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

Case No. ADJ2628913
Regular
Jan 02, 2014

BARRY BLAYLOCK vs. NEGHEBORN AUTO CENTER, dba NEBHEBORN LINCOLN MERCURY, et al

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding a finding of serious and willful misconduct. The applicant sustained a permanent and total disability due to lung damage caused by heavy workplace smoking, specifically by a coworker in an enclosed office. Despite repeated complaints and an emergency room visit, the employer knowingly permitted the violation of a workplace smoking prohibition. The Board found sufficient evidence of employer knowledge of the safety order and the resulting harm to the applicant.

Workers' Compensation Appeals BoardSerious and Willful MisconductLabor Code Section 4553Reconsideration DeniedPetition for ReconsiderationWCJ ReportCredibility FindingSerious and WillfulViolation of Safety OrderWorkplace Smoking Prohibition
References
Case No. ADJ3489554 (SFO 0460075), ADJ409657 (SFO 0473579)
Regular
May 10, 2010

REBHI AYESH vs. ARCO/BP AMERICA, Permissibly Self-Insured, Administered By ESIS

The Workers' Compensation Appeals Board reversed an administrative law judge's award, ruling that the applicant is not entitled to industrial workers' compensation benefits for erectile dysfunction. The Board found the erectile dysfunction was caused by non-industrial factors like diabetes and smoking, not the applicant's work-related psychiatric injury. While the psychiatric injury was recognized as a compensable consequence of a prior back injury, medical evidence did not sufficiently demonstrate it contributed to the need for erectile dysfunction treatment. Consequently, the Board rescinded the award for further medical care related to the erectile dysfunction.

Workers Compensation Appeals Boardpsychiatric injuryindustrial injurylow back injuryerectile dysfunctiondiabetessmokingmedical treatmentcausationqualified medical evaluator
References
Case No. ADJ6526755; ADJ6526979 ADJ6671938; ADJ6672994
Regular
Jul 13, 2015

Diane Nye vs. WALGREENS COMPANY

In this workers' compensation case, the Workers' Compensation Appeals Board denied Walgreens' petition for reconsideration of four findings and awards issued to applicant Diane Nye. Walgreens challenged the awards, claiming a May 14, 2004 psychiatric injury was nonindustrial, the combined permanent disability exceeded 100%, further apportionment was needed for obesity, smoking, and a subsequent nonindustrial injury, and Nye's occupation was misclassified. The Board found substantial evidence supported the WCJ's findings, including industrial psychiatric injury and appropriate apportionment based on AME opinions. The Board also affirmed the dual occupation classification and resulting permanent disability rating, as Nye's stock clerk duties were an integral part of her employment.

Petition for ReconsiderationIndustrial InjuryPsycheHypertensionGastric SystemPermanent DisabilityAgreed Medical EvaluatorApportionmentObesitySmoking
References
Case No. ADJ6720899
Regular
May 15, 2012

MELISSA ROSAS vs. CITY OF SAN BERNARDINO POLICE DEPARTMENT, CITY OF SAN BERNARDINO

The Workers' Compensation Appeals Board denied the City of San Bernardino Police Department's petition for reconsideration. The Board adopted the judge's report, which found the applicant, Melissa Rosas, sustained a compensable injury in the form of cancer. This decision was based on the applicant being a police officer exposed to known carcinogens and the presumption under Labor Code § 3212.1 not being rebutted by the defense. The judge found the applicant's treating physician's opinion on variable cancer latency periods more persuasive than the defense expert's.

Labor Code § 3212.1cancer presumptionpolice officercarcinogen exposurebenzenecigarette smokegasoline fumesauto accidentsvehicle firesresidence fires
References
Case No. ADJ8550333
Regular
May 15, 2015

STEPHEN MARTIN BLOXHAM vs. LITHIA FORD MAZDA SUZUKI, HARTFORD ACCIDENT & INDEMNITY, ESIS

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration. The Board affirmed the finding that a car salesman's injuries from a car accident while purchasing cigarettes on a paid, employer-authorized break arose out of and occurred in the course of employment. This falls under the personal comfort doctrine, an exception to the going and coming rule, and the employer's encouragement of "prospecting" at the store further supported coverage. The Board rejected the defendant's argument that smoking's health detriments should disqualify it from the personal comfort doctrine.

Petition for ReconsiderationFindings of FactOrderOpinion on DecisionAOE/COEgoing and coming rulepersonal comfort doctrinepaid breakemployer's permissionprospecting
References
Case No. ADJ2704934 (LAO 0884502) ADJ168414 (LAO 0885268)
Regular
Apr 14, 2014

DESIGN MCCRAY vs. ECHOSTAR COMMUNICATIONS CORPORATION, ACE/USA, Administered By ESIS

The Workers' Compensation Appeals Board granted reconsideration and rescinded prior findings and awards. The court found that medical expert opinions on apportionment of the applicant's permanent disability to non-industrial factors were insufficient and lacked substantial medical evidence. The case was returned to the trial level for further proceedings and a new decision, including potentially further medical evaluation or depositions. The court emphasized the need for clear reasoning and adherence to current apportionment laws in medical reports.

ApportionmentPermanent DisabilityCausationSubstantial Medical EvidenceQualified Medical ExaminerIndustrial InjuryNonindustrial FactorsLabor Code Section 4663Escobedo RulingPre-existing Conditions
References
Case No. ADJ1742598 (SDO 0321754)
Regular
May 02, 2011

JOSE G. HERNANDEZ vs. LABORERS INTERNATIONAL UNION OF NORTH AMERICA, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the WCJ's finding that the applicant did not sustain industrial injury to his heart, psyche, or internal organs. The Board found the applicant's medical expert's opinion to be unsubstantial as it was based on an incomplete and inaccurate medical history provided by the applicant. Conversely, the Board found the defendant's QME's well-reasoned and thorough medical opinions, which considered extensive non-industrial risk factors, constituted substantial evidence to support the WCJ's decision. Therefore, the applicant failed to meet his burden of proof for an industrial injury.

AOE/COEPetition for ReconsiderationQualified Medical Examiner (QME)substantial evidencemedical opinionindustrial injuryWCJlabor historycardiac diseasediabetes
References
Case No. ADJ3339526
Regular
Oct 14, 2008

Jeffrey Zajdel vs. CALIPATRIA STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to address the issue of apportionment of the applicant's permanent disability due to a heart and brain injury. The Board rescinded the prior decision that apportioned 50% of the disability to non-industrial factors, finding the medical opinion supporting apportionment speculative and not based on established legal principles. Consequently, the Board issued a new award for 100% permanent disability without apportionment and reinstated the applicant's attorney's fees based on this higher award.

WORKERS' COMPENSATION APPEALS BOARDJEFFREY ZAJDELCALIPATRIA STATE PRISONSTATE COMPENSATION INSURANCE FUNDADJ3339526VNO 0491968OPINION AND ORDER GRANTING RECONSIDERATIONSUPPLEMENTAL FINDINGS AND AWARDINDUSTRIAL INJURYHEART INJURY
References
Case No. LBO 0383984
Regular
Dec 27, 2007

PATRICK ESPOSITO vs. NORTHWEST AIRLINES, INC., LIBERTY MUTUAL INSURANCE

The Workers' Compensation Appeals Board denied reconsideration, affirming the finding that Patrick Esposito's injury sustained while falling from a hotel balcony to smoke was compensable. The Board adopted the reasoning that the act of smoking fell under the "personal comfort and convenience" and "commercial traveler" doctrines, making it incidental to his employment as a flight attendant on layover. The Court found that the employee's poor decisions after being locked out did not negate the compensability of the injury.

WORKERS' COMPENSATION APPEALS BOARDPATRICK ESPOSITONORTHWEST AIRLINESLIBERTY MUTUAL INSURANCEORDER DENYING RECONSIDERATIONworkers' compensation administrative law judgepersonal comfort and convenience doctrinecommercial traveler ruleon callper diem
References
Case No. ADJ7166686
Regular
Jul 24, 2012

RICHARD ANDERSON vs. JAGUAR/LANDROVER OF VENTURA, COMPWEST INSURANCE COMPANY

This case involves an applicant who suffered a stroke and subsequent 100% permanent disability following surgery for an industrial shoulder injury. The defendant sought reconsideration, arguing for apportionment to pre-existing conditions and challenging the attorney's fee calculation. The Appeals Board affirmed the 100% permanent disability finding, finding no basis for apportionment as the applicant's pre-existing conditions did not cause the disability itself. However, the Board modified the attorney's fee award, requiring commutation using a specific method and a 3% cost of living adjustment, finding the previously assumed 4.6% to be speculative.

Workers Compensation Appeals BoardRichard AndersonJaguar/Landrover of VenturaCompwest Insurance CompanyADJ7166686ReconsiderationFindings and AwardIndustrial InjuryBrain InjuryNeurological System
References
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