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

Case No. ADJ383777
Regular
Apr 04, 2011

Roxanna Ortiz vs. ONE SOURCE, ESIS

The Workers' Compensation Appeals Board denied Roxanna Ortiz's petition for reconsideration of a prior findings and order. The initial ruling determined she sustained industrial injury only to her cervical spine as a janitor, not to other body parts or any resulting temporary/permanent disability or need for further medical treatment. Ortiz argued the judge erred by favoring defense medical reports and discrediting her testimony due to minor inconsistencies in her injury description. The Board adopted the WCJ's report, emphasizing deference to credibility determinations and that admissibility of medical reports should have been challenged at trial, not on reconsideration. A dissenting opinion argued the judge overemphasized minor variations in Ortiz's account and that medical evidence did not sufficiently support denial of other injuries or further treatment.

OrtizOne SourceESISWCABFindings and OrderPetition for ReconsiderationWorkers' Compensation Administrative Law Judgeindustrial injurycervical spineright arm
References
Case No. ADJ9625407
Regular
Sep 12, 2018

KEITH FIELD vs. CITY OF PINOLE

This case involves a firefighter who sustained bilateral carpal tunnel syndrome after retirement. The Appeals Board reversed the trial judge, holding that Labor Code section 4458.5 applies, entitling the applicant to permanent disability benefits calculated at the maximum indemnity rate. This applies regardless of the applicant's actual earnings or the fact that carpal tunnel syndrome is not a specifically enumerated presumptive injury. The case is remanded for determination of the precise date of injury to calculate the benefit rate.

Workers' Compensation Appeals BoardKeith FieldCity of PinolePermissibly Self-InsuredMunicipal Pooling AuthorityADJ9625407Opinion and Decision After Reconsiderationindustrial injuryfirefighterbilateral upper extremities
References
Case No. ADJ1806235 (OAK 0229406) ADJ3677836 (OAK 0279846) ADJ3058455 (OAK 0347422)
Regular
Jun 03, 2013

THEODORE FERNANDEZ vs. TENET HEALTHCARE dba SAN RAMON REGIONAL MEDICAL CENTER, SEDGWICK CMS, VALLEYCARE HEALTH SYSTEM, LUMBERMEN'S UNDERWRITING ALLIANCE, TRAVELERS PROPERTY AND CASUALTY INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case to the trial level for further proceedings. The Board found insufficient medical evidence to definitively link the applicant's wrist condition to his 1993 injury. It noted the applicant's wrist symptoms emerged and worsened years after his employment with the original employer, suggesting a potential cumulative trauma injury with a subsequent employer. The Board ordered further development of the medical record to clarify the nature and causation of the applicant's bilateral wrist issues.

WCABReconsiderationCumulative TraumaBilateral Upper ExtremitiesCarpal Tunnel SyndromeUlnar NeuritisCubital Tunnel SyndromeAgreed Medical EvaluatorApportionmentSubstantial Medical Evidence
References
Case No. ADJ4430701 (EUR 0038510)
Regular
Nov 25, 2008

Darron D. Dunlap vs. THE PACIFIC LUMBER COMPANY

The Appeals Board granted reconsideration, rescinded the WCJ's decision, and found the applicant sustained cumulative trauma injury to his bilateral elbows and claimed cumulative injury to his wrists. The Board found that medical evidence supported a cumulative injury rather than the previously determined specific injury. The case was returned to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderAdministrative Law JudgeCompensable Cumulative TraumaSpecific InjuryBilateral ElbowsBilateral WristsCarpal Tunnel SyndromeCubital Tunnel Syndrome
References
Case No. ADJ10750466
Regular
Aug 02, 2019

GRISELDA ANTUNEZ vs. WM CORPORATE SERVICES, INC./WASTE MANAGEMENT SERVICES, INC., and ACE AMERICAN INSURANCE, administered by GALLAGHER BASSETT SERVICES, INC

The Workers' Compensation Appeals Board (WCAB) granted reconsideration, rescinded the prior Findings & Award, and returned the matter for further proceedings. The WCAB found that the defendant's medical expert's opinions, which concluded applicant did not sustain injury AOE/COE, did not constitute substantial evidence due to inconsistencies and reliance on inadequate history. The existing medical reports from treating physicians in the record do not address the cumulative trauma injury issue. Therefore, the WCAB ordered further development of the record, possibly through an agreed medical examiner or a court-appointed physician.

WCABPetition for ReconsiderationFindings & AwardQualified Medical ExaminerQMEArising out of and occurring in the course of employmentAOE/COESubstantial EvidenceCumulative TraumaCarpal Tunnel Syndrome
References
Case No. GOL 86641, GOL 99800
Regular
Aug 07, 2008

MIGUEL TORRES vs. HENDRY TELEPHONE PRODUCTS, CONNECTICUT INDEMNITY/ROYAL & SUNALLIANCE INSURANCE, HR3 STAFFING SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, LEGION INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to correct errors in the original award, specifically the misidentification of employers and their insurers. The WCAB rescinded the prior award and returned the case for further proceedings to determine the existence of a cumulative injury and clarify employer liability. The Board also noted that Connecticut Indemnity's policy likely constitutes "other insurance," thus precluding CIGA's involvement.

Workers' Compensation Appeals BoardJoint Findings and AwardReconsiderationIndustrial InjuryNeckRight Upper ExtremityCarpal Tunnel SyndromeCubital Tunnel SyndromeHeadachesDizziness
References
Case No. ADJ7775170
Regular
Jul 16, 2012

JUANA NEGRETE vs. SHURFLO, HAMPSHIRE INSURANCE COMPANY

This case involves an applicant's workers' compensation claim filed after layoff, triggering Labor Code Section 3600(a)(10). The Appeals Board granted reconsideration, finding the applicant met her burden of proof that she notified her employer of her injury prior to her layoff. The applicant's unrebutted testimony and supporting medical evidence demonstrated employer notice, thus overcoming the statutory bar to compensation. The case was remanded for further proceedings on the merits of the applicant's claim.

Workers' Compensation Appeals BoardJuana NegreteShurfloHampshire Insurance CompanyADJ7775170Opinion and Order Granting ReconsiderationDecision After Reconsiderationbilateral armsbilateral elbowssleep problems
References
Case No. ADJ2737564 (SBR 0322205)
Regular
Nov 10, 2009

Oscar G. Sanchez vs. DIETRICH INDUSTRIES, ST. PAUL/TRAVELERS INSURANCE COMPANY

The Appeals Board denied reconsideration of an opinion and order granting reconsideration and decision after reconsideration. The Board reaffirmed that the 2005 permanent disability rating schedule applied, denying the applicant’s petition for reconsideration.

Permanent Disability Rating ScheduleCumulative Trauma InjuryOtolaryngologistMedical-Legal ReportTreating PhysicianLabor Code Section 4660(d)Exception2005 PDRS1997 PDRSTinnitus
References
Case No. ADJ3582743 (STK 0215397)
Regular
Apr 11, 2014

KERI LARSEN vs. MODESTO IRRIGATION DISTRICT

This case concerns defendant Modesto Irrigation District's petition for reconsideration of a workers' compensation award. The Workers' Compensation Appeals Board granted reconsideration, finding the administrative law judge erred in using an incorrect impairment number for calculating permanent disability. The Board amended the award to reflect an 18% permanent disability rating, based on the agreed medical evaluator's opinion regarding lateral epicondylitis and decreased grip, not nerve entrapment. The Board also corrected the finding for future medical treatment to the right arm and elbow, aligning with the amended disability rating.

Workers' Compensation Appeals BoardModesto Irrigation DistrictKerri Larsenpermanent disability ratingAMA GuidesAlmarez-Guzmanstraight ratingReport And Recommendation On Petition For ReconsiderationAgreed Medical EvaluatorAME
References
Case No. ADJ8581707, ADJ9202518
Regular
Sep 15, 2017

GERALDINE SWEATT vs. J. S. WEST COMPANIES, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's finding that a prior stipulation for an award was based on a mutual mistake of fact. The central issue was whether the applicant sustained a specific injury to her bilateral upper extremities. The Board agreed that a subsequent change in the qualified medical evaluator's opinion, after the award was entered, created a situation unforeseeable to the parties, justifying the reconsideration of the award's validity. The Board noted concerns about the QME's methodology and encouraged the parties to consider an Agreed Medical Evaluator.

Petition for ReconsiderationMutual Mistake of FactBilateral Upper ExtremitiesStipulations with Request for AwardQualified Medical EvaluatorCausationSubstantial EvidenceMedical OpinionCumulative TraumaRepetitive Strain Injury
References
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