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

Case No. ADJ7775170
Regular
Jul 16, 2012

JUANA NEGRETE vs. SHURFLO, HAMPSHIRE INSURANCE COMPANY

This case involves an applicant's workers' compensation claim filed after layoff, triggering Labor Code Section 3600(a)(10). The Appeals Board granted reconsideration, finding the applicant met her burden of proof that she notified her employer of her injury prior to her layoff. The applicant's unrebutted testimony and supporting medical evidence demonstrated employer notice, thus overcoming the statutory bar to compensation. The case was remanded for further proceedings on the merits of the applicant's claim.

Workers' Compensation Appeals BoardJuana NegreteShurfloHampshire Insurance CompanyADJ7775170Opinion and Order Granting ReconsiderationDecision After Reconsiderationbilateral armsbilateral elbowssleep problems
References
Case No. VNO 0365922
Regular
Mar 03, 2008

NANCY COULTER vs. SULPHUR SPRINGS UNION SCHOOL DISTRICT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The applicant sought reconsideration of a WCJ's award, arguing injury to her psyche, neck, shoulders, and cardiovascular system, in addition to her teeth. The Appeals Board granted reconsideration to amend the finding of injury to specifically include "teeth (bruxism) resulting in myofascial pain to her jaw and muscle tenderness." Ultimately, the Board affirmed the original award, finding no industrial injury to the psyche, neck, shoulders, or cardiovascular system, relying on the credibility of a witness and substantial medical evidence.

Workers' Compensation Appeals BoardSulphur Springs Union School DistrictCalifornia Insurance Guarantee AssociationFindings and Awardpermanent disabilitypsychiatric injurygood faith personnel action defensePetition for Reconsiderationbruxismmyofascial pain
References
Case No. ADJ8096704
Regular
Dec 02, 2019

ALFREDO JAUREGUI vs. AMERICAN PROPERTY MANAGEMENT/ RADISSON HOTEL, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The Workers' Compensation Appeals Board denied reconsideration of a previous award that found applicant sustained a left shoulder injury but not a cervical spine injury. The applicant contended their neck injury was AOE/COE and sought to discredit the Agreed Medical Examiner's (AME) opinion. The Board found the AME's opinion, which was clarified through deposition and consistent with other medical opinions, constituted substantial evidence. Therefore, the WCJ's original findings regarding the absence of a compensable neck injury were upheld.

AOE/COEPetition for ReconsiderationFindings and AwardAdministrative Law JudgeAgreed Medical ExaminerWhole Person ImpairmentCervical Spine InjuryLeft Shoulder InjuryRotator Cuff RepairSubacromial Decompression
References
Case No. ADJ4151507 (SFO 0487197)
Regular
Feb 02, 2020

Tracy Sullivan vs. Café Amsterdam, State Compensation Insurance Fund

The Appeals Board granted reconsideration and amended the previous award, finding the applicant's burn injury did not qualify for the "severe burns" exception to the temporary disability indemnity limit under Labor Code section 4656(c)(3)(D). Consequently, temporary disability indemnity is limited to 104 weeks from the commencement of payments on August 10, 2004. The Board affirmed the WCJ's finding that the applicant's psychiatric injury was compensable, meeting the "sudden and extraordinary" employment condition exception. Clerical errors in the original findings were also corrected.

ADJ4151507SFO 0487197Tracy SullivanCafé AmsterdamState Compensation Insurance FundPetition for ReconsiderationFindings Award and OrderWCJindustrial injurycervical spine
References
Case No. SAC 357129
Regular
Sep 24, 2007

MICHAEL HANCOCK vs. TOWNSEND & SCHMIDT MASONRY, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant injured in a car accident while commuting to work, with the employer arguing the "going and coming" rule barred recovery. The Workers' Compensation Appeals Board affirmed a finding that the applicant's injuries were industrial, holding that the rule did not apply. The Board reasoned that the applicant's use of his personal vehicle to transport tools, the potential for inter-job site travel, and the employer's travel pay policy conferred a benefit to the employer, thus justifying an exception to the rule.

going and coming ruleindustrial injuryautomobile accidentcommutebrick tendercourse of employmentWCJpetition for reconsiderationemployer benefitwork materials
References
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
Case No. ADJ1058308 (VNO 0482296)
Regular
May 28, 2013

DONNA DeRUSSY vs. ANTELOPE VALLEY HEALTH CARE SYSTEM, TRAVELERS INSURANCE, SAFETY NATIONAL, FRONTIER INSURANCE

This case involves a workers' compensation appeal where the defendants seek reconsideration of a prior award. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, rescinded the prior award, and remanded the case for further proceedings. The primary grounds for this decision were that the defendants were denied due process by not being given an opportunity to cross-examine the rating rater and that the award relied on outdated medical reports. The WCAB also suggested obtaining current medical evaluations due to the time elapsed since the original reports.

Workers' Compensation Appeals BoardReconsiderationJoint Findings and AwardAttorney FeesPermanent Disability RatingApportionmentIndustrial InjuryLumbar SpineTreating PhysiciansMedical Reports
References
Case No. MISC. 251
Significant
Jul 08, 2008

Ramon B. Pellicer vs.

The Appeals Board denied Ramon B. Pellicer's petition to appear as a non-attorney representative, based on his disciplinary history with the State Bar and legal precedent preventing disbarred or suspended attorneys from practicing before the WCAB.

WCABPetition to PracticeHearing RepresentativeNon-AttorneyInvoluntary Inactive EnrollmentState Bar CourtDisciplinary ChargesRules of Professional ConductBusiness and Professions CodeMoral Turpitude
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. ADJ2979319 (LAO 0864585)
Regular
Nov 21, 2008

PETRA GARCIA vs. BANKERS WEST FUNDING CORPORATION, NATIONAL LIABILITY AND FIRE INSURANCE COMPANY

This case concerns an applicant's entitlement to temporary disability indemnity (TDI) following a right upper extremity injury. The defendant sought reconsideration of an award, arguing TDI should cease earlier based on a QME's opinion and statutory limits. The Appeals Board granted reconsideration, amending the award to find TDI payable from January 3, 2006, through September 2, 2008, and continuing, while establishing the "date of commencement" for the two-year TDI limit as July 1, 2008, the date of first payment. The Board found the treating physician's opinion more persuasive than the QME's regarding the duration of temporary disability.

Workers' Compensation Appeals BoardPetra GarciaBankers West Funding CorporationNational Liability and Fire Insurance CompanyADJ2979319ReconsiderationTemporary Total DisabilityLabor Code section 4656(c)(1)Panel Qualified Medical Evaluator (QME)Ernest Washington M.D.
References
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