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

Case No. ADJ300802 (AHM 0109743) ADJ2310921 (AHM 0115931)
Regular
Nov 21, 2008

CHRISTOPHER SHIELDS vs. LAIDLAW TRANSIT; BROADSPIRE

The Appeals Board granted reconsideration, amending the original award to establish a permanent and stationary date of January 3, 2005, for applicant's abdominal hernia injuries. The Board deferred the issues of permanent disability and attorneys' fees, returning the case to the trial level for re-rating based on hernia/abdominal injuries rather than spinal injuries. The Board affirmed the finding of an industrial inguinal hernia injury, while also noting that the defendant did not provide evidence of unreasonable refusal of medical treatment for the hernias.

HerniaUmbilical herniaInguinal herniaLow back painPermanent and stationary dateTemporary total disabilityMedical treatmentAttorney's feesReconsiderationWorkers' Compensation Appeals Board
References
Case No. ADJ10222181 (MF) ADJ10222198
Regular
Jan 30, 2019

SAM ALBOUDOOR vs. AMJES, INC. dba K&B FREIGHT SYSTEMS

This case concerns claims for hernias and spine injuries sustained by a truck driver. The Workers' Compensation Appeals Board granted reconsideration to review the finding that hernias were work-related, noting the medical evaluator's conflicting opinions on causation. The Board determined further medical development is required on the hernia issue due to contradictory expert testimony. Additionally, the issue of reimbursement for self-procured medical treatment was deferred pending the resolution of the hernia claims.

Workers' Compensation Appeals BoardAMJES INCK&B Freight SystemsSam Alboudoorherniahiatal herniainguinal hernialumbar spinethoracic spinePQME
References
Case No. SDO 0322942
Regular
Jan 31, 2008

ROBERT WEIS vs. VULCAN MATERIALS COMPANY, ZURICH NORTH AMERICA

The applicant claims an admitted industrial spinal injury caused his umbilical hernia, but the WCJ denied benefits for the hernia, finding it nonindustrial. The applicant argues the Qualified Medical Evaluator's opinion supports industrial causation for the hernia, contradicting the defense. The Appeals Board granted reconsideration to obtain a report from the WCJ regarding this contested issue.

Workers' Compensation Appeals BoardVulcan Materials CompanyZurich North AmericaRobert Weisindustrial injuryspineherniaumbilical herniatruck driverqualified medical evaluator
References
Case No. ADJ8208235
Regular
Jun 25, 2013

MARIA T. SOTO vs. ROSANNA, INC.; BROADSPIRE

The applicant sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that only recognized an inguinal hernia as an industrial injury. The applicant contended the WCAB erred by not finding industrial injuries to her right shoulder and lumbar spine, arguing the decision lacked substantial medical evidence. The WCAB denied reconsideration, adopting the administrative law judge's report which found the applicant failed to meet her burden of proof for shoulder and spine injuries due to a lack of contemporaneous medical records. The judge noted that while the hernia was compensable due to documented treatment, the subjective complaints for the shoulder and back lacked such support and were deemed unreliable.

WCABPetition for ReconsiderationFindings of Factindustrial injuryinguinal herniaright shoulderlumbar spinesubstantial medical evidencethird-party administratorreasonable probability of industrial causation
References
Case No. ADJ7751160
Regular
Jun 26, 2012

WALLACE MANNS vs. AMERICAN LABOR POOL, OLD REPUBLIC GENERAL INSURANCE CORPORATION

This case concerns a worker's compensation claim for an inguinal hernia sustained prior to a layoff. The employer argued the claim was barred by Labor Code section 3600(a)(10) as it was filed after notice of termination. The Appeals Board granted reconsideration, finding the Administrative Law Judge erred by requiring proof of retaliatory intent. The Board rescinded the original finding, concluding the post-termination defense applied as no exceptions under the statute were met. The applicant's claim was therefore barred.

Workers' Compensation Appeals BoardWallace MannsAmerican Labor PoolOld Republic General Insurance CorporationADJ7751160Riverside District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWCJ
References
Case No. POM 291107
Regular
Oct 15, 2007

RAMON GALBADON vs. NEWPORT FARMS, INC., STATE COMPENSATION INSURANCE FUND

The Appeals Board rescinded a $1,500 nominal permanent disability award, finding no substantial medical evidence that future disability was "reasonably probable" from the applicant's January 11, 2005 right inguinal hernia. The Board noted the applicant's physician stated he had no permanent disability and could return to work without restrictions. Instead, the Board reinstated a stipulated award for further medical treatment and benefits, consistent with the parties' agreement.

Nominal permanent disabilityLabor Code section 5802Industrial injuryRight inguinal herniaTruck driverReconsiderationStipulated awardFuture medical treatmentPhysician office visitsMedication refill
References
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
Case No. ADJ10782441 ADJ9193836
Regular
Apr 15, 2019

Stacy Smith vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration to affirm the applicability of Labor Code section 3212 presumptions for hypertension and hernia injuries to an ocean lifeguard. However, the Board amended the decision to defer issues of permanent disability and apportionment. This deferral is due to the apparent conflict between the WCJ's 50% apportionment of hernia disability and the non-attribution clause of Labor Code section 3212. The Board returned these issues to the trial level for further hearing and determination.

Workers' Compensation Appeals BoardLabor Code Section 3212Heart trouble presumptionHernia presumptionFire department memberOcean lifeguardCumulative injuryLumbar spine injuryRight knee injurySkin injury
References
Case No. ADJ2653887 (SAL 0116844)
Regular
Dec 24, 2008

CARROL BARRIE vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, amending a prior finding to award further medical treatment for admitted industrial hernias. While the original finding denied permanent disability and further treatment, the Board found a stipulation by the parties and the Agreed Medical Evaluator's opinion supported the need for ongoing medical follow-up. The Board affirmed the original finding that the injury did not cause ratable permanent disability based on the AME's report and statutory guidelines.

Workers' Compensation Appeals BoardIndustrial InjuryVentral HerniaUmbilical HerniaRegistered NursePermanent DisabilityFurther Medical TreatmentAgreed Medical EvaluatorAMA GuidesLabor Code Section 5802
References
Case No. ADJ6475661
Regular
May 11, 2015

ALAN COLGROVE vs. SANTA ROSA PRESS DEMOCRAT, TRAVELERS PROPERTY & CASUALTY COMPANY OF AMERICA

The Appeals Board rescinded the WCJ's decision finding a hernia to be a compensable consequence of a back injury, citing insufficient medical evidence. Dr. Klein’s opinion on causation was found to be inconsistent and not substantial evidence. The Board concluded the medical record requires further development to determine if the hernia is causally related to the industrial injury. Therefore, the case is returned to the trial level for further proceedings and a new decision by the WCJ.

COMPENSABLE CONSEQUENCEPETITION TO REOPENMEDICAL RECORD DEVELOPMENTQUALIFIED MEDICAL EVALUATOR (PQME)OPINIONCAUSAL RELATIONSHIPHERNIABACK INJURYSTIPULATIONSSUBSTANTIAL EVIDENCE
References
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