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

Case No. ADJ9870999
Regular
Feb 13, 2017

ROBIN SMITH vs. CITY OF SUNNYVALE

This case involves a firefighter claiming breast cancer arose from employment exposure to carcinogens, triggering a statutory presumption of industrial causation under Labor Code section 3212.1. The employer sought to rebut this presumption by arguing a medical examiner found no studies linking applicant's specific exposures to breast cancer. However, the Appeals Board denied reconsideration, affirming that the employer failed to prove there is *no reasonable link* between workplace carcinogen exposure and the applicant's cancer, a higher bar than simply the absence of direct scientific studies. The Board reiterated that an employer must affirmatively demonstrate a lack of reasonable connection, not just highlight a lack of studies supporting causation.

Labor Code section 3212.1presumption of industrial causationpublic safety officerfirefightercarcinogen exposurebreast cancerdisputable presumptioncontroverted evidencereasonable linkburden of proof
References
Case No. SFO 0496923
Regular
Jan 15, 2008

ROBERT THOMPSON (Deceased) NATALIA THOMPSON (Widow) vs. STATE OF CALIFORNIA, CALIFORNIA HIGHWAY PATROL, Legally Uninsured; STATE COMPENSATION INSURANCE FUND, Adjusting Agency

This case concerns a California Highway Patrol officer who died from melanoma. The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior award of death benefits, and found the injury was not industrial. The Board concluded the applicant failed to demonstrate a reasonable link between his employment and the melanoma, citing non-industrial risk factors such as childhood sun exposure and family history.

Workers' Compensation Appeals BoardRobert ThompsonNatalia ThompsonCalifornia Highway PatrolLegally UninsuredState Compensation Insurance FundSFO 0496923Opinion and Order Granting ReconsiderationDecision After ReconsiderationFindings and Award
References
Case No. ADJ8150668
Regular
Aug 21, 2014

STEVEN JUDD vs. CITY OF DESERT HOT SPRINGS, CORVEL CORVEL CORPORATIONS

This case concerns Steven Judd's workers' compensation claim for kidney cancer. The Appeals Board affirmed the finding that Judd sustained an industrial injury as a peace officer, granting him the presumption of compensability under Labor Code section 3212.1. The Board found the cancer developed during his employment, satisfying the statute's requirements even though it manifested later. The defendant failed to rebut the presumption by proving no reasonable link between the carcinogens Judd was exposed to and his cancer.

Labor Code section 3212.1peace officerkidney cancercumulative traumapresumptioncarcinogenlatency periodmanifestationdevelopmentAgreed Medical Evaluator (AME)
References
Case No. ADJ11721215
Regular
Mar 20, 2023

GLEN HODGES vs. STATE OF CALIFORNIA

This case concerns a firefighter's claim for melanoma under Labor Code section 3212.1, which presumes cancer is industrially caused. While the applicant raised the presumption through evidence of carcinogen exposure, the Appeals Board overturned the initial finding of industrial injury due to melanoma. The Board found the presumption was rebutted by expert medical opinion concluding the applicant's melanoma was not reasonably linked to industrial sun exposure, citing significant childhood sun exposure, tanning bed use, family history, and minimal workplace sun exposure to the affected area. The Board therefore granted reconsideration and amended the decision to exclude melanoma as an industrial injury, though actinic keratosis was still found to be industrially caused.

Labor Code section 3212.1cancer presumptionrebutted presumptionqualified medical evaluatorindustrial injuryactinic keratosismelanomafirefightercarcinogenInternational Agency for Research on Cancer
References
Case No. ADJ3172767
Regular
May 10, 2017

VICTOR GONZALEZ vs. CITISTAFF SOLUTIONS, STATE COMPENSATION INSURANCE FUND

The Appeals Board affirmed the WCJ's decision finding the lien claimant, Monrovia Memorial Hospital, was entitled to nothing for its services. The WCJ properly excluded the lien claimant's expert declaration as it was submitted after discovery closed. The lien claimant failed to meet its burden of proving its charges were reasonable and based on a reasonable cost basis, as required by precedent in cases exempt from the Official Medical Fee Schedule. Mere presentation of usual and customary charges, without evidence of reasonableness or comparability, is insufficient.

Workers' Compensation Appeals BoardVictor GonzalezCitistaff SolutionsState Compensation Insurance FundMonrovia Memorial Hospitallien claimantbill review expertdue processreasonableness of chargesOMFS exemption
References
Case No. ADJ4024660 (LAO 0887729)
Regular
Feb 03, 2017

ALFREDO COLLAZO vs. MECA NAG CORPORATION, EMPLOYERS COMPENSATION

The Appeals Board granted reconsideration, rescinded the prior order, and returned the case to the trial level for a new decision. The WCJ erred in determining the lien claimant's entitlement to payment solely on a multiplier of Medicare rates, rather than a reasonable cost basis. The Board clarified that while the facility's charges are not subject to the Official Medical Fee Schedule, their entitlement must be based on their actual costs plus a reasonable profit. Therefore, further proceedings are required to properly assess the reasonable cost basis for the services rendered.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderLien ClaimantReasonable Cost BasisMedicare ReimbursementOfficial Medical Fee ScheduleLong Term Care HospitalKunz StudyTapia
References
Case No. ADJ 7511877, ADJ 7396932
Regular
May 03, 2017

MARIA MORALES vs. MONTEBELLO UNIFIED SCHOOL DISTRICT, YORK RISK SERVICES GROUP, INC.

The Appeals Board affirmed the WCJ's decision disallowing further payment on Monrovia Memorial Hospital's lien. The court found that Monrovia failed to provide sufficient evidence to establish that its requested charges were reasonable and consistent with a "reasonable cost basis" as required for long-term care hospitals exempt from the Official Medical Fee Schedule. Lien claimants bear the affirmative burden of proving the reasonableness of their liens by a preponderance of the evidence. The Board also noted that discovery was properly closed at the lien conference, precluding Monrovia's delayed introduction of evidence.

Workers' Compensation Appeals BoardJoint Findings and OrderIndustrial InjuryCervical SpineLumbar SpineRight HipBilateral KneesPsycheLien ClaimantMonrovia Memorial Hospital
References
Case No. ADJ6884625
Regular
Jun 19, 2012

JASON PETERSON, KIRSTIE MCCRAINE-PETERSON vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

This case concerns the death of Jason Peterson, a correctional officer, from a pulmonary embolism after injuring his calf in a kickboxing class. The applicant, his widow, claimed the injury and death were work-related, arguing the kickboxing class was a reasonable expectancy of employment due to a general fitness requirement and incentive program. The Workers' Compensation Appeals Board (WCAB) affirmed the WCJ's decision, finding the claim barred by Labor Code Section 3600(a)(9) because the decedent's belief that kickboxing was required was not objectively reasonable, as mere general assertions of fitness expectations are insufficient. Commissioner Brass dissented, believing the decedent's participation was both subjectively and objectively reasonable given its likely benefit to his job performance as a correctional officer.

Labor Code Section 3600(a)(9)Pulmonary EmbolismCorrectional OfficerKickboxingOff-duty Recreational ActivityReasonable Expectancy of EmploymentSubjective BeliefObjective ReasonablenessEzzy testCity of Stockton v. Workers' Comp. Appeals Bd. (Jenneiahn)
References
Case No. ADJ4225434 (LAO0864755)
Regular
Dec 10, 2008

CHING YEN vs. C & C INTERNATIONAL GROUP, STATE COMPENSATION INSURANCE FUND

This case involves an applicant injured in a car accident while traveling to a wedding with her employer. The applicant claimed her participation in the trip was a reasonable expectancy of her employment as an account assistant, which involved driving and travel. The Board denied reconsideration of the workers' compensation judge's finding that the injury was industrial, determining the applicant's subjective belief of being required to attend the trip was objectively reasonable given her job duties and her employer's direction.

Workers' Compensation Appeals BoardIndustrial InjuryReasonable ExpectancyOff-duty recreational activitySubjective beliefObjectively reasonableMotor vehicle accidentAccount assistantCommercial travelSpecial mission
References
Case No. ADJ3463668 (AHM 0129255) ADJ3379175 (AHM 0128291)
Regular
Nov 07, 2013

LEO CORCORAN vs. C.A.T., INC.; TIG SPECIALTY INSURANCE SOLUTIONS

The Workers' Compensation Appeals Board denied a petition for reconsideration filed by a lien claimant, Midas Recovery Services, representing the Sheet Metal Workers Trust Fund. The claimant sought over $330,000 for services rendered, but the Board affirmed the judge's award of only $23,694.58. This was because the lien claimant failed to meet its burden of proving the reasonableness and necessity of its services and their value. Specifically, the provided documentation did not adequately itemize or detail the goods and services rendered to support the claimed amount.

WCABPetition for Reconsiderationlien claimantburden of proofreasonablenessnecessityreasonable valueC.A.T.Inc.TIG Specialty Insurance Solutions
References
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