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Case Law Database

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

Case No. FRE 0159318
Regular
Nov 05, 2007

ROGELIO RODRIGUEZ vs. AMERICAN GRAPE HARVESTERS, STATE COMPENSATION INSURANCE FUND

This case involves Rogelio Rodriguez seeking workers' compensation for injuries to his right arm and psyche. The defendant, American Grape Harvesters and State Compensation Insurance Fund, petitioned for reconsideration of a 100% permanent disability award, arguing insufficient evidence and failure to consider pre-existing factors. The Workers' Compensation Appeals Board denied reconsideration, adopting the judge's report which found the evidence supported the 100% award and that pre-existing factors were properly addressed.

Workers' Compensation Appeals BoardReconsideration DeniedPermanent DisabilityVocational RehabilitationOrthopedic InjuryPsychiatric DisabilityAgreed Medical ExaminerQualified Medical EvaluatorApportionmentNon-Industrial Factors
References
7
Case No. ADJ2728533 (VNO 0389518) ADJ2462440 (VNO 0193190)
Regular
Jul 27, 2015

ALICIA VALENZUELA vs. LEATHERCRAFT TECHNOLOGIES dba ALEXANDER HANDBAGS, CYPRESS INSURANCE COMPANY, c/o BERKSHIRE HATHAWAY HOMESTATE CO., CONSTITUTION STATE SERVICE CO.

This case concerns a defendant's petition for reconsideration of an arbitrator's decision regarding a lien claim for medical treatment reimbursement. The arbitrator found the defendant responsible for 80% of low back treatment costs but not kidney or psyche treatment, despite the applicant's injuries being attributed to "pre-existing factors." The defendant argued it was denied due process and that the arbitrator erred in terminating its lien rights based on stipulations. The Board denied reconsideration, finding the defendant had a fair hearing and failed to meet its burden of proof that the "pre-existing factors" included a prior 1987 injury, with medical evidence supporting the arbitrator's conclusion.

Workers' Compensation Appeals BoardPetition for ReconsiderationLienMedical TreatmentPre-existing FactorsCumulative InjurySpecific InjuryDue ProcessFair HearingBurden of Proof
References
12
Case No. MISSING
Regular Panel Decision

Claim of Milner v. Country Developers, Inc.

The Special Disability Fund appealed decisions by the Workmen’s Compensation Board which imposed liability on the Fund for a claimant's injuries. The Board found that the employer, Country Developers, continued to employ the claimant, a carpenter, with knowledge of his pre-existing permanent physical impairment, triggering liability under subdivision 8 of section 15 of the Workmen’s Compensation Law. The claimant suffered a fracture of the nose and a hip dislocation in 1964, having a history of three ruptured disc surgeries and other conditions. The appeal centered on whether the employer had sufficient knowledge of the claimant’s permanent condition. Testimony from the employer’s foreman, Mr. Pahlck, indicated awareness of the claimant's back issues, including wearing a back brace and being favored by co-workers. The court affirmed the Board’s decision, reiterating that employer knowledge is a question of fact for the Board, and its findings, if supported by substantial evidence, will not be disturbed.

Workers' Compensation LawSpecial Disability FundEmployer LiabilityPre-existing Permanent ImpairmentEmployer KnowledgeSubstantial EvidencePermanent Partial DisabilityFracture of NoseHip DislocationRuptured Discs
References
3
Case No. SAL 0112833
Regular
Jan 11, 2008

MICHAEL MERCIER vs. INTEL CORPORATION, PSI, administered by BROADSPIRE CLAIM SERVICES

The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration, reinstating an earlier award that apportioned 20% of the applicant's permanent disability to pre-existing factors. The WCAB found the Agreed Medical Evaluator's (AME) opinion on apportionment to be substantial evidence under current law, even though the pre-existing conditions were asymptomatic prior to the industrial injury. This decision reverses the WCJ's later finding of 32% permanent disability without apportionment.

Workers' Compensation Appeals BoardIndustrial InjuryFabrication TechnicianLower Back InjuryPermanent DisabilityApportionmentAgreed Medical EvaluatorDr. ConradPre-existing FactorsDegenerative Change
References
3
Case No. ADJ8032740
Regular
Sep 17, 2014

LAURA RAMIREZ vs. LOYOLA MARYMOUNT UNIVERSITY, TRAVELERS

This case involved a custodian injured on the job, causing admitted industrial injury to her knee and lumbar spine. The Administrative Law Judge apportioned 50% of the permanent disability to pre-existing arthritis, a decision the applicant contested. The Workers' Compensation Appeals Board denied reconsideration, finding the apportionment supported by medical evidence indicating the industrial injury and pre-existing arthritis jointly necessitated knee replacement surgery. This aligns with precedent requiring apportionment to all causative factors, including underlying pathology.

ApportionmentPre-existing arthritisIndustrial injuryPermanent disabilityWCJPetition for reconsiderationLabor Code 4663PQMEOrthopaedic surgeonArthroplasty
References
4
Case No. ADJ966838 (SJO 0266465)
Regular
Jun 18, 2012

LOLA ROBINSON vs. SHELTER NETWORK, SUBSEQUENT INJURIES FUND of the STATE OF CALIFORNIA

The Workers' Compensation Appeals Board affirmed a prior award for applicant Lola Robinson against the Subsequent Injuries Benefits Trust Fund (SIBTF). The award compensated her for a combined permanent disability of 78%, stemming from a subsequent industrial injury to her upper extremity and pre-existing conditions of hepatitis C and a hysterectomy. The Board found that medical evidence established pre-existing whole person impairments from these conditions, meeting the "labor disabling" threshold for SIBTF benefits. The Board held that the physician's ratings under the AMA Guides constituted prima facie evidence of pre-existing impairment, which the SIBTF failed to rebut.

Subsequent Injuries FundSIBTFHepatitis CHysterectomyPermanent Partial DisabilityLabor DisablingAMA GuidesWhole Person ImpairmentWCJReconsideration
References
7
Case No. MISSING
Regular Panel Decision

Claim of Kakuriev v. Home Service Systems, LLC

The Special Disability Fund appealed a Workers' Compensation Board decision that granted reimbursement to an employer and its carrier for a claimant's pre-existing knee injuries. The claimant, a home health aide, suffered work-related injuries to her knees, back, and neck, leading to a determination of mild to moderate permanent partial disability. The employer sought reimbursement under Workers’ Compensation Law § 15 (8), asserting pre-existing knee conditions. However, the appellate court reversed the Board's determination, finding that the employer failed to present evidence that the claimant's pre-existing impairment hindered her job potential, which is a requirement for reimbursement from the Fund. The matter was remitted to the Workers’ Compensation Board for further proceedings.

Special Disability FundReimbursementPreexisting ImpairmentJob PotentialPermanent Partial DisabilitySubstantial EvidenceAppellate ReviewWorkers' Compensation Law § 15 (8)Medical EvidenceBurden of Proof
References
4
Case No. MISSING
Regular Panel Decision
Jul 30, 1982

Claim of Terwilliger v. Green Fuel Economizer, Inc.

The claimant appealed a Workers' Compensation Board decision, challenging both the apportionment of his award between an industrial accident and a pre-existing condition, and the board's finding of moderate disability. The court emphasized that full compensability hinges on whether the industrial accident activated a previously dormant and non-disabling pre-existing condition. Despite the claimant's attending physician testifying that his pre-existing condition was asymptomatic prior to the accident, the record contained evidence of prior low back problems. The court reiterated that resolving conflicting medical evidence, concerning both apportionment and the degree of disability, falls exclusively within the Board's purview. Since the Board's decision was supported by substantial evidence, the appellate court affirmed it.

Workers' CompensationApportionmentPre-existing conditionDisabilityMedical evidenceConflicting testimonySubstantial evidenceAppellate reviewIndustrial accidentBoard decision
References
3
Case No. MISSING
Regular Panel Decision

Claim of Peziol v. Vaw of America

The claimant, a millhand with a pre-existing severe arthritic spinal condition and a 20-pound lifting restriction since October 1992, sustained a back injury in June 1994 while lifting aluminum pipes, rendering him totally disabled. The Workers' Compensation Board ruled that the claimant's disability was causally related to a work-related accident and awarded benefits. The employer contested this decision, arguing for apportionment due to the pre-existing condition. However, the court found substantial evidence supporting the Board's decision, noting that the claimant was able to perform his duties despite the pre-existing condition until the work-related injury. Consequently, the court affirmed the Board's decision, concluding that apportionment did not apply.

Workers' CompensationSpinal InjuryPre-existing ConditionCausally Related DisabilityApportionmentMillhandLifting RestrictionTotal DisabilityAppellate DecisionSubstantial Evidence
References
5
Case No. MISSING
Regular Panel Decision

Claim of Garcia v. Brassiere Restaurant

A claimant with a known pre-existing brain condition suffered a lacerated scalp at work. Subsequently, the claimant developed cerebellar degeneration and became permanently and totally disabled. An impartial neurologist determined that while the claimant experienced minor head and neck pain causally related to the accident, the severe disability stemmed from a progressive degenerative disease and a posttraumatic seizure disorder, neither of which were found to be causally related to the work accident or exacerbated by the pre-existing condition. The Workers’ Compensation Board relieved the Special Fund from liability, concluding that the pre-existing impairment did not materially and substantially increase the permanent disability beyond what the subsequent injury alone would have caused. The appellate court affirmed the Board's decision, citing substantial evidence.

Workers' CompensationSpecial FundPermanent Total DisabilityPre-existing ConditionCausal RelationshipCerebellar DegenerationHead InjuryMedical OpinionImpartial Medical ExaminerAppellate Review
References
2
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