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

Case No. 2016-03-0400
Regular Panel Decision
Jul 18, 2016

Dunn, Jason v. United States Infrastructure

Jason Dunn, a utility worker for United States Infrastructure (USI), injured his right shoulder in October 2014. After multiple surgeries and physical therapy for his right shoulder, he began experiencing left shoulder problems in February 2015, which his authorized physician, Dr. Eric A. Morgan, diagnosed as an over-compensation injury related to the original right shoulder injury. Dr. Morgan recommended left shoulder surgery, which utilization review approved but Liberty Mutual denied. An independent medical evaluation by Dr. Edward Kahn concluded the left shoulder injury was age-related and not caused by the work incident. The Court weighed the conflicting medical opinions, giving greater weight to Dr. Morgan's opinion due to his greater contact with Mr. Dunn, and found that Mr. Dunn is likely to prevail on the merits, granting his request for left shoulder surgery.

Shoulder InjuryOvercompensation InjuryMedical BenefitsCausationConflicting Medical OpinionsExpedited HearingPreponderance of EvidenceDirect and Natural Consequences RuleMedical Treatment AuthorizationUtilization Review
References
7
Case No. ADJ1498961
Regular
Sep 23, 2010

DALE ARNOLD vs. RALPH'S AKA KROGER

This case involves an applicant's claim for workers' compensation benefits for a right shoulder injury. While the initial award recognized industrial injury to the applicant's left shoulder, right elbow, and right forearm, the defendant sought reconsideration, arguing the right shoulder injury was not work-related. The Appeals Board granted reconsideration, finding the applicant failed to meet the burden of proof for the right shoulder injury. They disagreed with the primary treating physician's opinion and found the agreed medical evaluator's opinion more persuasive, ultimately reversing the finding for the right shoulder.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardCumulative TraumaIndustrial InjuryLeft ShoulderRight ElbowRight ForearmRight ShoulderPrimary Treating Physician
References
0
Case No. 2023-03-8156
Regular Panel Decision
Nov 13, 2024

Sullivan, Leah v. Petree Arbor Lawn & Landscape, Inc.

This interlocutory appeal concerns an employee's request for medical evaluation and treatment of a left shoulder condition, which the employer contested as not part of her accepted work-related injuries. Following a work accident, Leah Sullivan received treatment for her neck, chest, and right shoulder, but her request for left shoulder treatment was denied by Petree Arbor Lawn & Landscape, Inc. The trial court ordered the employer to provide the requested medical care, a decision subsequently affirmed by the Workers' Compensation Appeals Board. The Board ruled that an employee is not obligated to identify every injury at the time of initial notice and that the employer's expert had not fully evaluated the left shoulder. Consequently, the case was remanded, upholding the order for the employer to authorize a left shoulder evaluation by Dr. Holloway.

Workers' CompensationMedical TreatmentLeft Shoulder InjuryCausationNotice of InjuryExpedited HearingTrial Court OrderAppeals BoardEmployer LiabilityMedical Evaluation
References
5
Case No. SFO 0425862 SFO 0425863
Regular
May 14, 2008

William Bishop vs. IGC POLYCOLD SYSTEMS, ROYAL & SUN ALLIANCE

This case involves a workers' compensation applicant claiming injury to his right shoulder and seeking a new vocational rehabilitation plan. The Appeals Board affirmed the WCJ's denial of a new vocational plan and the finding of no industrial injury to the right shoulder. However, they reversed the WCJ to award benefits resulting from right shoulder surgery, deeming it a consequence of the compensable left shoulder injury.

Workers' Compensation Appeals BoardReconsiderationVocational Rehabilitation PlanIndustrial InjuryRight ShoulderLeft ShoulderTemporary DisabilityQualified Medical EvaluationCausationNon-Industrial
References
8
Case No. 2021-06-0468
Regular Panel Decision
Dec 17, 2021

Walker, Dionnie v. Clarksville Dep’t of Electricity

Dionnie Walker sought medical benefits and temporary disability for a left shoulder injury, which she claimed resulted from overusing her left arm after a right shoulder injury while working for the Clarksville Department of Electricity. The employer argued the claim was barred by the statute of limitations and lacked medical proof connecting the left shoulder injury to work. The Court found the statute of limitations had not run but denied relief, stating Ms. Walker failed to provide sufficient medical evidence to prove her left shoulder condition was primarily work-related or a direct consequence of her compensable right shoulder injury. The Court acknowledged Ms. Walker's testimony regarding the employer's failure to accommodate was credible and her theory plausible, but emphasized the need for expert medical testimony. The case is set for a status hearing, and the denial does not prevent Ms. Walker from seeking further evidence.

Expedited HearingStatute of Limitations DefenseLeft Shoulder Injury ClaimRight Shoulder InjuryMedical CausationTemporary Disability BenefitsMedical Proof InsufficiencyWork-RelatednessEmployer Non-AccommodationPhysician Assistant Assessment
References
6
Case No. ADJ3849140 (RDG 0119253)
Regular
Apr 04, 2011

THEMAS TRESLER vs. MOUNTAIN SATELLITE, STATE COMPENSATION INSURANCE FUND

This case involves a dispute over workers' compensation jurisdiction regarding a left shoulder injury. The defendant, SCIF, sought reconsideration of a WCJ's award of treatment for the shoulder, arguing lack of jurisdiction. The Appeals Board granted reconsideration, rescinded the prior award, and returned the matter for further proceedings. This decision acknowledges that the left shoulder claim may not have been definitively resolved by prior stipulations and requires the WCJ to determine if Labor Code section 5815 applies, potentially leading to a full hearing on the shoulder injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryLow Back InjuryLeft Shoulder InjuryStipulation with Request for AwardDeclaration of Readiness to ProceedContinuing JurisdictionLabor Code Section 5909
References
5
Case No. ADJ8361032
Regular
Sep 04, 2019

CAROL WORKMAN vs. ST. THERESA/ST. JOSEPH SCHOOL

This case concerns Carol Workman's claim for benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF) due to bilateral shoulder injuries. The Workers' Compensation Appeals Board (WCAB) overturned a prior decision and found Workman entitled to SIBTF benefits. This was based on evidence showing her current work-related shoulder injuries, when combined with prior non-industrial and industrial shoulder issues, met the statutory threshold for SIBTF eligibility. The Board found that the cumulative injury to her shoulders resulted in at least 5% permanent disability before adjustments, satisfying the requirement for SIBTF benefits.

SIBTFSubsequent Injuries Benefits Trust Fundwhole person impairmentcumulative traumaacromegalybilateral shouldersrange of motionmotor deficitapportionmentdiminished future earning capacity
References
17
Case No. ADJ3481462 (OAK 0297878)
Regular
Sep 24, 2009

KATHRYN MILLS vs. BERKELEY UNIFIED SCHOOL DISTRICT, STATE COMPENSATION INSURANCE FUND

The defendant sought reconsideration of an award finding industrial injury to the applicant's left upper extremity and shoulder, causing temporary disability and need for further medical care. The applicant's treating physician, Dr. Nolan, provided opinions regarding her left shoulder and other body parts, while Dr. Cabayan also provided opinions on the left shoulder and other extremities. The Workers' Compensation Appeals Board granted reconsideration and amended the award, clarifying that future medical care is consistent with Dr. Cabayan's opinions for the left shoulder and Dr. Nolan's opinions for other body parts. The Board affirmed the award with this specific amendment.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryInstructional AssistantLeft Upper ExtremityCompensable ConsequenceTemporary DisabilityFurther Medical CareSubstantial Evidence
References
0
Case No. MISSING
Regular Panel Decision
Sep 07, 2004

Claim of Senecal v. Allied Bendix

Claimant sustained a work-related left shoulder injury in 1991, leading to surgery in 1992 and retirement in 1995. In 2002, he sought workers' compensation benefits for a consequential right shoulder injury, claiming it resulted from favoring his left shoulder. While a Workers' Compensation Law Judge initially established a causally related consequential injury, a Board panel reversed this decision. The Appellate Division affirmed the Board's ruling, finding substantial evidence that the right shoulder condition, which manifested 10-11 years post-initial injury and 7 years post-retirement, was consistent with natural aging and not causally related to the prior work injury.

Workers' CompensationConsequential InjuryRight Shoulder PainLeft Shoulder InjuryCausationMedical EvidenceDegenerative ChangesSpecial Fund for Reopened CasesAppellate ReviewSubstantial Evidence
References
1
Case No. 524823
Regular Panel Decision
Feb 07, 2019

Matter of Napoli v. Edison

John Napoli, a mechanic, injured both shoulders in a 2003 work accident at the World Trade Center site. He was initially awarded a 20% schedule loss of use (SLU) for each shoulder. In 2012, his condition changed, and liability was transferred to the Special Fund for Reopened Cases. A Workers' Compensation Law Judge (WCLJ) found an additional 45% SLU for each shoulder, but the Workers' Compensation Board reversed this finding after an evaluation by an impartial specialist and crediting an independent medical examiner. The Appellate Division affirmed the Board's decision, concluding that the Board's finding that the additional deterioration in the condition of his shoulders was not causally related to the underlying accident was supported by substantial medical evidence.

Workers' CompensationSchedule Loss of UseShoulder InjuryCausationMedical EvidenceIndependent Medical ExaminationImpartial SpecialistReopened CasesAppellate ReviewSubstantial Evidence
References
11
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