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

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. ADJ7464646
Regular
Apr 24, 2017

DONALD THOMPSON vs. STATE OF CALIFORNIA

The Workers' Compensation Appeals Board granted reconsideration and increased the applicant's permanent disability award from 22% to 52%. This decision stemmed from the Board's finding that the applicant's hypertension constituted "heart trouble" under Labor Code section 3212.2, a presumption applicable to Department of Corrections employees with custodial duties. Consequently, the hypertension-related disability is not subject to apportionment, unlike the prior award which had applied apportionment. The applicant, a teacher at a correctional facility, is thus entitled to an unapportioned award for his industrial injury.

Labor Code § 3212.2presumption of injurycustodial dutiesheart troubleapportionmenthypertensioncoronary heart diseaseindustrial injurypermanent disabilityLabor Code § 4663(e)
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. 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. ADJ1892285 (SAC 0364476)
Regular
Apr 24, 2009

BEVERLY LINDSAY (Widow) vs. EPPS CHEVROLET-PONTIAC-OLDSMOBILE, CAMBRIDGE SAN DIEGO

This case involves a widow's petition for reconsideration of a denial of death benefits for her husband, William Lindsay, who died of heart disease. The applicant argued the deceased's death was industrially caused due to cumulative trauma and stress, supported by her testimony and one medical evaluator's opinion. However, the defense medical evaluator opined that Mr. Lindsay's fatal heart condition was due to non-industrial causes like obesity and a possible viral infection, and was not exacerbated by work stress. The Board denied reconsideration, adopting the findings of the administrative law judge and finding the defense medical opinion more persuasive and substantial.

WCABPetition for Reconsiderationindustrial cumulative traumaheart diseasecardiovascular systemwidow's claimdate of knowledgequalified medical evaluatorsubstantial evidencenon-industrial conditions
References
Case No. ADJ7454744
Regular
Oct 25, 2019

CAROL PHILLIPS vs. COUNTY OF FRESNO, RISICO CLAIMS MANAGEMENT, INC.

The Workers' Compensation Appeals Board granted reconsideration of an administrative law judge's (WCJ) decision regarding Carol Phillips' workers' compensation claim against the County of Fresno. The Board affirmed the WCJ's findings that Phillips sustained an industrial injury to her circulatory and heart systems, resulting in 15% permanent disability. However, the Board deferred the issue of temporary disability indemnity pending further development of the record. The Board also corrected the permanent disability indemnity rate to $230 per week and returned the matter to the WCJ for further proceedings.

AOE/COESection 3212 presumptioncorrectional officerpsychiatric injurypermanent disabilitytemporary disability indemnityQualified Medical Examiner (QME)apportionmentduty to return to workmedical retirement
References
Case No. ADJ3526973 (SDO 0315558) ADJ2783481 (SDO 0355255)
Regular
Jan 21, 2011

THEMAS CARMODY vs. CITY OF SAN DIEGO POLICE DEPARTMENT

The Workers' Compensation Appeals Board reversed a WCJ's decision finding no industrial injury to the applicant's heart and hypertension. The Board found that the Agreed Medical Evaluator's initial reports strongly supported industrial causation for hypertension and heart trouble, triggering the Labor Code section 3212.5 presumption. The Board held the AME's subsequent deposition testimony, which reversed his opinion without adequate explanation and rejected the legislative premise of stress-induced heart disease, was insufficient to rebut the presumption. Consequently, both the applicant's heart/hypertension claim and a previously decided claim for lung and hernia injuries were returned to the trial level for benefit determination.

Workers' Compensation Appeals BoardPolice SergeantHeart ConditionHypertensionLabor Code Section 3212.5Presumption of CompensabilityAgreed Medical EvaluatorRebuttal of PresumptionIndustrial CausationDeposition Testimony
References
Case No. ADJ663546
Regular
Oct 01, 2009

Sudha Rajender vs. TOBIN LUCKS, MALMQUIST, FIELDS & CAMASTRA

The WCJ found insufficient evidence of significant stress to support a conclusion that work stress contributed to applicant's coronary heart disease. The Board affirmed the WCJ's determination and denied the petition for reconsideration.

Workers' Compensation Appeals BoardSudha RajenderTobin LucksMalmquist Fields Camastracumulative trauma injurymyocardial infarctionQualified Medical EvaluatorDr. Gerald Bessespetition for reconsiderationindustrial causation
References
Case No. ADJ7760117
Regular
Jul 10, 2020

SAMUEL SMITH vs. KERN COUNTY SHERIFF'S DEPARTMENT, COUNTY OF KERN

This case involves Samuel Smith, a deputy sheriff, seeking workers' compensation for claimed industrial injuries to his heart. The Workers' Compensation Appeals Board rescinded the prior decision, finding the medical record regarding the applicant's heart condition insufficiently developed. The Board remanded the case for further proceedings to determine when the applicant's hypertensive heart disease developed and whether it falls under the statutory presumption of industrial injury for sheriffs. Crucially, the Board requires additional medical evidence to establish causation by a reasonable medical probability.

Workers' Compensation Appeals BoardSamuel SmithKern County Sheriff's DepartmentDeputy SheriffReconsiderationFindings Orders and AwardLumbar SpineUpper ExtremitiesGERDCardiovascular System
References
Case No. ADJ6456347
Regular
Jan 30, 2012

MARK WILLIAMS vs. CITY OF PASADENA

This case involves a police officer claiming industrial injury to his heart due to hypertensive heart disease, a condition he argued was distinct from previously compensated hypertension. The Workers' Compensation Appeals Board (WCAB) rescinded the administrative law judge's decision, finding the claim was not barred by res judicata. The WCAB clarified that while hypertension alone is not considered heart trouble, left ventricular hypertrophy, as diagnosed in the current claim, constitutes a distinct condition. The case is returned to the trial level for further proceedings on other unresolved issues.

res judicatahypertensive heart diseasepolice officerLabor Code section 3212.5heart trouble presumptionleft ventricular hypertrophystipulated awardindustrial injurypermanent disabilityapportionment
References
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