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

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. GOL 96757
Regular
Jun 10, 2008

SA YANG LO vs. CUSTOM SENSORS & TECHNOLOGIES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a prior award, upholding the application of the 2005 Permanent Disability Rating Schedule. The Board found that exceptions allowing for the 1997 Schedule did not apply, as the applicant's temporary disability indemnity extended beyond January 1, 2005, and no qualifying pre-2005 reports indicated permanent disability. Furthermore, the Board found the applicant's vocational expert's opinion regarding diminished future earning capacity unpersuasive, thus affirming the initial 9% permanent disability rating.

Workers' Compensation Appeals BoardSA Yang LoCustom Sensors & TechnologiesInc.State Compensation Insurance FundGOL 96757Opinion and Order Denying ReconsiderationFindings and AwardWorkers' Compensation Administrative Law JudgeWCJ
References
Case No. ADJ869605
Regular
Nov 19, 2012

MILES GRAY vs. AT&T, permissibly self-insured, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves an applicant who sustained a severe right lower extremity injury, leading to multiple surgeries, significant leg length discrepancy, and fused ankle/foot, requiring constant mobility aids. The Agreed Medical Evaluator (AME) provided opinions on impairment, and vocational experts testified regarding the applicant's ability to return to work. The Workers' Compensation Appeals Board denied reconsideration of the prior award, finding substantial evidence supporting the applicant's unsuitability for rehabilitation. Defendant's supplemental reply did not alter this decision.

Agreed Medical EvaluatorVocational ExpertPetition for ReconsiderationDeniedRight Lower Extremity InjuryMultiple FracturesLeg Length DiscrepancyShoe LiftAnkle FusionGait Derangement
References
Case No. ADJ7200914
Regular
Jul 19, 2012

KENNETH WILLIAMS vs. THE BOEING COMPANY

The Workers' Compensation Appeals Board granted reconsideration to amend a previous award. The Board found that the applicant's primary treating physician's apportionment of 15% of the hip disability to non-industrial factors was based on substantial medical evidence, and should have been incorporated. This amendment reduced the applicant's permanent disability rating from 72% to 66%. The dissenting opinion argued that the physician's apportionment lacked sufficient detail to constitute substantial evidence.

Workers' Compensation Appeals BoardKenneth WilliamsThe Boeing Companyaircraft mechaniccumulative injurypermanent disabilityapportionmentPhilip A. SobolM.D.orthopedist
References
Case No. ADJ9176582
Regular
Feb 21, 2020

MARIA MORENO vs. GARROUTTE FARMS, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding applicant sustained industrial injury to her left shoulder, left wrist, left hip, and low back, causing temporary and permanent disability. While the Board denied the defendant's petition regarding the low back injury and temporary disability, it deferred the issue of the permanent disability rating. This deferral includes a potential increase to the whole person impairment for pain, which will be determined at the trial level after further hearing. The Board confirmed an award for additional temporary total disability and further medical treatment.

ADJ9176582Petition for ReconsiderationFindings Award and OrderIndustrial InjuryLeft ShoulderLeft WristLeft HipLow BackTemporary DisabilityPermanent Disability
References
Case No. ADJ9010662
Regular
Dec 04, 2017

ELSA UMANZOR vs. TWO CHEFS ON A INSPE, INSURANCE, administered by SEDG, CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration. The Board adopted the WCJ's report, correcting a typo to clarify that Dr. Shlens found no work-related injury. The Board gave significant weight to the WCJ's credibility determinations and found no substantial evidence to reject them. Therefore, the applicant's petition for reconsideration was denied.

WCABPetition for ReconsiderationDeniedWCJDr. ShlensApplicant's complaintsnot attributedrepetitive workobjective evidencecumulative trauma
References
Case No. ADJ8045546
Regular
Jul 29, 2013

THOMAS FORD III vs. WASTE MANAGEMENT, ACE AMERICAN INSURANCE CO.

This case involves a haul truck driver's claim for a low back and right hip injury against Waste Management. The defendant sought reconsideration, arguing the applicant's right hip condition was nonindustrial due to childhood surgeries and a prior car accident, citing a PQME's opinion. The Workers' Compensation Appeals Board granted reconsideration to correct clerical errors in the original award. They affirmed the finding of industrial injury to the right hip, finding the primary treating physician's opinion more persuasive than the PQME's, and amended the award to specify temporary disability indemnity and EDD lien reimbursement. Issues of future temporary disability, permanent disability, and apportionment remain deferred.

Industrial injuryLow back injuryRight hip injuryLeft hip injuryHaul truck driverCumulative traumaQualified medical evaluatorPrimary treating physicianSubstantial medical evidenceTemporary disability indemnity
References
Case No. ADJ2554534
Regular
Jan 03, 2023

WENDY COLLIE vs. STATE OF CALIFORNIA, EMPLOYMENT DEVELOPMENT DEPARTMENT, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration of a prior award. The initial award found the applicant sustained an injury AOE/COE to multiple body parts, resulting in permanent total disability without apportionment. The employer argued the finding of chronic pain syndrome was improper, and that the WCJ ignored credibility issues and apportionment opinions. The Appeals Board found substantial medical evidence supported the chronic pain syndrome diagnosis and that the employer failed to provide sufficient evidence for apportionment of permanent disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderAdministrative Law JudgeInjury AOE/COELumbar SpineCervical SpineLeft ShoulderRight HipRight Knee
References
Case No. ADJ10667998
Regular
Mar 21, 2019

GRECIA ALFARO vs. APPLE, INC., SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves an applicant who sustained admitted injuries to her thoracic spine and left arm after a slip and fall at work. The applicant also claimed industrial injury to her psyche and right hip, which the employer contested. The Workers' Compensation Appeals Board (WCAB) denied reconsideration of the judge's finding that the applicant did not sustain an industrial injury to her right hip. The WCAB deferred to the judge's credibility determination, noting that the applicant's reporting of hip pain was inconsistent and poorly documented by treating physicians. The Board also cited that one physician's opinion can constitute substantial evidence, even if it conflicts with other medical opinions.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJCredibility DeterminationSubstantial EvidencePhysician's OpinionAdmitted InjuryDenied InjuryRight HipPsyche
References
Case No. ADJ237483
Regular
Nov 13, 2012

RAYEK J. FAHOUM vs. KAISER FOUNDATION HOSPITAL

The Workers' Compensation Appeals Board denied Rayek J. Fahoum's petition for reconsideration, upholding the findings of the Workers' Compensation Judge. The Judge's report found Fahoum sustained industrial injury to his neck and low back with secondary chronic pain syndrome, awarding 41% permanent disability. This decision relied on the opinions of the Agreed Medical Examiner and Dr. Renee Rinaldi, who concluded Fahoum experienced symptom magnification and that his condition was chronic pain syndrome, not fibromyalgia as claimed by Dr. Allen Salick. The Board extended great weight to the Judge's credibility findings regarding the medical opinions.

Workers' Compensation Appeals BoardReconsideration DeniedAgreed Medical ExaminerSubstantial Medical EvidenceFibromyalgiaChronic Pain SyndromeSymptom MagnificationOrthopedic InjuryLumbosacral StrainCervical Strain
References
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