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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. AHM 98231
Regular
Sep 24, 2007

MYLINH WHITMAN vs. CINGULAR WIRELESS, SEDGWICK CLAIMS MANAGEMENT

The Appeals Board is reconsidering whether the defendant, Cingular Wireless, is entitled to a credit for salary continuation benefits paid to the applicant. The key issue is whether these benefits were of the "same general character" as workers' compensation, which would permit integration and a credit. The case is returned to the trial level for further evidence development on this specific point, rescinding the prior award of a credit.

Workers' Compensation Appeals BoardCreditSalary continuation planWage loss planMetropolitan Life Short Term Disability PolicyHealth and Welfare Benefits PlanSummary plan descriptionEmployer policyTaxable benefitsPermanent disability indemnity
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ6473555, ADJ7393801
Regular
Sep 18, 2014

Frank Jones (Deceased), Araceli Jones, Mya Jaedyn Jones vs. CDCR KERN VALLEY STATE PRISON, State Compensation Insurance Fund

The Workers' Compensation Appeals Board affirmed a previous award for death benefits to the minor daughter of deceased correctional officer Frank Jones. The WCJ found that the daughter, Mya Jones, was entitled to the special minor's death benefit due to "good cause," as her mother is now a sole provider facing significant financial hardship after the decedent's death. The Board agreed, citing compelling evidence of the mother's financial strain and the minor's ongoing needs. This decision overrides the defendant's contentions that the award was improper and denies credit for prior permanent disability advances.

Workers' Compensation Appeals BoardCalPERSspecial death benefitminor dependentGuardian Ad LitemLabor Code section 4704good causeaverage weekly earningstemporary total disabilitypermanent disability indemnity
References
Case No. ADJ7231381
Regular
Oct 24, 2011

ERIN HEALY vs. WE ARE 6J INCI, FARMERS INSURANCE

The Workers' Compensation Appeals Board granted the Employment Development Department's (EDD) petition for reconsideration. The Board found the original decision failed to properly address EDD's lien for State Disability Indemnity (SDI) benefits paid to the applicant. Specifically, the decision did not provide for EDD's reimbursement when temporary and permanent disability indemnity were awarded for the same periods applicant received SDI. The matter was remanded for further proceedings and a new decision that will satisfy EDD's statutory entitlement to reimbursement.

EDD lienSDI benefitsPetition for ReconsiderationFindings Award and Ordertemporary disability indemnitypermanent disability indemnityLabor Code section 4903(f)Labor Code section 4904(b)defective servicestatutory interest
References
Case No. ADJ1298520
Regular
Dec 24, 2010

CLUSEGUN AFOLAYAN (DECEASED), OLUWASEUN AFOLAYAN, et al vs. STATE OF CALIFORNIA CDCR, CALIFORNIA REHABILITATION CENTER, Legally Uninsured, SCIF/STATE CONTRACTS

In this workers' compensation case, the Appeals Board reconsidered a WCJ's award of dependency benefits to three adult children of a deceased worker. The WCJ had awarded $192,000 total, based on the children being total dependents despite the widow electing CalPERS benefits which typically bar other death benefits. The Board agreed that the adult children are entitled to benefits under Labor Code section 4702, as the widow's CalPERS election does not necessarily exclude other dependents with good cause. However, the Board disagreed with the WCJ's calculation method and remanded the case for a new decision, directing the adult children to divide the difference between the maximum benefit for a widow with dependents and the benefit for a widow without dependents.

Workers' Compensation Appeals BoardDependency benefitsLabor Code Section 4702Adult childrenDeath benefitsLabor Code Section 4707CalPERS special death benefitGood causeTotal dependentsWidow's benefits
References
Case No. ADJ2549830 (LAO 0657500)
Regular
Apr 04, 2011

ANTHONY WELCH vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of a WCJ award that included a $29,000 lump-sum attorney fee. The SIBTF argued this violated Labor Code section 5100.5, which prohibits commutation of SIBTF benefits for attorney fees. The Appeals Board granted reconsideration, finding the attorney's unilateral addition of the lump sum to stipulations unacceptable. The Board amended the award to provide the attorney a fee of 15% of each weekly indemnity payment, affirming the remainder of the award.

Subsequent Injuries Benefits Trust FundPetition for ReconsiderationAttorney FeesLabor Code Section 5100.5CommutationStipulations with Request for AwardUnilateral AlterationWCJ AwardPermanent Disability IndemnityLife Pension Indemnity
References
Case No. ADJ2745839 (AHM 0136320)
Regular
Dec 15, 2008

Linda Kiehlmeier vs. CALIFORNIA EMERGENCY PHYSICIAN, TRAVELERS ORANGE

This case involves a physician's assistant claiming cumulative industrial injuries from 2000-2006. The WCAB granted reconsideration to clarify temporary disability indemnity, affirming the finding of injury but amending the benefit period and rates for temporary total disability. The applicant will receive benefits starting January 1, 2008, with adjusted weekly amounts for different periods, crediting the defendant for benefits already paid.

Petition for ReconsiderationCumulative Industrial InjuryPhysician's AssistantTemporary DisabilityMaximum RatePanel QMEAquatic TherapyTempurpedic MattressRetroactive BenefitsReport and Recommendation
References
Case No. ADJ3603721 (ANA 0385798) ADJ3874014 (ANA 4689669) ADJ4689669 (ANA 0388899)
Regular
Nov 07, 2014

CAROL HILL vs. UNILAB CORPORATION/QUEST DIAGNOSTICS, TRAVELERS INSURANCE COMPANY

This case involves an applicant seeking reconsideration of a WCJ's decision regarding unreasonable delays in benefit payments. The Board granted reconsideration and affirmed the finding of unreasonable delay for temporary disability indemnity, awarding a 25% penalty. However, the Board deferred the issue of permanent disability indemnity advance penalties for further analysis due to record ambiguity. The Board also found no unreasonable delay in medical treatment benefits and reversed an award of attorney's fees under LC 5814.5, but allowed fees from the temporary disability penalty recovery.

Workers' Compensation Appeals BoardUnreasonable DelayTemporary Disability IndemnityPermanent Disability Indemnity AdvancesLabor Code Section 5814 PenaltyMedical Treatment BenefitsAttorney's FeesPetition for ReconsiderationAdministrative Law JudgeJoint Findings and Award
References
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