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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. ADJ8511004 ADJ8509547
Regular
Nov 14, 2019

JEREMY JONES vs. DAHL'S EQUIPMENT RENTALS, INC., STAR INSURANCE COMPANY

In this case, the defendant sought reconsideration of a finding that the applicant's orthopedic and psychiatric disabilities should be added together, resulting in 86% permanent disability. The Appeals Board granted reconsideration, affirming the original finding in part but modifying it. The Board found that the Qualified Medical Examiner's (QME) reports were not substantial evidence due to inconsistencies regarding whether to combine or add disabilities. Therefore, the matter was returned to the WCJ for further proceedings to develop the record on permanent disability and attorney fees.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardCombined Values Chartorthopedic disabilitypsychiatric disabilityAgreed Medical ExaminerQualified Medical ExaminerAlmaraz/Guzman analysispermanent disability
References
Case No. ADJ2428736 (SJO 0217650)
Regular
Jan 26, 2017

PAMELA GRAHAM vs. MONTESSORI SCHOOL OF FREMONT; CIGA

This Workers' Compensation Appeals Board decision denies reconsideration, upholding the administrative law judge's finding that the defendant failed to meet their burden of proof on apportionment. The Board found the orthopedic agreed medical examiner's opinions on apportionment were not substantial evidence because they lacked detailed reasoning, failed to explain the causal connection between degenerative disc disease and permanent disability, and did not adequately address apportionment to non-industrial causes. Therefore, the defendant's petition for reconsideration was denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedApportionmentBurden of ProofMedical OpinionReasonable Medical ProbabilitySpeculativePertinent FactsAdequate Examination
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. ADJ3185622 (BAK 0149638) ADJ2237701 (BAK 0153467)
Regular
Jan 06, 2014

MARDI WHEELER vs. STATE OF CALIFORNIA, CDCR - WASCO STATE PRISON, Legally Uninsured; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES, Adjusting Agency

The Workers' Compensation Appeals Board granted reconsideration of a lower decision that awarded 79% permanent partial disability without apportionment between two industrial injuries. The Board found the orthopedic Agreed Medical Examiner's opinion lacked substantial evidence because it did not sufficiently apportion disability to each specific injury as required by law. Consequently, the matter was returned to the trial level to obtain a supplemental medical report from the examiner. This report must clarify the percentage of impairment attributable to each of the two work-related injuries.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardPermanent Partial DisabilityApportionmentNon-industrial factorsAlmaraz-Guzman analysisSubstantial evidenceAgreed Medical Examiner (AME)Orthopedic
References
Case No. ADJ6408456
Regular
May 17, 2010

KENNETH M. HOOVER vs. CITY OF POMONA

The Appeals Board granted reconsideration of the WCJ's award of 100% permanent total disability. The Board found that the WCJ's decision was not supported by substantial evidence, primarily due to deficiencies in Dr. Grodan's medical reporting regarding the applicant's skin and cardiovascular conditions. The matter was returned to the trial level for further development of the record and a new decision. The Board confirmed the application of the 1997 Permanent Disability Rating Schedule and the admission of Dr. Shirman's report.

WORKERS' COMPENSATION APPEALS BOARDADJ6408456KENNETH M. HOOVERCITY OF POMONAreconsiderationFindings and Award and Orderworkers' compensation administrative law judgeWCJMay 172010
References
Case No. ADJ2709955 (MON 0356320)
Regular
Jun 21, 2017

Mario Cocola vs. California Hospital Medical Center

The Workers' Compensation Appeals Board denied Mario Cocola's petition for reconsideration, upholding the finding that he sustained $69\%$ permanent disability from industrial injuries. Cocola argued the administrative judge erred by disregarding the Agreed Medical Examiner's opinion that he was totally disabled from the open labor market due to orthopedic injuries. The Board agreed with the judge's report that the physician's opinion lacked sufficient objective basis for the change in work restrictions. A dissenting opinion argued the medical and vocational evidence supported a $100\%$ permanent disability finding and requested clarification from the medical examiner.

Petition for ReconsiderationFindings of Fact and Awardpermanent disabilitycumulative traumalumbar spinecervical spinepsychecervicogenic headachesEmergency Unit CoordinatorAgreed Medical Examiner
References
Case No. ADJ7430217
Regular
May 17, 2012

LETICIA FLORES vs. RABOBANK; CHUBB GROUP OF INSURANCE COMPANIES

The Workers' Compensation Appeals Board denied reconsideration of the applicant's claim for injuries sustained from continuous trauma at Rabobank. The Board adopted the WCJ's report, which found the applicant's orthopedic injuries arose out of and in the course of employment, relying heavily on the credible testimony of the applicant and the persuasive report of the Agreed Medical Examiner. Despite the defendant's arguments regarding lack of prior medical complaints and other activities, the WCJ found the applicant's testimony credible and the Agreed Medical Examiner's findings sufficient to support an award of temporary disability benefits. The Board affirmed the WCJ's findings, extending great weight to the credibility determination.

Workers' Compensation Appeals BoardPetition for ReconsiderationAgreed Medical ExaminerInjury AOE/COEContinuous TraumaTemporary DisabilityCredibility FindingLabor Code Section 3202.5Liberal ConstructionPreponderance of Evidence
References
Case No. ADJ400686 (VNO 0499836)
Regular
Nov 08, 2016

MICHAEL CURZI vs. PHARMAVITE, LLC, TRAVELERS DIAMOND BAR

In *Curzi v. Pharmavite, LLC*, the Workers' Compensation Appeals Board (WCAB) granted reconsideration to further study the case. The WCAB amended the original decision to defer issues of sleep disorder, permanent disability, apportionment, and attorney fees. This action was taken to allow for further development of the record regarding the industrial causation of the sleep disorder. The matter is returned to the trial level for further proceedings and a new decision by the WCJ.

Workers' Compensation Appeals BoardPharmaviteLLCTravelers Diamond BarADJ400686VNO 0499836Opinion and Decision After ReconsiderationFindings and Awardcomputer operatorindustrial injury
References
Case No. ADJ9103770
Regular
Jul 20, 2017

ADRIAN NUNURA vs. TRICOR COURIER & CARGO SYSTEM, TRAVELERS PROPERTY CASUALTY COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior decision finding the applicant sustained orthopedic injuries AOE/COE. The WCAB rescinded the prior award because the Administrative Law Judge's (ALJ) finding was insufficiently specific regarding which body parts were injured. The matter was returned to the trial level for further proceedings to allow the ALJ to issue a new decision with specific findings on the nature and extent of any work-related injury.

AOE/COEPanel Qualified Medical ExaminerCumulative TraumaFindings and AwardPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeAppeals BoardBody PartsMedical Examiner DiscrepancySubstantial Evidence
References
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