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

Case No. ADJ10443669
Regular
Oct 04, 2017

Donna Carter vs. Rose International Group, OneBeacon Insurance Group

The Appeals Board affirmed the Workers' Compensation Judge's finding that Donna Carter sustained an industrial injury to her right knee and left wrist on May 18, 2016. Despite inconsistencies in the applicant's testimony regarding a slip and fall incident, her account was corroborated by a witness who found her on the floor. Medical records from the day of the incident also supported the applicant's claim, establishing a clear mechanism of injury. The Board found that the common sense nature of a slip and fall does not require expert medical opinion to establish industrial causation for the incident itself.

ADJ10443669Rose International GroupOneBeacon Insurance GroupDonna CarterWorkers' Compensation Appeals BoardOpinion and Decision After Reconsiderationslip and fallindustrial injuryright kneeleft wrist
References
Case No. ADJ9210498
Regular
Apr 04, 2017

ELEANOR DEFRANCO vs. MONTEREY FISH COMPANY, ENSTAR (US) INC., dba ENSTAR ADMINISTRATORS FOR SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior award that found industrial injury to applicant's right ankle, right shoulder, and back, but not her right knee. The WCAB rescinded the finding of industrial injury to the back, while otherwise affirming the prior decision. Specifically, the WCAB affirmed the finding that the applicant sustained industrial injury to her right ankle and right shoulder, and that medical treatment for her right knee is compensable to relieve the effects of the industrial injuries. The WCAB adopted the WCJ's reasoning for these decisions, including the application of the *Braewood* principle for treating the non-industrial knee condition.

Workers' Compensation Appeals BoardEleanor DefrancoMonterey Fish CompanyEnstarSeabright Insurance CompanyIndustrial InjuryRight AnkleRight ShoulderRight KneeBack Injury
References
Case No. ADJ3566472 (SFO 04633189)
Regular
Apr 05, 2010

MAURICE EDWARDS vs. CALIFORNIA PACIFIC MEDICAL CENTER

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant argued the judge erred by combining work restrictions for the left knee and subjective pain for the right knee. The Board found the rating justified, noting the Agreed Medical Examiner stated the applicant was more disabled due to right knee pain. The Board concluded the rater's testimony supported the combined rating without improper addition of disability percentages.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryLeft KneeRight KneePsycheApportioned Permanent Partial DisabilityBilateral Knee DisabilityWork Restrictions
References
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. ADJ8330411
Regular
Jul 07, 2017

LARRY SINGLETARY vs. PARAMOUNT PICTURES

The Workers' Compensation Appeals Board (WCAB) denied Paramount Pictures' petition for reconsideration, upholding the Administrative Law Judge's (ALJ) decision. Paramount argued the ALJ erred by applying a 50% WPI for the applicant's right lower extremity, instead of 30%, based on conflicting reports from an agreed medical examiner. The ALJ found the evidence insufficient to prove the applicant could walk more than a "block" without a walker, which was the key factor in the different WPI ratings. The WCAB gave great weight to the ALJ's credibility determinations and found no substantial evidence to overturn them.

Petition for ReconsiderationDeniedWCJCredibility determinationsGarza v. Workmen's Comp. Appeals Bd.Permanent disabilityWPIRight lower extremityOrthopedic AMESpecific date of injury
References
Case No. ADJ3023725 (STK 0186210) ADJ 6853419
Regular
Mar 03, 2016

IGNACIO ROA vs. ROHRER BROTHERS/GENERAL PRODUCE; FREMONT COMPENSATION INSURANCE COMPANY, in liquidation CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, administered by SEDGWICK; XL SPECIALTY/BROADSPIRE; STATE COMPENSATION INSURANCE FUND

This case concerns applicant Ignacio Roa's petition for reconsideration of a workers' compensation award finding 20% permanent disability for a right knee injury with 50% apportionment to nonindustrial factors. Roa also sought to establish an industrial injury to his left knee as a consequence of the right knee injury and a cumulative trauma injury to both knees, which the Workers' Compensation Appeals Board denied. The Board affirmed the judge's findings, relying on Dr. Henrichsen's opinion that Roa's left knee symptoms were due to the natural progression of prior surgery and wear, not industrial factors. A dissenting opinion argued for further medical development, finding persuasive evidence of industrial contribution to the left knee condition.

Workers' Compensation Appeals BoardIgnacio RoaRohrer BrothersFremont Compensation Insurance CompanyCIGAXL SpecialtyState Compensation Insurance Fundpermanent disabilityapportionmentnonindustrial factors
References
Case No. ADJ7264915
Regular
Jul 15, 2013

ANA GONZALES vs. WAL-MART ASSOCIATES, INC., ACE AMERICAN INSURANCE

This case involves an applicant who sustained industrial psychiatric injury but whose orthopedic claims were denied due to insufficient medical evidence. The Appeals Board denied the applicant's petition for reconsideration, finding the applicant failed to present substantial medical evidence of industrial causation for her orthopedic complaints. A dissenting commissioner argued that the primary medical evaluator's report was deficient and lacked substantial evidence, warranting further development of the record on orthopedic injuries and other claims. The dissent emphasizes the Board's duty to ensure substantial justice, suggesting it should have ordered further investigation on the denied orthopedic issues.

WCABPetition for ReconsiderationFindings and Orderindustrial injurypsychelow backneckright shoulderright wristright elbow
References
Case No. ADJ383777
Regular
Apr 04, 2011

Roxanna Ortiz vs. ONE SOURCE, ESIS

The Workers' Compensation Appeals Board denied Roxanna Ortiz's petition for reconsideration of a prior findings and order. The initial ruling determined she sustained industrial injury only to her cervical spine as a janitor, not to other body parts or any resulting temporary/permanent disability or need for further medical treatment. Ortiz argued the judge erred by favoring defense medical reports and discrediting her testimony due to minor inconsistencies in her injury description. The Board adopted the WCJ's report, emphasizing deference to credibility determinations and that admissibility of medical reports should have been challenged at trial, not on reconsideration. A dissenting opinion argued the judge overemphasized minor variations in Ortiz's account and that medical evidence did not sufficiently support denial of other injuries or further treatment.

OrtizOne SourceESISWCABFindings and OrderPetition for ReconsiderationWorkers' Compensation Administrative Law Judgeindustrial injurycervical spineright arm
References
Case No. ADJ8336436
Regular
Mar 25, 2016

CARMEN NAVARRO vs. VENICE COMMUNITY HOUSING CORPORATION, ATHENS ADMINISTRATORS

Here's a summary for a lawyer: The Workers' Compensation Appeals Board (WCAB) denied Carmen Navarro's petition for reconsideration. Navarro sought to establish her right knee injury as a compensable consequence of a prior admitted left knee injury. The WCJ's report, adopted by the WCAB, found the right knee injury to be non-industrial. Medical evidence, particularly from QME Dr. Williamson, indicated the right knee pain arose independently in August 2013, distinct from the earlier left knee injury and treatment period. The Board specifically rejected any consideration of "rashly undertaken" activity as irrelevant to the legal analysis.

WCABPetition for ReconsiderationWorkers' Compensation Appeals BoardVenice Community Housing CorporationAthens AdministratorsADJ8336436Los Angeles District OfficeWCJcompensable consequenceleft knee injury
References
Case No. ADJ6820278
Regular
Mar 14, 2011

FELIX AQUINO CRUZ vs. DOLE FOOD COMPANY, SPECIALTY RISK SERVICES

This case involves a dispute over temporary disability and medical treatment for applicant Felix Aquino Cruz's right knee injury sustained in 2008. The defendant sought reconsideration of an award finding total temporary disability and entitlement to further care, including surgery. The Appeals Board granted reconsideration, finding the original decision lacked substantial medical evidence due to deficiencies in the treating physician's reports and the employer's failure to properly utilize review the treatment requests. The matter was returned to the trial level for further proceedings to properly develop the medical record.

Workers' Compensation Appeals BoardReconsiderationFindings of FactAward & OrdersIndustrial InjuryRight KneeTotal Temporary DisabilityLabor Code Section 4656(c)(2)104-week capFurther Medical Care
References
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