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Case No. ADJ10964016

Regular

Jun 28, 2019

VALENTE GONZALEZ vs. WASCO STATE PRISON, STATE COMPENSATION INSURANCE FUND

This case involves an applicant who sustained an industrial injury to his back on July 7, 2017, which defendants sought to deny as a new injury. The applicant had a prior back injury from 2014. While a medical evaluator termed the 2017 incident a "flare-up," the Board found it constituted a new injury under Labor Code section 3208.1(a) as it was an employment-related incident causing disability. Therefore, the Board denied the defendant's petition for reconsideration.

Workers' Compensation Appeals BoardValente GonzalezWasco State PrisonState Compensation Insurance Fundcorrectional officerindustrial injuryback injuryspecific injurystipulated awardtemporary disability

References

Case No. ADJ6751877 ADJ6997475

Regular

Nov 17, 2010

BLANCA SUSANA DE LA VEGA vs. SONY CORPORATION OF AMERICA

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board adopted the judge's report, which found the applicant was not entitled to spinal surgery based on the Agreed Medical Examiner's opinion. The applicant also failed to prove a new injury occurred on March 13, 2009, as evidence indicated a flare-up of a prior injury. The Board found the Agreed Medical Examiner's opinion constituted substantial evidence and saw no reason to deviate from it.

ADJ6751877ADJ6997475Petition for ReconsiderationAgreed Medical Examinerspinal surgerylumbar fusionhysterical conversion reactionAOE/COEsubstantial medical evidenceprimary treating physician

References

Case No. ADJ7839872

Regular

Aug 13, 2015

, Kathleen Sears vs. , Campbell Union High School District; Permissibly Self-Insured, Administered by TRISTAR

The Workers' Compensation Appeals Board denied reconsideration of a decision finding no industrial injury AOE/COE for Kathleen Sears against Campbell Union High School District. The applicant, CIGA, argued that Dr. Damore's report supported a new cumulative trauma injury. However, the WCJ's report, adopted by the Board, found that Dr. Damore's findings were limited to conditions not covered by the original award and that subsequent medical evidence and the applicant's testimony did not support a sustained new injury. The Board concluded that Dr. Damore's findings likely represented a short-term flare-up, not a new cumulative trauma.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJCIGAcumulative injurybilateral upper extremitiesstipulated awardliquidationsubsequent injuryPQME

References

Case No. ADJ1347643

Regular

Apr 15, 2009

EVA RODRIGUEZ vs. AMERIKLEEN, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration to address inconsistencies in the trial judge's findings regarding lien claimant Cordova Chiropractic's treatment dates. The Board found the record unclear as to which specific treatment dates were disallowed and whether Dr. Park's QME report was properly considered. Specifically, the Board noted that Dr. Park's report appeared to approve past medical care, including May 2008 treatments rejected by the trial judge, and that the trial judge's reasoning for disallowing treatment lacked clear justification. The case is returned to the trial level for further proceedings to clarify the record and ensure proper application of relevant medical guidelines.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings and AwardPresiding Workers' Compensation JudgeReasonable and Necessary TreatmentQualified Medical EvaluatorACOEM GuidelinesLabor Code Section 4600Senate Bill 899

References

Case No. AHM 0111701

Regular

Jan 24, 2008

KATHY BOTT vs. THE ALLEY, EVEREST NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration, upholding the judge's finding that the applicant did not sustain an industrial injury. The applicant's lien for medical treatment was disallowed as a consequence of this determination. The Board also noted a clerical error in the original Findings and Order which will be corrected at the trial level.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeFindings and OrderLien ClaimantIndustrial InjuryPreexisting ConditionCompromise and ReleaseMedical TreatmentBurden of Proof

References

Case No. ADJ1567874 (SAC 0256813)

Regular

Oct 20, 2009

JEFFREY FRANKLIN vs. SAN JUAN UNIFIED SCHOOL DISTRICT

The WCAB affirmed the WCJ's decision that weekly chiropractic treatment for the applicant's industrial injury was reasonably required. The WCJ's decision was based on prior awards and applicant's testimony regarding pain relief and ability to work.

Utilization ReviewACOEM GuidelinesTreating Physician PresumptionLabor Code Section 4062(a)Reasonable and Necessary TreatmentChronic Neck and Back ConditionFlare-upsMedical Treatment AwardFunctional CapacityWCJ

References

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VALENTE GONZALEZ vs. WASCO STATE PRISON, STATE COMPENSATION INSURANCE FUND

BLANCA SUSANA DE LA VEGA vs. SONY CORPORATION OF AMERICA

ADJ6751877ADJ6997475Petition for ReconsiderationAgreed Medical Examinerspinal surgerylumbar fusionhysterical conversion reactionAOE/COEsubstantial medical evidenceprimary treating physician

, Kathleen Sears vs. , Campbell Union High School District; Permissibly Self-Insured, Administered by TRISTAR

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJCIGAcumulative injurybilateral upper extremitiesstipulated awardliquidationsubsequent injuryPQME

EVA RODRIGUEZ vs. AMERIKLEEN, STATE COMPENSATION INSURANCE FUND

KATHY BOTT vs. THE ALLEY, EVEREST NATIONAL INSURANCE COMPANY

JEFFREY FRANKLIN vs. SAN JUAN UNIFIED SCHOOL DISTRICT