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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. LAO 838220
Regular
May 14, 2007

MARIA SERAFIN vs. LANSCO DIE CASTING, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the previous award, and remanded the case to determine permanent disability using the 1997 Schedule. This decision stems from the Board's finding that the applicant's treating physician's December 20, 2004, report indicated the existence of permanent disability, triggering an exception under Labor Code section 4660(d). Consequently, the outdated 1997 Schedule, not the 2005 Schedule, must be applied to calculate the applicant's permanent disability benefits.

Workers' Compensation Appeals BoardMaria SerafinLansco Die CastingState Compensation Insurance FundLAO 838220ReconsiderationFindings and AwardWCJIndustrial InjuryRight Shoulder
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. ADJ8668832
Regular

BACILIO ANGEL SALAZAR vs. SAN DIEGO PERSONNEL AND EMPLOYMENT AGENCY, INC., AMTRUST NORTH AMERICA for CASTLEPOINT NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for removal, rescinding a prior order that deemed a QME report timely. The Board found Dr. Tahami's psychiatric evaluation report was untimely served on the defendant. As the defendant objected prior to receiving the report, they are entitled to a replacement QME panel in psychiatry.

Petition for RemovalQualified Medical EvaluatorQME paneluntimely reportreplacement QMEAdministrative Director RuleLabor Codepsychiatric injurymedical-legal evaluationsubstantial prejudice
References
Case No. ADJ3603544
Regular
Mar 29, 2010

LUIS ALVAREZ vs. CONTROLLED CLIMATE CONSTRUCTION, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior award, and returned the case for a new decision. The applicant argued the WCJ erred in applying the 2005 permanent disability schedule to a 2004 injury. The Board found that the treating surgeon's operative report, combined with the Agreed Medical Evaluator's testimony, constituted substantial evidence of a pre-2005 indication of permanent disability. Therefore, the case must be rated under the 1997 Permanent Disability Schedule.

Petition for ReconsiderationFindings and AwardPermanent Disability1997 Schedule2005 ScheduleLabor Code Section 4660(d)Comprehensive Medical-Legal ReportTreating Physician's ReportSubstantial Medical EvidenceOperative Report
References
Case No. ADJ6535347, ADJ6534384
Regular
Nov 02, 2015

CHRISTINE KNAPP vs. COUNTY OF FRESNO

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration. The applicant sought to overturn findings of $53\%$ permanent disability and disputed the exclusion of vocational expert reports and a claim of $100\%$ disability. The Board found the petition contained numerous factual misrepresentations and violations of WCAB rules and professional conduct by the applicant's attorney. The Board adopted the WCJ's report, which recommended denial due to the petition's legal defects and factual inaccuracies.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardOccupational Group NumberIndustrial InjuryRight ShoulderMigraine HeadachesPermanent DisabilityAgreed Medical ExaminerQualified Medical Examiner
References
Case No. ADJ10614264
Regular
Aug 30, 2017

ELIZABETH MARTINEZ vs. UVP LLC, BERKLEY REGIONAL INSURANCE COMPANY

This case concerns an applicant's petition for reconsideration of a finding denying temporary disability benefits. The Workers' Compensation Appeals Board granted reconsideration, finding that the prior decision was based on an incomplete review of medical evidence, specifically the PQME's report which referenced an incomplete operative report and contradicted applicant's testimony. The Board deferred the issue of temporary disability to allow for further development of the record at the trial level. A dissenting opinion argued that the applicant failed to meet her burden of proof and should instead pursue a petition to reopen if new evidence emerges.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactPanel Qualified Medical ExaminerTemporary DisabilitySubstantial Medical EvidenceMedical ReportOperative ReportPrimary Treating PhysicianDevelop the Record
References
Case No. OAK 240649 OAK 240651 OAK 279879
Regular
Jan 15, 2008

BUNNIE ORANGE vs. HILTON HOTEL CORPORATION, SPECIALTY RISK SERVICES

The Appeals Board granted reconsideration because the administrative law judge incorrectly used the 1997 Permanent Disability Rating Schedule instead of the 2005 Schedule for the applicant's cumulative trauma injury. The Board also found the calculation of permanent disability indemnity was improper and remanded the case for re-rating under the 2005 Schedule. Upon remand, any overlap between the current award and a prior stipulated award must be identified and subtracted before calculating the final indemnity.

WORKERS' COMPENSATION APPEALS BOARDBUNNIE ORANGEHILTON HOTEL CORPORATIONSPECIALTY RISK SERVICESOAK 240649OAK 240651OAK 279879OPINION AND ORDERGRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATION
References
Case No. ADJ7242422
Regular
Sep 24, 2013

TRACIE WHITE vs. COUNTY OF SACRAMENTO, DEPARTMENT OF FINANCE

The Workers' Compensation Appeals Board denied the County of Sacramento's Petition for Removal. The County sought to replace a Qualified Medical Evaluator (QME) due to an allegedly untimely supplemental report. The Board affirmed the administrative law judge's denial, interpreting Administrative Director Rule 38(h) to grant QMEs sixty days for supplemental reports. The Board also noted the County objected to the report before receiving it.

Petition for RemovalQualified Medical EvaluatorQME panelsupplemental reportuntimely reportAdministrative Director Rule 38Report and RecommendationFajardo v. Workers' Comp. Appeals Bd.WCJoff calendar
References
Case No. ADJ9292791
Regular
Sep 29, 2015

HIEP LE NGOC NGUYEN vs. OAKS CLUB ROOM, NATIONAL CASUALTY COMPANY, NATIONWIDE AGRIBUSINESS INSURANCE COMPANY

This case concerns applicant's petition for removal after the WCJ denied their request for a new Qualified Medical Examiner (QME) panel. The denial was based on the original QME's failure to issue a timely supplemental report despite two requests. Although the QME claimed non-receipt of the requests, the supplemental report has now been provided. The Appeals Board denied removal, finding that issuing a new panel would only cause further delay given the report is now available.

Petition for RemovalQualified Medical ExaminerSupplemental ReportRule 38(i)Administrative Law JudgeWCJ ReportPrejudiceIrreparable HarmUntimely ReportPanel Qualified Medical Examiner
References
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