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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ8128282
Regular
Jan 23, 2014

ANGELA EGBIKUADJE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings. The defendant, California Department of Corrections and Rehabilitation, argued that the applicant's psychiatric injury claim was preempted by the ADA and not proven under Labor Code section 3208.3. The Board found the original decision lacked proper analysis regarding predominant industrial causation and the good faith personnel action defense. Therefore, the case was remanded for further development of the record, including expert medical opinion on these issues.

Workers' Compensation Appeals BoardAngela EgbikuadjeCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8128282Van Nuys District OfficeReconsiderationFindings and AwardIndustrial cumulative trauma injury
References
Case No. ADJ4225526 (GOL 0092072)
Regular
Apr 20, 2017

JESUS ARROYO vs. JOHN CRAVENS PLASTERING, STATE COMPENSATION INSURANCE FUND

This case involves Jesus Arroyo's petition for reconsideration of a Workers' Compensation Appeals Board decision. The Board denied reconsideration, adopting the reasoning of the workers' compensation administrative law judge. Medical evidence from Dr. Markovitz established that Arroyo suffered a total and permanent disability resulting from industrial injuries, including an aortic aneurysm repair and subsequent strokes. The Board found Dr. Markovitz's opinions constituted substantial medical evidence, despite conflicting defense opinions, and affirmed that all necessary medical care and permanent disability were industrially caused.

Workers' Compensation Appeals BoardJesus ArroyoJohn Cravens PlasteringState Compensation Insurance FundPetition for ReconsiderationAgreed Medical ExaminerGerald Markovitzechocardiogramaortic root dilationexpanding aortic aneurysm
References
Case No. ADJ1577836
Regular
May 04, 2009

JESUS GAVINO-REMIGIO vs. STRATUS SERVICES GROUP, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant injured when stepping on a metal hook, sustaining an admitted industrial injury to his right foot. The applicant sought reconsideration after the Workers' Compensation Judge (WCJ) denied findings that the injury also affected his internal systems (diabetes), eyes, and psyche, along with associated disability. The Board denied reconsideration, finding the defendant's medical expert's opinion on non-industrial diabetes causation to be substantial evidence, while deeming the applicant's medical experts' opinions insufficient. A dissenting commissioner argued the applicant's medical evidence sufficiently supported industrial causation for diabetes aggravation, warranting reconsideration.

Workers' Compensation Appeals Boardindustrial injuryright footinternal systemseyespsychediabetes mellituspermanent disabilitytemporary disabilityGerald Markovitz M.D.
References
Case No. ADJ3512142 (MON 0288509)
Regular
Jan 12, 2009

JOSE LUIS LARA vs. BRATIFF HOME CORP. dba METRO DINER and SCOTT BROFFMAN as substantial shareholder; UNINSURED EMPLOYERS BENEFIT TRUST FUND

The Appeals Board reversed the WCJ's finding that the applicant was an employee of Metro Diner on the date of injury, concluding that he was an independent contractor.

Workers' Compensation Appeals BoardBratiff Home Corp.Metro DinerScott BroffmanUninsured Employers Benefit Trust FundADJ3512142MON 0288509Opinion and Order Granting ReconsiderationDecision After ReconsiderationAdministrative Law Judge
References
Case No. ADJ11030955
Regular
Jan 06, 2020

JOSE RIVAS ESCALANTE vs. WEST ANAHEIM MEDICAL CENTER, SAFETY NATIONAL INSURANCE

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's finding of industrial injury. The Board agreed that the claim was not barred by post-termination provisions because the applicant's date of injury, defined by disability and knowledge of its industrial cause, occurred after notice of termination. Evidence showed the applicant did not suffer a compensable disability or ratable permanent disability until after he was terminated. Furthermore, the Board found that medical evaluators adequately considered non-industrial conditions in their findings of industrial causation.

Labor Code section 3600(a)(10)post-termination provisionsexception 3600(a)(10)(D)date of injurynotice of terminationcertified nurse's assistantindustrial injurycervical spinelumbar spineleft wrist
References
Case No. ADJ1402736
Regular
Jan 04, 2010

SANDY BASTIAN vs. COUNTY OF VENTURA

This case involves a firefighter diagnosed with breast cancer who claimed industrial injury under California Labor Code section 3212.1. The defendant employer argued the statutory presumption of industrial causation was rebutted by an Agreed Medical Examiner's opinion stating the cancer was non-industrial, citing a lack of studies linking female firefighter exposures to breast cancer. The Appeals Board affirmed the WCJ's decision, finding the applicant sufficiently demonstrated exposure to carcinogens and the defendant failed to meet its burden to prove the exposure was "not reasonably linked" to the cancer. The court clarified that the mere absence of specific epidemiological studies does not rebut the presumption under section 3212.1.

Labor Code section 3212.1firefightercancer presumptionindustrial injuryrebuttable presumptioncarcinogen exposureAgreed Medical Examiner (AME)non-industrial causationindustrial causationAppeals Board
References
Case No. ADJ9971016
Regular
Aug 27, 2019

BALDEMAR GONZALEZ, JR. vs. MORGANITE INDUSTRIES, GALLAGHER BASSETT SERVICES, INC.

This case involves a dispute over the apportionment of permanent disability benefits for an applicant's hearing loss. The Workers' Compensation Appeals Board (WCAB) rescinded the original award because the administrative law judge (WCJ) failed to provide the formula used to calculate the 16% permanent disability rating. Additionally, the WCAB found that the medical evaluator's report lacked sufficient reasoning to explain how the applicant's asymmetrical hearing loss was apportioned between industrial and non-industrial causes. The matter was returned to the WCJ for further proceedings, potentially including a new medical report and deposition.

Workers' Compensation Appeals BoardReconsiderationPermanent Disability RatingApportionmentIndustrial InjuryNon-IndustrialOccupational Noise ExposureAsymmetrical Hearing LossQualified Medical EvaluatorOtology Report
References
Case No. VNO 0386181
Regular
Apr 05, 2007

SUSAN PASCALE vs. BLUE CROSS/WELLPOINT DENTAL, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION on behalf of FREMONT INDEMNITY

This case concerns applicant Susan Pascale's claim for workers' compensation benefits due to industrial injuries resulting in fibromyalgia and other conditions. The WCJ awarded 80% permanent disability, apportioning 20% to applicant's pre-existing personality traits based on medical opinions. The Appeals Board affirmed this decision, finding the apportionment was supported by substantial medical evidence of causation, as allowed by recent statutory changes.

Workers' Compensation Appeals BoardSusan PascaleBlue Cross/Wellpoint DentalCalifornia Insurance Guarantee AssociationFremont IndemnityVNO 0386181Opinion and Decision After ReconsiderationApplicantDefendantWCJ
References
Case No. ADJ8501790
Regular
Jul 29, 2015

Kelly Chase vs. St. Louis Blues Hockey Club, Federal Insurance Company

The Workers' Compensation Appeals Board (WCAB) reversed a prior finding of industrial injury for a professional hockey player against the St. Louis Blues. The WCAB found insufficient connection to California for jurisdiction, citing the player's limited games in the state compared to his overall career. This decision followed the precedent set in *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)*, which requires a legitimate and substantial connection to the state for jurisdiction. The WCAB concluded that 21 games out of 485 did not meet this standard for a cumulative injury claim.

WCABSt. Louis Blues Hockey ClubFederal Insurance CompanyADJ8501790Opinion and Decision After Reconsiderationcumulative industrial injuryprofessional hockey playersubject matter jurisdictionstatute of limitationssubstantial medical evidence
References
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