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

Case No. ADJ12288761
Regular
Dec 29, 2020

MICHAEL GOMEZ vs. CALIFORNIA INSTITUTION FOR WOMEN, STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding a finding of 62% permanent disability for a correctional officer with cumulative trauma. The core issue was whether Left Ventricular Hypertrophy (LVH), found by a QME, constituted "heart trouble" under Labor Code section 3212.2, triggering a presumption of industrial injury. The Board affirmed the WCJ's decision, relying on prior case law and expert medical opinions that LVH, even if minor, qualifies as "heart trouble" for purposes of the presumption. Defendant's arguments that LVH was not "heart trouble" and that medical opinions were contradicted were rejected as insufficient to rebut the presumption.

Workers' Compensation Appeals BoardCalifornia Institution for Womencorrectional officercumulative traumainternal organshypertensionGERDheart trouble presumptionLabor Code section 3212.2Left Ventricular Hypertrophy
References
Case No. ADJ7494670
Regular
Jun 01, 2012

JOSEPH CURRAN, Deceased, JERI CURRAN, Spouse vs. CITY OF SACRAMENTO

The Workers' Compensation Appeals Board denied reconsideration of a decision finding that the deceased firefighter, Joseph Curran, suffered a heart injury arising out of and in the course of employment. The Board affirmed that the Labor Code Section 3212 heart trouble presumption applied. The defendant failed to rebut this presumption by demonstrating that a contemporaneous non-work-related event was the *sole* cause of the heart trouble. Dr. Bellinger's testimony, while stating the presumption was necessary, did not affirmatively prove exclusive non-industrial causation.

Labor Code 3212heart trouble presumptionindustrial causationrebutted presumptionanti-attribution clausesole causenonwork-related eventcumulative injuryfirefighterdeath benefits
References
Case No. ADJ10343521
Regular
Jan 03, 2019

JESUS LOPEZ vs. CITY OF COMPTON

This case involves a firefighter's claim for workers' compensation benefits for heart trouble. The applicant, Jesus Lopez, was found to have sustained 54% permanent disability due to an industrial injury to his heart on December 17, 2015. The Workers' Compensation Appeals Board (WCAB) affirmed the administrative law judge's decision, relying on Labor Code section 3212, which presumes heart trouble in firefighters arises out of employment. The defendant, City of Compton, argued that the presumption was rebutted by evidence of non-industrial events and that the Qualified Medical Evaluator's opinion was not substantial medical evidence. However, the WCAB found that the defendant failed to provide substantial medical evidence to rebut the presumption, particularly in light of the anti-attribution clause in Labor Code section 3212.

Labor Code section 3212presumption of industrial causationheart troublefirefighter paramedicQualified Medical EvaluatorQMEsubstantial medical evidencedue processrebut the presumptionanti-attribution clause
References
Case No. ADJ3526973 (SDO 0315558) ADJ2783481 (SDO 0355255)
Regular
Jan 21, 2011

THEMAS CARMODY vs. CITY OF SAN DIEGO POLICE DEPARTMENT

The Workers' Compensation Appeals Board reversed a WCJ's decision finding no industrial injury to the applicant's heart and hypertension. The Board found that the Agreed Medical Evaluator's initial reports strongly supported industrial causation for hypertension and heart trouble, triggering the Labor Code section 3212.5 presumption. The Board held the AME's subsequent deposition testimony, which reversed his opinion without adequate explanation and rejected the legislative premise of stress-induced heart disease, was insufficient to rebut the presumption. Consequently, both the applicant's heart/hypertension claim and a previously decided claim for lung and hernia injuries were returned to the trial level for benefit determination.

Workers' Compensation Appeals BoardPolice SergeantHeart ConditionHypertensionLabor Code Section 3212.5Presumption of CompensabilityAgreed Medical EvaluatorRebuttal of PresumptionIndustrial CausationDeposition Testimony
References
Case No. ADJ7464646
Regular
Apr 24, 2017

DONALD THOMPSON vs. STATE OF CALIFORNIA

The Workers' Compensation Appeals Board granted reconsideration and increased the applicant's permanent disability award from 22% to 52%. This decision stemmed from the Board's finding that the applicant's hypertension constituted "heart trouble" under Labor Code section 3212.2, a presumption applicable to Department of Corrections employees with custodial duties. Consequently, the hypertension-related disability is not subject to apportionment, unlike the prior award which had applied apportionment. The applicant, a teacher at a correctional facility, is thus entitled to an unapportioned award for his industrial injury.

Labor Code § 3212.2presumption of injurycustodial dutiesheart troubleapportionmenthypertensioncoronary heart diseaseindustrial injurypermanent disabilityLabor Code § 4663(e)
References
Case No. ADJ8984554; ADJ8984560
Regular
Dec 30, 2020

LLOYD DEGONIA vs. CITY OF TORRANCE

This case involves a police officer's cumulative trauma claim for spinal injuries, heart condition, and skin cancer. The defendant argued the claim was barred by the statute of limitations and that apportionment of disability was not properly addressed. The Appeals Board affirmed the initial findings, holding that the statute of limitations was not a bar because the applicant did not know or reasonably should not have known his disability was work-related. Furthermore, specific statutory presumptions for police officers prevented apportionment of permanent disability to pre-existing factors in this case.

AOE/COEstatute of limitationsapportionmentagreed medical examinerqualified medical examinerpermanent disabilitycumulative injuryactinic keratosisbasal cell carcinomahypertension
References
Case No. ADJ10653999
Regular
Feb 11, 2020

Rodney McMillan vs. CITY OF RIVERSIDE

Applicant, a police officer, sought reconsideration after a WCJ denied his heart trouble claim under Labor Code § 3212.5. The parties stipulated the heart trouble presumption applied, shifting the burden to the employer to rebut it. While the Agreed Medical Examiner identified alcoholism as the probable cause of applicant's cardiomyopathy, he could not definitively state it was the "sole cause" or that employment played no role. The Appeals Board granted reconsideration, rescinded the original order, and remanded the case for further proceedings to determine if the presumption was adequately rebutted.

Heart trouble presumptionLabor Code section 3212.5Rebuttal of presumptionAgreed Medical ExaminerDilated cardiomyopathyNon-industrial alcoholismSole causeIndustrial causationPetition for ReconsiderationFindings of Fact and Order
References
Case No. ADJ7730915
Regular
Sep 18, 2015

TODD PALOMBO vs. CITY OF COSTA MESA

This case involves a firefighter claiming industrial heart injury under Labor Code § 3212, which presumes such injuries are work-related unless rebutted. The defense argued pre-existing conditions and lifestyle choices caused the applicant's cardiac arrhythmia. However, the medical expert did not definitively state non-work-related factors were the *sole* cause of the heart trouble, failing to overcome the statutory presumption. Therefore, the Workers' Compensation Appeals Board affirmed the finding of industrial injury.

Labor Code section 3212firefighterheart troublepresumptionindustrial injurycirculatory systemcumulative periodPetition for ReconsiderationWCJagreed medical evaluator
References
Case No. ADJ7941040
Regular
Sep 30, 2014

JESSE NICASIO vs. CITY OF MODESTO, Administered by YORK INSURACE SERVICES

The applicant, a former fire chief, sustained industrial injuries to his heart and multiple myeloma. The Appeals Board affirmed the WCJ's finding that his heart trouble was industrially caused, based on the presumption under Labor Code section 3212 and the AME's opinion that it developed during employment. Regarding cancer, the Board found the applicant's multiple myeloma developed within the statutory timeframe, making it presumptively compensable under Labor Code section 3212.1, and the defendant failed to rebut this presumption. Therefore, the applicant is entitled to benefits for both conditions.

Labor Code section 3212.1heart trouble presumptioncancer presumptionmultiple myelomabenzene exposureleft ventricular hypertrophyfire chieflatency periodmanifestationdevelopment
References
Case No. ADJ10501478
Regular
Feb 20, 2018

MICHAEL SILVESTRI vs. COUNTY OF EL DORADO

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, affirming the finding that Michael Silvestri, a Deputy Sheriff, sustained an industrial heart injury under the Labor Code Section 3212.5 presumption. The Board found that premature ventricular contractions (PVCs) constitute "heart trouble" within the expansive meaning of the statute, even if asymptomatic or not ratably disabling. Defendant failed to rebut the presumption by proving a solely non-industrial cause for the condition.

Workers' Compensation Appeals BoardCounty of El DoradoMichael SilvestriYork Risk Services GroupADJ10501478Opinion and Order Denying Petition for ReconsiderationFindings of Factindustrial injuryheart trouble presumptionLabor Code sections 3212 and 3212.5
References
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