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

Case No. ADJ9674255
Regular
Jul 10, 2017

YAN LIU vs. HAWAIIAN GARDENS CASINO, INSURANCE COMPANY OF THE WEST

This case concerns an applicant who alleges both orthopedic and psychiatric injuries from her employment as a casino dealer. While the Board affirmed the finding of orthopedic injury, it deferred the issue of psychiatric injury. The Board clarified that Labor Code § 4660.1(c) does not bar psychiatric claims arising directly from employment events, but it requires a medical apportionment of causation between direct psychiatric injury and injury as a consequence of physical injury. The matter was returned to the trial level for further development of the record regarding the psychiatric injury and its apportionment.

AOE/COELabor Code Section 4660.1(c)psychiatric injurycompensable consequenceviolent actsubstantial medical evidencetreating physicianQMEcontinuous traumaharassment
References
10
Case No. ADJ9944770
Regular
Oct 19, 2018

Sam Zavalata vs. Conifer Value Based Care, LLC

This case involves applicant Sam Zavaleta's workers' compensation claim for psychiatric and orthopedic injuries against Conifer Value Based Care, LLC. The Workers' Compensation Appeals Board (WCAB) rescinded the trial judge's decision, finding that the medical opinions from both the orthopedic and psychiatric evaluators required further development. Specifically, issues exist regarding the orthopedic causation of cumulative trauma injury to the applicant's psyche, back, neck, and wrist, as well as the substantial causation of the psychiatric injury in relation to the defendant's good faith personnel action defense. The matter is returned to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderPsychiatric InjuryCumulative TraumaPersonnel Action DefenseGood FaithCausationMedical OpinionApportionment
References
12
Case No. ADJ6596343
Regular
May 16, 2018

GARY GOBIN vs. INTEL CORPORATION

The Appeals Board rescinded the WCJ's decision and returned the case for further development, finding the WCJ erred by deferring the determination of whether personnel actions were a substantial cause of the psychiatric injury to the medical evaluator. The Board noted that the applicant's psychiatric injury likely stemmed from job stressors predating the employer's subsequent personnel actions. Competent medical evidence is required to distinguish causation of injury from causation of permanent disability, and the applicant's injury may have been caused by inability to adapt to workload demands before personnel actions were taken.

Workers' Compensation Appeals BoardGary GobinIntel Corporationcumulative traumapsyche injurygood faith personnel actionsLabor Code section 3208.3(h)Panel Qualified Medical Evaluator (PQME)Dr. Alberto LopezRolda v. Pitney Bowes
References
7
Case No. ADJ10625165
Regular
Apr 26, 2019

Rafael Arevalo vs. STATE OF CALIFORNIA, CALIFORNIA DEPARTMENT OF CORRECTIONS & REHABILITATION, CALIFORNIA CORRECTIONAL INSTITUTE-TEHACHAPI

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address the applicant's claim for a psychiatric injury. The initial finding by the WCJ recognized industrial hypertension but denied a psychological injury despite medical evidence of PTSD. The WCAB found the medical opinions regarding causation were not substantial evidence due to an incorrect factual history and potential confusion between legal standards. Therefore, the case is remanded for further proceedings to develop the record, particularly concerning the applicant's psychiatric injury causation and the definition of "actual events of employment."

WCABAOE/COEHypertensionPsyche injuryPosttraumatic Stress DisorderPTSDViolent actActual events of employmentPredominant causeSubstantial cause
References
14
Case No. ADJ3926578 (GOL 0088323)
Regular
Apr 15, 2010

Joseph Villa vs. FOOD 4 LESS, ESIS/ACE USA

The Appeals Board granted reconsideration of a prior award finding applicant sustained a 100% permanent disability due to back and psyche injuries. Defendant argued against the psychiatric injury claim based on the applicant's short employment duration and lack of a sudden/extraordinary event. The Board found the medical evidence regarding the psychiatric injury's causation was insufficient and potentially contradictory. Therefore, the case is returned to the trial level for further development of the record on causation and to address the six-month employment rule and the "sudden and extraordinary" event requirement if applicable.

Workers' Compensation Appeals BoardPsychiatric InjurySudden and Extraordinary Employment ConditionPredominant CauseSubstantial Medical EvidenceRes JudicataLachesApportionmentSomatizationDerivative Injury
References
21
Case No. MISSING
Regular Panel Decision

Claim of Kessler v. Fairmont Theater, Inc.

Claimant, employed for two days in 1986 as a projectionist, sought workers' compensation benefits for psychiatric injury and eye injury. He alleged harassment from his employer and supervisor caused a nervous breakdown, and projector light injured his eyes. The Workers’ Compensation Law Judge dismissed the psychiatric injury claim but found prima facie evidence for vision impairment, remitting that part for further development. The Workers’ Compensation Board subsequently ruled against the psychiatric trauma claim, a decision supported by employer and supervisor testimony denying harassment and claimant's psychiatrist confirming prior psychiatric issues. The appellate court affirmed the Board's decision, concluding that it was based on substantial evidence and that issues of credibility are within the Board's purview.

Psychiatric InjuryNervous BreakdownEye InjuryEmployment TerminationIntoxicationHarassmentCredibilitySubstantial EvidenceWorkers' Compensation BenefitsAppellate Review
References
2
Case No. ADJ3817836 (SJO 0250881)
Regular
May 31, 2012

ZUFAN A. REDA vs. FRY'S ELECTRONICS, INC., ZURICH NORTH AMERICAN INSURANCE

This case concerns applicant Zufan A. Reda's claim for permanent total disability due to a psychiatric injury. The Workers' Compensation Appeals Board (WCAB) is ordering the development of the record because neither the applicant's QME, Dr. Sidle, nor the defendant's QME, Dr. Keins, provided substantial evidence regarding the apportionment of psychiatric permanent disability. The WCAB found that Dr. Sidle's report incorrectly addressed causation of injury rather than apportionment of disability, and Dr. Keins' report was rejected as non-substantial due to prior rulings on industrial causation. Therefore, the WCAB has appointed Dr. Roy Curry as a "regular physician" to conduct a new evaluation on the issue of psychiatric permanent disability.

Petition for ReconsiderationDevelopment of RecordLabor Code section 5701Industrial InjuryPsychiatric InjuryCompensable ConsequenceSection 5803Section 5804Section 5410Permanent Total Disability
References
3
Case No. ADJ9474687
Regular
Jun 14, 2019

GUSTAVO NIEVES UGALDE vs. ROCKWELL DRYWALL, INC., STARR INDEMNITY, adjusted by YORK RISK MANAGEMENT GROUP

The Workers' Compensation Appeals Board (WCAB) rescinded the prior award and remanded the case for further proceedings, finding the applicant's psychiatric injury was a consequence of his physical injury, not directly from a violent act. The Board determined the applicant's fall from stilts, while accepted as industrial, did not meet the legal definition of a "violent act" required for an increased psychiatric impairment rating under Labor Code § 4660.1(c)(2)(A). Therefore, the case must be returned to allow the WCJ to first determine if the injury qualifies as "catastrophic" under § 4660.1(c)(2)(B) for potential increased psychiatric rating. The WCAB acknowledged the applicant's credible testimony regarding the use of stilts and the psychiatric QME's opinion on causation but found the issue of a "violent act" was not sufficiently established.

AOE/COEViolent ActCompensable ConsequencePsychiatric InjuryPermanent DisabilityReconsiderationFindings and AwardMedical EvaluatorVocational ExpertLabor Code Section 4660.1
References
11
Case No. ADJ1279352
Regular
Nov 18, 2010

WARREN BARNA vs. PACIFIC TUBE, ST. PAUL TRAVELERS, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of an award finding them liable for an applicant's psychiatric injury. The applicant had previously settled orthopedic claims and a cumulative trauma claim. The Appeals Board granted reconsideration to amend the original decision, adding specific findings required by Labor Code section 4751 regarding the applicant's pre-existing psychiatric disability and the compensable industrial psychiatric injury. The Board affirmed the original finding of liability against the SIBTF, while clarifying the applicant's eligibility for SIBTF benefits and addressing the issue of potential offsets.

Subsequent Injuries Benefits Trust Fundpsychiatric disabilitypre-existing disabilityindustrial injurypermanent partial disabilityLabor Code section 4751Workers' Compensation Appeals Boardreconsiderationcumulative traumaspecific injury
References
0
Case No. ADJ413851
Regular
May 10, 2010

TRACIA ARNETT vs. VERIZON WIRELESS, AMERICAN HOME ASSURANCE

Applicant Tracia Arnett sought reconsideration of a decision denying her workers' compensation claim for psychiatric injury. The administrative law judge found the claim barred under Labor Code section 3208.3, relating to the causation of psychiatric injuries. Arnett argued the supervisor's conversation was not in good faith and her injury resulted from mistreatment. The Appeals Board denied reconsideration, adopting the judge's report which supported the bar of the psychiatric claim.

Labor Code section 3208.3psychiatric injurygood faith conversationmistreatment by supervisorFindings of Fact and OrderPetition for Reconsiderationworkers' compensation administrative law judgeWCJ Report and Recommendationdenial of petitionVerizon Wireless
References
0
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