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

Case No. ADJ803377 (RIV 0075685) ADJ6675892

Regular

Oct 05, 2017

SANDRA ARMENTA vs. SAN BERNARDINO SHERIFF'S DEPARTMENT

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address a plainly erroneous finding of fact in an Independent Medical Review (IMR) determination. The IMR incorrectly stated there was no documentation of constipation, despite medical reports confirming this issue, which was a basis for denying Amitiza. The WCAB also noted a case numbering error in the original findings of fact. Consequently, the WCAB rescinded the findings and returned the matter to the trial level for correction and further proceedings regarding the IMR determination's validity.

WCABReconsiderationIndependent Medical Review Determination (IMR)Findings of Fact (FOF)San Bernardino Sheriff's DepartmentApplicantPlainly Erroneous FactDocumentationPain ReliefFunctional Benefit

References

Case No. ADJ9785802

Regular

Aug 16, 2017

Edix PORTILLO vs. BRIMCO, LLC, AIG, administered by HELMSMAN MANAGEMENT

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of the WCJ's Findings of Fact. The applicant sought reconsideration of the finding that he did not sustain injury arising out of and in the course of employment (AOE/COE) for his right foot, constipation, IBS, and internal/external hemorrhoids. The Board adopted the WCJ's reasoning, finding that the medical evidence supporting the applicant's claims was speculative. Specifically, the applicant's chosen physician's opinions were considered less credible than those of the employer-appointed QMEs, who found no substantial medical issues.

AOE/COEPetition for ReconsiderationWCJQualified Medical Evaluator (QME)substantial evidencemedical opinionNSAIDsconstipationIBShemorrhoids

References

Case No. ADJ1 398270 (VNO 0553926)

Regular

Aug 15, 2016

JESUS JOSE RAMIREZ vs. ZIXTA ENTERPRISES, SPRINGFIELD INSURANCE COMPANY

This case involves an applicant seeking reconsideration of a workers' compensation award. The applicant argued the award incorrectly excluded injuries to diabetes, IBS, constipation, and hypertension, and that psychiatric temporary disability and permanent disability were improperly calculated. The Appeals Board granted reconsideration solely to correct a clerical error, amending the findings to reflect injury to the applicant's *left* lower extremity instead of the right. The Board affirmed the original award regarding the excluded conditions and the determination of temporary and permanent disability based on substantial medical evidence.

Workers' Compensation Appeals BoardPetition for ReconsiderationAmended Findings and AwardInjury to PsycheTemporary DisabilityPermanent DisabilitySubstantial Medical EvidencePQMEConflicting Medical ReportsClerical Error

References

Case No. ADJ8222803

Regular

Aug 05, 2019

Terry Lasko vs. Entertainment Partners, AIG, Cast & Crew, Zurich North America, Universal Studios, Paramount Pictures

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of an arbitrator's decision regarding contribution between two employers, Entertainment Partners and Cast & Crew. The WCAB modified the award, ordering Cast & Crew to contribute to future medical care for the applicant's left shoulder, finding substantial evidence of industrial injury. However, the WCAB affirmed the arbitrator's denial of Cast & Crew's contribution for temporary disability and future medical care for GERD, constipation, and high blood pressure due to insufficient evidence of industrial causation for those conditions. One commissioner dissented, arguing for Cast & Crew's contribution to future medical care for the internal conditions.

Cumulative TraumaContribution PetitionLabor Code Section 5500.5Compromise and ReleaseFuture Medical CareApportionmentPanel Qualified Medical EvaluatorSubstantial Medical EvidenceNon-Industrial InjuryIndustrial Injury

References

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SANDRA ARMENTA vs. SAN BERNARDINO SHERIFF'S DEPARTMENT

WCABReconsiderationIndependent Medical Review Determination (IMR)Findings of Fact (FOF)San Bernardino Sheriff's DepartmentApplicantPlainly Erroneous FactDocumentationPain ReliefFunctional Benefit

Edix PORTILLO vs. BRIMCO, LLC, AIG, administered by HELMSMAN MANAGEMENT

AOE/COEPetition for ReconsiderationWCJQualified Medical Evaluator (QME)substantial evidencemedical opinionNSAIDsconstipationIBShemorrhoids

JESUS JOSE RAMIREZ vs. ZIXTA ENTERPRISES, SPRINGFIELD INSURANCE COMPANY

Terry Lasko vs. Entertainment Partners, AIG, Cast & Crew, Zurich North America, Universal Studios, Paramount Pictures