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

Case No. ADJ383777
Regular
Apr 04, 2011

Roxanna Ortiz vs. ONE SOURCE, ESIS

The Workers' Compensation Appeals Board denied Roxanna Ortiz's petition for reconsideration of a prior findings and order. The initial ruling determined she sustained industrial injury only to her cervical spine as a janitor, not to other body parts or any resulting temporary/permanent disability or need for further medical treatment. Ortiz argued the judge erred by favoring defense medical reports and discrediting her testimony due to minor inconsistencies in her injury description. The Board adopted the WCJ's report, emphasizing deference to credibility determinations and that admissibility of medical reports should have been challenged at trial, not on reconsideration. A dissenting opinion argued the judge overemphasized minor variations in Ortiz's account and that medical evidence did not sufficiently support denial of other injuries or further treatment.

OrtizOne SourceESISWCABFindings and OrderPetition for ReconsiderationWorkers' Compensation Administrative Law Judgeindustrial injurycervical spineright arm
References
Case No. SAC 256953, SAC 256954, SAC 256955
Regular

CAROL TORREZ vs. SUPERSHUTTLE, CLARENDON NATIONAL INSURANCE

This case involves cross-petitions for reconsideration concerning an applicant's workers' compensation claims for upper back/neck, low back, and upper extremity injuries sustained as an airport shuttle driver. The Appeals Board granted both applicant's and defendant's petitions, largely affirming the WCJ's findings but amending several clerical and factual errors. Key amendments include correcting defendant identification, clarifying stipulation regarding the low back injury, adjusting attorney fees and liens, and crediting EDD payments against temporary disability indemnity.

Workers' Compensation Appeals BoardSupershuttleClarendon National InsuranceCIGACalifornia Compensation Insurance Companyindustrial injuryupper backnecklow backcumulative trauma
References
Case No. ADJ2341016 (RIV 0079129) ADJ1104225 (RIV 0079132)
Regular
Dec 17, 2010

MARCO FLORES vs. STARWOOD HOTELS AND RESORTS, ZURICH INSURANCE GROUP

This case involves a lien claimant, Grace Zausch, seeking reconsideration after her lien for unpaid rent was disallowed. The WCAB granted reconsideration, finding the WCJ erred in disallowing the lien. Although the claimant sought $13,434, the applicant admitted under oath owing $6,400 in back rent. The Board determined that this debt for rent constitutes compensable living expenses under Labor Code section 4903(c). Consequently, the prior order was rescinded, and the matter was returned to the trial level for further proceedings, with instructions to allow Ms. Zausch's lien for $6,400 against the defendant's disability indemnity.

Workers' Compensation Appeals BoardLien claimantReconsiderationFindings and OrderIndustrial injuryBackKneesPsychePermanent disabilityLabor Code section 4903(c)
References
Case No. RIV 42174
Regular
Jul 20, 2007

VICTOR LOPEZ vs. DOANE'S PET CARE, ROYAL SUNALLIANCE INSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration to correct a clerical error regarding the temporary disability period. While affirming the finding of industrial injury to the back, leg, and psyche resulting in 86% permanent disability, the Board amended the temporary disability period to commence August 2, 2001, aligning it with the date of injury. The Board specifically noted they would not adopt the WCJ's comment regarding improper fax filing of the petition for reconsideration.

Victim LopezDoane's Pet CareRoyal Sunalliance Insurance Co.RIV 42174Petition for ReconsiderationFindings and Awardindustrial injurybackright legpsyche
References
Case No. ADJ1584272
Regular
Dec 03, 2010

RICHARD SILVA vs. PAZIN & MYERS, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding of 100% permanent disability for the applicant's back and psyche injuries. The Board found that the workers' compensation judge properly applied the 1997 Schedule for Rating Permanent Disabilities due to pre-existing medical reports indicating permanent disability. Substantial evidence, including the Agreed Medical Examiner's opinion on permanent total disability and the applicant's treating psychologist's opinion, supported the 100% disability rating. The defendant failed to meet its burden to prove apportionment of the disability.

ADJ1584272FRE 0244029Pazin & MyersInc.State Compensation Insurance FundFindings and AwardSeptember 142010industrial injuryback
References
Case No. ADJ8501790
Regular
Jul 29, 2015

Kelly Chase vs. St. Louis Blues Hockey Club, Federal Insurance Company

The Workers' Compensation Appeals Board (WCAB) reversed a prior finding of industrial injury for a professional hockey player against the St. Louis Blues. The WCAB found insufficient connection to California for jurisdiction, citing the player's limited games in the state compared to his overall career. This decision followed the precedent set in *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)*, which requires a legitimate and substantial connection to the state for jurisdiction. The WCAB concluded that 21 games out of 485 did not meet this standard for a cumulative injury claim.

WCABSt. Louis Blues Hockey ClubFederal Insurance CompanyADJ8501790Opinion and Decision After Reconsiderationcumulative industrial injuryprofessional hockey playersubject matter jurisdictionstatute of limitationssubstantial medical evidence
References
Case No. ADJ7927883
Regular
May 22, 2015

JEFF JANZEN vs. CITY OF COSTA MESA, COSTA MESA FIRE DEPARTMENT

This case involves a fire captain's cumulative trauma claim for injuries to multiple body parts, including sinuses, lungs, and back. The employer, City of Costa Mesa, argued the claim was time-barred under Labor Code §5412. However, the Workers' Compensation Appeals Board upheld the administrative law judge's decision, finding the applicant lacked knowledge of the cumulative nature of his injury until consulting an attorney. Therefore, the Board determined the statute of limitations did not bar the claim, as his disability was not known to be industrially caused until shortly before filing.

Workers' Compensation Appeals BoardJEFF JANZENCITY OF COSTA MESAPermissibly Self-InsuredFindings Award and Orderindustrial injurysinuseslungsskinneck
References
Case No. ADJ4317262 (ANA 0327568)
Regular
Apr 13, 2009

JOSE GONZALEZ vs. BURR ROOFING, INC., SCIF INSURED SANTA ANA

The applicant sought reconsideration of a workers' compensation award, primarily arguing the permanent disability rating undervalued his urological condition and the WCJ erred in not crediting vocational rehabilitation expert opinion. The Appeals Board granted reconsideration solely to award additional attorney fees for temporary disability benefits. While the majority affirmed the WCJ's original findings on permanent disability, a dissenting commissioner argued the urological condition was significantly underestimated and requested a new rating.

Workers Compensation Appeals BoardJose GonzalezBurr RoofingSCIF Insured Santa Anapermanent disabilityapportionmentrooferupper back injurymid back injurylow back injury
References
Case No. ADJ3758714 (VNO 0553350) ADJ3611380 (ANA 0372874)
Regular
Nov 24, 2008

Herbert J. Ware, Jr. vs. LOS ANGELES TIMES, Permissibly SelfInsured, Administered by GALLAGHER BASSETT SERVICES

The Appeals Board denied reconsideration of a decision that reversed a finding of cumulative trauma psychiatric injury for the applicant. The denial was based on the lack of substantial medical evidence establishing the cumulative trauma claim in one case, and the fact that a separate claim for psychiatric injury as a consequence of a back injury was not properly litigated. The Board indicated the case would return to the trial level for further proceedings on other issues.

Workers' Compensation Appeals BoardCumulative TraumaPsyche InjurySpecific InjuryBack InjuryCompensable ConsequenceReconsideration DeniedMedical EvidenceTemporary DisabilityFurther Medical Treatment
References
Case No. ADJ4242850 (GOL 0093209) ADJ1997616 (GOL 0093305)
Regular
Mar 10, 2010

RAMON LEON vs. UNIVERSITY OF CALIFORNIA AT SANTA BARBARA, Permissibly Self-Insured

This case concerns a defendant's appeal regarding an award of specific medical treatment (TENS unit and back brace) and attorney fees for industrial injuries sustained in 2001 and 2002. The defendant argued the treatment was not causally related to the accepted injuries and lacked prior notice for utilization review. The Appeals Board granted reconsideration to address the attorney fees. While affirming the need for medical treatment, the Board reversed the attorney fee award, citing Labor Code section 4607 and the Supreme Court's *Smith* decision, which limits such fees to instances of successfully resisting termination of treatment awards, not challenging denial of specific requests.

Workers' Compensation Appeals BoardJoint Findings of Fact and Awardindustrial injuryneck and low backpermanent disabilityfurther medical treatmentback braceTENS unitphysician's reportreconsideration
References
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