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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. GOL 96757
Regular
Jun 10, 2008

SA YANG LO vs. CUSTOM SENSORS & TECHNOLOGIES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a prior award, upholding the application of the 2005 Permanent Disability Rating Schedule. The Board found that exceptions allowing for the 1997 Schedule did not apply, as the applicant's temporary disability indemnity extended beyond January 1, 2005, and no qualifying pre-2005 reports indicated permanent disability. Furthermore, the Board found the applicant's vocational expert's opinion regarding diminished future earning capacity unpersuasive, thus affirming the initial 9% permanent disability rating.

Workers' Compensation Appeals BoardSA Yang LoCustom Sensors & TechnologiesInc.State Compensation Insurance FundGOL 96757Opinion and Order Denying ReconsiderationFindings and AwardWorkers' Compensation Administrative Law JudgeWCJ
References
Case No. ADJ237483
Regular
Nov 13, 2012

RAYEK J. FAHOUM vs. KAISER FOUNDATION HOSPITAL

The Workers' Compensation Appeals Board denied Rayek J. Fahoum's petition for reconsideration, upholding the findings of the Workers' Compensation Judge. The Judge's report found Fahoum sustained industrial injury to his neck and low back with secondary chronic pain syndrome, awarding 41% permanent disability. This decision relied on the opinions of the Agreed Medical Examiner and Dr. Renee Rinaldi, who concluded Fahoum experienced symptom magnification and that his condition was chronic pain syndrome, not fibromyalgia as claimed by Dr. Allen Salick. The Board extended great weight to the Judge's credibility findings regarding the medical opinions.

Workers' Compensation Appeals BoardReconsideration DeniedAgreed Medical ExaminerSubstantial Medical EvidenceFibromyalgiaChronic Pain SyndromeSymptom MagnificationOrthopedic InjuryLumbosacral StrainCervical Strain
References
Case No. ADJ3931400 (MON 0218725) ADJ4561489 (MON 0257189)
Regular
Nov 07, 2008

ELLEAN SLAUGHTER vs. CENTINELA HOSPITAL MEDICAL CENTER/TENET HEALTHCARE CORPORATION

This case involves a petition to reopen a worker's compensation claim where the applicant's permanent disability increased from 77.5% to 100% due to chronic pain syndrome. The defendant argued for apportionment to non-industrial conditions like multiple sclerosis and chronic fatigue syndrome. The Appeals Board granted reconsideration, rescinded the original award, and remanded the case for a new permanent disability rating, specifically requiring apportionment of the increased disability to the applicant's non-industrial conditions as per *Vargas v. Atascadero State Hospital*.

ReconsiderationPermanent DisabilityApportionmentNew and Further DisabilityChronic Pain SyndromeMultiple SclerosisChronic Fatigue SyndromeAgreed Medical ExaminersSB 899Vargas v. Atascadero State Hospital
References
Case No. ADJ1088522 (RIV 0015524)
Regular
Jan 03, 2013

SAMANTHA VAN DUINHOVEN vs. SPA HOTEL & CASINO, CALIFORNIA CASUALTY, Administered by GAB ROBINS NORTH AMERICA

This case involved an applicant who claimed industrial injury to her neck, back, left shoulder, psyche, and associated chronic pain syndrome, resulting in a finding of permanent total disability. The defendant sought reconsideration, arguing the medical evidence did not support injury to the low back or a diagnosis of chronic pain syndrome. The Appeals Board reversed the findings on the low back and chronic pain syndrome, finding no substantial evidence to support them. Consequently, the applicant's permanent disability award was amended to 70%, based on ratings for her neck, left shoulder, and psyche.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent Total DisabilityChronic Pain SyndromeAgreed Medical EvaluatorQualified Medical EvaluatorMedical Record ReviewIndustrial InjuryPermanent Disability Indemnity
References
Case No. ADJ605947 (MON 0274664)
Regular
Feb 02, 2009

LESLIE CELLUCCI vs. FLORENCE MACHINE PRODUCTS, STATE COMPENSATION INSURANCE FUND

This case concerns a workers' compensation claim for injuries to the applicant's hands, upper extremities, and neck, resulting in chronic pain syndrome and a sleep disorder. The defendant disputed the extent of permanent disability and the diagnoses of chronic pain syndrome and sleep disorder. The Appeals Board affirmed the finding of industrial injury and the 85% permanent disability rating, including the diagnoses of chronic pain syndrome and sleep disorder. The Board also granted reconsideration to amend the award to include a life pension for the applicant, as required by law for an 85% permanent disability finding.

Workers' Compensation Appeals BoardLeslie CellucciFlorence Machine ProductsState Compensation Insurance FundADJ605947Opinion and Order Granting ReconsiderationFindings and AwardPermanent DisabilityChronic Pain SyndromeSleep Disorder
References
Case No. ADJ3896064 (SAL 0121108)
Regular
Aug 08, 2012

BRUCE AYERS vs. GRANITE ROCK COMPANY, ZURICH AMERICAN INSURANCE COMPANY

This Workers' Compensation Appeals Board order denies reconsideration of a prior award finding permanent and total disability. The applicant's treating physician and vocational experts opined that the applicant's multiple impairments, including chronic pain, medication side effects, and sleep disturbances, render him unemployable. The Board found the defendant failed to present a fair and complete picture of the medical evidence regarding the applicant's employability, specifically omitting key portions of the physician's opinion. The Board also noted the defendant's attempt to reopen discovery regarding sleep medication was without merit, as the applicant's testimony was credible and the existing evidence supported his ongoing disability.

Workers' Compensation Appeals BoardGranite Rock CompanyZurich American Insurance CompanyPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeSleep StudySleep MedicationEarning CapacitySuitable and Gainful EmploymentVocational Experts
References
Case No. ADJ2554534
Regular
Jan 03, 2023

WENDY COLLIE vs. STATE OF CALIFORNIA, EMPLOYMENT DEVELOPMENT DEPARTMENT, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration of a prior award. The initial award found the applicant sustained an injury AOE/COE to multiple body parts, resulting in permanent total disability without apportionment. The employer argued the finding of chronic pain syndrome was improper, and that the WCJ ignored credibility issues and apportionment opinions. The Appeals Board found substantial medical evidence supported the chronic pain syndrome diagnosis and that the employer failed to provide sufficient evidence for apportionment of permanent disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderAdministrative Law JudgeInjury AOE/COELumbar SpineCervical SpineLeft ShoulderRight HipRight Knee
References
Case No. ADJ8693536
Regular
Dec 28, 2017

MARQUITA DONES vs. WEST CONTRA COSTA UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied Marquita Dones' petition for reconsideration regarding an increase in permanent disability benefits. The Board adopted the Workers' Compensation Judge's report, which found no objective medical evidence supported an increase in disability beyond the original 7% award. While applicant testified to increased pain, neither the Qualified Medical Evaluator nor the treating physician could establish an increase in impairment, as required by the AMA Guides. The Board also admonished applicant's attorney for filing a non-compliant document.

WCABPetition for ReconsiderationDeniedPermanent DisabilityCumulative InjuryLeft ElbowLeft WristAwardPetition to ReopenNew and Further Disability
References
Case No. ADJ12180865
Regular
Dec 01, 2022

FRANCELIA DIAZ vs. MEDTRONIC, INC., ACE AMERICAN INSURANCE COMPANY

The Appeals Board granted reconsideration and rescinded the WCJ's order for an additional pain management QME panel. The Board found the applicant did not demonstrate good cause for the panel, as the current orthopedic QME's reports sufficiently addressed the applicant's diagnoses, including CRPS. The Board substituted new findings acknowledging the applicant's AOE/COE injuries but denying the request for a pain management QME panel.

Workers' Compensation Appeals BoardMedtronicInc.Ace American Insurance CompanyAdjudication Number ADJ12180865Petition for ReconsiderationAmended Opinion on DecisionFindings of Fact and OrderInjury AOE/COEQuality Control Inspector
References
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