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

Case No. ADJ6619965 ADJ9843987
Regular
Jul 16, 2018

JESUS ZARAGOZA vs. KOOL KOUNTRY, LLC, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Board granted reconsideration to review the finding of injury to the bladder, sleep disorder, sexual dysfunction, and cognitive disability/headaches, as well as the applicant's earnings. The Board affirmed the finding of injury to the bladder, sleep disorder, and sexual dysfunction but reversed the finding of injury related to cognitive impairment/headaches, finding insufficient medical evidence. Additionally, the Board amended the applicant's earnings to $270.00 per week, based on the parties' stipulation regarding the permanent disability rate, and affirmed the overall award except for these specific modifications.

Workers' Compensation Appeals BoardReconsiderationFindings of FactAwardAdministrative Law JudgePermanent DisabilityAverage Weekly EarningsStipulationAgreed Medical ExaminerQualified Medical Examiner
References
0
Case No. GOL 0088273
Regular
Aug 18, 2008

ROBERT SIEBURG vs. RONALD WOLFE & ASSOCIATES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the original award, and returned the case for further development of the record. The Board found the findings of the administrative law judge regarding $97\%$ permanent disability and apportionment were not supported by substantial medical evidence. Specifically, the opinion of Dr. Kahmann was deemed deficient due to internal inconsistencies, lack of explanation for apportionment, and undefined work restrictions. The Board also found Dr. Basham's report did not meet the standard for substantial medical evidence regarding cognitive dysfunction.

WORKERS' COMPENSATION APPEALS BOARDROBERT SIEBURGRONALD WOLFE & ASSOCIATESSTATE COMPENSATION INSURANCE FUNDGOL 0088273OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONFindings and AwardWCJmaintenance person
References
5
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
10
Case No. ADJ11197293
Regular
Dec 18, 2020

KEVIN TORRES vs. ARCTIC MECHANICAL, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case concerns an applicant's entitlement to an increased impairment rating for sleep dysfunction. The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration. The Board affirmed the Administrative Law Judge's finding that Labor Code Section 4660.1(c)(1) does not preclude an increased impairment rating for sleep dysfunction if it is directly caused by the industrial injury, rather than a consequence of it. Medical evidence from Dr. Jonathan Wang established a direct causal link between the applicant's sleep dysfunction and the industrial injury. The Board found Dr. Wang's report and deposition testimony constituted substantial medical evidence supporting this conclusion and rejected the defendant's arguments.

Labor Code 4660.1(c)(1)sleep dysfunctiondirect causationincreased impairment ratingcompensable consequencepsychiatric disordersubstantial medical evidenceQME reportdeposition testimonyAMA Guides
References
2
Case No. STK 100401, STK 102758, STK 151721
Regular
May 01, 2007

JACK LITTLE vs. TRI-VALLEY GROWERS, NATIONAL UNION FIRE INSURANCE COMPANY

Applicant Jack Little sustained admitted industrial injuries to his knees and back, resulting in permanent disability and a need for ongoing medical treatment, including for his hypertension. The Appeals Board denied reconsideration of the finding that applicant's erectile dysfunction is not a compensable consequence of the industrial injuries, as both medical evaluators concluded it was not caused by the work injuries. However, a dissenting commissioner argued for reconsideration to further develop the record regarding whether the industrially-caused hypertension and its medications contribute to the erectile dysfunction.

Workers' Compensation Appeals BoardTri-Valley GrowersNational Union Fire Insurance CompanyJack Littleindustrial injurieskneesbackmaintenance mechanicpermanent disabilitymedical treatment
References
3
Case No. ADJ7082851
Regular
Jan 30, 2019

HUMBERTO GONZALEZ vs. AMERICAN AUTO WRECKING, STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to amend the original findings, establishing applicant's earnings at $500.00 per week. The Board affirmed the finding of industrial injury to the psyche and right inguinal hernia, but deferred issues of injury to the reproductive system (sexual dysfunction) and sleep disorder. The matter was returned to the WCJ for further development of the record concerning these deferred issues, particularly regarding the specific impact of sleep disorder on impairment and corroboration of sexual dysfunction.

AOE/COEFindings and AwardPetition for ReconsiderationAdministrative Law JudgeAgreed Medical ExaminerQualified Medical ExaminerMaximum Medical ImprovementGeneral LaborerRight inguinal herniaSexual dysfunction
References
0
Case No. MISSING
Regular Panel Decision

Claim of Giudi v. New Paltz Fire Department

The Workers' Compensation Board's finding that the claimant remains unable to perform their prior employment duties as a chef, or those of a reasonable substitute, due to cognitive impairments, is supported by substantial evidence. This evidence includes the claimant's testimony and the opinion of a clinical neuropsychologist, who stated that the cognitive impairments prevent the claimant from working as a chef or military police officer. The Board's crediting of this evidence, which justified the finding of over 75% earning capacity loss, was upheld. The employer's argument that the Board applied an incorrect legal standard was rejected. The decision is affirmed.

cognitive impairmentsearning capacity lossdisability benefitsneuropsychologyoccupational injurymedical opinionappellate reviewsubstantial evidenceworkers' compensation lawemployment duties
References
5
Case No. ADJ7037201
Regular
Apr 22, 2013

Eddie Avakian vs. CITY OF BALDWIN PARK, ADMINSURE

This case involves an applicant police officer seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that awarded 72% permanent partial disability. The applicant contended the WCJ erred by excluding sleep disturbances and sexual dysfunction from the disability rating and by apportioning his cardiovascular disability. The WCAB granted reconsideration, rescinded the original award, and found the applicant's sexual dysfunction and sleep disorder compensable. The matter was returned to the trial level for a new decision, with the WCAB stating it would not disturb other findings, including the hypertension apportionment.

Workers' Compensation Appeals BoardEddie AvakianCity of Baldwin ParkPermissibly Self-InsuredAdministered By ADMINSUREADJ7037201Opinion and Order Granting ReconsiderationDecision After ReconsiderationFindings and Award and OrderAdministrative Law Judge
References
0
Case No. ADJ8023073
Regular
Mar 08, 2018

ERIKA GOMEZ GONZALEZ vs. FRONT PORCH, permissibly self-insured

The Workers' Compensation Appeals Board granted reconsideration of the prior award finding industrial injury, including to the psyche and sexual dysfunction, stemming from an exploding electrical outlet. The Board affirmed the award, specifically ruling that the exploding outlet constituted a "sudden and extraordinary employment condition" exempting the applicant from the six-month employment rule for psychiatric injuries. However, the Board rescinded the specific EDD reimbursement amount and remanded that issue for further proceedings. A dissenting commissioner argued the incident was routine and the sexual dysfunction lacked objective evidence.

Labor Code section 3208.3(d)sudden and extraordinary employment conditionpsychiatric injurysexual dysfunctionEmployment Development Department (EDD) reimbursementsubstantial evidencemedical opiniondioxine electrical outlettemporary disability indemnitypermanent disability
References
1
Case No. ADJ1880234 (GOL 0097047)
Regular
Oct 06, 2014

HSING TEREK vs. EMBASSY SUITES/WINDSOR CAPITAL GROUP

In this workers' compensation case, the applicant suffered an admitted industrial injury from a slip and fall as a housekeeper. The defendant sought reconsideration of the findings of total permanent disability and injury to the "psyche, head, internal, and neurological/cognitive impairment." The Appeals Board granted reconsideration to address the ambiguity of the "internal" injury finding, which they found insufficiently specified. While affirming the total permanent disability finding and injury to psyche, head, and neurological/cognitive impairment, the Board rescinded the "internal" injury finding and returned the case for further proceedings to clarify the specific internal systems or conditions injured.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardIndustrial InjuryPsycheNeurological/Cognitive ImpairmentTotal Permanent DisabilityApportionmentHousekeeperSlip and Fall
References
1
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