanent Disability RatingAMA GuideWhole Person ImpairmentPetition for ReconsiderationFindings and AwardDecision After Reconsideration
References
0
Case No. ADJ6729105
Regular
Sep 16, 2009

, ## Applicant, vs. , ## Defendant(s).

The Workers' Compensation Appeals Board denied reconsideration of a ruling that utilization review for the applicant's shoulder surgery was timely. The applicant argued she did not receive the denial letter within the required timeframe, but the Board found that the denial was properly sent to the treating physician and carbon-copied to the applicant within the statutory period. The Board clarified that WCAB Rule 10505(d) regarding official address records did not apply at the time of the denial because no claim application was yet filed. Therefore, the carrier's obligation was to communicate the denial in writing within the specified time, which they did.

Workers' Compensation Appeals BoardCadbury SchweppesGallagher Bassett ServicesUtilization ReviewPetition for ReconsiderationApplication for Adjudication of ClaimWCAB Rule 10505(d)Labor Code Section 4610ArthroscopyBiceps Tenodesis
References
0
Case No. ADJ1812731 (LBO 0352930), ADJ4306876 (LBO 0297758)
Regular
Mar 19, 2014

Applicant vs. Defendant

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration. The dismissal was based on the applicant's failure to file proof of service with the petition, a mandatory procedural requirement. Even if the merits were considered, the WCAB would have denied the petition based on the Judge's report. The applicant had sought reconsideration of a denial for a Petition to Reopen and claimed new and further disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition to ReopenFindings and OrderAgreed Medical EvaluatorNew and Further DisabilityTemporary DisabilityBad FaithProof of ServiceDismissal
References
0
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