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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 The Board rescinded the original award and remanded the case for a new rating that incorporates the QME's findings on sleep disturbance.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. 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 Consequently, the Appeals Board granted reconsideration, rescinded the prior award, and returned the case to the trial level for further proceedings and a new decision.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. ADJ2209378 (VNO 0366651)
Regular
Oct 07, 2013

SCOTT LENETT vs. CITY OF MONTEREY PARK, CORVEL CORPORATION/HAZELRIGG RISK MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to address the defendant's petition to terminate liability for Applicant's pool maintenance award. The Board rescinded the prior decision and remanded the case for further proceedings. The core issue is whether the Applicant is entitled to the full maintenance award when he no longer directly pays for or maintains the pool, but rather pays HOA dues that contribute to pool upkeep. The Board clarified that while the award itself is not inappropriate, reimbursement should be based on Applicant's actual out-of-pocket costs for pool maintenance.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPool Maintenance AllowanceAqua TherapyContinuing JurisdictionLabor Code Section 5803Labor Code Section 5804Termination of LiabilityMedical Treatment Award
References
Case No. AHM 0116452 AHM 0116457 AHM 0116470
Regular
Jul 21, 2008

BRUCE SERVISS vs. RALPH'S GROCERY, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration and amended the award to clarify that the applicant is not entitled to duplicative temporary disability and vocational rehabilitation maintenance allowance payments for the same period. The Board found the defendant breached its duty to provide timely vocational rehabilitation notices after the applicant's January 16, 2004 permanent and stationary date. Consequently, the defendant remains liable for vocational rehabilitation maintenance allowance from that date, adjusted for prior payments.

Workers' Compensation Appeals BoardReconsiderationVocational RehabilitationMaintenance AllowanceTemporary DisabilityIndustrial InjuryMeat CutterRalph's GrocerySedgwick Claims Management ServicesPermanent and Stationary
References
Case No. ADJ4250427 (MON 0359204)
Regular
Sep 16, 2011

ANA AGUILAR vs. METRO BUILDING MAINTENANCE, STATE COMPENSATION INSURANCE FUND

In this case, the Workers' Compensation Appeals Board granted reconsideration and rescinded an order dismissing applicant Ana Aguilar's claim for lack of prosecution. The Board found that applicant's attorney was relieved as counsel and had lost contact with the applicant prior to the dismissal order, raising due process concerns. The dismissal order was based on a defendant's petition and a notice of intention to dismiss, but the Board found no evidence that the applicant actually received these notices. Therefore, the matter was returned to the trial level to ensure the applicant has an opportunity to be heard.

WCAB Rule 10582dismissal for lack of prosecutionex parte orderdue processlack of noticepetition for dismissalnotice of intention to dismissmotion to be relieved as counselcumulative traumamaintenance worker
References
Case No. SFO 0487591
Regular
Mar 01, 2008

GUADALUPE RODRIGUEZ vs. ABLE BUILDING MAINTENANCE COMPANY, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, rescinded the WCJ's award, and found that the applicant failed to meet his burden of proof. This decision was based on the Board's independent review of the evidence, which revealed inconsistent and unsubstantiated accounts from the applicant regarding the mechanism of his alleged industrial back injury. Consequently, the Board determined that there was insufficient substantial evidence to support a finding of industrial injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderIndustrial InjuryBack InjuryPsyche InjuryCompensable ConsequenceSubstantial EvidenceBurden of ProofCredibility
References
Case No. ADJ6502802
Regular
Feb 28, 2011

JOSE OLIVEIRA vs. RIVER FRONT APARTMENTS, ILLINOIS MIDWEST INSURANCE AGENCY, PENNSYLVANIA MANUFACTURERS' ASSOCIATION INSURANCE COMPANY

This case concerns a maintenance worker's shoulder injury sustained on June 8, 2007. The workers' compensation judge awarded 39% permanent disability based on a qualified medical evaluator's analysis. The defendant argued this analysis, which applied the hernia chapter of the AMA Guides, was flawed and that impairment should be assessed using the upper extremity chapter. After reconsideration, the Appeals Board affirmed the original Findings and Award, adopting the judge's reasoning.

Workers' Compensation Appeals BoardPetition for Reconsiderationindustrial injurymaintenance workerleft shoulderpermanent disabilitypanel qualified medical evaluatorAMA Guides to the Evaluation of Permanent Impairmenthernia chapterWhole Person Impairment
References
Case No. ADJ8501522
Regular
Nov 19, 2014

AMADOR VILLAREAL vs. FRESH START BAKERIES, THE HARTFORD

This Workers' Compensation Appeals Board case concerns an applicant injured as a maintenance technician whose employer challenges an award of transportation services for his children. The Board granted reconsideration to further study the record regarding this specific expense. While the initial administrative law judge found the transportation reasonable and necessary due to the applicant's inability to drive after his injury, the Board determined the applicant had not yet met his burden of proof that these services are medically necessary. The case is returned to the trial level for further development of the record on the medical necessity of child transportation services.

Workers' Compensation Appeals BoardReconsiderationFindings of FactMaintenance TechnicianIndustrial InjuryNeck InjuryHead InjuryVision InjuryPsyche InjuryBrain Injury
References
Case No. ADJ2209378
Regular
Jan 09, 2012

SCOTT LENETT vs. CITY OF MONTEREY PARK, CORVEL

The Workers' Compensation Appeals Board denied the applicant's Petition for Removal because removal is an extraordinary remedy requiring a showing of substantial prejudice or irreparable harm, which was not demonstrated. The underlying dispute concerns the defendant's petition to terminate liability for a $573 monthly pool maintenance award. While the Appeals Board noted the applicant's argument that the award was too old to reopen, they also highlighted that medical treatment awards are contingent on the applicant availing themselves of the treatment. The WCJ recommended denial as the applicant failed to prove irreparable harm from the order setting the case for trial.

Petition for RemovalWorkers' Compensation Appeals BoardIndustrial InjuryTotal DisabilityStipulation with Request for AwardFurther Medical TreatmentMedical Treatment AwardPetition to Terminate LiabilityLoss of JurisdictionPool Maintenance
References
Case No. ADJ7481451
Regular
Jun 03, 2011

RAMON PALAFOX vs. TEXTRON INC., Permissibly Self-Insured, administered by Broadspire

This case concerns an employee's claim for an industrial injury to his right shoulder sustained on January 25, 2006, while working as a maintenance worker. The defendant sought reconsideration of the original award, arguing the injury finding was unsupported and the statute of limitations applied. The Board denied reconsideration, finding the defendant failed to rebut the applicant's testimony of seeking treatment from the company nurse, which constituted more than first aid and triggered the employer's duty to provide a claim form. The Board also affirmed the judge's reliance on treating physician reports over those related to a prior injury, as the defendant did not pursue further medical evaluation options.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and AwardMaintenance WorkerIndustrial InjuryRight ShoulderStatute of LimitationsLabor Code Section 5400Medical ReportingDr. Larry Barnhart
References
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