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

Case No. ADJ8168988
Regular
Oct 23, 2015

JOSE CEJA vs. YORBA LINDA CAR WASH, PENNSYLVANIA MANUFACTURERS INSURANCE GROUP

This case involves applicant Jose Ceja's petition for reconsideration of a Workers' Compensation Appeals Board decision. The Board denied reconsideration, upholding the finding that while Ceja sustained industrial injuries to his spine and knee, he failed to prove industrial causation for neurological, psychiatric, or sleep disorders. The medical evidence presented was deemed insufficient, lacking reasonable medical probability and proper reasoning for causation. Specifically, expert opinions were criticized for speculation, inadequate history, and reliance on applicant's subjective reporting without sufficient medical analysis.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrdersIndustrial InjuryCervical SpineLumbar SpineRight KneeNeurological SystemPsycheSleep Disorder
References
5
Case No. ADJ6845087
Regular
Feb 27, 2017

DENNIS DEMARCO vs. PACIFIC BELL TELEPHONE COMPANY, SEDGWICK CMS

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration in the case of Dennis Demarco. The defendant failed to meet its burden of proof for apportionment because the medical opinions presented were not sufficiently reasoned or based on reasonable medical probability. The Board adopted the WCJ's reasoning, which found the opinions of the agreed medical evaluators regarding industrial causation for sleep disorders to be persuasive.

ApportionmentMedical OpinionSubstantial EvidenceReasonable Medical ProbabilitySpeculativePertinent FactsAdequate ExaminationIndustrial CausationSleep DisordersAgreed Medical Evaluator (AME)
References
7
Case No. ADJ1244874
Regular
Apr 19, 2010

ENRIQUE ROJAS vs. COSTCO

This case involves a meat cutter/wrapper's claim for an industrial injury to his respiratory system, diagnosed as hypersensitivity pneumonitis. The defendant contested the finding of industrial causation, arguing the medical evidence was insufficient. The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The Board affirmed the administrative law judge's decision, finding that the agreed medical examiner, Dr. Markovitz, established a reasonable medical probability of industrial causation, despite not identifying the precise causative agent. The Board relied on Dr. Markovitz's expert opinion, which utilized a process of elimination and epidemiological considerations to conclude the condition was likely work-related.

Hypersensitivity PneumonitisIndustrial CausationAgreed Medical EvaluatorPulmonologistMeat CutterMeat WrapperRespiratory System InjuryCumulative TraumaProcess of EliminationReasonable Medical Probability
References
3
Case No. ADJ10863930
Regular
Aug 05, 2019

BERNARDINO HERNANDEZ vs. HAMMERHEAD AVIATION, PREFERRED EMPLOYERS

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The WCAB affirmed the finding that the applicant sustained injuries to his neck, elbows, and bilateral extremities, based on substantial evidence from treating physicians. The Board found the defendant's argument that the medical opinions were conclusory unpersuasive, and the PQME's opinions on causation lacked sufficient reasoning. The applicant's proof of injury arising out of and occurring during employment was found to be reasonably probable.

WCABPetition for ReconsiderationFindings of Fact and OrderInjuryNeckElbowsBilateral ExtremitiesPost-termination defenseLabor Code Section 5412Substantial Evidence
References
0
Case No. MISSING
Regular Panel Decision
Nov 05, 1997

Neblett v. Davis

This case involves an appeal by the New York City Department of Correction, the plaintiff's employer, from an order of the Supreme Court, Kings County, dated November 5, 1997. The order granted the plaintiff's motion, permitting her to settle an action for personal injuries for $30,000, pursuant to Workers’ Compensation Law § 29. The Supreme Court affirmed the order, finding no improvident exercise of discretion. The court reasoned that the settlement was reasonable given the low probability of the plaintiff proving causation for her alleged disability from the automobile accident.

Personal InjuryWorkers' CompensationSettlementAppealEmployer LiabilityDisability ClaimAutomobile AccidentCausation DisputeJudicial DiscretionAppellate Review
References
7
Case No. ADJ8586896
Regular
Dec 27, 2017

, Jose Benitez (Deceased), Zeferina Higuera Quezada vs. , AG Force, LLC, , Intercare Holding Insurance Services, , Gurmail Chehal and Samarjit Kaur, as Husband and Wife, Uninsured

This case concerns a deceased laborer, Jose Benitez, whose widow claimed his death from cellulitis resulted from an insect bite sustained while working for AG Force, LLC. Despite the lack of direct witnesses, the Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration. The WCAB found that the Administrative Law Judge's (ALJ) determination of industrial causation was supported by the credible testimony of the applicant's wife and medical reports. The Board emphasized the "reasonable probability" standard for industrial causation and gave deference to the ALJ's credibility findings.

Industrial causationreasonable probabilitycircumstantial evidencecredible testimonyWCJ credibility assessmentinsect bitecellulitisspider bitebrown recluse spiderattending physician
References
4
Case No. ADJ1748495 (SAC 0288002)
Regular
Jan 25, 2010

ERIC STEWART vs. SOLON FIRE CONTROL, CAMBRIDGE SAN DIEGO

This case involves an applicant claiming workers' compensation for sarcoidosis allegedly caused by occupational exposure to dry fire extinguisher chemicals. The administrative law judge initially found no industrial causation, favoring the defendant's medical examiner over the applicant's. On reconsideration, the Appeals Board affirmed this decision, finding the applicant failed to prove it was reasonably probable his condition arose from employment due to a lack of early irritative symptoms and the presence of prior skin lesions. The dissenting commissioner argued that the applicant's credible testimony and the applicant's QME's report sufficiently established industrial causation, as sarcoidosis can have an insidious onset.

SarcoidosisIndustrial causationQualified Medical Examiner (QME)Dry fire extinguisher chemicalsCumulative traumaPulmonary systemSkin involvementMedical evidenceOccupational exposureImmunologic processes
References
2
Case No. MISSING
Regular Panel Decision

Lucas v. Hartford Accident & Indemnity Co.

Leonard T. Lucas, an employee, suffered an ankle injury in August 1974, which subsequently led to thrombophlebitis and permanent incapacity. Despite Lucas receiving a favorable jury verdict for worker's compensation, the court of civil appeals reversed, concluding there was no evidence of a causal link between the injury and disability. The Supreme Court of Texas examined the medical testimony of Dr. Nathan Caldwell, who opined that the injury likely initiated the thrombophlebitis and that Lucas would probably not have developed the severe condition without the cut. The Supreme Court determined that Dr. Caldwell's testimony, even with some qualifying language, met the legal standard for reasonable medical probability regarding causation. Therefore, the Supreme Court reversed the judgment of the court of civil appeals and remanded the case for reconsideration of the evidence's sufficiency and weight.

Worker's CompensationCausal ConnectionDisability BenefitsMedical TestimonyThrombophlebitisAnkle InjuryEvidence SufficiencyAppellate ReviewRemandTexas Supreme Court
References
11
Case No. 2024 NY Slip Op 04824
Regular Panel Decision
Oct 03, 2024

People v. Zubidi

The case of People v Zubidi addresses an appeal of a conviction for criminal possession of a weapon and reckless endangerment. The defendant challenged the lawfulness of the police stop of his van, the probable cause for his arrest, the suggestiveness of a lineup identification, and the excessiveness of his sentences. The Appellate Division, First Department, affirmed the conviction, ruling that the police had reasonable suspicion to stop the defendant's van. This suspicion was based on the van's involvement in a prior road rage incident where a weapon was discharged, and a subsequent incident where the driver fled from a traffic agent. The court reasoned that a logical inference could be drawn that the vehicle's registered owner was likely its driver. When stopped, the defendant resisted, reached for a gun, and pointed it at an officer, providing probable cause for arrest. The court also found the lineup procedure not unduly suggestive. A dissenting opinion argued that reasonable suspicion was lacking due to the absence of prior visual identification of the driver matching the perpetrator's description and the attenuated nature of the owner-driver inference over time.

Criminal Possession of WeaponReckless EndangermentSuppression MotionReasonable SuspicionAutomobile StopProbable Cause for ArrestLineup IdentificationUnduly SuggestiveAppellate ReviewFourth Amendment
References
68
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
3
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