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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. 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. ADJ8501790
Regular
Jul 29, 2015

Kelly Chase vs. St. Louis Blues Hockey Club, Federal Insurance Company

The Workers' Compensation Appeals Board (WCAB) reversed a prior finding of industrial injury for a professional hockey player against the St. Louis Blues. The WCAB found insufficient connection to California for jurisdiction, citing the player's limited games in the state compared to his overall career. This decision followed the precedent set in *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)*, which requires a legitimate and substantial connection to the state for jurisdiction. The WCAB concluded that 21 games out of 485 did not meet this standard for a cumulative injury claim.

WCABSt. Louis Blues Hockey ClubFederal Insurance CompanyADJ8501790Opinion and Decision After Reconsiderationcumulative industrial injuryprofessional hockey playersubject matter jurisdictionstatute of limitationssubstantial medical evidence
References
Case No. ADJ1943752
Regular
Nov 09, 2009

ROSA VERA vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

The WCJ's finding regarding the need for further medical treatment related to applicant's back is not justified by substantial medical evidence. Reconsideration is granted, the prior decision is rescinded, and the matter is returned to the WCJ for a new permanent disability rating.

Workers' Compensation Appeals BoardRosa VeraLos Angeles Unified School DistrictADJ1943752ReconsiderationFindings and AwardPermanent DisabilityMedical TreatmentLabor Code Section 5313Qualified Medical Evaluator
References
Case No. ADJ10829802
Regular
Apr 26, 2019

Antonio Corona vs. Custom Pipe & Coupling Company, Inc., The Hartford, Insurance Company of the West

The Workers' Compensation Appeals Board granted reconsideration to clarify findings regarding applicant Antonio Corona's industrial injury. The Board substituted new findings, confirming injury to his thoracic spine, lumbar spine, left shoulder, bilateral wrists, bilateral hands, and left knee, and held the claim was not barred by the post-termination defense. The Board awarded temporary total disability from April 25, 2017, through June 8, 2017, and permanent disability at 18%, returning the matter to the trial level to resolve issues of average weekly wage, additional temporary disability periods, and an EDD lien. The Board adopted the WCJ's report, particularly regarding the credibility of the applicant's treating physician and the absence of substantial evidence to support the defense's arguments.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardMachine OperatorThoracic Spine InjuryLumbar Spine InjuryLeft Shoulder InjuryBilateral Wrists InjuryBilateral Hands InjuryLeft Knee Injury
References
Case No. ADJ 1612085, ADJ 3458861, VNO 407730, VNO 407729
Regular
Aug 29, 2008

JOHN HANSEN vs. TILE TRENDS, STATE COMPENSATION INSURANCE FUND, ZC INSURANCE

The WCAB denied reconsideration of a decision awarding permanent disability benefits to the applicant for industrial injuries to his spine, shoulders, knees, back, neck, and heart/internal system. The defendants argued that the WCJ erred in finding the date of injury, relying on certain medical opinions, and apportioning liability.

WCABTile SetterSpine InjuryShoulder InjuryKnee InjuryBack InjuryNeck InjuryHeart InjuryInternal System InjuryTemporary Disability
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ3149661 (SDO 0271415)
Regular
Apr 27, 2012

Elsa Cervantes vs. COSTCO WHOLESALE CORPORATION, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to find that applicant Elsa Cervantes sustained an industrial injury to her left shoulder, overturning the WCJ's prior decision. The Board found substantial medical evidence supported that the rotator cuff tear arose from the April 27, 2000 incident, reversing the WCJ's reliance on Dr. Lane's opinion. Applicant is entitled to further medical treatment, including surgery, and continuing temporary disability benefits for the left shoulder injury. However, the Board affirmed the WCJ's decision regarding the defendant's right to control medical treatment through its Medical Provider Network, finding no contrary evidence of substantiality to overturn the credibility findings.

Workers Compensation Appeals BoardElas CervantesCostco Wholesale CorporationSedgwick Claims Management Servicesindustrial injuryneck injuryleft trapezius muscle injurypsyche injuryleft shoulder injuryMedical Provider Network (MPN)
References
Case No. ADJ1958969 (WCK 0041753) ADJ3020638 (WCK 0041752) ADJ3068271 (OAK 0324422)
Regular
May 03, 2010

LORA MAYBERRY vs. ADDUS HEATHCARE, AIG INSURANCE COMPANY, ALTA BATES MEDICAL CENTER, SUTTER HEALTH WORKERS' COMPENSATION

This case involves an applicant with multiple industrial injuries, including three against Addus Healthcare in 1997 and one against Alta Bates Medical Center in 2005. The administrative law judge found the 1997 low back injury contributed 40% to the medical treatment need for the 2005 injury, with the 2005 injury causing the remainder. Addus sought reconsideration, arguing a medical report was improperly admitted into evidence. The Appeals Board granted reconsideration, rescinded the prior order, and returned the case for further proceedings to determine the admissibility of the report under Labor Code § 5703(a)(2).

Workers' Compensation Appeals BoardAddus HealthcareAlta Bates Medical Centerlicensed vocational nurseindustrial injuryneck injuryshoulder injuryarm injurylow back injuryleft knee injury
References
Case No. OXN 0132192
Regular
Jan 23, 2008

JAMES NICHOLS vs. ENTERTAINMENT PARTNERS, CNA CLAIMS PLUS

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address the applicant's and defendant's challenges to a previous decision. The WCAB rescinded the prior award, finding that the administrative law judge improperly applied the now-obsolete *Wilkinson* rule for apportionment. The case is returned to the trial level for further proceedings and a new decision, applying the causation-based apportionment principles established in *Benson v. The Permanente Medical Group*.

Workers' Compensation Appeals BoardReconsiderationJoint Findings and AwardIndustrial InjuryNeck InjuryHead InjuryBack InjuryKnee InjuryShoulder InjuryHernia
References
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