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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ10713529
Regular
Nov 30, 2017

MARIA SOSA vs. CINTAS CORPORATION, TRAVELERS PROPERTY AND CASUALTY INSURANCE COMPANY OF AMERICA, SEDGWICK

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding applicant entitled to temporary total disability. The Board found insufficient evidence regarding applicant's specific job duties and whether they conflicted with the agreed medical evaluator's work restrictions. Therefore, the case is returned to the trial level for further development of the record, specifically for the AME to review a detailed job analysis. This is to determine if applicant could have continued her usual and customary duties but for her termination for cause.

Temporary total disabilityPetition for ReconsiderationFindings and AwardAgreed Medical Evaluator (AME)Work restrictionsTermination for causeJob dutiesFurther proceedingsDevelop the recordModified work
References
Case No. ADJ4638227 (LAO 0848464), ADJ519038 (LAO 0848465)
Regular
Oct 18, 2010

TINA ROBINSON vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award based on the defendant's argument that the applicant's permanent disability rating was incorrect. The Board found the record underdeveloped regarding the applicant's actual job duties as a traffic officer, which is crucial for determining the proper occupational group and variant under the 2005 Schedule. The case is returned to the trial level for further evidence and a new decision on the permanent disability issue.

ADJ4638227ADJ519038CITY OF LOS ANGELESTINA ROBINSONOccupational Group 4902005 Schedule for Rating Permanent Disabilitiesoccupational variantpermanent disability ratingJoint Findings and AwardReconsideration
References
Case No. ADJ8890531
Regular
Jan 10, 2014

HECTOR RODRIGUEZ vs. G & F ROOFING SUPPLY, INC., STATE COMPENSATION INSURANCE FUND

This case involves Hector Rodriguez's workers' compensation claim following a lumbar spine injury. The applicant appeals the denial of temporary total disability payments, arguing the employer's modified work offer was improper. The employer provided a sales position at a higher wage initially, but reduced the pay when the applicant failed to perform all assigned duties, which the judge found unrelated to his injury. The Board adopted the judge's report and denied the petition for reconsideration, finding the employer made a proper modified work offer and the applicant abandoned his job.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary Disability RateTemporary Total DisabilityModified DutyJob PerformanceCredibility of WitnessesWage Loss CompensationJob AbandonmentLumbar Spine Injury
References
Case No. ADJ7032862 ADJ8942352
Regular
Jan 31, 2019

Robert Lockhart vs. Lexmar Distribution, Inc., Safety National Casualty Company, MATRIX, Redwood Fire, BHHC, California Insurance Guarantee Association, SEDGWICK CLAIMS MANAGEMENT SERVICES, ULLICO CASUALTY COMPANY

Here's a summary of the case in four sentences for a lawyer: The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award finding a cumulative trauma injury. The Board found that neither of the medical evaluators adequately understood the applicant's specific job duties as a hostler driver. Without a proper understanding of the cumulative physical impact of these duties, their opinions lack substantial evidence to support a finding of cumulative trauma. The matter is returned to the trial level for further development of the medical record regarding the applicant's job duties.

Workers' Compensation Appeals BoardCumulative TraumaSpecific InjuryPermanent DisabilityMedical EvidenceAgreed Medical EvaluatorPanel Qualified Medical ExaminerJob DutiesHostler DriverTruck Driver
References
Case No. ADJ10887310
Regular
Jan 30, 2023

OSCAR MARTINEZ vs. SECURITA AMERICA, INC., GALLAGHER BASSETT, EVEREST NATIONAL INSURANCE

The applicant, Oscar Martinez, was injured on May 3, 2017, resulting in a 3% permanent disability. He returned to his regular job duties with his employer, Securita America, Inc., but was laid off approximately five months later due to his employer's contract ending. While Martinez subsequently worked for a new employer at the same location and performing similar duties, the Board found that this did not satisfy the requirement of returning to the "same job for the same employer" for at least 12 months. Therefore, the Appeals Board amended the prior finding, ruling that Martinez is entitled to a Supplemental Job Displacement Benefit (SJDB) voucher.

Supplemental Job Displacement BenefitSJDB voucherpermanent partial disabilityemployer's dutyregular work offermodified work offeralternative work offer12-month durationRule 10133.31(c)substantial evidence
References
Case No. ADJ8128282
Regular
Jan 23, 2014

ANGELA EGBIKUADJE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings. The defendant, California Department of Corrections and Rehabilitation, argued that the applicant's psychiatric injury claim was preempted by the ADA and not proven under Labor Code section 3208.3. The Board found the original decision lacked proper analysis regarding predominant industrial causation and the good faith personnel action defense. Therefore, the case was remanded for further development of the record, including expert medical opinion on these issues.

Workers' Compensation Appeals BoardAngela EgbikuadjeCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8128282Van Nuys District OfficeReconsiderationFindings and AwardIndustrial cumulative trauma injury
References
Case No. ADJ1805486 (GOL 0100327)
Regular
Apr 30, 2010

SUZANNE SINGER vs. DISNEYLAND, DISNEY WORLD WIDE SERVICES, Permissibly Self-Insured

This case involves an employee, Suzanne Singer, injured in a car accident after attending an employer-sponsored service award dinner. The employer, Disneyland, argued the injury was non-industrial due to a major deviation from a special mission exception to the going and coming rule and intoxication. While the Appeals Board agreed the injury occurred after a substantial deviation from the special mission, they noted the employer failed to prove intoxication was the proximate cause of the accident and might be estopped from raising that defense. Ultimately, the Board affirmed the finding of no industrial injury but deleted the intoxication finding.

Special mission exceptionGoing and coming ruleDeviationIntoxication defenseEstoppelCredibility determinationCourse of employmentArising out of employmentCumulative trauma injuryService award dinner
References
Case No. ADJ9099900
Regular
May 04, 2015

JESSEKA BETTS vs. YMCA OF THE EAST VALLEY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, affirming a prior award. The applicant, a YMCA site director, sustained injuries in a car accident while en route to a work-related meeting. The Board found that the "required vehicle exception" to the going and coming rule applied, as the applicant was required to use her personal vehicle for her job duties, for which she was reimbursed mileage. Therefore, her injuries were deemed to have arisen out of and in the course of employment.

Workers' Compensation Appeals Boardgoing and coming defenserequired vehicle exceptionmaterial deviationwork-related meetingmileage reimbursementsplit shiftssite directorcar insurancelicensing inspection
References
Case No. ADJ7253662, ADJ7254554
Regular
Sep 02, 2012

Guillermo Rivera vs. Cal Scan Trade Company/Villa Auto Sales, ACE USA, Preferred Employers

The Workers' Compensation Appeals Board denied reconsideration of a decision finding that Guillermo Rivera did not sustain an injury arising out of and in the course of employment. The Board adopted the Workers' Compensation Judge's (WCJ) report, which found the employer's witness more credible regarding job duties and the reported incident. Key factors for the WCJ's decision included the applicant's lack of timely medical treatment, the credibility of the applicant's testimony compared to the employer's witness, and the insufficient reasoning in the medical report. The Board gave great weight to the WCJ's credibility findings.

Workers' Compensation Appeals BoardPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeCredibility FindingLabor Code section 5903Adjudication of ClaimCar SalesmanInjury Arising Out of and Occurring in the Course of EmploymentMedical EvidenceJob Duties
References
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