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

Case No. ADJ7785974
Regular
Mar 20, 2019

REFUGIO JOSE ALFARO (Deceased) vs. INTERSTATE HOME SERVICES, INSURANCE COMPANY OF THE WEST GROUP

This case involved a worker's compensation claim for death benefits after Refugio Alfaro died from a myocardial infarction. The defendant contested that the death was industrially caused, challenging the qualified medical examiner's (QME) opinion. The Appeals Board affirmed the finding of industrial causation, finding the QME's opinion substantial evidence supported by deposition testimony. However, the Board rescinded the award and returned the case for further proceedings to identify and determine eligibility of dependents, as the original applicant spouse was deceased.

AOE/COEmyocardial infarctiondeath benefitsQMEsubstantial evidencereconsiderationWCJindustrial causationdependencyaggravated condition
References
Case No. ADJ1609633 (POM 0277100)
Regular
May 28, 2014

DAVID WILSON (Deceased), PATRICIA WILSON (Widow) vs. POMONA UNIFIED SCHOOL DISTRICT

This case concerns a widow's claim for workers' compensation death benefits following her husband's fatal myocardial infarction. The applicant argued cumulative occupational stress caused his cardiovascular condition and death. However, the Administrative Law Judge and the Appeals Board found the decedent's death resulted from diverticular bleeding leading to a heart attack, a condition deemed not work-related by the chosen medical expert. The Board affirmed the decision denying the claim, finding the medical evidence supporting a non-industrial cause to be more persuasive.

WCABIndustrial InjuryCardiovascular SystemHypertensionHypertensive Ventricular HypertrophyMyocardial InfarctionCumulative Occupational StressDiverticular BleedingColectomyCausation
References
Case No. ADJ1994269 (LBO 0278150)
Regular
Feb 04, 2013

RAYMOND LANE vs. CAMPBELL HALL SCHOOL, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT COMPENSATION INSURANCE COMPANY

This Workers' Compensation Appeals Board case concerns applicant Raymond Lane's permanent disability rating following a myocardial infarction and subsequent psychiatric injury. The Board granted reconsideration, modifying the previous award to reflect a 93.5% permanent disability rating. This adjustment was based on the Board's finding that while cardiac permanent disability is apportionable, psychiatric permanent disability is not to be apportioned to non-industrial factors, aligning with expert medical opinions and statutory requirements. The applicant is awarded a specific weekly payment for a set period, followed by a life pension, with provisions for attorney fees.

Workers' Compensation Appeals BoardPetition for ReconsiderationDecision After ReconsiderationPermanent DisabilityApportionmentLabor Code Sections 4663Labor Code Sections 4664Myocardial InfarctionPsychiatric InjuryAgreed Medical Evaluators (AMEs)
References
Case No. ADJ7026523; ADJ7026470
Regular
Oct 26, 2011

Nancy Parker vs. FOLSOM ORTHOPEDIC SURGERY, HARTFORD FIRE INSURANCE COMPANY

This case involves Nancy Parker's claims of work-related heart injury stemming from exposure to an aerosol cleaner and emotional distress from a co-worker. The Workers' Compensation Appeals Board denied reconsideration of the WCJ's findings. The WCJ found that the alleged exposure to the cleaning product likely occurred weeks before the claimed injury date, and the applicant's description of her interaction with the co-worker was significantly inaccurate. Consequently, the WCJ concluded the applicant did not sustain industrial injuries as alleged.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJGarza v. Workers' Comp. Appeals Bd.Folsom OrthopedicsHartford Fire Insurance CompanyADJ7026523ADJ7026470cumulative traumaSprayway
References
Case No. ADJ7099563, ADJ7825176
Regular
Mar 07, 2014

MARIA GONZALEZ (WIDOW) vs. THE GAP, INC. dba BANANA REPUBLIC, AMERICAN ZURICH INSURANCE C/O SPECIALTY RISK

The Workers' Compensation Appeals Board affirmed a prior decision finding that the deceased employee did not sustain an industrial injury to his nervous, cardiac, or hypertension systems. Furthermore, his death was determined not to be industrially caused, and his widow's claim for death benefits was denied. The Board found that the defendant's timely denial of the employee's inter vivos claim precluded the need for a separate denial of the death benefit claim arising from the same alleged injury. The Board also concluded that the applicant failed to present substantial medical evidence demonstrating industrial causation for the alleged conditions or the resulting death.

Workers' Compensation Appeals BoardMiguel Angel GonzalezMaria GonzalezThe Gap Inc.Banana RepublicAmerican Zurich Insuranceindustrial injurynervous systemcardiac systemhypertension
References
Case No. ADJ3259433 (GOL 0088786) ADJ1074235 (GOL 0094396)
Regular
Aug 28, 2009

Sonnia Waugh vs. FRANCISCAN FRIARS OF CALIFORNIA, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE INSURANCE COMPANY, In Liquidation

This case involves a workers' compensation claim for industrial injuries to the back, lower extremities, and heart, with a dispute over psyche injury. The Appeals Board affirmed the finding of industrial heart injury, relying on medical evidence that the prescribed pain medication contributed to the heart attack. However, the Board deferred the issue of psyche injury, remanding it for further proceedings to determine if it arose from the industrial injury and to potentially reassess permanent disability and attorney's fees. The matter of cumulative trauma injury in a separate claim was also left unresolved at the trial level.

CIGAReliance Insurance CompanyWCJindustrial injuryspecific injurycumulative traumareconsiderationsubstantial evidenceapportionmentmedical treatment
References
Case No. ADJ663546
Regular
Oct 01, 2009

Sudha Rajender vs. TOBIN LUCKS, MALMQUIST, FIELDS & CAMASTRA

The WCJ found insufficient evidence of significant stress to support a conclusion that work stress contributed to applicant's coronary heart disease. The Board affirmed the WCJ's determination and denied the petition for reconsideration.

Workers' Compensation Appeals BoardSudha RajenderTobin LucksMalmquist Fields Camastracumulative trauma injurymyocardial infarctionQualified Medical EvaluatorDr. Gerald Bessespetition for reconsiderationindustrial causation
References
Case No. ADJ11237884; ADJ11237778
Regular
Oct 02, 2019

LUIS CARDENAS vs. SELECT STAFFING, CORVEL CORPORATION, XL GROUP

The Workers' Compensation Appeals Board granted reconsideration for both the applicant and defendant. The Board rescinded the previous Findings and Orders and Findings of Fact, finding that the record was not sufficiently developed. Specifically, the parties failed to clearly define the body parts injured and the date of injury for the cumulative trauma claim. The matters are returned to the trial level for further proceedings and development of the record.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrdersFindings of FactWCJPQMEmyocardial infarctionspecific injurycumulative injurydate of injury
References
Case No. ADJ1321659 (RIV 0027849) ADJ3991283 (RIV 0027850)
Regular
Jan 21, 2007

Robin Klein vs. Boeing Aircraft, INSURANCE COMPANY OF PENNSYLVANIA

The WCAB denied defendant's petition for reconsideration, affirming the WCJ's finding that applicant's heart disease and depression arose from his work injuries.

Workers Compensation Appeals BoardPetition for ReconsiderationAmended Joint Findings and Awardheart injurypsyche injuryneck injuryback injuryleft shoulder injurypermanent disabilityapportionment
References
Case No. ADJ10537232, ADJ10537109, ADJ10058212
Regular
Jan 25, 2018

CHARLES CONLEY vs. STATE OF CALIFORNIA DEPARTMENT OF HEALTHCARE SERVICES

The Appeals Board granted reconsideration to further study the applicant's psychiatric and heart injury claims arising from his employment. The WCJ found the claims barred by the statute of limitations and denied a cumulative trauma claim due to lack of medical evidence. The Board rescinded the Findings and Orders, returning the case for further proceedings to address the WCJ's mischaracterization of specific injuries as cumulative trauma and the potential tolling of the statute of limitations. The Board also noted a need for further development of medical evidence on causation for the cumulative trauma claim.

Petition for ReconsiderationFindings and OrdersQualified Medical EvaluatorStatute of LimitationsCumulative TraumaSpecific InjuryIndustrial CausationEstoppelMyocardial InfarctionCoronary Artery Bypass Surgery
References
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