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

Case No. ADJ7941925 (VNO 0120392) ADJ2139821 (VNO 0472608)
Regular
Mar 25, 2013

KIM A. ALLEN vs. CITY OF PASADENA

The Workers' Compensation Appeals Board granted reconsideration, rescinded the WCJ's decision, and returned the case to the trial level. The defendant argued that the WCJ erred in finding industrial causation for the applicant's coronary artery disease, citing res judicata and the issue not being properly raised. However, the Board found no substantial medical evidence supported the finding of industrial injury for the current condition, necessitating further proceedings. The applicant had prior stipulated awards for heart conditions, but the coronary artery disease was alleged as a new problem.

Workers' Compensation Appeals BoardCity of PasadenaPermissibly Self-InsuredFindings of FactInjury AOE/COECoronary Artery DiseaseCardiovascular SystemFirefighterCumulative PeriodRes Judicata
References
Case No. ADJ1576347 (FRE 0235267) ADJ8047239
Regular
Sep 12, 2013

MICHAEL MANFREDI vs. CITY OF FRESNO, AMERICAN ALL-RISK LOSS ADMINISTRATORS

The Workers' Compensation Appeals Board denied Michael Manfredi's petition for reconsideration. Manfredi, a police officer, sought to establish two separate cumulative trauma injuries for his coronary artery disease and hypertension, rather than the single injury found by the WCJ. The Board affirmed the WCJ's finding that the continuous need for medical treatment between periods of exposure constituted a single compensable injury, citing *Western Growers*. Therefore, the original award of 20% permanent disability stands.

Cumulative traumacoronary artery diseasehypertensionpermanent disabilityreconsiderationJoint Findings of Fact and AwardWCJ ReportWestern Growers v. Workers' Comp. Appeals Board (Austin)separate injuriessingle injury
References
Case No. ADJ6776516
Regular
May 30, 2017

FRANCIS HARGREAVES vs. SOUTHWEST AIRLINES, ACE USA INSURANCE CO.

This case involves an applicant seeking workers' compensation benefits for injuries sustained on the job, including to his back, left shoulder, left wrist, and psyche, as well as complex regional pain syndrome, coronary artery disease, and a sleep disorder. The defendant sought reconsideration of the initial award, arguing that the medical evidence did not support the $90\%$ permanent disability finding. The Appeals Board granted reconsideration, affirming the findings of injury and treatment for Complex Regional Pain Syndrome but reducing the permanent disability to $88\%$ by excluding the sleep disorder impairment due to insufficient objective evidence. The applicant's permanent disability payments were recalculated and ordered to commence from January 21, 2011.

Workers' Compensation Appeals BoardFrancis HargreavesSouthwest AirlinesACE USA Insurance Co.Sedgwick CMSADJ6776516Opinion and Order Granting Petition for ReconsiderationFindings Award and OrderAOE/COEback injury
References
Case No. ADJ158588 (STK 0192737)
Regular
Jan 11, 2010

ROBERT NORMAN vs. CLARK PEST CONTROL, AMERICAN HOME ASSURANCE, GALLAGHER BASSETT SERVICES

The Workers' Compensation Appeals Board granted reconsideration, rescinded the original award, and returned the case for further proceedings. This decision arose from conflicting medical opinions on whether the applicant's heart condition was caused by industrial stress. The Board found that neither medical evaluator adequately addressed the issue, particularly in light of established case law recognizing the link between occupational stress and heart disease. Further development of the record is necessary to ensure substantial justice and a decision supported by substantial evidence.

cumulative traumaheart diseaseoccupational stresscoronary artery diseasequalified medical evaluatorsubstantial evidencemedical opinionconflicting medical evidencefurther proceedingsdevelopment of the record
References
Case No. ADJ7469760
Regular
Mar 25, 2016

GILBERT MARENTEZ vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, CALIFORNIA REHABILITATION CENTER

The Appeals Board affirmed the finding of industrial injury and 84% permanent disability for hypertensive cardiovascular disease but modified the start date for the 15% permanent disability increase under Labor Code section 4658(d)(2) to January 19, 2014. The Board also upheld the requirement for the employer to provide treatment for the applicant's non-industrial diabetes when necessary to cure or relieve the effects of the industrial injury. The Board also affirmed the WCJ's discretionary allowance of a credit to the defendant for overpaid temporary disability benefits. The case is returned for reissuance of the award with the correct section 4658(d) date and determination of SAWW and attorney fees.

Workers' Compensation Appeals Boardhypertensive cardiovascular diseasecoronary artery diseasearrhythmiapermanent disabilityLabor Code section 4658(d)(2)temporary disability creditAgreed Medical Examiner (AME)permanent and stationary dateQualified Injured Worker (QIW)
References
Case No. 2816864 (VNO 0561423), ADJ2085813 (VNO 0561424), ADJ2591629 (VNO 0561426), ADJ7666693
Regular
Feb 02, 2012

RICHARD BARROW vs. County of Orange

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, affirming the finding that Richard Barrow's cumulative trauma injury, including spindle cell carcinoma and heart disease, was industrially caused. The Board found that the statute of limitations did not bar Barrow's claim as he did not know, nor should he have reasonably known, that his disability was work-related until later medical advice. The Board also upheld the temporary disability indemnity rate, finding it should be based on the date of payment, not the date of disability.

Workers' Compensation Appeals BoardCumulative traumaStatute of LimitationsLabor Code section 5412Date of injuryAgreed Medical ExaminerSpindle cell carcinomaCoronary artery diseasePulmonary restrictive lung diseaseRadiation induced cardiomyopathy
References
Case No. ADJ3705124 (VNO 0496493)
Regular
Jul 09, 2015

Dusty Glenn Garman vs. California Department of Corrections, California Substance Abuse Treatment Facility; Subsequent Injuries Benefits Trust Fund

The Appeals Board reversed a WCJ's decision, finding that applicant Dusty Glenn Garman had preexisting permanent disability or impairment prior to his industrial injury. This finding was based on substantial medical evidence, including deposition testimony from Dr. Markovitz and cardiac catheterization lab results, indicating significant coronary artery stenosis. Consequently, the Board determined that the Subsequent Injuries Benefits Trust Fund (SIF) is liable for benefits as the applicant met the statutory thresholds for such liability.

Subsequent Injuries Benefits Trust FundPreexisting permanent disabilityRetroactive prophylactic work restrictionCoronary artery diseaseApportionmentHeart troubleLabor Code § 4751Labor Code § 3212.2Medical evidenceStenosis
References
Case No. ADJ10763960
Regular
May 20, 2019

DENNIS ROMERO vs. COUNTY OF SAN DIEGO

This case involves a workers' compensation appeal where the defendant, County of San Diego, sought reconsideration of an award granting the applicant, Dennis Romero, permanent disability. The defendant argued that the administrative law judge improperly overlapped factors of disability when assessing the applicant's $94\%$ permanent disability rating. The Appeals Board denied reconsideration, adopting the judge's report which found that the qualified medical evaluator considered factors beyond shortness of breath, such as left ventricular hypertrophy and lightheadedness, when determining impairments for hypertensive and coronary heart disease. The Board also cited legal precedent that the multiple disabilities rating schedule accounts for any overlap.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderDeputy SheriffIndustrial InjuryHeart InjuryHypertensionPermanent DisabilityHypertensive Heart DiseaseCoronary Heart Disease
References
Case No. ADJ9184413
Regular
Oct 27, 2020

JEFFREY SPRINGER vs. RJ DONOVAN CORRECTIONAL FACILITY, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation claim by Jeffrey Springer against RJ Donovan Correctional Facility. The Applicant sustained injuries resulting in industrially caused hypertension, hypertensive kidney disease, and hypertensive heart disease. The primary dispute centered on how to combine a prior 28% permanent disability rating for kidney disease with a new 49% rating for heart disease. The defendant argued these were part of a single cardiovascular system and sought to subtract the prior award's monetary value from the new rating. The WCJ found the injuries to the kidney and heart were distinct, justifying combining them, and awarded 63% permanent disability after deducting the prior award's value. The Appeals Board denied the defendant's petition for reconsideration, adopting the WCJ's reasoning.

Workers Compensation Appeals BoardRJ Donovan Correctional FacilityLegally UninsuredState Compensation Insurance FundPetition for ReconsiderationPermanent DisabilityHypertensionHypertensive Kidney DiseaseHypertensive Heart DiseaseHypertensive Cardiovascular Disease
References
Case No. ADJ7785974
Regular
Mar 20, 2019

REFUGIO JOSE ALFARO (Deceased) vs. INTERSTATE HOME SERVICES, INSURANCE COMPANY OF THE WEST GROUP

This case involved a worker's compensation claim for death benefits after Refugio Alfaro died from a myocardial infarction. The defendant contested that the death was industrially caused, challenging the qualified medical examiner's (QME) opinion. The Appeals Board affirmed the finding of industrial causation, finding the QME's opinion substantial evidence supported by deposition testimony. However, the Board rescinded the award and returned the case for further proceedings to identify and determine eligibility of dependents, as the original applicant spouse was deceased.

AOE/COEmyocardial infarctiondeath benefitsQMEsubstantial evidencereconsiderationWCJindustrial causationdependencyaggravated condition
References
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