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

Case No. ADJ9426340 ADJ9182419
Regular
May 18, 2016

ANTHONY FISHER vs. PUTNAM LEXUS, PUBLIC SERVICE MUTUAL INSURANCE COMPANY, CORVEL CORPORATION

This case concerns applicant Anthony Fisher's claim for stem cell treatment for his knees. The primary treating physician submitted Requests for Authorization (RFAs) which the defendant argued were never received. The Workers' Compensation Appeals Board (WCAB) rescinded the prior denial, finding the exclusion of applicant's witness testimony (Sarina Brown) was an error. The matter is returned to the trial level to admit Ms. Brown's declaration and allow both parties to present further evidence regarding RFA transmission and the medical necessity of the treatment.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderRequest for Authorizationmesenchymal Adipose derived stem cellutilization reviewAgreed Medical Evaluatordeclaration of Sarina Brownhearsaydue process
References
Case No. ADJ8493192, ADJ8386046
Regular
Feb 05, 2016

HECTOR CAMPOS vs. CELL-CRETE CORPORATION, OLD REPUBLIC GENERAL INSURANCE CORPORATION, GALLAGHER BASSETT SERVICES, INC., INFRASOURCE, OLD REPUBLIC INSURANCE COMPANY

This case involves applicant Hector Campos seeking reconsideration of a Findings and Award concerning cumulative injuries sustained while employed by Cell-Crete Corporation and Infrasource. The Workers' Compensation Judge (WCJ) found applicant sustained a curable injury at Cell-Crete but no injury at Infrasource. Applicant argued improper consolidation and need for further discovery, while Cell-Crete asserted a post-termination defense and challenged the WCJ's reliance on an Agreed Medical Evaluator's opinion. The Workers' Compensation Appeals Board (WCAB) reviewed the petitions and answers, ultimately adopting the WCJ's report and denying reconsideration, affirming the original Findings and Award.

Workers' Compensation Appeals BoardCell-Crete CorporationOld Republic General Insurance CorporationGallagher Bassett ServicesInc.InfrasourceOld Republic Insurance CompanyADJ8493192ADJ8386046Deputy Commissioner
References
Case No. ADJ7039301
Regular
Mar 16, 2011

ROBLY HART vs. LA JOLLA PACIFIC/DRR NEFF & ASSOCIATES, OAKS RIVER INSURANCE/BERKSHIRE HATHAWAY HOMESTATE COMPANIES

This case concerns Robly Hart's workers' compensation claim for an injury sustained in a motorcycle accident. The applicant was a construction consultant who used his motorcycle for work, traveling between home, job sites, and interviews. The primary dispute centers on whether the accident occurred during the course and scope of his employment, with conflicting evidence regarding his activities and timeline leading up to the incident. The Workers' Compensation Appeals Board denied reconsideration, adopting the judge's report that found the applicant's testimony lacked credibility due to inconsistent statements and timeline discrepancies.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJGarza v. Workers' Comp. Appeals Bd.Findings and OrderCourse of EmploymentConstruction ConsultantBuilding InspectorMotorcycle TravelJob Sites
References
Case No. ADJ8386046, ADJ8493192
Regular
Oct 13, 2015

HECTOR CAMPOS vs. CELL-CRETE CORPORATION, OLD REPUBLIC GENERAL INSURANCE CORPORATION, GALLAGHER BASSETT SERVICES, INC., INFRASOURCE, OLD REPUBLIC INSURANCE COMPANY

This case involves a petition for reconsideration filed by both the applicant and the defendant, Cell-Crete, concerning a decision issued on July 22, 2015. The Workers' Compensation Appeals Board (WCAB) has granted reconsideration to allow for a more thorough review of the factual and legal issues presented. This decision is necessary to ensure a just and reasoned outcome after a complete understanding of the record. All further correspondence related to the petitions must be filed directly with the WCAB Commissioners' office.

WORKERS' COMPENSATION APPEALS BOARDPETITION FOR RECONSIDERATIONCELL-CRETE CORPORATIONOLD REPUBLIC GENERAL INSURANCE CORPORATIONGALLAGHER BASSETT SERVICES INCINFRASOURCEADJ8386046ADJ8493192San Francisco District OfficeOPINION AND ORDER
References
Case No. ADJ7721471
Regular
Jun 18, 2012

DANIEL MURPHY vs. CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to clarify that the applicant's basal cell carcinoma is not an insidious progressive disease, therefore jurisdiction cannot be reserved for future permanent disability beyond the statutory five-year limit. The Board amended the findings to state that the injury was to the applicant's nose, not all sun-exposed skin, and future basal cell carcinomas would be considered new injuries. This decision clarifies that the applicant's current award covers the injury to his nose, and any future skin cancers will require separate claims.

Workers' Compensation Appeals BoardCalifornia Highway PatrolState Compensation Insurance FundDaniel MurphyHighway Patrol Officerbasal cell carcinomainsidious progressive diseasereservation of jurisdictionLabor Code section 5804General Foundry Service v. Workers' Comp. Appeals Bd. (Jackson)
References
Case No. ADJ9509417
Regular
Apr 05, 2023

ELIZABETH ARBOGAST vs. CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed an award for further medical treatment and attorney fees for an applicant diagnosed with ovarian cancer, hernia, peripheral neuropathy, and colon issues sustained during her employment with the California Highway Patrol. The Board found the applicant's ovarian cancer to be an insidious and progressive disease, warranting a reservation of jurisdiction over permanent disability. This reservation allows for future determination of permanent disability if the condition worsens or recurs.

Workers' Compensation Appeals BoardCalifornia Highway Patrolmedically uninsuredState Compensation Insurance FundAdjudication NumberOpinion and Decision After ReconsiderationFindings and Awardworker's compensation administrative law judgeovarian cancerhernia
References
Case No. ADJ4571860
Regular
Oct 16, 2008

FRANK REID vs. COUNTY OF SAN DIEGO

The Appeals Board reversed the trial judge's decision, finding the applicant's skin cancer was not an insidious, progressive disease and thus jurisdiction over permanent disability could not be reserved. They also disallowed apportionment of the applicant's 37 percent permanent disability, as he had no prior awards and was covered by a statutory exception for peace officer injuries. The Board established July 28, 2003, as the permanent and stationary date and corrected the date of injury to July 28, 2003.

Workers' Compensation Appeals BoardFrank ReidCounty of San DiegoCriminal Investigator IVindustrial injuryskin cancerinsidious disease processpermanent and stationarypermanent disabilityapportionment
References
Case No. ADJ8081180
Regular
Mar 14, 2014

SILVIA ESTRADA vs. TAMTAM MEDICAL GROUP, INC., PREFERRED EMPLOYERS INSURANCE COMPANY

This case involves a lien claimant, Southland Spine & Rehabilitation, seeking reconsideration of a denial of its lien. The Workers' Compensation Appeals Board (WCAB) denied reconsideration, upholding the finding that Southland's lien was barred. The WCJ previously ruled that the applicant's claim was resolved by a compromise and release and was barred as a post-termination claim, making the lien derivative and therefore also barred. The WCAB found that Southland failed to establish industrial injury AOE/COE by a preponderance of evidence and that this issue was waived by not being raised earlier.

Workers' Compensation Appeals BoardFindings and OrderPetition for ReconsiderationLien claimantInjury AOE/COECompromise and ReleaseLabor Code Section 3600(a)(10)Post-termination claimDerivative rightsPreponderance of evidence
References
Case No. ADJ843966 (SDO 0338705)
Regular
Dec 13, 2013

Reed Thomas Kirby vs. Arthur Gonzales, STATE FARM INSURANCE COMPANY, KEITH PATRICK DONNELLY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to amend a prior award. The WCAB affirmed the finding that the applicant sustained an injury while employed as a tree trimmer by an uninsured employer, Keith Patrick Donnelly. However, the WCAB amended the award to reflect that liability rests solely with the uninsured employer, not the Uninsured Employers Benefits Trust Fund (UEBTF), as UEBTF's liability is derivative. The WCAB rejected arguments that the City of San Diego was also responsible and confirmed the applicant is entitled to benefits from Donnelly.

Uninsured Employers Benefits Trust FundUEBTFKeith Patrick DonnellyTarzan Tree SpecialistsArthur GonzalesState Farm Insurance Companytree trimmerderivative defendantLabor Code section 3352(h)City of San Diego
References
Case No. ADJ4244211
Regular
Apr 30, 2010

MARIA RAMIREZ vs. KELLY SERVICES, INC., ESIS

The Workers' Compensation Appeals Board (WCAB) granted removal and rescinded an administrative law judge's (WCJ) order taking a lien claimant's case off-calendar without a hearing. The WCJ incorrectly applied res judicata based on the applicant's stipulation in a prior Compromise and Release agreement regarding an MPN. The WCAB found that the lien claimant's rights are derivative but not automatically bound by the applicant's stipulation without due process. Therefore, the case is returned to the trial level for a proper hearing on the lien claim.

Medical Provider NetworkLien ClaimantCompromise and ReleaseRes JudicataCollateral EstoppelRemovalPetition for ReconsiderationOff-Calendar OrderDue ProcessDerivative Rights
References
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