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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. ADJ7785251
Regular
Nov 14, 2014

Jon Brothers vs. STATE OF CALIFORNIA, DEPARTMENT OF FORESTRY AND FIRE PROTECTION, COASTAL/NORTH REGION; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to clarify that the applicant's cumulative trauma orthopedic injury claim is still under development. The Board agreed with the WCJ that the defense's medical expert, Dr. Baldwin, failed to provide substantial medical evidence due to a misunderstanding of cumulative trauma principles. Dr. Baldwin improperly required documented prior specific injuries to opine on cumulative trauma, thereby failing to adequately assess the applicant's extensive work history. Therefore, the case is affirmed except for the amendment of a finding of fact to reflect that the orthopedic injury claim is contested and requires further medical evaluation.

Cumulative traumaQualified Medical EvaluatorIndependent Medical Evaluatorsubstantial medical evidenceorthopedic injurybinaural hearing losscardiovascular systemBattalion Chiefretired annuitantorthopedic cumulative trauma
References
Case No. ADJ7332241
Regular
Jun 30, 2011

Jesus Hernandez vs. JCB CLARK ENTERPRISES INC, U.S. FIRE AND GUARANTY

Here's a summary for a lawyer: The Workers' Compensation Appeals Board denied Jesus Hernandez's petition for reconsideration, affirming the WCJ's decision that he failed to meet his burden of proof for a cumulative trauma injury ending March 17, 2007. The applicant argued that prior injuries and a doctor's report supported his claim for a longer period, but the Board found his arguments unpersuasive. A dissenting commissioner believed the case should be returned for further proceedings on orthopedic cumulative trauma claims due to disputed employment periods and available evidence.

Cumulative TraumaPetition for ReconsiderationFindings and AwardWorkers' Compensation Administrative Law Judge (WCJ)Burden of ProofIndustrial Cumulative TraumaPast Industrial InjuryMedical EvidenceSubstantial Medical EvidenceFaulty History
References
Case No. ADJ3864552 (LAO 0788138)
Regular
Jan 03, 2011

ANTONIETA GUERRERO vs. WELLPOINT HEALTH NETWORK, INC., ZURICH LOS ANGELES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For FREMONT In Liquidation

The Workers' Compensation Appeals Board granted reconsideration of a prior award due to insufficient analysis by the WCJ regarding the date(s) of cumulative trauma. The Board found the WCJ's decision lacked specific reference to evidence, particularly on whether multiple or a single period of cumulative trauma applied. The matter was returned to the trial level for further proceedings, a new decision, and adequate analysis of all contentions, including permanent disability and apportionment.

Cumulative traumaOveruse syndromeFibromyalgiaPsyche injuryPermanent total disabilityApportionmentAttorney feesFindings and AwardReconsiderationWCJ
References
Case No. ADJ2630861 (LAO 0880530)
Regular
Nov 16, 2012

MARTHA PONCE vs. ASHLEY & J PHARMACY CORP, dba ROSS MEDICAL PHARMACY, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to amend a prior award, rescinding the permanent disability award for applicant's sleep loss. While the applicant was found to have sustained cumulative trauma injury to her neck, back, and psyche, the Board determined that an additional impairment rating for sleep loss was duplicative of existing orthopedic and psychiatric ratings. The original award of 53% permanent disability was reduced to 47%, and the attorney's fees were adjusted accordingly. The Board also rejected the defendant's argument for apportionment to a specific back injury, as the cumulative trauma finding was already final.

Workers Compensation Appeals BoardAshley & J Pharmacy CorpEmployers Compensation Insurance CompanyMartha PonceOpinion and Order Granting ReconsiderationDecision After Reconsiderationsleep losscumulative trauma injuryneckback
References
Case No. ADJ9172692
Regular
Feb 25, 2016

TIMOTHY FRYE vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION, Legally Uninsured; STATE COMPENSATION INSURANCE FUND

This case involves a correctional lieutenant who claimed a cumulative industrial injury to his heart, knees, hip, cardiovascular system, and hypertension. The defendant sought reconsideration, arguing for separate injury periods for orthopedic and internal conditions. The Board denied the petition, upholding the finding of a single cumulative trauma period ending on the applicant's last day of employment. The Board found no evidence that the applicant knew his disability was work-related prior to consulting an attorney, thus establishing the date of injury as post-employment.

Cumulative traumaDate of injuryIndustrial injuryCardiovascular systemHypertensionOrthopedic claimInternal claimPetition for reconsiderationFindings of Fact and AwardsWCJ
References
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. ADJ7050517
Regular
Jun 16, 2010

Gary Tull vs. YOUNGS MARKET, Permissibly Self-Insured Administered By CANNON COCHRAN MANAGEMENT SERVICES

This case concerns an applicant claiming cumulative trauma injury to his right knee. The WCJ denied the claim, finding the Panel QME's report insufficient to establish cumulative trauma. The Appeals Board granted reconsideration, noting the PQME found an injury and work-related causation but incorrectly characterized it as a specific injury on a particular date. The Board remanded the case to develop the medical record, specifically directing a supplemental report from the PQME on the cumulative trauma aspect of the claim.

Cumulative traumaPanel Qualified Medical EvaluatorPQMEIndustrial injuryRight kneeFindings and OrderReconsiderationTake nothing orderSubstantial medical evidenceBurden of proof
References
Case No. ADJ 10459549, ADJ 10459544
Regular
Jul 07, 2017

SAUL MEJIA VALLADARES vs. SERVICON SYSTEMS, INCORPORATED

In this case, the Appeals Board affirmed the Arbitrator's denial of the applicant's specific injury claim from March 7, 2016, due to credibility issues and lack of substantial evidence. However, the Board rescinded the denial of the cumulative trauma claim from April 2011 to April 2016. The Board found that medical records indicated prior orthopedic complaints within the cumulative trauma period, necessitating further medical evaluation despite the applicant's credibility issues on other claims. Therefore, the cumulative trauma claim is returned to the Arbitrator for further development of the medical record.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaSpecific InjuryArbitratorCredibility DeterminationMedical EvaluationLabor Code Section 4060Carve-out CaseLabor Code Sections 3201.5
References
Case No. MON 0306639
Regular
Aug 09, 2007

Eugene Minet vs. QWEST COMMUNICATIONS

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior order due to an inadequate trial record, noting that findings of industrial injury must be supported by substantial medical evidence. The Board emphasized that medical reports were disorganized and not properly admitted as exhibits, and that lay testimony alone is insufficient for establishing cumulative trauma. The case is returned to the trial judge for further proceedings to create a proper record and a new decision.

Workers' Compensation Appeals BoardQwest CommunicationsFindings of Fact and Orderorthopedic injuryvision injurycumulative injurypreponderance of the evidencemedical recordneutral orthopedic physiciantrial record
References
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