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

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The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings.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. ADJ9065052
Regular
May 13, 2015

MARK SUAREZ vs. COUNTY OF SANTA BARBARA

This case involves applicant Mark Suarez, a deputy sheriff, who suffered a heart injury on February 4, 2013. Initially, the WCJ found the injury was due to a congenital condition and not work-related. However, the Appeals Board granted reconsideration, finding that Labor Code section 3212.5's "heart trouble" presumption for law enforcement officers applied. The Board determined that while medical evidence indicated a congenital cause, the statute's "anti-attribution" clause prevents rebutting the presumption solely based on a pre-existing condition without evidence of a contemporaneous non-work-related event. Consequently, the Board amended the prior order to find the injury industrially caused, remanding for further proceedings on benefits.

Labor Code section 3212.5heart trouble presumptiondeputy sheriffindustrial injurycongenital conditionaortic stenosisrebuttable presumptionanti-attribution clausenonwork-related eventMuznik
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ7494670
Regular
Jun 01, 2012

JOSEPH CURRAN, Deceased, JERI CURRAN, Spouse vs. CITY OF SACRAMENTO

The Workers' Compensation Appeals Board denied reconsideration of a decision finding that the deceased firefighter, Joseph Curran, suffered a heart injury arising out of and in the course of employment. The Board affirmed that the Labor Code Section 3212 heart trouble presumption applied. The defendant failed to rebut this presumption by demonstrating that a contemporaneous non-work-related event was the *sole* cause of the heart trouble. Dr. Bellinger's testimony, while stating the presumption was necessary, did not affirmatively prove exclusive non-industrial causation.

Labor Code 3212heart trouble presumptionindustrial causationrebutted presumptionanti-attribution clausesole causenonwork-related eventcumulative injuryfirefighterdeath benefits
References
Case No. ADJ7730915
Regular
Sep 18, 2015

TODD PALOMBO vs. CITY OF COSTA MESA

This case involves a firefighter claiming industrial heart injury under Labor Code § 3212, which presumes such injuries are work-related unless rebutted. The defense argued pre-existing conditions and lifestyle choices caused the applicant's cardiac arrhythmia. However, the medical expert did not definitively state non-work-related factors were the *sole* cause of the heart trouble, failing to overcome the statutory presumption. Therefore, the Workers' Compensation Appeals Board affirmed the finding of industrial injury.

Labor Code section 3212firefighterheart troublepresumptionindustrial injurycirculatory systemcumulative periodPetition for ReconsiderationWCJagreed medical evaluator
References
Case No. ADJ10343521
Regular
Jan 03, 2019

JESUS LOPEZ vs. CITY OF COMPTON

This case involves a firefighter's claim for workers' compensation benefits for heart trouble. The applicant, Jesus Lopez, was found to have sustained 54% permanent disability due to an industrial injury to his heart on December 17, 2015. The Workers' Compensation Appeals Board (WCAB) affirmed the administrative law judge's decision, relying on Labor Code section 3212, which presumes heart trouble in firefighters arises out of employment. The defendant, City of Compton, argued that the presumption was rebutted by evidence of non-industrial events and that the Qualified Medical Evaluator's opinion was not substantial medical evidence. However, the WCAB found that the defendant failed to provide substantial medical evidence to rebut the presumption, particularly in light of the anti-attribution clause in Labor Code section 3212.

Labor Code section 3212presumption of industrial causationheart troublefirefighter paramedicQualified Medical EvaluatorQMEsubstantial medical evidencedue processrebut the presumptionanti-attribution clause
References
Case No. ADJ10544667
Regular
Nov 15, 2019

NEREYDA VARGAS vs. WELLS FARGO BANK NORTH AMERICA, OLD REPUBLIC INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a decision finding no industrial psychiatric injury. The Board found the original decision failed to conduct the multi-level analysis required by *Rolda v. Pitney Bowes, Inc.* concerning actual employment events and lawful, good faith personnel actions. The case is returned to the trial level for further development and analysis to determine if actual employment events predominated the injury and if any lawful personnel actions were a substantial cause. The Workers' Compensation Judge must specifically address all alleged events, medical evidence, and potential inconsistencies in the Qualified Medical Evaluator's reports.

psychiatric injurycumulative traumaRolda analysispredominant causelawful personnel actionnondiscriminatorygood faithactual events of employmentpredicate eventsmedical evidence
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ8935673
Regular
Jun 08, 2015

ANGEL URRUTIA vs. CARDENAS MARKETS, INC.

The Workers' Compensation Appeals Board granted reconsideration of a decision denying applicant's claim for psychological injury. The Board found that while the applicant's alleged work events occurred, the medical evidence regarding predominant causation was unclear. Therefore, the matter was returned to the trial level for further development of the medical record, specifically requesting clarification from Dr. Surapaneni on whether actual employment events were the predominant cause of the applicant's injury. The Board emphasized the need for clear medical evidence establishing work-related causes as more than 50% of all causal factors.

Labor Code section 3208.3psychiatric injurypredominant causationindustrial cumulative traumagender transitionrestroom usediscriminationactual events of employmentsubstantial medical evidencefurther development of the record
References
Case No. ADJ2901317 (FRE0226671)
Regular
May 02, 2011

Connie Mehia vs. CITY OF FRESNO C/O AMERICAN ALL RISK LOSS ADMINISTRATORS (AARLA)

The applicant sought workers' compensation benefits for a stroke, claiming it arose out of and in the course of employment due to workplace stress. The Administrative Law Judge (WCJ) denied the claim, finding no credible evidence that a workplace incident caused the stroke. The Workers' Compensation Appeals Board (WCAB) affirmed the WCJ's decision, concluding that the applicant failed to prove the crucial element of a work-related precipitating event. Both QMEs opined the stroke could be industrially related, but their opinions relied on the applicant's account of a specific workplace argument that the WCJ found unsubstantiated.

AOE/COEindustrial strokeworkers' compensationreconsiderationcausationpre-existing conditionQualified Medical Examinercredibilitysubstantial evidencework-related stress
References
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