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

Case No. ADJ3489554 (SFO 0460075), ADJ409657 (SFO 0473579)
Regular
May 10, 2010

REBHI AYESH vs. ARCO/BP AMERICA, Permissibly Self-Insured, Administered By ESIS

The Workers' Compensation Appeals Board reversed an administrative law judge's award, ruling that the applicant is not entitled to industrial workers' compensation benefits for erectile dysfunction. The Board found the erectile dysfunction was caused by non-industrial factors like diabetes and smoking, not the applicant's work-related psychiatric injury. While the psychiatric injury was recognized as a compensable consequence of a prior back injury, medical evidence did not sufficiently demonstrate it contributed to the need for erectile dysfunction treatment. Consequently, the Board rescinded the award for further medical care related to the erectile dysfunction.

Workers Compensation Appeals Boardpsychiatric injuryindustrial injurylow back injuryerectile dysfunctiondiabetessmokingmedical treatmentcausationqualified medical evaluator
References
10
Case No. ADJ11197293
Regular
Dec 18, 2020

KEVIN TORRES vs. ARCTIC MECHANICAL, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case concerns an applicant's entitlement to an increased impairment rating for sleep dysfunction. The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration. The Board affirmed the Administrative Law Judge's finding that Labor Code Section 4660.1(c)(1) does not preclude an increased impairment rating for sleep dysfunction if it is directly caused by the industrial injury, rather than a consequence of it. Medical evidence from Dr. Jonathan Wang established a direct causal link between the applicant's sleep dysfunction and the industrial injury. The Board found Dr. Wang's report and deposition testimony constituted substantial medical evidence supporting this conclusion and rejected the defendant's arguments.

Labor Code 4660.1(c)(1)sleep dysfunctiondirect causationincreased impairment ratingcompensable consequencepsychiatric disordersubstantial medical evidenceQME reportdeposition testimonyAMA Guides
References
2
Case No. ADJ7082851
Regular
Jan 30, 2019

HUMBERTO GONZALEZ vs. AMERICAN AUTO WRECKING, STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to amend the original findings, establishing applicant's earnings at $500.00 per week. The Board affirmed the finding of industrial injury to the psyche and right inguinal hernia, but deferred issues of injury to the reproductive system (sexual dysfunction) and sleep disorder. The matter was returned to the WCJ for further development of the record concerning these deferred issues, particularly regarding the specific impact of sleep disorder on impairment and corroboration of sexual dysfunction.

AOE/COEFindings and AwardPetition for ReconsiderationAdministrative Law JudgeAgreed Medical ExaminerQualified Medical ExaminerMaximum Medical ImprovementGeneral LaborerRight inguinal herniaSexual dysfunction
References
0
Case No. STK 100401, STK 102758, STK 151721
Regular
May 01, 2007

JACK LITTLE vs. TRI-VALLEY GROWERS, NATIONAL UNION FIRE INSURANCE COMPANY

Applicant Jack Little sustained admitted industrial injuries to his knees and back, resulting in permanent disability and a need for ongoing medical treatment, including for his hypertension. The Appeals Board denied reconsideration of the finding that applicant's erectile dysfunction is not a compensable consequence of the industrial injuries, as both medical evaluators concluded it was not caused by the work injuries. However, a dissenting commissioner argued for reconsideration to further develop the record regarding whether the industrially-caused hypertension and its medications contribute to the erectile dysfunction.

Workers' Compensation Appeals BoardTri-Valley GrowersNational Union Fire Insurance CompanyJack Littleindustrial injurieskneesbackmaintenance mechanicpermanent disabilitymedical treatment
References
3
Case No. ADJ7037201
Regular
Apr 22, 2013

Eddie Avakian vs. CITY OF BALDWIN PARK, ADMINSURE

This case involves an applicant police officer seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that awarded 72% permanent partial disability. The applicant contended the WCJ erred by excluding sleep disturbances and sexual dysfunction from the disability rating and by apportioning his cardiovascular disability. The WCAB granted reconsideration, rescinded the original award, and found the applicant's sexual dysfunction and sleep disorder compensable. The matter was returned to the trial level for a new decision, with the WCAB stating it would not disturb other findings, including the hypertension apportionment.

Workers' Compensation Appeals BoardEddie AvakianCity of Baldwin ParkPermissibly Self-InsuredAdministered By ADMINSUREADJ7037201Opinion and Order Granting ReconsiderationDecision After ReconsiderationFindings and Award and OrderAdministrative Law Judge
References
0
Case No. ADJ6619965 ADJ9843987
Regular
Jul 16, 2018

JESUS ZARAGOZA vs. KOOL KOUNTRY, LLC, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Board granted reconsideration to review the finding of injury to the bladder, sleep disorder, sexual dysfunction, and cognitive disability/headaches, as well as the applicant's earnings. The Board affirmed the finding of injury to the bladder, sleep disorder, and sexual dysfunction but reversed the finding of injury related to cognitive impairment/headaches, finding insufficient medical evidence. Additionally, the Board amended the applicant's earnings to $270.00 per week, based on the parties' stipulation regarding the permanent disability rate, and affirmed the overall award except for these specific modifications.

Workers' Compensation Appeals BoardReconsiderationFindings of FactAwardAdministrative Law JudgePermanent DisabilityAverage Weekly EarningsStipulationAgreed Medical ExaminerQualified Medical Examiner
References
0
Case No. ADJ8023073
Regular
Mar 08, 2018

ERIKA GOMEZ GONZALEZ vs. FRONT PORCH, permissibly self-insured

The Workers' Compensation Appeals Board granted reconsideration of the prior award finding industrial injury, including to the psyche and sexual dysfunction, stemming from an exploding electrical outlet. The Board affirmed the award, specifically ruling that the exploding outlet constituted a "sudden and extraordinary employment condition" exempting the applicant from the six-month employment rule for psychiatric injuries. However, the Board rescinded the specific EDD reimbursement amount and remanded that issue for further proceedings. A dissenting commissioner argued the incident was routine and the sexual dysfunction lacked objective evidence.

Labor Code section 3208.3(d)sudden and extraordinary employment conditionpsychiatric injurysexual dysfunctionEmployment Development Department (EDD) reimbursementsubstantial evidencemedical opiniondioxine electrical outlettemporary disability indemnitypermanent disability
References
1
Case No. ADJ4118575
Regular
May 26, 2010

MANUEL ORTIZ vs. TOWER INDUSTRIES, INC., SCIF INSURED INLAND EMPIRE

This case involves a worker, Manuel Ortiz, who sustained a severe admitted industrial injury resulting in 100% permanent disability. The defendant, SCIF, sought reconsideration, arguing the WCJ's jump from a 98% to 100% rating lacked sufficient justification and that injury to sleep and erectile dysfunction were erroneously found. However, the Appeals Board denied the petitions, finding the evidence supported the 100% permanent disability rating. The Board emphasized Ortiz's significant injuries, ongoing pain, inability to control bodily functions, and uncorrected erectile dysfunction as establishing total permanent disability.

Workers' Compensation Appeals BoardPetitions for ReconsiderationPermanent DisabilityLabor Code section 4662Agreed Medical ExaminersUrological InjuryErectile DysfunctionSleep DisorderPermanent Total DisabilityFindings and Award
References
1
Case No. ADJ4118575 (MON 0342974)
Regular
May 26, 2010

MANUEL ORTIZ vs. TOWER INDUSTRIES, INC., SCIF INSURED INLAND EMPIRE

This case involves an applicant who sustained severe injuries in a riding accident, including multiple pelvic fractures and urological damage, requiring extensive surgeries. The applicant was awarded 100% permanent disability due to his constant pain, limited mobility, and functional impairments, including urinary incontinence and erectile dysfunction. The defendant appealed, arguing the 100% disability rating was not justified and disputing the findings of sleep disorder and erectile dysfunction. The Workers' Compensation Appeals Board affirmed the applicant's 100% permanent disability, finding the evidence supported total permanent disability based on the facts of his severe injury and ongoing functional limitations. The Board denied the defendant's petitions for reconsideration.

Workers' Compensation Appeals BoardPermanent Total DisabilityPetitions for ReconsiderationFindings and AwardAgreed Medical ExaminersLabor Code Section 4662Pelvis InjuryLower Extremity InjuryUrethra InjuryPsyche Injury
References
1
Case No. MISSING
Regular Panel Decision
Aug 16, 2000

Thompson v. Port Authority of New York & New Jersey

The Supreme Court, New York County, affirmed a judgment denying damages for future pain and suffering and loss of consortium to a construction worker and his wife following a personal injury suit. The jury found insufficient persuasive medical evidence to corroborate the plaintiff's subjective complaints of persistent headaches, low back pain, and sexual dysfunction. Evidence showed the plaintiff had not maintained a continuous course of treatment and had a pre-existing degenerative spinal disease. While the plaintiff was awarded damages for future loss of earnings due to disability from strenuous work, his claims for ongoing pain and sexual dysfunction were deemed incredible or unrelated to the accident. The court also upheld the trial court's charge on the plaintiff's duty to mitigate damages by seeking vocational rehabilitation, given the credibility issues surrounding his ability to work.

Personal InjuryConstruction AccidentFuture Pain and SufferingLoss of ConsortiumMedical EvidenceCredibility AssessmentMitigation of DamagesVocational RehabilitationPre-existing ConditionJury Verdict
References
3
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