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

Case No. ADJ8552864
Regular
Jan 28, 2014

ELAINE DEVILLE vs. VERIZON, SEDGWICK CMS

This case involves Elaine Deville's workers' compensation claim against Verizon for an injury to her neck. The defendant, Verizon, sought reconsideration of the finding that the injury arose out of and occurred in the course of employment (AOE/COE), arguing the medical evidence was insufficient. The Workers' Compensation Appeals Board denied reconsideration, deferring to the judge's credibility findings and adopting the judge's reasoning. The judge relied on the applicant's consistent testimony and the Agreed Medical Examiner's report, which linked the applicant's cervical spine disability to repetitive trauma from her job.

Petition for ReconsiderationDENIEDWORKERS' COMPENSATION APPEALS BOARDAOE/COEDr. Wertheimersubstantial evidenceapplicant's testimonyindustrial cumulative traumacervical spinerepetitive trauma
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. ADJ7456826 ADJ7507377
Regular
May 29, 2012

MARIA ARELLANO vs. ON SECOND THOUGHT DBA PENINSULA CLEANING administered by ARGO SELECT

The Workers' Compensation Appeals Board denied applicant Maria Arellano's petition for reconsideration of the judge's findings. The judge previously determined that Arellano did not sustain injury arising out of and in the course of employment for both specific and cumulative trauma claims. Applicant's argument that the judge erred by not considering the Panel Qualified Medical Evaluator's report as substantial evidence and by not developing the record on her job description was rejected. The Board found that the applicant failed to establish estoppel based on a disputed agreement to accept liability and that the PQME's opinion was not substantial evidence due to an inaccurate history.

Petition for ReconsiderationDeniedAOE/COESpecific Trauma InjuryCumulative Trauma InjuryPanel Qualified Medical Evaluator (PQME)Substantial EvidenceJob DescriptionEstoppelMinutes of Hearing
References
Case No. ADJ4142754 (AHM 0142785) ADJ6726440
Regular
Sep 05, 2013

Joshua Hubbard vs. United Parcel Service, Liberty Mutual Insurance

This case concerns Joshua Hubbard's workers' compensation claims for a cardiac arrest and alleged cumulative trauma. The Workers' Compensation Appeals Board denied reconsideration of the decision to deny Hubbard's claims. The WCJ's report, adopted by the Board, found no medical evidence supported either a cumulative trauma injury or that the specific cardiac arrest arose out of employment. The medical opinions cited by the applicant were found insufficient to establish causation, lacking definitive information regarding work hours and applicable medical theories.

WCABPetition for ReconsiderationDeniedCardiac ArrestCourse of EmploymentArising Out Of EmploymentCumulative TraumaSpecific InjuryMedical EvidenceDr. Dimmick
References
Case No. ADJ7945624
Regular
Jun 07, 2013

JUAN SANTA CRUZ vs. MARTIN RUBBER, PATRIOT RISK SERVICES

The Workers' Compensation Appeals Board denied reconsideration of its prior decision. The applicant claimed injury from continuous trauma as a machine operator but provided inconsistent testimony regarding lifting weights. The employer's testimony contradicted the applicant's account of his duties and lifting requirements. The Board found the applicant's testimony less credible, affirmed the judge's findings, and denied the petition for reconsideration.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationWCJ ReportcredibilityGarza v.Workmen's Comp. Appeals Bd.industrial injurycontinuous traumamachine operatorPetitioner's Contentionsfraud
References
Case No. ADJ8453660, ADJ8930519
Regular
Aug 01, 2014

JOZEF APANEL vs. CASCADE WATER SERVICES, FEDERAL INSURANCE, CHUBB, TWIN CITY FIRE INSURANCE COMPANY, THE HARTFORD

The Workers' Compensation Appeals Board denied reconsideration of a decision that applicant Jozef Apanel sustained injuries arising out of and in the course of employment. The Board adopted the Judge's report, which found the primary treating physician's reports substantial evidence despite some minor errors. The defendants' petition was denied due to mischaracterizations of applicant testimony and failure to fairly state all material evidence. The judge's report found the applicant credible and met his burden of proof for cumulative trauma injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedWCJ's ReportMaterial EvidenceCumulative TraumaPrimary Treating PhysicianQualified Medical EvaluatorSubstantial Medical EvidenceApplicant's Credibility
References
Case No. ADJ6757153
Regular
Jan 12, 2012

GUSTAVO ACOSTA vs. NORM REEVES HONDA, TRAVELERS

This case concerns Gustavo Acosta's petition for reconsideration of a workers' compensation decision. The applicant claimed continuous trauma injury to multiple body parts while employed by Norm Reeves Honda. The employer denied the claim, asserting it was filed after applicant's termination and without timely notice of injury. The Administrative Law Judge found the applicant failed to prove reporting the injury to employer representatives or providing medical evidence of treatment prior to termination. The Workers' Compensation Appeals Board adopted the ALJ's report and denied the petition for reconsideration, giving great weight to the ALJ's credibility findings.

Workers' Compensation Appeals BoardNorm Reeves HondaTravelersPetition for ReconsiderationDeniedWCJ ReportGarza v. Workers' Comp. Appeals Bd.CredibilityContinuous TraumaLabor Code §3600(a)(10)
References
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. ADJ10087769, ADJ10087742
Regular
Dec 01, 2016

JORGE HUERTA HUERTA vs. IL COLORE, INC.; ACE AMERICAN INSURANCE COMPANY, administered by BARRETT BUSINESS SERVICES

In this workers' compensation case, the defendant appealed the WCJ's issuance of PQME panels in a denied cumulative trauma claim (ADJ10087769), arguing it was improperly processed via an expedited hearing. The Appeals Board denied the petition for removal, finding that while an expedited hearing was inappropriate for a denied claim, the WCJ correctly treated it as a status conference. The Board noted that the defendant did not contest the underlying propriety of issuing PQME panels in the denied case, thus failing to demonstrate substantial prejudice or irreparable harm required for removal. The defendant's objection was primarily to the procedural method used, not the ultimate decision to issue the panels.

Petition for RemovalPanel Qualified Medical ExaminerExpedited HearingDenied ClaimAccepted ClaimCumulative TraumaSpecific InjuryDeclaration of ReadinessStatus ConferenceLabor Code Section 4060
References
Case No. SAC 0250554, SAC 0346177
Regular
Apr 04, 2008

MICHAEL ISQUIERDO vs. CHEVREAUX CONCRETE, INC., CAMBRIDGE INTEGRATED SERVICES

The Workers' Compensation Appeals Board denied reconsideration of a decision regarding Michael Isquierdo's claims. The Board found that the Workers' Compensation Judge's determination that the applicant did not sustain an industrial injury during the period ending August 1, 1998, was supported by substantial medical evidence. Consequently, the issue of whether the claim was barred by the statute of limitations was not reached, and the petitions for reconsideration were denied.

Workers' Compensation Appeals BoardReconsideration DeniedSubstantial Medical EvidenceIndustrial InjuryStatute of LimitationsCumulative TraumaApportionmentPermanent DisabilityCredibilityMedical-Legal Report
References
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