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

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. ADJ7555409
Regular
Mar 04, 2014

JESUS ESCANUELA vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the defendant's Petition for Reconsideration and dismissed the applicant's untimely petition. The WCAB found that the Agreed Medical Examiner's (AME) opinion regarding psychiatric permanent disability was not supported by substantial evidence, as it did not properly address causation under the current PDRS. Consequently, the case is remanded to the trial level for further development of the record concerning psychiatric permanent disability. The WCAB deferred the issue of permanent disability and attorney's fees pending this further development.

Workers' Compensation Appeals BoardJesus EscanuelaCalifornia Department of Correctionslegally uninsuredState Compensation Insurance FundADJ7555409Fresno District OfficeOpinion and OrderPetition for ReconsiderationFindings and Award
References
Case No. POM 0231129
Regular
Jun 03, 2008

PEGGY MAYER SPIER vs. BRIDGECREEK RETIREMENT HOME, LIBERTY MUTUAL INSURANCE COMPANY

This case involves a dispute over attorney's fees from a workers' compensation settlement. The WCJ initially divided the remaining $10,500 in fees based solely on the length of representation, awarding $9,450 to the applicant for self-representation and $1,050 to the former attorney. The former attorney sought reconsideration, arguing the WCJ improperly ignored statutory factors like responsibility, care, time, and results obtained. The Appeals Board granted reconsideration and remanded the case for a new fee determination based on all four statutory criteria.

Workers' Compensation Appeals BoardReconsiderationAttorney's FeesCompromise and ReleasePropria PersonaLien ClaimantAgreed Medical ExaminerThoracic Outlet SyndromeLabor Code Section 4906(d)Rule 10775
References
Case No. ADJ3303329 (MON 0363353) ADJ6697361
Regular
Oct 21, 2010

RAMIRO O. VELASQUEZ vs. MOONLIGHT MOLDS, CYPRESS INSURANCE COMPANY, BROOKSHIRE HATHAWAY HOME STATE COMPANIES

The Workers' Compensation Appeals Board rescinded a prior award, returning the case for further proceedings. The original award found the applicant suffered an industrial injury resulting in 64% permanent disability and the need for further medical treatment, including a rebuttal of the future earning capacity component. The defendant challenged the permanent disability rating, arguing the judge improperly applied the Ogilvie standard for assessing diminished future earning capacity. The Board found the applicant's testimony alone insufficient to rebut the scheduled factor, necessitating development of the record on earning capacity.

Workers' Compensation Appeals BoardMoonlight MoldsCypress Insurance CompanyRamiro O. Velasquezsandblasterlaborerindustrial injurylow backfuture earning capacitypermanent disability
References
Case No. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
Case No. ADJ7607362
Regular
Jun 28, 2016

GUILLERMO ANAYA vs. BAY AREA CARBIDE, VALLEY FORGE INSURANCE COMPANY

This case involves a claim for industrial injury to the lungs, psyche, and diabetes resulting from exposure to metal dust. The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, affirming the finding of total permanent disability under Labor Code section 4662(b). The Board found substantial medical evidence supported the applicant's total permanent disability despite the defendant's arguments regarding scheduled ratings and vocational expertise. A dissenting commissioner argued for further development of the record regarding vocational rehabilitation and future earning capacity.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award And OrdersIndustrial InjuryLungsRespiratory SystemPsycheDiabetesTool HandlerTemporary Total Disability
References
Case No. ADJ892742 (SJO 0240973) MF ADJ6718849
Regular
Jul 21, 2000

SALLY MACKIN vs. SANTA CLARA COUNTY FAIRGROUNDS

Here's a summary of the case for a lawyer in four sentences: The applicant sought reconsideration of a WCJ's decision finding industrial injuries to her shoulders, neck, and wrists, resulting in 43% and 9% permanent disability respectively, and awarded future medical treatment but denied claims for hypertension and psychological injury. Applicant contended the WCJ erred in permanent disability ratings, the application of the PDRS, and the DEU rater's methodology. The Board denied reconsideration, adopting the WCJ's report which found the 1997 PDRS was not applicable to the cumulative injury and that the DEU rater acted within her expertise. A dissenting commissioner argued the 1997 PDRS should apply to the cumulative injury and that the record needed further development regarding permanent disability.

Workers' Compensation Appeals BoardSally MackinSanta Clara County FairgroundsADJ892742ADJ6718849Findings Awards and Orderspermanent disabilitycumulative injuryhypertension injuryfuture medical treatment
References
Case No. ADJ2023756 (SAC 0323234)
Regular
Aug 30, 2013

VICTORIA BRESHEARS vs. THE KROGER COMPANY DBA RALPH'S GROCERY COMPANY

The Workers' Compensation Appeals Board granted the employer's Petition for Reconsideration due to discrepancies regarding the timeliness of its filing. The Board issued a Notice of Intention to Dismiss, requiring the employer to provide proof of timely electronic filing via EAMS, specifically the Batch ID and submission date/time. If the employer fails to demonstrate the petition was filed before 5:00 PM on July 8, 2013, it will be dismissed as untimely.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardFindings and OrderWCJEAMSElectronic Adjudication Management SystemBatch IDTimely FiledProof of Service
References
Case No. ADJ3897011 (LBO 0296196)
Regular
Jul 09, 2010

MICHAEL BROTHERS vs. RIVER LEASING CORPORATION, LIBERTY MUTUAL INSURANCE GROUP

The Workers' Compensation Appeals Board denied Michael Brothers' petition for reconsideration of a Stipulated Award. The applicant mistakenly believed the award was a final settlement like a Compromise and Release, and sought to renegotiate based on discovered costs of surgery and medication. However, a Stipulated Award, unlike a Compromise and Release, obligates the defendant to provide ongoing reasonable and necessary medical treatment, including medications and mileage for future appointments, to cure or relieve the effects of the industrial injury. The Board found the petition timely filed and the applicant's grounds for reconsideration were based on a misunderstanding of the award's nature.

Workers' Compensation Appeals BoardPetition for ReconsiderationStipulated AwardCompromise and ReleaseAdministrative Law JudgeLabor CodeCode of Civil ProcedureElectronic Adjudication Management SystemFuture Medical TreatmentTemporary Disability
References
Case No. ADJ8546247
Regular
Sep 22, 2014

CHERYL VICKERY vs. SAVEMART SUPERMARKETS

In this workers' compensation case, the defendant, SaveMart Supermarkets, sought reconsideration of an administrative law judge's award finding applicant sustained industrial injury and required future medical treatment. SaveMart argued the Appeals Board lacked jurisdiction due to the applicant's prior Independent Medical Review (IMR) of a denied treatment authorization. The Board denied reconsideration, primarily because SaveMart's own Utilization Review denial was untimely under Labor Code section 4610(g)(1). The Board also noted procedural defects in SaveMart's petition for reconsideration.

WCABCHERYL VICKERYSAVEMART SUPERMARKETSADJ8546247OPINION AND ORDER DENYING PETITION FOR RECONSIDERATIONindustrial injuryneckleft shouldergrocery checkerfuture medical treatment
References
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