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

Case No. ADJ9365063
Regular
Dec 30, 2016

SABRINA RICCIO vs. STATE COMPENSATION INSURANCE FUND, legally uninsured, adjusted by, THE HARTFORD

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant argued that the applicant's psyche injury was not predominantly caused by actual employment events and that her internal injuries were not compensable as they were caused by stress. The Board affirmed the WCJ's findings, clarifying that the physical injury (heart attack) caused the psychiatric injury, making the heart attack compensable as a physical injury. The Board also distinguished this case from situations where a physical condition is solely the result of a non-compensable psychiatric injury.

AOE/COEpsychiatric injuryphysical injurystresscausation of injurycausation of disabilityapportionmentcompensable consequencemental-physical injuryLabor Code § 3208.3
References
9
Case No. MISSING
Regular Panel Decision
Sep 12, 2001

Claim of Oberson v. Bureau of Ferry Aviation & Transportation

The claimant was terminated from his employment as a marine oiler after a physical altercation with his supervisor in January 1993. He sought workers' compensation benefits, claiming a compensable psychological injury from the altercation. A Workers’ Compensation Law Judge disallowed the claim due to the claimant's failure to timely notify the employer of his injury. The Workers’ Compensation Board affirmed this decision, which was subsequently affirmed on appeal. Although the employer had actual knowledge of the altercation and termination, there was no indication they had actual knowledge of a psychological injury stemming from the altercation until 1999, approximately six years later. The Board's determination that the employer did not have timely notice and was prejudiced by the delay was supported by substantial evidence.

Workers' Compensation NoticePsychological Injury ClaimTimeliness of NoticeEmployer PrejudiceActual KnowledgeWorkplace AltercationEmployment TerminationWorkers' Compensation Board AffirmationAppellate ReviewStatutory Interpretation
References
6
Case No. ADJ6900339
Regular
Nov 13, 2017

Gloria Frialde vs. TJ Ward, Truck Insurance Exchange, Subsequent Injuries Benefit Trust Fund

This Workers' Compensation Appeals Board decision amends a prior award, primarily by removing a finding of industrial injury related to a sleep disorder. The Board found that the applicant's sleep issues stemmed from pain from her physical injuries, not a separate sleep disorder, and thus not separately compensable. The matter is returned to the trial level to re-determine the applicant's permanent disability, considering the corrected findings and specific instructions regarding life pension and permanent disability indemnity rates. The applicant's claim for benefits from the Subsequent Injuries Benefit Trust Fund was denied.

Workers Compensation Appeals BoardReconsiderationOpinion and DecisionFindings Orders and AwardCumulative TraumaPermanent DisabilityApportionmentSubsequent Injuries Benefit Trust FundVocational ExpertAlmaraz/Guzman
References
10
Case No. ADJ10544189
Regular
Nov 09, 2018

MARTIN GARCIA vs. HARVEST CHURCH, GUIDEONE MUTUAL

This case involves an applicant seeking an increased permanent impairment rating for a psychiatric injury stemming from a physical injury to his left foot. The applicant's injury occurred when a gate fell on his foot, and he claims this constitutes a "violent act" under Labor Code section 4660.1(c)(2)(A), which allows for exceptions to a general rule against increased impairment ratings for psychiatric issues arising from physical injuries. The Appeals Board denied reconsideration, affirming the WCJ's finding that the gate falling was an accidental injury, not a violent act, based on definitions involving strong physical force or extreme threats. The Board found the applicant's experience lacked the intensity seen in prior cases of violent acts, such as being struck by a car or being crushed in a vehicle.

AOE/COEViolent ActLabor Code Section 4660.1Psychiatric InjuryPermanent Impairment RatingPetition for ReconsiderationFindings of FactWorkers' Compensation Judge (WCJ)Industrial InjuryPreponderance of the Evidence
References
6
Case No. 535739
Regular Panel Decision
May 18, 2023

Matter of DiMeo v. Trinity Health Corp.

Claimant Maria DiMeo, an outpatient physical therapist aide, suffered a myocardial infarction in July 2020 following a stressful workplace interaction and filed a workers' compensation claim. Although a Workers' Compensation Law Judge initially established the claim, the Workers' Compensation Board later reversed this, disallowing the claim on the grounds that DiMeo did not sustain a physical injury. On appeal, the Appellate Division, Third Department, reversed the Board's decision. The court found that the Board's conclusion of no physical injury was inconsistent with the uncontroverted medical evidence from cardiologist Leslie Parikh, who unequivocally diagnosed a myocardial infarction, which constitutes a physical injury. The case was remitted to the Board for further proceedings consistent with the Appellate Division's decision.

Workers' CompensationMyocardial InfarctionCausationPhysical InjuryEmotional StressMedical EvidenceSubstantial EvidenceAppellate ReviewBoard Decision ReversalRemittal
References
7
Case No. ADJ5779347, ADJ6812428, ADJ6812429
Regular
Nov 16, 2012

RICHARD RAMIREZ vs. GEORGIA-PACIFIC, LLC

This case involves an applicant claiming psychiatric injury along with physical injuries. The Workers' Compensation Appeals Board granted reconsideration to address the defendant's contention that the applicant failed to meet the statutory threshold for psychiatric injury. Ultimately, the Board found no industrial psychiatric injury, rescinded the previous award, and issued a new award for physical injuries, permanent disability, and necessary future medical treatment for those injuries. The Board also clarified that while the applicant needs treatment for depression and sleep issues, these were not found to be industrially caused.

WCABGeorgia-PacificLLCESISFindings and OrderReconsiderationFindings and Awardpsychiatric injurycumulative traumapermanent disability
References
0
Case No. ADJ8674800 ADJ8674808 ADJ8674815
Regular
Jul 10, 2015

SHIMO WANG vs. SOUTHERN CALIFORNIA EDISON

The Workers' Compensation Appeals Board rescinded the prior finding that applicant did not suffer a heart injury arising out of and in the course of employment. The Board found the cardiologist's report insubstantial and remanded for further proceedings to develop the record on industrial causation. It clarified that the "good faith personnel action" defense applies to psychiatric injuries, not directly to physical injuries like heart conditions, unless the physical injury is a direct and sole consequence of a non-compensable psychiatric injury.

Workers' Compensation Appeals BoardShimo WangSouthern California EdisonAOE/COEheart attackcoronary syndromesQME cardiologistQME psychiatristadjustment disordergood faith personnel action
References
6
Case No. 535739
Regular Panel Decision
May 18, 2023

In the Matter of the Claim of Maria DiMeo

Claimant, an outpatient physical therapist aide, suffered a myocardial infarction after a stressful interaction with her supervisor. She filed a workers' compensation claim, asserting a work-related stress injury. The Workers' Compensation Law Judge established the claim, but the Workers' Compensation Board reversed, finding no physical injury. The Appellate Division, Third Judicial Department, reversed the Board's decision, finding that the Board's conclusion was not supported by substantial evidence and contradicted medical evidence that a myocardial infarction constitutes a physical injury. The court remitted the matter to the Board for further proceedings.

Myocardial InfarctionWork-Related StressCausationWorkers' Compensation BoardAppellate ReviewSubstantial EvidencePhysical InjuryMedical EvidenceReversalRemittal
References
7
Case No. MISSING
Regular Panel Decision

Claim of Passari v. New York City Housing Authority

A mason sustained a work-related injury, which was subsequently amended to include a right knee injury. The self-insured employer conducted surveillance, revealing the claimant engaged in strenuous construction tasks despite reporting disability and undergoing medical evaluations. The employer contended claimant made false statements in violation of Workers’ Compensation Law § 114-a. Although the Workers’ Compensation Board initially found no violation, the appellate court reversed, concluding that claimant knowingly concealed his physical capabilities to obtain benefits. The matter was remitted to the Board for further proceedings consistent with the court's decision.

Workers' Compensation FraudFalse RepresentationSurveillance VideoDisability BenefitsAppellate ReviewMedical EvaluationRight Knee InjuryPost-Traumatic Stress DisorderMaterial FactRemittal
References
2
Case No. MISSING
Regular Panel Decision

Claim of Schuyler v. City of Newburgh Fire Department

Claimant, having sustained a work-related back injury, was involved in a motor vehicle accident while off-duty. Prior to the accident, he attended physical therapy for his back and picked up his paycheck from his employer. Subsequently, he embarked on personal errands, stopping at a bank and a bike shop before the accident occurred on his way home. The Workers’ Compensation Board determined that the injuries from the motor vehicle accident were not compensable, asserting that the personal errands broke the causal connection to his employment. The appellate court affirmed this decision, finding the Board's conclusion rational despite the initial work-related aspects of the trip.

Workers' CompensationMotor Vehicle AccidentOff-duty InjuriesCausal ConnectionPersonal ActivityScope of EmploymentAppellate AffirmationTrip DeviationPhysical TherapyPaycheck Collection
References
3
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