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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ7555409
Regular
Mar 04, 2014

JESUS ESCANUELA vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the defendant's Petition for Reconsideration and dismissed the applicant's untimely petition. The WCAB found that the Agreed Medical Examiner's (AME) opinion regarding psychiatric permanent disability was not supported by substantial evidence, as it did not properly address causation under the current PDRS. Consequently, the case is remanded to the trial level for further development of the record concerning psychiatric permanent disability. The WCAB deferred the issue of permanent disability and attorney's fees pending this further development.

Workers' Compensation Appeals BoardJesus EscanuelaCalifornia Department of Correctionslegally uninsuredState Compensation Insurance FundADJ7555409Fresno District OfficeOpinion and OrderPetition for ReconsiderationFindings and Award
References
Case No. ADJ3817836 (SJO 0250881)
Regular
May 31, 2012

ZUFAN A. REDA vs. FRY'S ELECTRONICS, INC., ZURICH NORTH AMERICAN INSURANCE

This case concerns applicant Zufan A. Reda's claim for permanent total disability due to a psychiatric injury. The Workers' Compensation Appeals Board (WCAB) is ordering the development of the record because neither the applicant's QME, Dr. Sidle, nor the defendant's QME, Dr. Keins, provided substantial evidence regarding the apportionment of psychiatric permanent disability. The WCAB found that Dr. Sidle's report incorrectly addressed causation of injury rather than apportionment of disability, and Dr. Keins' report was rejected as non-substantial due to prior rulings on industrial causation. Therefore, the WCAB has appointed Dr. Roy Curry as a "regular physician" to conduct a new evaluation on the issue of psychiatric permanent disability.

Petition for ReconsiderationDevelopment of RecordLabor Code section 5701Industrial InjuryPsychiatric InjuryCompensable ConsequenceSection 5803Section 5804Section 5410Permanent Total Disability
References
Case No. ADJ1167311 (LBO 0303498) ADJ749429 (LBO 0296277)
Regular
Apr 29, 2011

RAMON ZIEBA vs. BAILLY SHOWCASE, SAFECO INSURANCE COMPANY

The Workers' Compensation Appeals Board denied lien claimant Dr. Halote's petition for reconsideration. Dr. Halote sought reimbursement for psychiatric treatment, arguing it was separate from a psychiatric injury claim. However, the only issue presented at trial was whether the applicant sustained a psychiatric injury arising out of and occurring in the course of employment. The Board found that the issue of the reasonableness of psychiatric treatment, for admitted orthopedic injuries, was not raised at trial and was therefore waived. Thus, the Board denied reconsideration as Dr. Halote could not raise this new issue for the first time on appeal.

Workers' Compensation Appeals Boardpsychiatric injuryAOE/COElien claimantPetition for ReconsiderationFindings of Factadministrative law judgeLabor Codecompensabilitypsychiatric treatment
References
Case No. ADJ3049738 (LAO 0866433) ADJ362854 (LAO 0866477)
Regular
Mar 30, 2012

ANGELA TORRES vs. LAUSD/L.A. ACADEMY MIDDLE SCHOOL, SEDGWICK

The Workers' Compensation Appeals Board (WCAB) granted the Petition for Reconsideration filed by lien claimant, Universal Psychiatric Medical Center, regarding a January 24, 2012 decision. This action was taken due to statutory time constraints and the need for further study of the factual and legal issues. The WCAB requires all future communications to be filed in writing with the Office of the Commissioners, not electronically or with any district office. A Decision After Reconsideration will be issued following this process.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ClaimantUniversal Psychiatric Medical CenterLAUSDSedgwickStatutory Time ConstraintsFactual IssuesLegal IssuesDecision After Reconsideration
References
Case No. ADJ8128282
Regular
Jan 23, 2014

ANGELA EGBIKUADJE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings. The defendant, California Department of Corrections and Rehabilitation, argued that the applicant's psychiatric injury claim was preempted by the ADA and not proven under Labor Code section 3208.3. The Board found the original decision lacked proper analysis regarding predominant industrial causation and the good faith personnel action defense. Therefore, the case was remanded for further development of the record, including expert medical opinion on these issues.

Workers' Compensation Appeals BoardAngela EgbikuadjeCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8128282Van Nuys District OfficeReconsiderationFindings and AwardIndustrial cumulative trauma injury
References
Case No. SAU8813471
Regular
Feb 07, 2023

KIMBERLY KENNEY vs. SEGUOYAH, INC., FARMERS INSURANCE EXCHANGE

The Workers' Compensation Appeals Board denied a lien claimant's petition for removal of an order consolidating liens and imposing a temporary stay. The consolidation aims to resolve a common legal issue regarding whether the lien claimant is controlled by a criminally charged physician, which would trigger an automatic stay under Labor Code section 4615. The Board found no due process violation, as the order only stays other lien issues pending the common issue's adjudication. Furthermore, the consolidation serves judicial efficiency by avoiding duplicate rulings on this critical threshold matter.

WCABPetition for RemovalOrder of Consolidation and StayLien ClaimantLabor Code section 4615Due ProcessIssue PreclusionConsolidation OrderWCJFarmers Insurance Exchange
References
Case No. ADJ8418862
Regular
Aug 26, 2018

CARMEN MEJIA vs. COUNTY OF ORANGE

This case involves an applicant seeking workers' compensation for a psychiatric injury and orthopedic issues against the County of Orange. The Appeals Board denied the defendant's petition for reconsideration regarding the psychiatric injury, finding the defendant failed to prove the injury was substantially caused by good faith personnel actions. The Board granted the applicant's petition, deferring orthopedic injury issues to the trial level due to insufficient medical evidence and contradictory expert opinions. The matter is returned for further development of the record regarding back, chest, and other orthopedic claims, as well as permanent disability and future medical treatment.

Labor Code section 3208.3psychiatric injurypredominant as to all causesactual events of employmentlawful nondiscriminatory good faith personnel actionsubstantial causetotality of circumstancesqualified medical evaluator (QME)panel qualified medical evaluator (PQME)cumulative trauma
References
Case No. ADJ1315350 (VNO 0557111)
Regular
Apr 20, 2012

LINDA KAMBOW vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, VALLEY STATE PRISON FOR WOMEN, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation claim by an inmate laborer for orthopedic and psychiatric injuries. The Workers' Compensation Appeals Board denied reimbursement to Hepps Pharmacy for medications, as no prescription was provided. The Board also reversed an award to Southern California Mental Health Associates for psychiatric treatment, ruling that inmate psychiatric injuries are not compensable under Labor Code section 3208.3(j). The Board found that the psychiatric injury was a consequence of the industrial orthopedic injury, and thus not a compensable independent non-industrial condition requiring treatment to relieve orthopedic effects.

Workers' Compensation Appeals BoardPsychiatric injuryLabor Code 3208.3(j)Inmate laborerIndustrial orthopedic injuryNon-industrial psychiatric treatmentPrimary treating physicianSubstantial medical evidenceCompromise and Release AgreementLien trial
References
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