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

Case No. ADJ3864552 (LAO 0788138)
Regular
Jan 03, 2011

ANTONIETA GUERRERO vs. WELLPOINT HEALTH NETWORK, INC., ZURICH LOS ANGELES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For FREMONT In Liquidation

The Workers' Compensation Appeals Board granted reconsideration of a prior award due to insufficient analysis by the WCJ regarding the date(s) of cumulative trauma. The Board found the WCJ's decision lacked specific reference to evidence, particularly on whether multiple or a single period of cumulative trauma applied. The matter was returned to the trial level for further proceedings, a new decision, and adequate analysis of all contentions, including permanent disability and apportionment.

Cumulative traumaOveruse syndromeFibromyalgiaPsyche injuryPermanent total disabilityApportionmentAttorney feesFindings and AwardReconsiderationWCJ
References
Case No. ADJ7332241
Regular
Jun 30, 2011

Jesus Hernandez vs. JCB CLARK ENTERPRISES INC, U.S. FIRE AND GUARANTY

Here's a summary for a lawyer: The Workers' Compensation Appeals Board denied Jesus Hernandez's petition for reconsideration, affirming the WCJ's decision that he failed to meet his burden of proof for a cumulative trauma injury ending March 17, 2007. The applicant argued that prior injuries and a doctor's report supported his claim for a longer period, but the Board found his arguments unpersuasive. A dissenting commissioner believed the case should be returned for further proceedings on orthopedic cumulative trauma claims due to disputed employment periods and available evidence.

Cumulative TraumaPetition for ReconsiderationFindings and AwardWorkers' Compensation Administrative Law Judge (WCJ)Burden of ProofIndustrial Cumulative TraumaPast Industrial InjuryMedical EvidenceSubstantial Medical EvidenceFaulty History
References
Case No. ADJ7050517
Regular
Jun 16, 2010

Gary Tull vs. YOUNGS MARKET, Permissibly Self-Insured Administered By CANNON COCHRAN MANAGEMENT SERVICES

This case concerns an applicant claiming cumulative trauma injury to his right knee. The WCJ denied the claim, finding the Panel QME's report insufficient to establish cumulative trauma. The Appeals Board granted reconsideration, noting the PQME found an injury and work-related causation but incorrectly characterized it as a specific injury on a particular date. The Board remanded the case to develop the medical record, specifically directing a supplemental report from the PQME on the cumulative trauma aspect of the claim.

Cumulative traumaPanel Qualified Medical EvaluatorPQMEIndustrial injuryRight kneeFindings and OrderReconsiderationTake nothing orderSubstantial medical evidenceBurden of proof
References
Case No. ADJ7785251
Regular
Nov 14, 2014

Jon Brothers vs. STATE OF CALIFORNIA, DEPARTMENT OF FORESTRY AND FIRE PROTECTION, COASTAL/NORTH REGION; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to clarify that the applicant's cumulative trauma orthopedic injury claim is still under development. The Board agreed with the WCJ that the defense's medical expert, Dr. Baldwin, failed to provide substantial medical evidence due to a misunderstanding of cumulative trauma principles. Dr. Baldwin improperly required documented prior specific injuries to opine on cumulative trauma, thereby failing to adequately assess the applicant's extensive work history. Therefore, the case is affirmed except for the amendment of a finding of fact to reflect that the orthopedic injury claim is contested and requires further medical evaluation.

Cumulative traumaQualified Medical EvaluatorIndependent Medical Evaluatorsubstantial medical evidenceorthopedic injurybinaural hearing losscardiovascular systemBattalion Chiefretired annuitantorthopedic cumulative trauma
References
Case No. ADJ6550186
Regular
Mar 18, 2013

KELVIN EDWARDS vs. DALLAS COWBOYS, TRAVELERS INDEMNITY COMPANY AND ITS CASUALTY AFFILIATES AND SUBSIDIARIES, SAN FRANCISCO 49ERS, NATIONAL UNION FIRE INSURANCE COMPANY, CHARTIS CLAIMS, INC.

This case involves a cumulative trauma injury claim by former professional football player Kelvin Edwards. The Workers' Compensation Appeals Board (Appeals Board) affirmed the finding of a single cumulative trauma injury to multiple body parts, rejecting the defendant's argument for apportionment to different employers and dates of injury. The Appeals Board also reversed the award of a Labor Code section 5814 penalty against the San Francisco 49ers, finding their delay in paying benefits was not unreasonable. The applicant's entitlement to permanent disability and future medical treatment, as initially awarded, remains in place.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaPermanent DisabilityLabor Code Section 5500.5Injurious ExposureApportionmentLabor Code Section 5814PenaltyUnreasonable Delay
References
Case No. ADJ2630861 (LAO 0880530)
Regular
Nov 16, 2012

MARTHA PONCE vs. ASHLEY & J PHARMACY CORP, dba ROSS MEDICAL PHARMACY, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to amend a prior award, rescinding the permanent disability award for applicant's sleep loss. While the applicant was found to have sustained cumulative trauma injury to her neck, back, and psyche, the Board determined that an additional impairment rating for sleep loss was duplicative of existing orthopedic and psychiatric ratings. The original award of 53% permanent disability was reduced to 47%, and the attorney's fees were adjusted accordingly. The Board also rejected the defendant's argument for apportionment to a specific back injury, as the cumulative trauma finding was already final.

Workers Compensation Appeals BoardAshley & J Pharmacy CorpEmployers Compensation Insurance CompanyMartha PonceOpinion and Order Granting ReconsiderationDecision After Reconsiderationsleep losscumulative trauma injuryneckback
References
Case No. ADJ7250315
Regular
Feb 14, 2020

ROBYN ARIAS vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS & REHABILITATION

This case involves a correctional officer's cumulative trauma claim. The employer sought reconsideration, arguing the cumulative trauma ended on July 8, 2014, as the applicant allegedly sustained no disability prior to that date. However, the Board denied reconsideration, affirming the WCJ's finding that the applicant experienced disability earlier due to chemotherapy for non-Hodgkins lymphoma. This disability, occurring from February 2007 to February 2008, establishes the injury's cumulative trauma period under Labor Code section 5412.

Cumulative traumaCorrectional officerLumbar spine injuryPsyche injuryNon-Hodgkins LymphomaPermanent disability indemnityCompensable consequence injuryLabor Code section 5412Date of injuryCumulative injury end date
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ6693720
Regular
Mar 15, 2010

KERRY NECHODOM vs. CITY OF GROVER BEACH

The Workers' Compensation Appeals Board granted reconsideration to amend the date of injury for Kerry Nechodom's right shoulder injury in case ADJ6693720 from February 3, 2007 - September 10, 2009 to August 12, 2008 - September 10, 2009. This amendment acknowledges a separate cumulative trauma injury due to distinct periods of disability and lack of continuous treatment between injuries. The Board affirmed the original award, finding that the applicant sustained two separate cumulative trauma injuries causing distinct periods of temporary disability. The employer's arguments regarding the cumulative trauma period and Labor Code $\S 4656$ limitations were addressed and resolved by this clarification.

Workers' Compensation Appeals BoardKerry NechodomCity of Grover BeachADJ6693720ADJ5791464ReconsiderationJoint Findings and AwardIndustrial InjuryRight ShoulderCumulative Injury
References
Case No. ADJ1936857
Regular
Jul 08, 2010

Robert Terrazas vs. COMPUSA, Westmont College, Zurich Los Angeles, COMPWEST Newport Beach

The Workers' Compensation Appeals Board (WCAB) amended a prior award concerning Robert Terrazas's cumulative trauma knee injury. The WCAB corrected the cumulative trauma injury date to February 25, 2008, establishing liability for employers during the final year of exposure, specifically Westmont College and COMPUSA. Apportionment of disability was confirmed, but the division of liability and reimbursement between the two employers was deferred pending mandatory arbitration. The WCAB also admonished Westmont's counsel for violating procedural rules in their petition for reconsideration.

Cumulative traumaSpecific injuryApportionmentDate of injuryContinuous traumaLeft kneePermanent disabilityIndustrial exposureEmployer liabilityContribution
References
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