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

Case No. ADJ6527507
Regular
Oct 18, 2010

Wayne Moore vs. EAST BAY MUNICIPAL UTILITY DISTRICT, ATHENS ADMINISTRATORS

The Appeals Board granted reconsideration, finding the WCJ improperly substituted his medical judgment for the Qualified Medical Evaluator's (QME) regarding the applicant's industrial sleep disturbance. The WCJ's finding of no industrial sleep impairment, despite the QME's opinion indicating such, was deemed erroneous. The Board rescinded the original award and remanded the case for a new rating that incorporates the QME's findings on sleep disturbance. Additionally, the WCJ must correct an identified occupational group number error in future rating calculations.

Workers' Compensation Appeals BoardWayne MooreEast Bay Municipal Utility DistrictAthens Administratorsmachinist maintenance workermachinistmachinist maintenancepermanent disabilityapportionmentQualified Medical Evaluator
References
Case No. ADJ6730955
Regular
Sep 13, 2010

JUAN MEDRANO, RAQUEL MEDRANO vs. CHIPCO MANUFACTURING COMPANY, EMPLOYERS COMPENSATION INSURANCE COMPANY

This case involves multiple workers' compensation claims for a deceased employee, Juan Medrano, including a death benefit claim for his dependents. The defendant sought reconsideration and removal after the Workers' Compensation Judge (WCJ) ordered a Mandatory Settlement Conference instead of a trial, citing insufficient applicant discovery. The Appeals Board dismissed the Petition for Reconsideration as the WCJ's order was interlocutory and not a final determination of substantive rights. They also denied removal, finding no prejudice or irreparable harm to the defendant. The Board directed the WCJ to set all three cases for an MSC to clarify the record and ensure due process during further discovery.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalMandatory Settlement ConferenceInterlocutory OrderSubstantive RightIrreparable HarmAgreed Medical EvaluatorDeclaration of ReadinessGuardian ad Litem
References
Case No. ADJ1311571 (SAC 0331121)
Regular
Apr 23, 2010

JOSEPH BAKER vs. TINK, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded a prior order, and returned the case for further proceedings. The dispute concerns reimbursement for an RS4i stimulator device, with the lien claimant arguing the initial utilization review denial was improper. The Board found the WCJ did not adequately address whether the RS4i device is equivalent to a TENS unit and how treatment guidelines apply to the applicant's chronic condition. Further development of the medical record is necessary to determine the reasonableness of the prescribed treatment.

RS4i stimulatorUtilization ReviewACOEM GuidelinesTENS unitchronic painacute low back painMedical Treatment Utilization Schedulelien claimantreconsiderationWCJ
References
Case No. ADJ7083586
Regular
Feb 10, 2015

JOSE PACHECO (Deceased) MARIA ELENA PACHECO (Widow) vs. HAWKER PACIFIC AEROSPACE, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the widow's petition for reconsideration of the denial of her claim for death benefits. The applicant failed to prove that her deceased husband's industrial exposure contributed to his death from internal system injuries. The majority adopted the WCJ's report, finding no error in the denial. One commissioner dissented, arguing the record should be further developed regarding the decedent's specific workplace exposures to harmful agents like nickel and chromium, as his employment need only be a contributing cause.

Workers' Compensation Appeals BoardPetition for ReconsiderationIndustrial InjuryCumulative TraumaDeath BenefitMachinistNickelChromiumCyanideLiver Cancer
References
Case No. ADJ1534094 (ANA 0371141), ADJ2039233 (ANA 0370928), ADJ1431772 (ANA 0388738), ADJ3092100 (ANA 0388739)
Regular
Feb 10, 2012

ROLANDO ALVARADO-CRUZ vs. SPRING INDUSTRIES, INC., ZURICH INSURANCE COMPANY

This case involves a workers' compensation applicant seeking reconsideration of a permanent disability award. The applicant argued against the administrative law judge's (WCJ) apportionment of 25% of the disability to pre-existing spondylolisthesis and the method of calculating the final award. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, agreeing that apportionment should be applied after adjustments for age and occupation, but otherwise affirmed the WCJ's findings. Consequently, the applicant's permanent disability award was increased to 21% for both the specific and cumulative trauma injuries.

Workers' Compensation Appeals BoardRolando Alvarado-CruzSpring IndustriesZurich Insurance CompanyFindings and AwardAdministrative Law JudgeMachinistPillow StufferSpecific InjuryCumulative Trauma Injury
References
Case No. ADJ2790090 (LAO 0278759) ADJ2006433 (LAO 0799986)
Regular
Aug 01, 2011

ORANGE PORTER vs. WESTEC GEAR CORPORATION, CNA CASUALTY OF CALIFORNIA

This case involves competing petitions for reconsideration of a workers' compensation award. The primary issue is the lack of a complete record, specifically the absence of served Minutes of Hearing and Summary of Evidence, which prevents meaningful review. Consequently, the Appeals Board granted reconsideration, rescinded the prior award, and returned the case to the trial level for further proceedings and a new decision. The parties raised various contentions regarding injury findings, apportionment, and indemnity rates, which will be addressed on remand.

Workers' Compensation Appeals BoardReconsiderationJoint Findings and AwardIndustrial InjuryCervical SpineLumbar SpineUpper ExtremitiesBilateralLeft Lower ExtremityPsyche
References
Case No. ADJ2247729
Regular
Apr 19, 2010

LAZARO MARTINEZ vs. WEDGESTONE CORPORATION, UNITED STATES FIRE INSURANCE

This case involves a defendant's petition for reconsideration of a workers' compensation award for industrial injuries to the applicant's right hand and psyche, back, and right shoulder, resulting in 81% permanent disability. The defendant argued the Administrative Law Judge (ALJ) should have relied on Dr. Sabbag's opinion for apportionment of disability. The Workers' Compensation Appeals Board (WCAB) denied reconsideration, finding Dr. Sabbag's apportionment opinion lacked sufficient reasoning and did not constitute substantial evidence. The WCAB also noted that applying Dr. Sabbag's apportionment would paradoxically result in a higher permanent disability rating.

Workers' Compensation Appeals BoardReconsiderationAmended Findings and AwardIndustrial InjuryMachinistRight HandPsycheBack InjuryRight ShoulderApportionment
References
Case No. ADJ7111686
Regular
Apr 14, 2010

DANIEL AVENDANO, JR. vs. RAYDON, INC., ENDURANCE INS. CO., FIRSTCOMP.

The defendant sought reconsideration of an approved Compromise and Release agreement, arguing the WCJ erred by not allowing a credit for permanent disability advances due to mutual mistake. The agreement settled the applicant's industrial injuries for $\$12,797.50$. However, the Compromise and Release form contained an ambiguous clause regarding permanent disability advances, with blanks left unfilled by the defendant. Because the defendant drafted the agreement and the applicant was unrepresented, any ambiguity is construed against the defendant. Therefore, the petition for reconsideration was denied, and the defendant is not entitled to a credit for permanent disability advances.

Permanent disability advancesCompromise and ReleaseMutual mistake of factWCABLabor Code section 5003AmbiguityUnrepresented applicantContract interpretationCreditIndustrial injury
References
Case No. ANA 0374544
Regular
Jun 09, 2008

JOHN T. TRAN vs. WMC GRINDING, AIG CLAIMS SERVICES

The applicant, John Tran, seeks reconsideration of a Workers' Compensation Appeals Board decision that denied penalties for delayed temporary and permanent disability payments. Tran argues the defendant unreasonably delayed payments after he became permanent and stationary, and seeks penalties under Labor Code section 5814. The Board granted reconsideration, vacated the prior decision, and returned the case for further development of the record on the issue of penalties.

ReconsiderationFindings and AwardIndustrial InjuryLow BackMachinistTemporary DisabilityPermanent DisabilityAgreed Medical Examiner (AME)Labor Code Section 5814Penalty
References
Case No. ADJ676456 (RIV 0010094) ADJ280975 (RIV 0039757)
Regular
Apr 11, 2016

John Adcock vs. Matrix Science Corp., Pomona Precision Grinding Co., Travelers Insurance, Farmers Insurance Group

The applicant sought reconsideration of WCAB findings that denied industrial injury to his back in two separate cases involving different dates of injury. The WCJ recommended granting the petitions for reconsideration to further develop the record regarding the back injury claim. The Board agreed and granted reconsideration, rescinding the original findings and returning the matter to the trial level for further proceedings. This decision specifically addresses the development of evidence concerning the applicant's alleged back injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactAmended Findings of Factindustrial injurygrinder/machinistright handright elbowright kneeback injury
References
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