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

Case No. ADJ10715455
Regular
Mar 18, 2019

MICHAEL KAMM vs. COUNTY OF MONTEREY, P.S.I., administered by INTERCARE HOLDINGS INSURANCE SERVICES, INC.

In this case, the Appeals Board partially rescinded the WCJ's award for psychiatric injury due to inconsistencies in the medical opinion regarding predominant causation. While the Board affirmed the rejection of the good faith personnel action defense, it found Dr. Lopez's opinion lacked clarity on whether employment events were the predominant cause of the applicant's overall psychiatric disability. Therefore, the matter is returned to the WCJ for further development of the medical record to clarify predominant causation before a new decision can be issued.

Workers' Compensation Appeals BoardReconsiderationPsychiatric InjuryPredominant CausationLabor Code Section 3208.3(h)Good Faith Personnel Action DefensePanel Qualified Medical Evaluator (PQME)Dr. LopezAnxiety DisorderMajor Depression
References
3
Case No. ADJ481349 (SAC 0357393), ADJ1911129 (SAC 0357544), ADJ7331702
Regular
Jun 18, 2015

MARIA TACLAY vs. COUNTY OF SACRAMENTO, COUNTY OF SACRAMENTO WORKERS' COMPENSATION

The Workers' Compensation Appeals Board affirmed a WCJ's finding that actual employment events on two separate dates substantially caused the applicant's psychiatric injury. The defendant, County of Sacramento, sought reconsideration, arguing that separate claims could not be combined to meet the predominant cause threshold. The Board adopted the WCJ's reasoning and upheld the original award. The decision confirms that multiple employment events, even from distinct claims, can collectively establish industrial causation for a psychiatric injury.

Workers' Compensation Appeals BoardReconsiderationFindings of FactOrder and AwardWCJPsychiatric InjuryIndustrial InjuryPredominant CauseSubstantial CauseActual Events of Employment
References
0
Case No. ADJ6967163
Regular
Nov 05, 2015

CAROLYN WILLIAMSON vs. HARRIS DIRECT, INC., STATE FARM INSURANCE COMPANY

This case involves an applicant seeking reconsideration of a denial for workers' compensation benefits due to a cumulative trauma injury. The administrative law judge found her psyche injury barred because it was predominantly caused by the employer's lawful, good faith personnel actions, including termination. The applicant argued harassment and unjust treatment exceeded this threshold, but her petition was denied. The Board affirmed the denial, finding no substantial medical evidence to support the applicant's claim of industrial causation for her psyche, back, and internal injuries, as these were primarily linked to the employer's actions or pre-existing conditions.

Good faith personnel actionsPsychiatric injuryCumulative traumaLabor Code 3208.3(h)ApportionmentMedical evidenceWCJ findingsSubstantial medical evidencePredominant causeIndustrial causation
References
11
Case No. ADJ8777230
Regular
Jun 29, 2015

TIMETHY BLAKELEY vs. AIR RESOURCES BOARD, STATE COMPENSATION INSURANCE FUND

This case concerns a petition for reconsideration filed by the defendants, Air Resources Board and State Compensation Insurance Fund, following a Workers' Compensation Appeals Board (WCAB) decision that awarded benefits to Timothy Blakeley. The defendants argued the administrative law judge erred in determining Blakeley's psychiatric injury was not primarily caused by lawful personnel actions and that the causation threshold was misapplied. The WCAB denied the petition, adopting the WCJ's report which found the defendants failed to demonstrate the personnel actions were in good faith and that the applicant's injury was predominantly work-related. The WCAB gave significant weight to the WCJ's credibility determination of the applicant's testimony.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ credibility determinationLabor Code §3208.3(h)substantial causegood faith personnel actionpsychiatric injuryAir Resources BoardSCIFAME Dr. Donald Feldman
References
2
Case No. MISSING
Regular Panel Decision

Kurz v. St. Francis Hospital

The defendants moved to preclude plaintiffs' expert testimony on causation or, alternatively, for a pretrial hearing regarding the plaintiff's vision loss. The plaintiff developed visual disturbances shortly after receiving Amiodarone intravenously following cardiac bypass surgery in 2008. Defendants argued a lack of scientific evidence linking short-term Amiodarone use to optic neuropathy, while the plaintiff's expert contended that rapid drug absorption could cause optic disc edema, a known side effect. Furthermore, the plaintiff highlighted medical records where defendant physicians themselves initially attributed the vision loss to the medication. The court, applying the Frye standard, determined that general causation—Amiodarone causing vision loss—is an established medical theory. It further ruled that the specific causation tests from Parker and Cornell, typically applied to toxic tort cases, were not strictly applicable here due to the distinct nature of medical malpractice. Consequently, the court denied the defendants' motion, finding an adequate foundation for the admissibility of the plaintiff's expert testimony, with any disputes regarding specific timing affecting only the weight of the evidence, not its admissibility.

Medical MalpracticeExpert TestimonyCausationAmiodaroneOptic NeuropathyVision LossMotion in LimineFrye StandardParker StandardCornell Standard
References
9
Case No. ADJ10301846 ADJ8235335
Regular
Feb 07, 2019

Jack Kessler vs. E. \u0026 J. Gallo Winery

Defendant E. & J. Gallo Winery sought reconsideration of a Workers' Compensation Appeals Board decision that found applicant Jack Kessler sustained a compensable psychiatric injury. The Board denied reconsideration, affirming the administrative law judge's finding that industrial factors were the predominant cause of the applicant's psyche injury. The defendant argued the applicant failed to meet the "predominant cause" standard for psychiatric injuries and that combining two separate injuries was impermissible. The Board clarified that the issue of injury causation is distinct from the apportionment of permanent disability, and the applicant's medical evidence met the predominant cause standard.

Workers' Compensation Appeals BoardPetition for ReconsiderationNew and Further DisabilityPsyche InjuryPredominant CauseLabor Code section 3208.2Labor Code section 3208.3Cumulative TraumaSpecific InjuryApportionment
References
5
Case No. ADJ9571986
Regular
Feb 22, 2019

ANNE CHOU vs. COUNTY OF RIVERSIDE

The Appeals Board granted reconsideration to address the apportionment of psychiatric permanent disability. The Board clarified that Labor Code section 3208.3(h) pertains to the causation of the injury itself, not the apportionment of permanent disability. Therefore, lawful nondiscriminatory personnel actions, which did not meet the 35% causation threshold for non-compensability, cannot be used to apportion permanent disability under Labor Code section 4663. Accordingly, the applicant's permanent disability was increased from 19% to 22%.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAdministrative Law JudgeIndustrial InjuryGastrointestinal SystemPsycheHypertensionTemporary DisabilityPermanent Disability
References
0
Case No. ADJ8645491
Regular
Apr 28, 2015

LEOPOLD VASQUEZ vs. G&K MANAGEMENT COMPANY, CHUBB INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior order, and returned the case for further proceedings because the Agreed Medical Examiner's psychiatric opinion regarding the predominant cause of the applicant's injury was unclear, contradictory, and lacked substantial evidence. The AME confused causation of injury with apportionment of disability, and did not definitively state that industrial factors were the predominant cause of the psychiatric injury. The Board determined the medical record required further development to properly adjudicate the claim.

Workers' Compensation Appeals BoardIndustrial InjuryPsyche InjuryAgreed Medical ExaminerCausationApportionmentPersonnel Action DefenseLabor Code Section 3208.3Liberal ConstructionPreponderance of Evidence
References
13
Case No. ADJ8984416
Regular
Nov 08, 2016

MARIA GARIBAY vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration and rescinded the WCJ's decision, which had denied an applicant's claim for psychiatric injury based on the good faith personnel action defense. The Board found that the Agreed Medical Evaluator's reports were deficient regarding causation percentages. The case is returned to the trial level for further development of the record, specifically to obtain a report from the AME addressing the percentage of causation for each workplace incident. This is to allow for a meaningful review of the WCJ's future decision on predominant and substantial cause.

Good faith personnel actionLabor Code section 3208.3psyche injurypredominant causesubstantial causeAgreed Medical Evaluatorpsychiatric disabilitycausation percentagesWorkers' Compensation Appeals Boardindustrial injury
References
1
Case No. ADJ8550821, ADJ9443562
Regular
Feb 06, 2017

ESMERALDA REYNOSO vs. COUNTY OF VENTURA

This case concerns a worker's compensation claim for psychiatric injury due to continuous trauma from 1998-2012. The defendant sought to overturn the finding that the injury arose out of employment, arguing the medical expert's reports lacked substantial evidence due to alleged inconsistencies and incomplete history. The Appeals Board affirmed the original award, finding the expert's opinions on industrial causation were sufficiently consistent and based on an adequate medical history. The Board found the defendant's arguments failed to undermine the expert's conclusions regarding predominant industrial causation.

Workers' Compensation Appeals BoardJoint Findings and AwardReconsiderationPanel Qualified Medical Examiner (PQME)Substantial Medical EvidenceContinuous Trauma InjuryPsychiatric InjuryCausationIndustrial FactorsPersonnel Actions
References
0
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