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

Case No. ADJ383777
Regular
Apr 04, 2011

Roxanna Ortiz vs. ONE SOURCE, ESIS

The Workers' Compensation Appeals Board denied Roxanna Ortiz's petition for reconsideration of a prior findings and order. The initial ruling determined she sustained industrial injury only to her cervical spine as a janitor, not to other body parts or any resulting temporary/permanent disability or need for further medical treatment. Ortiz argued the judge erred by favoring defense medical reports and discrediting her testimony due to minor inconsistencies in her injury description. The Board adopted the WCJ's report, emphasizing deference to credibility determinations and that admissibility of medical reports should have been challenged at trial, not on reconsideration. A dissenting opinion argued the judge overemphasized minor variations in Ortiz's account and that medical evidence did not sufficiently support denial of other injuries or further treatment.

OrtizOne SourceESISWCABFindings and OrderPetition for ReconsiderationWorkers' Compensation Administrative Law Judgeindustrial injurycervical spineright arm
References
Case No. ADJ1901810 (SAC 0362345) ADJ381755 (SAC 0362346)
Regular
Feb 03, 2010

RONALD WILLIAMS vs. MV TRANSPORTATION, INC.; AMERICAN HOME ASSURANCE, adjusted by BROADSPIRE

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's petition for reconsideration as it was untimely filed and not properly verified. The WCAB also denied the defendant's petition for reconsideration, adopting the reasoning of the Workers' Compensation Judge. The underlying decisions found the applicant sustained an industrial injury to his low back, requiring further treatment but no permanent disability. A separate decision found an industrial injury to his right upper extremity (CRPS) and neck/upper back (myofascial pain syndrome), resulting in 75% permanent disability and entitlement to further medical treatment.

Complex Regional Pain SyndromeMyofascial Pain SyndromeAgreed Medical EvaluatorAMA Guides 5th EditionLabor Code section 4658(d)Permanent Disability IndemnityPetition for ReconsiderationUntimely FilingLack of VerificationJurisdictional Time Limit
References
Case No. GOL 96757
Regular
Jun 10, 2008

SA YANG LO vs. CUSTOM SENSORS & TECHNOLOGIES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a prior award, upholding the application of the 2005 Permanent Disability Rating Schedule. The Board found that exceptions allowing for the 1997 Schedule did not apply, as the applicant's temporary disability indemnity extended beyond January 1, 2005, and no qualifying pre-2005 reports indicated permanent disability. Furthermore, the Board found the applicant's vocational expert's opinion regarding diminished future earning capacity unpersuasive, thus affirming the initial 9% permanent disability rating.

Workers' Compensation Appeals BoardSA Yang LoCustom Sensors & TechnologiesInc.State Compensation Insurance FundGOL 96757Opinion and Order Denying ReconsiderationFindings and AwardWorkers' Compensation Administrative Law JudgeWCJ
References
Case No. ADJ2554534
Regular
Jan 03, 2023

WENDY COLLIE vs. STATE OF CALIFORNIA, EMPLOYMENT DEVELOPMENT DEPARTMENT, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration of a prior award. The initial award found the applicant sustained an injury AOE/COE to multiple body parts, resulting in permanent total disability without apportionment. The employer argued the finding of chronic pain syndrome was improper, and that the WCJ ignored credibility issues and apportionment opinions. The Appeals Board found substantial medical evidence supported the chronic pain syndrome diagnosis and that the employer failed to provide sufficient evidence for apportionment of permanent disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderAdministrative Law JudgeInjury AOE/COELumbar SpineCervical SpineLeft ShoulderRight HipRight Knee
References
Case No. ADJ237483
Regular
Nov 13, 2012

RAYEK J. FAHOUM vs. KAISER FOUNDATION HOSPITAL

The Workers' Compensation Appeals Board denied Rayek J. Fahoum's petition for reconsideration, upholding the findings of the Workers' Compensation Judge. The Judge's report found Fahoum sustained industrial injury to his neck and low back with secondary chronic pain syndrome, awarding 41% permanent disability. This decision relied on the opinions of the Agreed Medical Examiner and Dr. Renee Rinaldi, who concluded Fahoum experienced symptom magnification and that his condition was chronic pain syndrome, not fibromyalgia as claimed by Dr. Allen Salick. The Board extended great weight to the Judge's credibility findings regarding the medical opinions.

Workers' Compensation Appeals BoardReconsideration DeniedAgreed Medical ExaminerSubstantial Medical EvidenceFibromyalgiaChronic Pain SyndromeSymptom MagnificationOrthopedic InjuryLumbosacral StrainCervical Strain
References
Case No. ADJ3931400 (MON 0218725) ADJ4561489 (MON 0257189)
Regular
Nov 07, 2008

ELLEAN SLAUGHTER vs. CENTINELA HOSPITAL MEDICAL CENTER/TENET HEALTHCARE CORPORATION

This case involves a petition to reopen a worker's compensation claim where the applicant's permanent disability increased from 77.5% to 100% due to chronic pain syndrome. The defendant argued for apportionment to non-industrial conditions like multiple sclerosis and chronic fatigue syndrome. The Appeals Board granted reconsideration, rescinded the original award, and remanded the case for a new permanent disability rating, specifically requiring apportionment of the increased disability to the applicant's non-industrial conditions as per *Vargas v. Atascadero State Hospital*.

ReconsiderationPermanent DisabilityApportionmentNew and Further DisabilityChronic Pain SyndromeMultiple SclerosisChronic Fatigue SyndromeAgreed Medical ExaminersSB 899Vargas v. Atascadero State Hospital
References
Case No. ADJ8693536
Regular
Dec 28, 2017

MARQUITA DONES vs. WEST CONTRA COSTA UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied Marquita Dones' petition for reconsideration regarding an increase in permanent disability benefits. The Board adopted the Workers' Compensation Judge's report, which found no objective medical evidence supported an increase in disability beyond the original 7% award. While applicant testified to increased pain, neither the Qualified Medical Evaluator nor the treating physician could establish an increase in impairment, as required by the AMA Guides. The Board also admonished applicant's attorney for filing a non-compliant document.

WCABPetition for ReconsiderationDeniedPermanent DisabilityCumulative InjuryLeft ElbowLeft WristAwardPetition to ReopenNew and Further Disability
References
Case No. ADJ3361459
Regular
Oct 15, 2012

Christiane Flynn vs. YOLANDA'S OF VENTURA, AMERICAN HOME ASSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration and amended its prior decision regarding Christiane Flynn's injury. The applicant sustained injuries including right shoulder, brachial nerve, upper extremities, thoracic outlet syndrome, complex regional pain syndrome, psyche, and fibromyalgia. Her permanent disability was found to be 100% total, entitling her to weekly indemnity payments. A substantial attorney fee of $47,451.89 was deemed reasonable and ordered payable.

Christiane FlynnYolanda's of VenturaAmerican Home AssuranceAIG Claim ServicesADJ3361459VEN 0112129ReconsiderationAdministrative Law JudgeWaitressOccupational Group 322
References
Case No. ADJ8731635
Regular
Apr 02, 2019

Daissy Contreras vs. CRESTWOOD BEHAVIORAL HEALTH, UNION FIRE INSURANCE COMPANY

The Appeals Board granted reconsideration and rescinded the prior award, finding the medical record inadequate to determine applicant's claim of Complex Regional Pain Syndrome (CRPS). While some physicians noted symptoms consistent with CRPS, the Agreed Medical Examiner (AME) found no objective evidence. The Board ordered the matter returned to the trial level for further development of the medical record by appointing a pain management specialist. This new evaluation will aim to diagnose the applicant's right upper extremity condition and determine its industrial causation.

Complex Regional Pain SyndromeCRPSskin injuryrashcumulative traumaAgreed Medical ExaminerAMEskin conditionright upper extremitypain management specialist
References
Case No. ADJ3896064 (SAL 0121108)
Regular
Aug 08, 2012

BRUCE AYERS vs. GRANITE ROCK COMPANY, ZURICH AMERICAN INSURANCE COMPANY

This Workers' Compensation Appeals Board order denies reconsideration of a prior award finding permanent and total disability. The applicant's treating physician and vocational experts opined that the applicant's multiple impairments, including chronic pain, medication side effects, and sleep disturbances, render him unemployable. The Board found the defendant failed to present a fair and complete picture of the medical evidence regarding the applicant's employability, specifically omitting key portions of the physician's opinion. The Board also noted the defendant's attempt to reopen discovery regarding sleep medication was without merit, as the applicant's testimony was credible and the existing evidence supported his ongoing disability.

Workers' Compensation Appeals BoardGranite Rock CompanyZurich American Insurance CompanyPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeSleep StudySleep MedicationEarning CapacitySuitable and Gainful EmploymentVocational Experts
References
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