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

Case No. ADJ488924 (SDO 0329999), ADJ226519 (SDO 0302236), ADJ2353553 (SDO 0250184), ADJ4021935 (SDO 0269434)
Regular
Dec 10, 2020

Craig Stevens vs. Subsequent Injuries Benefits Trust Fund

The Workers' Compensation Appeals Board (WCAB) rescinded a previous order denying benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). Applicant Craig Stevens sought SIBTF benefits for a claimed subsequent cumulative trauma injury to his neck ending April 2, 2009, with a compensable consequence injury to his right shoulder and low back. The WCAB found the medical evidence regarding the causation, date of injury, and permanent disability ratings for the alleged subsequent injuries, as well as prior injuries, to be insufficient and inconsistent. The case was returned to the trial level for further development of the record, including obtaining new medical opinions to clarify the various injuries and establish SIBTF eligibility thresholds.

Subsequent Injuries Benefits Trust FundSIBTF eligibilitycumulative trauma injurycompensable consequence injurypermanent disabilityapportionmentmedical evidencecausationfurther development of the recordLabor Code section 4751
References
9
Case No. ADJ6445214, ADJ7300126, ADJ4142400 (SRO 0141131), ADJ1321514 (SRO 0141130)
Regular
Aug 03, 2016

BONNIE MCLAUGHLIN vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND, ALBERTSON'S/SAVE MART

This case involves Bonnie McLaughlin's claim for Subsequent Injuries Benefits Trust Fund (SIBTF) benefits stemming from multiple industrial injuries to her neck, back, extremities, and psyche. The Workers' Compensation Appeals Board (WCAB) overturned a prior decision denying these benefits. The WCAB found that McLaughlin met the criteria for SIBTF eligibility under Labor Code section 4751, as her cumulative injury through May 3, 2007, resulted in additional permanent disability that, when combined with prior injuries, caused a disability greater than that from the subsequent injury alone. Therefore, SIBTF benefits are awarded.

Subsequent Injuries Benefits Trust FundSIBTFpermanent disabilitycumulative traumaspecific injuryapportionmentvocational expertAgreed Medical EvaluatorQualified Medical Evaluatorcompensable injury
References
4
Case No. ADJ2651648 (MON 0342704)
Regular
Jul 18, 2017

TERESA SANCHEZ vs. HAWTHORNE UNIFIED SCHOOL DISTRICT, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of an award granting applicant benefits for a 2006 industrial injury, arguing the prior disability rating was insufficient. The applicant had two industrial injuries: a 1997-2002 cumulative trauma and the 2006 specific injury, both causing fibromyalgia. The WCJ found the combined disability from both injuries exceeded the threshold for SIBTF benefits, based on her primary treating physician's rating. The Appeals Board affirmed the WCJ's decision, adopting the judge's report which found the applicant met the criteria for SIBTF benefits, and denied the SIBTF's petition.

Subsequent Injuries Benefits Trust FundSIBTFcumulative traumacompensable consequencefibromyalgiapermanent and stationaryAgreed Medical ExaminerAMA Guides1997 rating scheduleprimary treating physician
References
0
Case No. ADJ2669193 (VNO 0474323) ADJ4691947 (VNO 0461922)
Regular
Nov 03, 2009

TERRY BLEDSOE vs. TOWER MANAGEMENT, BROADSPIRE FOR LUMBERMENS MUTUAL CASUALTY COMPANY

The WCAB denied reconsideration of an arbitrator's finding that SCIF was liable for applicant's cumulative trauma injury. SCIF argued the injury date should be the date of a specific injury, but the AME found disability from both the specific and cumulative injuries. The WCAB affirmed, finding no evidence that the applicant knew or should have known of the cumulative injury earlier.

Workers Compensation Appeals BoardCumulative Trauma InjuryDate of InjurySpecific InjuryAgreed Medical ExaminerApportionment of ResponsibilityCompensable Temporary DisabilityPermanent DisabilitySection 5412Section 5500.5
References
3
Case No. ADJ2719991 (VNO 0485134) ADJ1334047 (VNO 0428744)
Regular
Aug 20, 2009

Catalina Barajas vs. WELLPOINT HEALTH NETWORK, INC., ZURICH LOS ANGELES

This case involves an applicant who initially sustained a cumulative trauma injury to her upper extremities during a period covered by one insurer. After returning to work with modified duties, she experienced a recurrence and worsening of symptoms, necessitating further treatment and surgery, which the Board now recognizes as a separate cumulative trauma injury. The Workers' Compensation Appeals Board granted reconsideration, reversing the prior finding of a single cumulative trauma injury. The Board held that distinct periods of compensable temporary or permanent disability, as established by medical evidence and treatment, demarcate separate cumulative trauma injuries, aligning with the *Rodarte* precedent. Consequently, the applicant was found to have sustained two separate cumulative trauma injuries, each attributed to different insurance coverage periods.

cumulative traumaanti-merger doctrineLabor Code sections 3208.25303Rodartecompensable temporary disabilitypermanent disabilitywage lossmodified workbilateral upper extremities
References
3
Case No. ADJ8514073 (MF) ADJ9995510 ADJ2721680 (FRE 0187462)
Regular
Sep 24, 2018

VICTOR VILLA vs. JOE CARDOZA DAIRY, PAULA INS. in receivership by CIGA, INSURANCE COMPANY OF THE WEST, SECURITY NATIONAL administered by RISICO, REPUBLIC INDEMNITY administered by SEDGWICK

This case concerns a dispute over the dates of a cumulative trauma injury to the applicant's left knee, following an admitted 1998 specific injury. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to amend the injury period. The WCAB determined the date of cumulative trauma injury under Labor Code § 5412 was September 4, 2012, the date the applicant retained counsel and gained awareness of the cumulative trauma concept. Consequently, liability for the cumulative trauma injury under Labor Code § 5500.5 was established as September 4, 2011, to September 4, 2012.

WORKERS COMPENSATION APPEALS BOARDJOE CARDOZA DAIRYPAULA INSCIGAINSURANCE COMPANY OF THE WESTSECURITY NATIONALREPUBLIC INDEMNITYSEDGWICKVICTOR VILLASUBSEQUENT CUMULATIVE TRAUMA
References
0
Case No. ADJ8939849
Regular
Jan 04, 2016

GEORGE KIMMEL vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation claim for hearing loss. The applicant, a former correctional officer, alleged injury from a 1978 bomb blast and cumulative trauma from noise exposure throughout his career. The Workers' Compensation Appeals Board (WCAB) rescinded the initial award finding a cumulative trauma injury with a 2014 date of injury. The WCAB determined the case involves potential specific and cumulative injuries, requiring further development of the record regarding the date of injury, last injurious exposure, and the exact nature of the injuries. The matter was returned to the trial level for these further proceedings.

Cumulative traumaStatute of limitationsLachesDate of injurySpecific injuryTinnitusHearing lossQualified Medical ExaminerImprovised explosive deviceMatch bomb
References
3
Case No. ADJ3280434 (MF) ADJ6953178
Regular
Dec 07, 2012

WILLIAM RICHARDSON vs. CHECKMATE TRANSPORT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for CASCADE NATIONAL INSURANCE, in liquidation, TONY'S SONS MOVING & STORAGE, STATE COMPENSATION INSURANCE FUND

This case concerns applicant William Richardson's claim for permanent disability due to specific and cumulative industrial injuries. The Workers' Compensation Appeals Board (WCAB) affirmed the finding of total permanent disability stemming from a specific injury in 2004. The WCAB clarified that the presumption of total permanent disability does not preclude apportionment, but found that the applicant's current total permanent disability was solely caused by the specific injury, not the cumulative trauma. Therefore, apportionment to the cumulative injury was denied, and the claim for cumulative trauma was dismissed.

Workers Compensation Appeals BoardCIGASCIFReconsiderationJoint FindingsAwardOrderAdministrative Law JudgeSpecific Industrial InjuryCumulative Trauma
References
2
Case No. ADJ2307991 (VNO 0427797) (MF) ADJ3536405 (VNO 0336819) ADJ487962 (VNO 0533632)
Regular
Jun 14, 2018

JACQUELINE AUSTIN vs. FIRST FOURSQUARE CHURCH OF VAN NUYS, GUIDE ONE MUTUAL INSURANCE COMPANY, FREMONT, CIGA, CYPRESS INSURANCE COMPANY, FOREST LAWN MEMORIAL PARK, SAFECO INSURANCE, TRAVELERS PROPERTY CASUALTY COMPANY

This case involves an applicant who sustained two separate cumulative trauma injuries to her neck, back, and gastrointestinal system, including GERD and fibromyalgia. The Workers' Compensation Appeals Board (WCAB) affirmed the findings that the applicant suffered distinct industrial injuries during employment with First Foursquare Church (insured by Cypress) and Forest Lawn Memorial Park (insured by Travelers). Defendant Cypress contested the dating of the injury and the finding of two separate cumulative trauma periods, while Travelers challenged the sufficiency of medical evidence for one injury. The WCAB found Cypress waived the issue of one versus two cumulative trauma injuries by failing to raise it timely. Ultimately, the WCAB adopted the WCJ's findings, confirming the two separate cumulative trauma periods and the respective carrier liabilities.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaDate of InjuryLabor Code Section 5412Labor Code Section 5500.5Findings of FactAward and OrderAdministrative Law JudgeCypress Insurance Company
References
9
Case No. ADJ4134943 (LAO 0800933), ADJ2639030 (LAO 0847979)
Regular
Jan 14, 2016

ARTURO GUILLEN vs. PRO AMERICA PREMIUM TOOLS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, INTERCARE INSURANCE SERVICES, PACIFIC NATIONAL INSURANCE COMPANY, HIGHLANDS INSURANCE COMPANY

This case involves a petition for reconsideration by Highlands Insurance Company regarding a prior decision that found the applicant sustained two cumulative trauma injuries. The Workers' Compensation Appeals Board affirmed its prior decision, finding one injury occurred when Pacific National Insurance Company was the insurer and the second injury occurred when Highlands was the insurer. Highlands argued the applicant sustained only one cumulative trauma injury or a single specific injury. The Board denied Highlands' petition, upholding the determination of two distinct cumulative trauma injuries.

Cumulative trauma injuryCalifornia Insurance Guarantee AssociationCIGAPacific National Insurance CompanyHighlands Insurance CompanyPro America Premium ToolsPetition for ReconsiderationDecision After Reconsiderationinsurer in liquidationservicing facility
References
1
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