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

Case No. ADJ1082547 (LBO 0311990), ADJ3651061 (LBO 0321320)
Regular
Nov 17, 2017

KARLA NEAL vs. J. PAUL GETTY TRUST; ESIS CENTRAL WC CLAIMS

The Workers' Compensation Appeals Board denied Karla Neal's Petition for Reconsideration, upholding the Workers' Compensation Judge's (WCJ) decision. The Board gave great weight to the WCJ's credibility determination based on observing the applicant's demeanor during testimony. The applicant's claims of worsening industrial injuries and newly developed psychiatric injury were not supported by substantial evidence or raised appropriately at trial. The WCJ found the applicant lacked credibility, presenting inconsistent histories and making disparaging accusations against medical examiners.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ credibility determinationAgreed Medical Examiner (AME)orthopedic injuriespsychiatric injurycumulative traumapro persubstantial evidenceindustrial injury
References
Case No. ADJ7341086, ADJ7618068
Regular
Jun 18, 2013

EVANGELINA RODRIGUEZ vs. TREND TECHNOLOGIES, ARGONAUT INSURANCE COMPANY, CONTINENTAL CASUALTY c/o CNA CLAIMS PLUS, ATR INTERNATIONAL, INC., NATIONAL UNION FIRE INSURANCE, Administered by AIG c/o CHARTIS

This case concerns Evangelina Rodriguez's claim for workers' compensation benefits due to pulmonary fibrosis, allegedly caused by industrial toxic substance exposure. The Administrative Law Judge (WCJ) previously found no causal link between her employment at Trend Technologies or ATR International and her condition. The Workers' Compensation Appeals Board (WCAB) denied reconsideration, adopting the WCJ's findings and concluding applicant failed to prove industrial causation by a preponderance of the evidence. One commissioner dissented, arguing substantial medical evidence supported a causal connection and advocating for granting reconsideration.

Pulmonary fibrosisCumulative trauma injuryIndustrial causationMedical evidencePreponderance of the evidenceReasonable probabilityToxic substancesWorkers' Compensation Appeals BoardFindings and OrderPetition for Reconsideration
References
Case No. ADJ2419502 (MON 0329358) ADJ4501373 (MON 0326365)
Regular
Oct 24, 2011

MACK JARAMILLO vs. COCA COLA BOTTLING CO., Permissibly Self-Insured

This case involves a warehouseman seeking workers' compensation for cumulative and specific injuries resulting in severe physical and psychological impairments. The applicant was awarded 100 percent permanent disability, including further medical treatment, for his specific injury. The defendant sought reconsideration, arguing the 100 percent permanent disability rating was improperly calculated by disregarding the AMA Guides' Combined Values Chart. The Appeals Board denied reconsideration, finding the WCJ properly determined the applicant was totally disabled "in accordance with the fact" under Labor Code Section 4662, supported by substantial evidence of total loss of earning capacity.

WCABPetition for ReconsiderationFindings and OrderFindings and Awardstipulationindustrial injurycervical spinelumbar spinepsycheseizure disorder
References
Case No. ADJ473373 (ANA 0406381)
Regular
Feb 10, 2012

FERNANDO GUTIERREZ vs. SOCAL FRAMING aka BMHC; ACE AMERICAN INSURANCE, administered by ESIS, INC.

This case concerns applicant's claim for extended temporary disability (TD) benefits beyond 104 weeks due to a left eye injury. The Appeals Board affirmed the WCJ's denial of the "amputation" exception, ruling that the surgical removal of an eye does not fit the statutory definition. However, the Board remanded the case for further development of the record on the "high-velocity eye injury" exception, as the velocity and force of the object that struck the applicant's eye were unclear. The applicant's Petition for Removal was dismissed as reconsideration was the appropriate remedy.

Workers' Compensation Appeals BoardFernando GutierrezSoCal FramingBMHCACE American InsuranceESISInc.ADJ473373ANA 0406381Opinion and Decision
References
Case No. ADJ984297 (OAK 0284148)
Regular
Sep 08, 2009

ANGELICA GONZALES vs. TREND TECHNOLOGIES, ARGONAUT INSURANCE COMPANY

This case involves a workers' compensation claim for an admitted industrial injury to the applicant's low back, right shoulder, and psyche. The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior award of 93% permanent disability. The Board amended the award to 71% permanent disability, finding that the original rating impermissibly double-counted the applicant's work restrictions. While the Board agreed with the WCJ that apportionment for pre-existing obesity was not properly established, they disagreed with the WCJ's vocational expert's assessment and its impact on the overall disability rating.

Agreed Medical EvaluatorApportionmentDisability Evaluation UnitDisability RatingIndustrial InjuryLife PensionNew and Further DisabilityPermanent DisabilityPetition for ReconsiderationPsychiatric Evaluation
References
Case No. OAK 309589, 309590, 309591
Regular
Apr 03, 2008

KYLE MAHLER vs. FLOOR TRENDS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed a finding of 100% permanent disability for the applicant, Kyle Mahler. The Board rejected the defendant's arguments for apportionment, finding that the medical opinions presented did not meet the evidentiary requirements for reducing the disability award. Ultimately, the Board concluded that the applicant's combined industrial injuries, even considering a prior shoulder injury, resulted in a total and permanent disability preventing competitive employment.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardsIndustrial InjuryNeckPsycheCumulative TraumaPermanent and StationaryPermanent DisabilityApportionment
References
Case No. ADJ7267845
Regular
Feb 21, 2012

JOSE ACEVEDO vs. TREND PERSONNEL, CHARTIS INSURANCE, GALLAGHER BASSETT SERVICES

This case concerns whether medical liens for treatment rendered after December 18, 2008, are valid. The primary treating physician, Dr. Hoegel, released the applicant from care on that date, and the applicant failed to object to this determination under Labor Code sections 4061 and 4062. Therefore, the applicant could not designate a new primary treating physician and any subsequent treatment liens are barred. The Appeals Board granted reconsideration to clarify that the applicant's failure to follow statutory objection procedures invalidates post-release medical liens.

Workers' Compensation Appeals BoardReconsiderationDecision After ReconsiderationFindings of Facts Re: LiensTenet/Centinela Hospital Medical Center v. Workers' Comp. Appeals Bd. (Rushing)Primary Physician's Permanent and Stationary ReportCompromise and ReleaseLien ClaimantsLabor Code section 4061(b)Labor Code section 4062(a)
References
Case No. LAO 0833666, VNO 0481174
Regular
Jan 07, 2008

JUANA HERNANDEZ vs. FORESTON TRENDS, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of a lien claimant's denied claim for diagnostic testing expenses. The Board found the initial denial by the judge was based on grounds not raised by the defendant and that pre-authorization rules were misapplied. The case is returned to the trial level to develop the medical record regarding the reasonableness and necessity of the diagnostic testing under ACOEM guidelines.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationMedical Treatment ExpensesAdministrative Director's RuleReasonableness and NecessityCompromise and ReleaseUpper and Lower Extremity NCVSomatosensory/Dermatormal Evoked PotentialOfficial Medical Fee Schedule
References
Case No. ADJ 1612085, ADJ 3458861, VNO 407730, VNO 407729
Regular
Aug 29, 2008

JOHN HANSEN vs. TILE TRENDS, STATE COMPENSATION INSURANCE FUND, ZC INSURANCE

The WCAB denied reconsideration of a decision awarding permanent disability benefits to the applicant for industrial injuries to his spine, shoulders, knees, back, neck, and heart/internal system. The defendants argued that the WCJ erred in finding the date of injury, relying on certain medical opinions, and apportioning liability.

WCABTile SetterSpine InjuryShoulder InjuryKnee InjuryBack InjuryNeck InjuryHeart InjuryInternal System InjuryTemporary Disability
References
Case No. ADJ1491092
Regular
Dec 26, 2014

SIPRIANO SERRANO vs. TREND OFFSET PRINTING, AMERICAN CASUALTY COMPANY OF READING PA c/o CNA

The Workers' Compensation Appeals Board (WCAB) dismissed Sipriano Serrano's Petition for Reconsideration because it was not filed from a "final" order that determined substantive rights or liabilities. The Board also dismissed the petition for removal as moot because the relevant lien claim had been resolved. Ultimately, the WCAB found that interlocutory procedural or evidentiary decisions are not subject to reconsideration. Therefore, both petitions were dismissed as inappropriate.

Petition for ReconsiderationPetition for RemovalFinal OrderSubstantive RightInterlocutory OrderProcedural DecisionEvidentiary DecisionMoot PetitionLien ClaimantWorkers' Compensation Appeals Board
References
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