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

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
6
Case No. ADJ6456347
Regular
Jan 30, 2012

MARK WILLIAMS vs. CITY OF PASADENA

This case involves a police officer claiming industrial injury to his heart due to hypertensive heart disease, a condition he argued was distinct from previously compensated hypertension. The Workers' Compensation Appeals Board (WCAB) rescinded the administrative law judge's decision, finding the claim was not barred by res judicata. The WCAB clarified that while hypertension alone is not considered heart trouble, left ventricular hypertrophy, as diagnosed in the current claim, constitutes a distinct condition. The case is returned to the trial level for further proceedings on other unresolved issues.

res judicatahypertensive heart diseasepolice officerLabor Code section 3212.5heart trouble presumptionleft ventricular hypertrophystipulated awardindustrial injurypermanent disabilityapportionment
References
6
Case No. ADJ8441431
Regular
Feb 14, 2020

MITCHELL LEMAY vs. CONTRA COSTA COUNTY; Permissibly SelfInsured; MARIN COMMUNITY COLLEGE DISTRICT; Permissibly Self-Insured; administered by KEENAN AND ASSOCIATES

The Workers' Compensation Appeals Board affirmed a previous decision regarding applicant Mitchell Lemay's claims for prostate cancer and heart trouble/hypertension, finding both employers jointly and severally liable. Reconsideration was granted primarily to address issues surrounding a hernia injury. The Board deferred the hernia injury claim, along with related medical treatment and permanent disability, due to insufficient evidence to determine if it was a separate injury or a consequence of medical treatment. The prior findings regarding the prostate cancer and heart trouble/hypertension, including no apportionment of permanent disability for these conditions, were upheld.

Workers' Compensation Appeals BoardContra Costa CountyMarin Community College DistrictDeputy SheriffChief of PoliceProstate CancerHeart TroubleHypertensionHerniaLabor Code section 3212.1
References
7
Case No. ADJ8508948
Regular
Apr 04, 2014

JOHN GIESE vs. COUNTY OF SAN LUIS OBISPO, SHERIFF'S DEPARTMENT, SEDGWICK CMS

The applicant sought reconsideration for additional benefits related to his hypertension, claiming it was a work-related heart injury under Labor Code sections 3212 and 3212.5. The Board denied reconsideration, affirming the judge's finding that hypertension alone, without end-organ damage, is not considered "heart trouble" for the purposes of these presumptions. Medical evidence indicated the applicant had no loss of cardiac function due to coronary artery disease and that the cause of his hypertension was complex and not demonstrably work-related. Therefore, his petition was denied.

Workers Compensation Appeals BoardPetition for ReconsiderationCumulative Industrial InjuryCardiovascular SystemSheriff's DepartmentTemporary DisabilityPermanent DisabilityHypertensionPresumption of CompensabilityLabor Code Sections 3212
References
3
Case No. ADJ8254799
Regular
Apr 21, 2014

TERRY MILLER vs. WASCO STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to find that correctional officer Terry Miller sustained an industrial heart injury, not just hypertension, based on Labor Code section 3212.2's presumption for heart trouble in correctional officers. The WCAB overturned the judge's decision to apportion the injury, ruling that Labor Code section 4663(e) prohibits apportionment for injuries covered by the heart trouble presumption. Consequently, Miller was awarded an unapportioned 60% permanent disability rating, an increase from the original 51%.

Labor Code section 3212.2heart trouble presumptioncorrectional officerleft ventricular hypertrophycumulative traumaindustrial hypertensionunapportioned awardpermanent disabilityWasco State PrisonState Compensation Insurance Fund
References
4
Case No. AD J8835024 AD J8996815
Regular
Jun 14, 2016

TRACIE KEILLOR vs. COUNTY OF SACRAMENTO

The Workers' Compensation Appeals Board granted reconsideration, rescinded a prior award, and found that the applicant, a deputy sheriff, did not sustain industrial injury from a stroke. While Labor Code section 3212.5 creates a presumption of industrial causation for heart trouble in peace officers, the applicant failed to establish, based on a qualified medical evaluator's opinions, that her stroke was caused by heart trouble or that she suffered from any heart trouble. The expert consistently found no evidence of heart trouble contributing to the stroke and opined that an intracranial thrombosis was the probable cause. Therefore, the presumption under section 3212.5 was not applicable as the applicant did not meet the threshold requirement of showing heart trouble.

Workers' Compensation Appeals BoardDeputy SheriffStrokeHeart PresumptionLabor Code Section 3212.5Occupational CausationMedical ProbabilityPanel Qualified Medical EvaluatorCardiologistIn Situ Thrombosis
References
6
Case No. ADJ11604315
Regular
Mar 20, 2023

JOSEPH HERNANDEZ vs. PLEASANT VALLEY STATE PRISON, CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILATION, STATE COMPENSATION INSURANCE FUND

This case concerns Joseph Hernandez's workers' compensation claim for heart trouble against Pleasant Valley State Prison. The applicant's claim was initially denied but subsequently granted after reconsideration. The defendant's Petition for Reconsideration was denied by the Appeals Board. The core issue revolved around the timing of the applicant's hypertension diagnosis, with the defense relying on a non-existent medical record to establish it as pre-existing. The Board found the defendant failed to rebut the statutory heart trouble presumption for correctional officers.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedADJ11604315Pleasant Valley State PrisonCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundJoseph HernandezCorrections Officer
References
7
Case No. ADJ3255503 (SDO0362975)
Regular
Mar 15, 2010

JOHN KOSICH vs. COUNTY OF SAN DIEGO SHERIFF'S DEPARTMENT

The Workers' Compensation Appeals Board (WCAB) rescinded a previous award, returning the case to the trial level for further proceedings. The core issue is whether the applicant deputy sheriff's hypertension constitutes "heart trouble" for the purposes of a statutory presumption of industrial injury. The WCAB found the agreed medical evaluator's opinion regarding "heart trouble" unclear, as it did not definitively address the broad legal definition of the term. Therefore, the case requires further medical evaluation and deposition to clarify the applicant's cardiac condition in relation to the legal standard.

Workers' Compensation Appeals BoardDeputy SheriffHeart Trouble PresumptionLabor Code Section 3212.5Labor Code Section 4663(e)ApportionmentAgreed Medical EvaluatorDr. Daniel J. BresslerHypertensionGERD
References
3
Case No. ADJ8279816 ADJ9818108
Regular
Aug 29, 2017

JAY SEVOIAN vs. COUNTY OF LOS ANGELES

This case involves a deputy sheriff seeking workers' compensation for cumulative industrial injuries. The Administrative Law Judge (ALJ) found compensable injuries to the applicant's knees, asthma, sleep disorder, hemorrhoids, irritable bowel syndrome, and hypertensive heart disease. The Defendant sought reconsideration, arguing that the hypertensive heart disease should only be attributed to the later injury date. The Board denied reconsideration, adopting the ALJ's report, which found that the stress from the original cumulative injury contributed to the hypertensive heart disease as a "new and further disability" or a "compensable consequence injury." Therefore, the injuries were correctly combined for a single permanent disability award, with no apportionment.

Workers' Compensation Appeals BoardDeputy SheriffCumulative InjuryHypertensive Heart DiseaseLabor Code Section 3212Permanent DisabilityApportionmentNew and Further DisabilityCompensable Consequence InjuriesAgreed Medical Evaluator
References
5
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
13
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