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

Case No. ADJ10387978
Regular
Aug 13, 2019

MELE LATU vs. HEWLETT PACKARD ENTERPRISE SERVICES, SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case involves a denied petition for reconsideration regarding Subsequent Injuries Benefits Trust Fund (SIBTF) benefits. The applicant settled her industrial injury claim for $937,166, then sought SIBTF benefits. The Board denied the petition because the applicant failed to prove a pre-existing "labor disabling" condition, which is a requirement for SIBTF eligibility even after statutory changes. Medical evidence indicated the applicant was asymptomatic and functional prior to her industrial injury, and any apportionment was to asymptomatic pathology, not a labor-disabling condition.

Subsequent Injuries Benefits Trust FundSIBTFLabor Code section 4751labor disablingpermanent partial disabilityapportionmentSenate Bill 899SB 899asymptomatic pathologyEscobedo v. Marshalls
References
2
Case No. ADJ9519541
Regular
Jul 26, 2019

Sonia Young-Mitchell vs. SECURITAS SECURITY SERVICES

This case involves an applicant seeking permanent total disability benefits after an admitted industrial injury to her back, lower extremities, right ankle, and left knee. The applicant argues the Workers' Compensation Judge (WCJ) erred by apportioning 10% of her left knee disability to a pre-existing asymptomatic condition. The Appeals Board granted reconsideration, finding that the Agreed Medical Examiner (AME) impermissibly apportioned to the cause of the injury rather than pre-existing pathology. Consequently, the Board amended the award to find the applicant 100% permanently totally disabled, returning the matter for a new award.

Workers Compensation Appeals BoardSonia Young-MitchellSecuritas Security ServicesSedgwick Claims Management Servicespermanent total disabilityapportionmentleft knee injurycompensable consequencevocational evidenceAgreed Medical Examiner
References
4
Case No. ADJ1220987 (SJO 0262634)
Regular
Nov 17, 2010

RICHARD GILLISPIE vs. PLASTECH, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) appealed an award of benefits to an applicant with a pre-existing disability, arguing a subsequent industrial back injury did not cause pathology in the opposite leg as required by statute. The Appeals Board affirmed the award, finding that Labor Code section 4751 only requires the subsequent injury to "affect" the opposite member, not necessarily cause direct pathology. Evidence showed the applicant's low back injury caused verified radiculopathy and impaired leg function, meeting the statutory requirement. The Board found SIBTF's legal arguments unpersuasive and the WCJ's findings supported by substantial evidence.

Subsequent Injuries Benefits Trust FundLabor Code section 4751industrial injurylow backradiculopathypermanent disabilityopposite and corresponding memberpathologyAMA GuidesDRE category III
References
2
Case No. MISSING
Regular Panel Decision

Storch v. Syracuse University

Plaintiffs Mark and Jenny Storch sued Syracuse University and Professor Douglas Biklen after their autistic daughter, Jenny, allegedly accused her father of sexual abuse through "facilitated communication." A Family Court had previously rejected this communication method as unreliable, leading to the withdrawal of abuse charges against Mark Storch. The state court action alleged fraud and violations of Education Law regarding speech-language pathology. The court granted summary judgment to the defendants, ruling that Biklen's statements were opinions on an evolving, controversial theory, not fraudulent misrepresentations, and that facilitated communication does not fall under the practice of speech-language pathology as defined by law. Consequently, the plaintiffs' complaint was dismissed.

Facilitated CommunicationAutism CommunicationChild Abuse AllegationsSummary JudgmentFraud ClaimsEducation LawSpeech-Language PathologyScientific ControversyExpert TestimonyAcademic Liability
References
14
Case No. MISSING
Regular Panel Decision

United States v. Yi Ching Liu

The case concerns defendant Yi Ching Liu, who was charged with using unauthorized credit card convenience checks and pled guilty. Liu sought a downward departure from sentencing guidelines, claiming diminished capacity due to pathological gambling addiction. Expert testimony from psychotherapist Stephen Block, supported by DSM IV criteria, confirmed Liu's severe addiction and a direct link to his criminal acts. The court, presided over by Senior District Judge Weinstein, granted a four-point downward departure under U.S.S.G. § 5K2.13, resulting in a 24-month incarceration sentence. The decision emphasizes that pathological gambling can constitute significantly reduced mental capacity for sentencing purposes, citing precedent and the evolving understanding of this disorder.

Diminished CapacityPathological GamblingSentencing GuidelinesDownward DepartureImpulse Control DisorderFraudCredit Card FraudCriminal SentencingDSM IVFederal Court
References
5
Case No. ADJ9813548
Regular
Feb 03, 2016

ANDREA LOPEZ ROCHA vs. BAKERSFIELD PATHOLOGY MEDICAL GROUP, WILLIAMSBURG NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) denied defendant's petition for removal. Defendant sought removal of an order allowing applicant to obtain vocational rehabilitation reports and depose experts, arguing it caused prejudice. The WCAB found no substantial prejudice or irreparable harm to the defendant, noting these issues could be addressed at trial or reconsideration. The WCAB affirmed the WCJ's decision to allow limited, timely discovery to move the case forward.

Petition for RemovalInterlocutory OrderVocational RehabilitationMandatory Settlement ConferenceDiscovery ClosureSubstantial PrejudiceIrreparable HarmPanel Qualified Medical EvaluationDeclaration of ReadinessAdministrative Law Judge
References
8
Case No. ADJ3625409 (SAL 0119152)
Regular
Sep 21, 2009

GUADALUPE BENAVIDES vs. SALINAS VALLEY MEMORIAL HOSPITAL, Permissibly Self-Insured, Administered By ACCLAMATION INSURANCE MANAGEMENT SERVICES

The Appeals Board granted reconsideration, rescinding the prior award. The WCJ incorrectly ruled that surgical knee replacement precluded apportionment of permanent disability. The Board found that Labor Code § 4663 requires apportionment based on causation, even if the contributing pathology is surgically removed. Therefore, the matter was returned for a new rating based on the QME's opinion that 75% of the applicant's permanent disability was due to pre-existing conditions.

ApportionmentPermanent DisabilityQualified Medical EvaluatorIndustrial InjuryNon-IndustrialPrevious InjuriesDegenerative ArthritisTotal Knee ReplacementLabor Code § 4663Causation
References
4
Case No. SRO 0277261
Regular
Aug 10, 2007

Luis M. Mariscal vs. Blakeley Construction, State Compensation Insurance Fund

This case involves a workers' compensation claim for a back injury where the defendant seeks reconsideration of the permanent disability rating. The core issue is whether to apportion a portion of the disability to the applicant's pre-existing pathological condition, despite the evaluating physician's potentially contradictory opinion. The Appeals Board granted reconsideration, rescinded the prior award, and returned the matter for a new rating consistent with apportionment principles established in recent case law.

Workers' Compensation Appeals BoardReconsiderationApportionmentPermanent DisabilityQualified Medical EvaluatorLabor Code section 4663CausationSubstantial Medical EvidenceGattenEscobedo
References
3
Case No. ADJ2329367 (OAK 0323054)
Regular
May 06, 2013

JOSEPH VALTIERRA vs. TCB INDUSTRIAL, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and rescinded the WCJ's award due to inadequate medical evidence regarding the applicant's left shoulder injury. Both the applicant's and defendant's medical evaluators provided opinions that were found to be speculative, incomplete, and not based on a full understanding of the underlying pathology. The Board determined that substantial evidence was lacking on the apportionment of disability and the precise nature of the left shoulder condition. The case is returned to the trial level for further development of the medical record.

Compensable consequenceApportionmentSubstantial evidenceMedical opinionReasonable medical probabilityUnderlying pathologyLeft shoulder injuryRight shoulder injuryMillwrightCumulative trauma
References
11
Case No. SJO 243795
Regular
Sep 17, 2007

BAIRO SISIC vs. VASONA MANAGEMENT, INC., UNITED STATES FIRE INSURANCE COMPANY

The Appeals Board granted reconsideration because the administrative law judge (WCJ) incorrectly applied the 1997 Permanent Disability Rating Schedule. The WCJ's reasoning for using the older schedule, based on pre-existing pathology and unadmitted medical reports, was flawed. The case is remanded for a new decision on which rating schedule applies, considering Labor Code § 4660(d) and whether specific reports or prior temporary disability payments trigger the 1997 schedule.

Workers' Compensation Appeals BoardVasona ManagementInc.United States Fire Insurance CompanyCrum & Forsterpermanent disability rating1997 Schedule2005 Schedulepre-existing pathologydegenerative disc disease
References
5
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