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Case Law Database

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. ADJ9749879
Regular
Mar 22, 2017

HERNAN VILLACIS vs. COUNTY OF LOS ANGELES SHERIFF'S DEPT.

The Workers' Compensation Appeals Board (WCAB) rescinded the previous findings of fact and returned the case for further proceedings. The central issue is whether the applicant's fall from a four-story building was an industrial injury or an intentional self-inflicted act. The Board found that the trial level erred by excluding the applicant's wife's testimony, which may have provided crucial evidence on the applicant's mental state. Furthermore, the Board noted the lack of medical evidence to definitively determine if the fall was suicidal, requiring further development of the record.

Workers' Compensation Appeals BoardIndustrial InjuryReconsiderationSelf-Inflicted InjuryMarital PrivilegeFall from HeightIntentional JumpSlip and FallCredibility DeterminationMedical Evidence
References
Case No. ADJ8752161
Regular
Sep 13, 2013

Daniel Rita vs. Cheesecake Factory, ACE American Insurance

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior finding of industrial injury for applicant Daniel Rita. The Board found that applicant failed to meet his burden of proof to establish an industrial slip and fall injury. This decision was based on the applicant's testimony being directly contradicted by three witnesses, rendering his self-serving statement about the fall less persuasive. Therefore, the Board ruled that no industrial injury occurred.

Workers' Compensation Appeals BoardReconsiderationFindings of FactIndustrial InjuryBurden of ProofPreponderance of the EvidenceCredibilityWitness TestimonySlip and FallServer
References
Case No. ADJ2012962
Regular
Oct 28, 2009

JOHN KEATING ENGLER vs. WALGREENS, PSI c/o SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The WCAB denied reconsideration of the WCJ's decision that the applicant sustained an injury arising out of and in the course of his employment due to a slip and fall. The WCAB found the applicant to be credible.

AOE/COESlip and FallCredibility FindingReconsideration DeniedWalgreensSedgwick Claims ManagementAssistant ManagerUnwitnessed InjuryDetergent SpillApportionment
References
Case No. ADJ8917550
Regular
Dec 16, 2014

CONSUELO DE SOLIS vs. BARBARA LEVY, FEDERAL INSURANCE COMPANY, CHUBB GROUP OF INSURANCE COMPANIES

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration in the case of Consuelo De Solis. The Board adopted the WCJ's report, which found the applicant a credible witness regarding her slip and fall injury on the employer's stairs. The WCJ's decision was supported by the applicant's testimony and medical evidence, including the treating physician's opinion. The defendant failed to rebut key evidence, leading to the denial of their petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedAdministrative Law JudgeApplicantDefendantSlip and FallHousekeeperDate of InjuryIndustrial Injury
References
Case No. ADJ7642434
Regular
Nov 05, 2012

Matthew Austin vs. Bridgestone/Firestone, Old Republic Insurance

The Workers' Compensation Appeals Board granted the employer's petition for reconsideration regarding a psyche injury claim. The Board found the applicant's slip and fall on a broken stair was not a "sudden and extraordinary employment condition" as required by Labor Code section 3208.3(d) for claims filed within six months of employment. Therefore, the applicant's psyche injury claim does not meet this exception. The case is returned to the trial level for further proceedings.

Labor Code section 3208.3(d)psyche injurysudden and extraordinary eventpetition for reconsiderationFindings and AwardWCJautomobile mechanicslip and fallbroken stepoccupational hazard
References
Case No. ADJ7691282
Regular
Jan 25, 2013

LETICIA MONREAL vs. LABORATORY CORP. OF AMERICA/LABCORP., ACE AMERICAN INSURANCE, administered by BROADSPIRE SERVICES, INC.

The Workers' Compensation Appeals Board (WCAB) denied reconsideration of a decision finding that Leticia Monreal sustained a work-related injury to her right hip and back from a slip and fall. The WCAB affirmed the Workers' Compensation Judge's (WCJ) credibility findings regarding the applicant's consistent reporting of the incident. The WCAB also upheld the award of temporary total disability benefits, noting the defendant's stipulation to this fact based on treating physician reports.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJGarza v. Workers' Comp. Appeals Bd.Labor and EmploymentInjurySlip and FallTemporary DisabilityPhlebotomistAgreed Medical Evaluator
References
Case No. ADJ8919283
Regular
Sep 16, 2014

JOSEPH REID vs. TIME WARNER CABLE, NEW HAMPSHIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Joseph Reid's petition for reconsideration, upholding the administrative law judge's (WCJ) findings. The WCJ found that Reid failed to prove by a preponderance of the evidence that he sustained a slip and fall injury on March 1, 2013, as alleged. This decision was based on credibility issues regarding Reid's testimony and that of his sole witness, along with inconsistencies in Reid's account of the incident and its reporting. The WCJ's credibility determination was given significant weight, leading to the denial of the petition.

WCABPetition for ReconsiderationSlip and FallCredibilityWitness TestimonyFindings of FactAdministrative Law JudgeBurden of ProofPreponderance of the EvidenceCompensable Injury
References
Case No. ADJ8161824
Regular
Feb 27, 2013

LILIAN CRUZ vs. SINCERE CARE SERVICES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of the decision that found her claimed slip and fall injury not industrial. The administrative law judge found significant credibility issues with the applicant's testimony due to numerous inconsistencies with her own prior statements and medical records. Furthermore, no medical evidence was presented linking the applicant's diagnosed degenerative conditions to the alleged work incident. The court declined to disturb the original finding, upholding the WCJ's credibility determinations and the lack of industrial causation evidence.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ ReportCredibilityMedical TreatmentSlip and FallDegenerative Disc DiseaseIndustrial InjuryBurden of ProofMedical-Legal Evaluation
References
Case No. ADJ1880234 (GOL 0097047)
Regular
Oct 06, 2014

HSING TEREK vs. EMBASSY SUITES/WINDSOR CAPITAL GROUP

In this workers' compensation case, the applicant suffered an admitted industrial injury from a slip and fall as a housekeeper. The defendant sought reconsideration of the findings of total permanent disability and injury to the "psyche, head, internal, and neurological/cognitive impairment." The Appeals Board granted reconsideration to address the ambiguity of the "internal" injury finding, which they found insufficiently specified. While affirming the total permanent disability finding and injury to psyche, head, and neurological/cognitive impairment, the Board rescinded the "internal" injury finding and returned the case for further proceedings to clarify the specific internal systems or conditions injured.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardIndustrial InjuryPsycheNeurological/Cognitive ImpairmentTotal Permanent DisabilityApportionmentHousekeeperSlip and Fall
References
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