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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ3766392 (AHM 0088962)
Regular
Jul 02, 2013

SHIRLEY HARRELSON vs. COUNTY OF ORANGE, YORK RISK SERVICES GROUP, INC.

This case concerns Shirley Harrelson's claim of discrimination under Labor Code §132a after she voluntarily retired for service and was subsequently denied disability retirement. The Workers' Compensation Appeals Board denied reconsideration, adopting the administrative law judge's report. The Board found Harrelson was not entitled to job reinstatement under Government Code §31725.7(b) because she voluntarily retired for service prior to her disability retirement application. Furthermore, she failed to prove she suffered disadvantages due to her injury or claim.

Workers' Compensation Appeals BoardCounty of OrangeYork Risk Services GroupShirley HarrelsonGovernment Code §31725.7Phillips v. County of FresnoDepartment of Rehabilitation/State of California v. Workers' Comp. Appeals Bd.Labor Code §132aservice retirementdisability retirement
References
Case No. ADJ 2437239 (AHM 0140146)
Regular
Aug 24, 2010

LAWRENCE MOORE vs. COUNTY OF ORANGE, Permissibly SelfInsured, Adjusted By SOUTHERN CALIFORNIA RISK MANAGEMENT

This case involves a sheriff's deputy who sustained industrial injuries to his spine, knees, and shoulder. He retired from service to receive retirement benefits. The defendant argued that Labor Code Section 4850 benefits, which provide leave of absence without loss of salary for up to one year, should not be awarded post-retirement. However, the Board affirmed the award, holding that Section 4850 benefits are not automatically terminated upon service retirement for those under the County Employees Retirement Law of 1937, unlike those retired under the Public Employees' Retirement System. The applicant's testimony indicated he did not voluntarily leave the labor market, thus maintaining his eligibility for temporary disability and Section 4850 benefits.

Labor Code section 4850sheriff's special officertemporary total disabilityretirementservice retirement1937 Actsafety officerleave of absenceloss of salaryearning capacity
References
Case No. ADJ436808 (MON 0271038)
Regular
Jun 30, 2010

Gregory Martinez vs. CITY OF ANAHEIM

This case involves the City of Anaheim's petition for reconsideration of an award of temporary total disability benefits to Gregory Martinez for a 2000 spinal injury. The City argued Martinez lacked a willingness to work due to his post-injury retirement and a three-year gap in seeking employment. The Appeals Board denied the petition, finding that Martinez's retirement was not a complete withdrawal from the labor market. The Board highlighted his subsequent self-employment in property rehabilitation as evidence of an intent to pursue other work and demonstrate an earning capacity.

Temporary Total DisabilityPetition for ReconsiderationEarning CapacityWillingness to WorkRetirementSelf-EmploymentIndustrial InjurySpine InjuryPipe FitterGonzales v. Workers' Comp. Appeals Bd.
References
Case No. ADJ2522709 (LBO 0369555)
Regular
Sep 08, 2014

CHARLES FUNKE vs. CITY OF GARDENA, CORVEL

The Workers' Compensation Appeals Board rescinded an award of temporary disability benefits to a retired police detective, Charles Funke. The Board found that while Labor Code section 4853 did not preclude benefits due to his service retirement, the key issue was whether Funke voluntarily withdrew from the labor market. Since evidence regarding his intent to continue working after retirement was insufficient, the case was returned to the trial level for further factual development.

Workers' Compensation Appeals BoardCity of GardenaCorvelCharles FunkeADJ2522709Opinion and Decision After ReconsiderationFirst Amended Findings and Awardtemporary disabilitycumulative traumalower extremities
References
Case No. ADJ1784264 (MON 0302991) ADJ2898466 (MON 0339769)
Regular
Oct 14, 2011

GIRGIS FAM vs. UCLA MEDICAL CENTER, permissibly self-insured, Administered by Sedgwick Claims Management Services

This case concerns the selection of a child care provider for a permanently and totally disabled applicant. The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for reconsideration. The WCAB reversed the judge's decision, allowing the applicant to select his own child care provider, reasoning that this service is personal, similar to selecting a physician. The Board emphasized that the continuity of care and applicant's confidence in the provider outweigh the employer's desire to use a licensed and bonded provider selected by them.

Workers' Compensation Appeals BoardPetition for ReconsiderationSupplemental Findings and AwardPermanently totally disabledCaretaking servicesChild care servicesGardening servicesPool maintenance servicesStructural modificationsCauda-equina syndrome
References
Case No. ADJ8475421
Regular
Mar 30, 2017

Jessica Duncan vs. Right At Home, Travelers Diamond Bar

The Workers' Compensation Appeals Board denied reconsideration of a lien claimant's claim for medical services. The Board found that the lien, filed on June 4, 2016, was barred by the 18-month statute of limitations under Labor Code section 4903.5(a). This was because the last date of service was August 8, 2013, which fell after the July 1, 2013, implementation date of the 18-month rule. The Board also held that it lacked the authority to rule on constitutional vagueness claims.

Labor Code section 4903.5(a)Lien claimStatute of limitationsReconsiderationWorkers' Compensation Appeals BoardWCJTimelinessDate of servicesContinuous treatmentUnconstitutionally vague
References
Case No. ADJ7507340
Regular
Nov 15, 2019

Richard Dela Rosa vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to amend a prior decision regarding applicant Richard Dela Rosa's permanent disability award. The Board found that despite the applicant's disability retirement, the employer's failure to offer modified or regular work within 60 days of the permanent and stationary date triggered a 15% increase in permanent disability payments under Labor Code section 4658(d)(2). This obligation arose even though the applicant retired due to disability and did not voluntarily resign. The Board affirmed the award but increased it by 15% due to the employer's inaction.

Labor Code section 4658(d)(2)permanent and stationarydisability retirementmodified workalternative workpetition to reopennew and further disabilitymaximum medical improvementindustrial disability retirementservice retirement
References
Case No. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
Case No. ADJ9116549
Regular
Mar 13, 2020

EMMA MEDINA vs. SUNRISE RESTAURANT, LLC, DENNY'S RESTAURANT, CANNON COCHRAN MANAGEMENT SERVICES, CHUBB INSURANCE

This Workers' Compensation Appeals Board case concerns the reimbursement for lien claimant Preferred Scan's copy services. The Board granted reconsideration to clarify what constitutes medical-legal expenses and the reasonable value of copy services. The Appeals Board rescinded the original award and returned the matter for further proceedings, finding that certain copy services for medical records were properly considered medical-legal expenses. However, the reasoning for doubling the copy service fee schedule was insufficient and requires further development at the trial level.

Workers' Compensation Appeals BoardReconsiderationLien ClaimantCopy ServicesMedical-Legal ServicesCopy Service Fee ScheduleLabor CodeSubpoena Duces TecumExplanation of ReviewCompromise and Release
References
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