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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ6913767
Regular
Jul 05, 2012

YOLANDA BARCENAS vs. IN HOME SUPPORT SERVICES (IHSS), STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, finding that the applicant's psychiatric reports were inadmissible. The primary treating physician, an orthopedist, did not review or incorporate the reports from the applicant's treating psychiatrist, nor did he designate the psychiatrist to provide opinions. Consequently, the Board struck the finding of injury to the psyche and amended the permanent disability award to 28%, solely based on orthopedic findings.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent DisabilityPrimary Treating PhysicianOrthopedistPsychiatristAdmissibility of ReportsLabor Code Section 4061.5Injury to Psyche
References
Case No. ADJ9002100
Regular
Feb 05, 2015

KENA PIERRE vs. KAISER PERMANENT, SEDGWICK CMS

The Workers' Compensation Appeals Board denied Kaiser Permanente's petition for reconsideration of an earlier decision. The Board adopted the findings of the Workers' Compensation Administrative Law Judge (WCJ), giving significant weight to the judge's credibility determination of the applicant. The WCJ found the applicant's testimony credible, despite minor inconsistencies, and supported by medical opinions from treating and QME physicians. The defendant's arguments regarding the substantiality of the evidence were rejected, and the judge's credibility assessments of defense witnesses were also unfavorable.

AOE/COEPetition for ReconsiderationCredibility DeterminationWCJSubstantial EvidencePsychiatric InjurySexual HarassmentLicensed Vocational NurseWorkers' Compensation Appeals BoardQME
References
Case No. ADJ7846344
Regular
Apr 19, 1984

CARLA EPTING-DAVIS vs. ALLIANCE SCHOOLS FOR COOPERATIVE INSURANCE PROGRAM (ASCIP) ON BEHALF OF SIERRA JOINT COMMUNITY COLLEGE DISTRICT adjusted by YORK RISK SERVICES

The Workers' Compensation Appeals Board denied the defendant's Petition for Removal, finding that removal is an extraordinary remedy requiring a showing of substantial prejudice or irreparable harm, which was not demonstrated. The Board adopted the Workers' Compensation Judge's report, which reasoned that the defendant failed to show such harm and that reconsideration would be an adequate remedy if a final adverse decision issues. The underlying issue involved the defendant's unsuccessful attempt to preclude the deposition of the applicant's treating psychiatrist, a situation distinguished from controlling case law by the WCJ. Ultimately, the Board concluded that the defendant did not meet the stringent criteria for removal.

Petition for RemovalWorkers' Compensation Appeals BoardExtraordinary RemedySubstantial PrejudiceIrreparable HarmReconsiderationAdministrative Law JudgeTreating PsychiatristDepositionPanel QME
References
Case No. ADJ2956078
Regular
Nov 17, 2010

FILIBERTO SANTOYO vs. FIESTA FOOD WAREHOUSE, SPRINGFIELD INSURANCE CO.

The Workers' Compensation Appeals Board denied the applicant's petition for removal, finding that the applicant misrepresented material evidence in the petition. The applicant had argued the trial judge issued an order without allowing a response, thus violating due process. However, the Board found inconsistencies between the applicant's claims regarding medical reports and the actual contents of those reports. The case is returned to the trial level for proceedings consistent with the opinion.

Petition for RemovalOrder RescindingDue ProcessQualified Medical EvaluatorsMedical Record DevelopmentApplication for Adjudication of ClaimIndustrial InjurySecurity GuardRight KneeLower Extremities
References
Case No. ADJ4664471
Regular
Jul 14, 2010

WILLIAM ROBERTS vs. WESTEN ENVIRONMENMTAL ENGINEERS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of a decision that denied his claim for psychiatric injury. The Board found the petition was skeletal and failed to cite legal principles or evidence. Furthermore, the applicant failed to meet his burden of proving work events were the predominant cause of his alleged psychiatric disorder due to credibility issues and an inaccurate history provided to medical evaluators. The Board adopted the Workers' Compensation Judge's report and recommendation in its entirety.

Workers' Compensation Appeals BoardReconsideration DeniedPsychiatric InjuryPredominant CauseCredibility DeterminationInaccurate HistoryBurden of ProofIntoxication DefenseNeurologistPsychiatrist
References
Case No. ADJ8415524
Regular
Jun 26, 2015

SYLVIA FERRAR BALCOMBE vs. WEST END YMCA, UNITED STATE FIRE INSURANCE COMPANY

This case concerns an applicant's petition for reconsideration following a Workers' Compensation Appeals Board decision. The Board denied the petition, adopting the judge's report which found the applicant's attorney failed to follow proper procedure in requesting medical panels. The judge also determined that medical reports from specific doctors were inadmissible due to this procedural error and lack of persuasive medical evidence. Consequently, the Board denied reconsideration and admonished the applicant's attorney regarding future fee requests.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ ReportCal. Code Regs tit. 8 § 10778Attorney's FeesInjuriesGERDIBSSpineQME
References
Case No. ADJ2461208 (MON 0351772)
Regular
Dec 24, 2010

YOLANDA CREWS vs. METHODIST HOSPITAL OF SOUTHERN CALIFORNIA

The Workers' Compensation Appeals Board granted reconsideration for both the applicant and defendant. The Board found the original award potentially erred by not fully considering the applicant's future earning capacity in calculating disability rates, despite her part-time employment and educational pursuits. Additionally, the Board remanded the case to address the defendant's claim for a credit against permanent disability for EDD benefits paid to the applicant. The matter was returned to the WCJ for further development of the record and issuance of a new decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact & AwardTemporary DisabilityPermanent DisabilityEarning CapacityEmployment Development DepartmentEDD LienAgreed Medical EvaluationsOrthopedist
References
Case No. ADJ984347 (FRE 0202559)
Regular
Apr 01, 2014

ENRICA TORRES vs. CLOVIS UNIFIED SCHOOL DISTRICT

This Workers' Compensation Appeals Board case involves an applicant who sustained a psyche injury due to cumulative trauma from workplace sexual harassment. The defendant, Clovis Unified School District, sought reconsideration of an award for further medical treatment. The Agreed Medical Examiner's (AME) opinions on the applicant's need for ongoing treatment were contradictory, leading to ambiguity. Therefore, the Board amended the award to defer the determination of further medical treatment pending clarification, requiring a supplemental AME report or stipulation.

Enrica TorresClovis Unified School DistrictYORK RISK SERVICES GROUPINC.ADJ984347ADJ4520728WORKERS' COMPENSATION APPEALS BOARDRECONSIDERATIONPERMANENT DISABILITYFURTHER MEDICAL TREATMENT
References
Case No. ADJ7037201
Regular
Apr 22, 2013

Eddie Avakian vs. CITY OF BALDWIN PARK, ADMINSURE

This case involves an applicant police officer seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that awarded 72% permanent partial disability. The applicant contended the WCJ erred by excluding sleep disturbances and sexual dysfunction from the disability rating and by apportioning his cardiovascular disability. The WCAB granted reconsideration, rescinded the original award, and found the applicant's sexual dysfunction and sleep disorder compensable. The matter was returned to the trial level for a new decision, with the WCAB stating it would not disturb other findings, including the hypertension apportionment.

Workers' Compensation Appeals BoardEddie AvakianCity of Baldwin ParkPermissibly Self-InsuredAdministered By ADMINSUREADJ7037201Opinion and Order Granting ReconsiderationDecision After ReconsiderationFindings and Award and OrderAdministrative Law Judge
References
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