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

Case No. ADJ19198086
Regular
Aug 25, 2025

MILTON WINSTON vs. ORACLE AMERICA, INC.; SAFETY NATIONAL INSURANCE

The defendant, Oracle America, Inc. and Safety National Insurance, petitioned for reconsideration of a Workers' Compensation Administrative Law Judge's (WCJ) finding that applicant Milton Winston was employed for a sufficient period to qualify for psychiatric injury compensation under Labor Code section 3208.3(d). The defendant contended the WCJ erred by including pre-onboarding activities in the employment calculation and by relying on an employment stipulation. The Workers' Compensation Appeals Board, adopting the WCJ's report, denied the petition, asserting that employment includes unpaid pre-onboarding service and that the defendant failed to prove otherwise or show good cause to withdraw from the stipulation. Consequently, the Board affirmed that the applicant's claim was not barred by the six-month employment requirement.

Workers' Compensation Appeals BoardLabor Code Section 3208.3(d)psychiatric injurysix months employmentactual servicepre-onboardingonboarding processpaid workstipulationburden of proof
References
Case No. SJO 0230368 SJO 0230369
Regular
Jan 14, 2008

John Anzevino vs. SUBSEQUENT INJURIES FUND

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant eligible for Subsequent Injuries Fund (SIBF) benefits. The Board determined that the applicant's credible, unrebutted testimony regarding his pre-existing left upper extremity limitations constituted substantial evidence of an "impairment" affecting that limb. Consequently, the case was returned for further proceedings to establish the extent of SIBF benefits.

Subsequent Injuries FundLabor Code section 4751Petition for ReconsiderationPre-existing disabilityLabor disabling conditionLeft upper extremityUnrebutted testimonyMedical evidenceOpposing memberSignificant impairment
References
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
Case No. ADJ916063 (VNO 0541860)
Regular
Mar 10, 2011

TERRY SCUDDER vs. VERIZON CALIFORNIA, INC.; Permissibly Self-Insured, Administered by SEDGWICK CMS

This case concerns an applicant who sustained industrial injuries and pre-designated a physician outside of the employer's established Medical Provider Network (MPN). The applicant's attorney subsequently referred him to physicians outside the MPN, whose reports were admitted by the WCJ. The Appeals Board overturned this, ruling that only the pre-designated physician, or referrals from that physician, could be outside the MPN and that referrals by an attorney were invalid. Consequently, the reports of these outside physicians were inadmissible, and the issues decided based on them were returned for further proceedings.

Workers' Compensation Appeals BoardMedical Provider NetworkMPNPre-designationTreating PhysicianQualified Medical EvaluatorQMEPermanent and Stationary DateApportionmentSelf-Procured Medical Treatment
References
Case No. ADJ3487625 (VNO 0525644)
Regular
Oct 16, 2017

TERESA SALAZAR vs. SENIOR SYSTEMS TECHNOLOGY, INC., THE HARTFORD

This case concerns a worker's claim for sanctions and penalties against her employer and their insurer. The applicant contended that the defendant's failure to provide written pre-authorization to her chosen physician constituted a denial of medical treatment, warranting penalties. However, the Workers' Compensation Appeals Board found no evidence of bad faith or unreasonable delay. Crucially, there was no statutory or case law requirement for the defendant to issue such a pre-authorization letter to the designated primary treating physician. Therefore, the Board affirmed the decision denying the applicant's claim for sanctions and penalties.

Petition for ReconsiderationFindings of FactWCJLabor Code section 5813Labor Code section 5814sanctionspenaltiespre-authorizationmedical treatmentprimary treating physician (PTP)
References
Case No. SJO 223167
Regular
Nov 07, 2007

PAUL NEAL vs. STEVENS CREEK TOYOTA, MID CENTURY INSURANCE, SUBSEQUENT INJURIES FUND of the STATE OF CALIFORNIA

The Workers' Compensation Appeals Board denied reconsideration for Paul Neal's case. The Board adopted the judge's report which found that Neal's pre-existing COPD constituted a pre-existing disability despite his prior employment. The judge also found Neal's testimony credible regarding his limited actual work hours, supporting the award of permanent total disability based on expert vocational opinion.

Workers Compensation Appeals BoardSubsequent Injuries FundPetition for ReconsiderationAdministrative Law JudgePermanent Total DisabilityPre-existing DisabilityChronic Obstructive Pulmonary DiseaseLabor DisablingVocational ExpertOdd-Lot
References
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
Case No. GOL 0096107
Regular
Mar 05, 2008

MIGUEL ANGEL CRUZ vs. EARL CLARK, FARMERS INSURANCE EXCHANGE, SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case concerns Miguel Angel Cruz's petition for reconsideration of a denial of Subsequent Injuries Benefits Trust Fund (SIBTF) benefits. The Workers' Compensation Appeals Board affirmed the denial, finding no evidence that Mr. Cruz's pre-existing degenerative spinal condition was "labor disabling" prior to his industrial injury. Crucially, the Board held that a retroactive prophylactic work restriction by a physician after the injury does not establish a pre-existing labor-disabling condition for SIBTF eligibility.

Subsequent Injuries Benefits Trust Fundpre-existing conditionlabor disablingpermanent disabilityapportioned disabilityindustrial injuryprimary treating physiciandegenerative changeslumbar spineprophylactic work restriction
References
Case No. ADJ7937623
Regular
Jun 27, 2025

Hadrian Lara vs. Subsequent Injuries Benefits Trust Fund, et. al.

The Workers' Compensation Appeals Board affirmed the August 16, 2021 Findings of Fact and Order to Take Nothing on SIBTF Petition. Applicant Hadrian Lara sought reconsideration, contending that the non-industrial apportionment of his hypertension proved a pre-existing permanent partial disability for SIBTF eligibility. The Board clarified that apportionment determines present disability causation and does not automatically establish a pre-existing, labor-disabling condition as required for SIBTF benefits under Labor Code section 4751.

Subsequent Injuries Benefits Trust FundSIBTFPermanent Partial DisabilityPre-existing DisabilityApportionmentHypertensionLabor DisablingCompensable InjuryMedical ReportingCumulative Trauma
References
Case No. ADJ10110995 (MF)
Regular
Jun 20, 2019

Preston Lee Brown Scott vs. City of Los Angeles

Applicant Preston Lee Brown Scott, previously declared a vexatious litigant, filed multiple documents seeking relief without obtaining the required pre-filing approval. The Workers' Compensation Appeals Board reviewed these filings and found no significant change in circumstances justifying reconsideration of prior rulings. Consequently, the Board issued an order stating that the submitted documents are not accepted for filing. This order reaffirms the pre-filing requirements for vexatious litigants absent representation by a licensed attorney.

Vexatious LitigantPre-Filing OrderAppeals Board Rule 10782In Pro PerApplication for AdjudicationDeclaration of ReadinessPleadingsPetitionLicensed AttorneyChange in Circumstances
References
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