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Case Law Database

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

Case No. ADJ6466823 ADJ6465939 ADJ7844561

Regular

Jan 08, 2016

CLIVIA PALACIOS vs. COUNTY OF FRESNO, Permissibly Self-Insured, Administered By RISCO

This case concerns a lien claimant, Michael Kesselman, seeking payment for psyche-related treatment. Kesselman argues he has standing because his bills weren't fully covered by the applicant's health insurer, and he disputes the prior finding of no industrial psyche injury. The Board granted reconsideration, clarifying that a prior unappealed award determined no industrial psyche injury occurred. Consequently, Kesselman's lien for psyche treatment cannot be recovered as it was not reasonably required to cure an industrial injury.

Lien claimantReconsiderationStandingPsyche injuryAgreed medical evaluatorSubstantial evidenceFinal determinationIndustrial injuryMedical treatmentReasonably required

References

Case No. ADJ8920276 ADJ8920282 ADJ9919338

Regular

Oct 29, 2018

MARIA JARAMILLO vs. U.S. AVIATION SERVICES CORPORATION, OLD REPUBLIC INSURANCE COMPANY, GALLAGHER BASSETT SERVICES

This case involves Maria Jaramillo's appeal regarding her workers' compensation claims, specifically her alleged injury to the psyche. The Appeals Board granted her petition for reconsideration, reversing the prior finding that she had not alleged a psyche injury. The Board found that the parties' own stipulations and the substantial medical evidence, including treating physician and QME reports, constituted an amendment to her application to include this claim. The case is remanded for further determination on the psyche injury and any statute of limitations defenses.

Petition for ReconsiderationAmended Joint Findings and OrderInjury to the psycheStatute of limitationsPre-Trial Conference StatementQualified Medical EvaluatorsLiberal pleading rulesCompensable consequenceCumulative trauma injurySpecific injury

References

Case No. ADJ6519716

Regular

Feb 10, 2017

HAO TRAN vs. CITY OF SANTA ANA

The Workers' Compensation Appeals Board denied reconsideration of an administrative law judge's decision that barred a lien claimant's recovery. The judge found the applicant sustained industrial injuries only to her back and right upper extremity, not her psyche. This psyche injury denial was based on a good faith personnel action defense and was no longer subject to reconsideration. Because the applicant's industrial injury did not include a psyche injury, the lien claimant, standing in the applicant's shoes, could not recover for services related to a non-compensable injury.

WCABPetition for ReconsiderationLien ClaimantFindings & OrderPsyche InjuryGood Faith Personnel Action DefenseLabor Code Section 3208.3(h)Preponderance of the EvidenceTrial on the MeritsIndustrial Injury

References

Case No. ADJ1211037

Regular

May 10, 2010

ANGELICA DAYRIT vs. WALGREENS

The Workers' Compensation Appeals Board granted Walgreens' petition for reconsideration, overturning the prior award for cervical, lumbar spine, and psyche injuries. The Board found the applicant failed to provide sufficient evidence and testimony to establish industrial injury to her cervical and lumbar spine. However, the Board affirmed the finding of a psyche injury, acknowledging that hearsay evidence from a physician's report could support this claim. The case is remanded for further proceedings to determine temporary disability, permanent disability, and attorney's fees based solely on the psyche injury.

Workers' Compensation Appeals BoardSenior Pharmacy TechnicianCumulative TraumaOrthopedic ComponentsPsychiatric ComponentsMandatory Settlement ConferenceApplicant Failure to AppearNotice to AppearDue ProcessSubstantial Evidence

References

Case No. ADJ2826672 (VNO 0385248)

Regular

Dec 09, 2011

LAURA MATOOK vs. NEW LIFE CINEMA, TRAVELERS INSURANCE COMPANY

This case involved applicant Laura Matook's claim for industrial injury to her head, spine, and psyche, initially awarded as permanent total disability. The defendant insurer, Travelers, sought reconsideration, leading to a prior decision rescinding the award and finding the psyche injury claim barred by res judicata. Applicant sought further reconsideration, arguing her psyche injury developed later and was not addressed in the initial claim. The Board affirmed its prior decision, finding the current psychiatric symptoms and diagnoses were not materially different from those addressed and denied in 2001, and therefore, res judicata applied.

Res judicataNew and further disabilityPetition to reopenIndustrial injuryPermanent total disabilityPsyche injuryHead injurySpine injuryWCJ decisionAppeals Board

References

Case No. ADJ2078638

Regular

Jun 07, 2010

Gloria Rivas vs. Posada Whittier/Berg Senior Services, Majestic Insurance Company

The applicant, Gloria Rivas, sought reconsideration of a prior Board decision that overturned a finding deferring determination on her psyche injury claim. The Board found the judge exceeded his authority by deferring the decision after the medical evidence presented was deemed not substantial. The applicant argued procedural errors related to trial scheduling, but the Board found the applicant stipulated to readiness for trial on the psyche injury issue, despite knowing her medical evidence was challenged as inadequate. Therefore, the Board denied reconsideration, reaffirming its decision to rule on the psyche injury claim based on the existing record.

Workers' Compensation Appeals BoardPetition for ReconsiderationOpinion and Order DenyingGloria RivasPosada WhittierMajestic Insurance CompanyADJ2078638LAO 0887310Opinion and Order Granting ReconsiderationDecision After Reconsideration

References

Case No. ADJ10908652, ADJ10908914

Regular

Sep 16, 2025

ZENAIDA AVILES vs. PIH HEALTH HOSPITAL, ATHENS ADMINISTRATORS

Applicant sought reconsideration of a Joint Findings and Award that denied industrial psyche injury (cumulative) and barred permanent disability from psyche injury (specific injury). Applicant contended that medical evidence supported cumulative psyche injury and that the WCJ erred in denying compensability of psychiatric permanent disability due to catastrophic consequences. The Appeals Board granted the petition for reconsideration, rescinded the prior Findings and Award, and returned the matter to the trial level for further proceedings, citing the need for further development of the medical record regarding intertwined disability and the application of the catastrophic injury exception.

Petition for ReconsiderationJoint Findings and AwardIndustrial InjuryPsycheCumulative PeriodSpecific InjuryPermanent DisabilityLabor Code section 4660.1Substantial Medical EvidenceQualified Medical Evaluator

References

Case No. ADJ1555118 (SAC 0336524) ADJ4532833 (SBR 0341290) ADJ457150 (SBR 0341294)

Regular

Jun 07, 2010

CLYTAN GUSMAN vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, Legally Uninsured, Adjusted BY STATE COMPENSATION INSURANCE FUND

The WCAB granted reconsideration of a prior award finding 82% permanent disability due to industrial injuries to the applicant's psyche and internal systems. The primary reason for rescission was that the expert psychiatric evaluator applied an incorrect legal theory regarding apportionment of psyche disability by failing to consider non-work-related factors that are now apportionable under SB 899. The case is returned to the trial level for further development of the record, specifically concerning apportionment of psyche disability and potential consolidation of injury dates into a single cumulative trauma. The Board also instructed the WCJ to ensure the evidentiary record complies with exhibit listing rules.

Workers' Compensation Appeals BoardCautan GusmanState of California Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundPsyche disabilityHeart disabilityInternal systems disabilityPermanent disabilityApportionment

References

Case No. ADJ7662819

Regular

Apr 27, 2015

JEWELL McKEE vs. MARTEN'S TRANSPORT, LTD, ACE AMERICAN INSURANCE COMPANY

This case involves an applicant alleging industrial injuries to various body parts, including psyche, hearing, and gait disorder, following a fall. The defendant sought reconsideration of the original award, primarily challenging the findings of psyche injury and gait disorder, as well as the award of temporary disability and a permanent disability increase. The Appeals Board granted reconsideration, deferring the issues of gait disorder and all permanent disability findings due to insufficient medical evidence on gait causation and the improper piecemeal determination of permanent disability. The Board otherwise affirmed the findings of industrial injury to psyche, additional temporary disability, and ordered further medical evaluation by an AME or IME.

Workers' Compensation Appeals BoardMarten's TransportACE American InsuranceIndustrial InjuryPsyche InjuryGait DisorderPermanent DisabilityLabor Code Section 4658(d)(2)Temporary DisabilityAgreed Medical Evaluator (AME)

References

Case No. ADJ7217859, ADJ7544106

Regular

Oct 21, 2014

YOLANDA MARTINEZ vs. MASS PRECISION, COMPWEST INSURANCE COMPANY, SCI @ BALANCE STAFFING SERVICE, ZURICH NORTH AMERICA

This case involves applicant Yolanda Martinez claiming industrial injuries (lumbar spine, right shoulder, psyche) from her employment at Mass Precision. Defendant Zurich North America, insurer for SCI @ Balance Staffing Service, contested liability for the psyche injury, arguing applicant's employment by SCI was less than the six-month statutory minimum. The Appeals Board affirmed the WCJ's finding of joint and several liability, holding that prior employment at the same worksite with dual employers counts towards the six-month requirement for psyche injury claims. This decision was based on the principle that the six-month rule aims to prevent claims from routine stress in new employment, a purpose not served when an employee has a longer-term relationship with the worksite.

Workers' Compensation Appeals BoardSpecific InjuryCumulative Trauma InjuryApportionmentPsychiatric InjuryLabor Code Section 3208.3(d)Six Month Employment RequirementDual EmploymentGeneral EmployerSpecial Employer

References

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Updated Daily

Case Law Database

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

Case No. ADJ6466823 ADJ6465939 ADJ7844561

Regular

Jan 08, 2016

CLIVIA PALACIOS vs. COUNTY OF FRESNO, Permissibly Self-Insured, Administered By RISCO

Lien claimantReconsiderationStandingPsyche injuryAgreed medical evaluatorSubstantial evidenceFinal determinationIndustrial injuryMedical treatmentReasonably required

References

Case No. ADJ8920276 ADJ8920282 ADJ9919338

Regular

Oct 29, 2018

MARIA JARAMILLO vs. U.S. AVIATION SERVICES CORPORATION, OLD REPUBLIC INSURANCE COMPANY, GALLAGHER BASSETT SERVICES

References

Case No. ADJ6519716

Regular

Feb 10, 2017

HAO TRAN vs. CITY OF SANTA ANA

References

Case No. ADJ1211037

Regular

May 10, 2010

ANGELICA DAYRIT vs. WALGREENS

References

Case No. ADJ2826672 (VNO 0385248)

Regular

Dec 09, 2011

LAURA MATOOK vs. NEW LIFE CINEMA, TRAVELERS INSURANCE COMPANY

Res judicataNew and further disabilityPetition to reopenIndustrial injuryPermanent total disabilityPsyche injuryHead injurySpine injuryWCJ decisionAppeals Board

References

Case No. ADJ2078638

Regular

Jun 07, 2010

Gloria Rivas vs. Posada Whittier/Berg Senior Services, Majestic Insurance Company

References

Case No. ADJ10908652, ADJ10908914

Regular

Sep 16, 2025

ZENAIDA AVILES vs. PIH HEALTH HOSPITAL, ATHENS ADMINISTRATORS

References

Case No. ADJ1555118 (SAC 0336524) ADJ4532833 (SBR 0341290) ADJ457150 (SBR 0341294)

Regular

Jun 07, 2010

CLYTAN GUSMAN vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, Legally Uninsured, Adjusted BY STATE COMPENSATION INSURANCE FUND

References

Case No. ADJ7662819

Regular

Apr 27, 2015

JEWELL McKEE vs. MARTEN'S TRANSPORT, LTD, ACE AMERICAN INSURANCE COMPANY

References

Case No. ADJ7217859, ADJ7544106

Regular

Oct 21, 2014

YOLANDA MARTINEZ vs. MASS PRECISION, COMPWEST INSURANCE COMPANY, SCI @ BALANCE STAFFING SERVICE, ZURICH NORTH AMERICA

References

Showing 1-10 of 487 results

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