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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. ADJ3057068
Regular
Nov 01, 2010

Cecilio Torres vs. Holbrook Construction, Inc., Lincoln General Insurance Company, American Claims Management, State Compensation Insurance Fund

The Workers' Compensation Appeals Board granted reconsideration, rescinded a prior decision, and returned the case for further proceedings. The applicant claimed a back and other injuries, alleging he notified his supervisor of the incident and subsequent pain before termination. The Board found the applicant met his burden to prove he provided sufficient notice of injury to his supervisor prior to termination, fulfilling the notice requirement of Labor Code section 3600(a)(10). Defendants failed to rebut the applicant's evidence that he reported the injury and requested medical treatment from his supervisor.

Workers' Compensation Appeals BoardReconsiderationLabor Code Section 3600(a)(10)Notice of InjuryTerminationPreponderance of EvidenceSupervisor NoticeActual NoticeEmployer KnowledgeWCJ Decision
References
Case No. ADJ7500739
Regular
May 25, 2012

SAMIRA HASAN vs. AMERICAN SHIELD PRIVATE SECURITY, GALLAGHER BASSETT

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior finding, ruling that Samira Hasan, a security guard, sustained an industrial injury. Hasan was struck by a car while crossing the street for coffee shortly before her shift began, having signed in and received implied approval from her supervisor. The Board found this to be a compensated coffee break exception to the "going and coming" rule, thus arising out of and in the course of employment. One Board member dissented, giving greater weight to the administrative law judge's credibility findings regarding the supervisor's testimony.

Workers' Compensation Appeals Boardindustrial injurycourse of employmentarising out of employmentgoing and coming rulecompensated lunch breaksign-in sheetsupervisor approvalcredibility findingsdissenting opinion
References
Case No. ADJ176329 (VNO 0542064)
Regular
Jun 15, 2009

Jesse W. Pratt vs. Lancaster Healthcare Center, Zurich America Insurance Company

This case involved a maintenance supervisor who claimed industrial injury to his psyche and various physical ailments due to alleged stress and harassment by his supervisor. The Appeals Board granted reconsideration, reversing the initial award. The Board found that the applicant's psychiatric injury was substantially caused by lawful, nondiscriminatory, good-faith personnel actions, specifically workplace critiques and job modifications by management. Consequently, compensability for the psychiatric injury was barred under Labor Code section 3208.3(h). The issue of whether the applicant's non-psychiatric conditions were industrially caused was deferred for further development of the record at the trial level.

Workers' Compensation Appeals BoardLabor Code section 3208.3(h)good faith personnel actionpsychiatric injuryindustrial injurycompensabilitymaintenance supervisorreconsiderationFindings and Awardactual events of employment
References
Case No. ADJ6603653
Regular
Mar 29, 2010

PEGGY MILLER vs. STATE OF CALIFORNIA, DEPARTMENT OF MENTAL HEALTH, Legally Uninsured, STATE COMPENSATION INSURANCE FUND

This case concerns applicant Peggy Miller's claim for a psychiatric injury allegedly arising from a verbal dispute with her supervisor over medication administration. The Workers' Compensation Appeals Board (WCAB) denied her petition for reconsideration of a prior finding that her injury was not compensable. The WCAB majority adopted the judge's report concluding the incident was a lawful, non-discriminatory, good faith personnel action and not a compensable industrial injury. However, one commissioner dissented, arguing the supervisor's directive to administer medication contrary to physician's orders was unlawful, thus not a "lawful, nondiscriminatory, good faith personnel action" under Labor Code section 3208.3(h).

Workers' Compensation Appeals BoardPsychiatric injuryVerbal exchange24 hour clockMedication administrationShift supervisorPersonnel actionLawfulNondiscriminatoryBad faith
References
Case No. ADJ7340845
Regular
Mar 05, 2012

MARIA INIGUEZ vs. PERKOS CAFÉ AND GRILL, ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of an applicant's claim. The applicant, Maria Iniguez, injured herself while working as a cook at Perkos Café and Grill. The Board upheld the judge's finding that Iniguez reported her injury to Maria Vargas, who was deemed a supervisor under Labor Code § 3600(a)(10), despite the employer's claims otherwise. The decision emphasized giving great weight to the judge's credibility findings regarding the witnesses.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ credibilityGarza v. Workmen's Comp. Appeals Bd.Findings of Fact and Ordershift supervisorreporting injuryL.C. §3600(a)(10)supervisory personperson in charge
References
Case No. ADJ8574227
Regular
Sep 17, 2013

Victor Morales vs. Fresh Start Harvesting, Sedgwick Claims Management Services

The Workers' Compensation Appeals Board denied reconsideration of a decision finding Victor Morales' injuryAOE/COE. Morales was injured in a motor vehicle accident while traveling in a caravan led by his supervisor to a work site. The WCAB adopted the Administrative Law Judge's report, which concluded the "going and coming" rule did not apply as Morales was following direct employer orders. The evidence supported that the injury occurred within the course and scope of employment.

WCABADJ8574227Petition for ReconsiderationDenialWCJ ReportGoing and Coming RuleAOE/COEIndustrially RelatedCaravanMotor Vehicle Accident
References
Case No. ADJ413851
Regular
May 10, 2010

TRACIA ARNETT vs. VERIZON WIRELESS, AMERICAN HOME ASSURANCE

Applicant Tracia Arnett sought reconsideration of a decision denying her workers' compensation claim for psychiatric injury. The administrative law judge found the claim barred under Labor Code section 3208.3, relating to the causation of psychiatric injuries. Arnett argued the supervisor's conversation was not in good faith and her injury resulted from mistreatment. The Appeals Board denied reconsideration, adopting the judge's report which supported the bar of the psychiatric claim.

Labor Code section 3208.3psychiatric injurygood faith conversationmistreatment by supervisorFindings of Fact and OrderPetition for Reconsiderationworkers' compensation administrative law judgeWCJ Report and Recommendationdenial of petitionVerizon Wireless
References
Case No. ADJ9176321
Regular
May 21, 2014

CAMILO MORALES vs. BLESSINGS HAND CAR WASH, HANOVER INSURANCE GROUP

The Workers' Compensation Appeals Board denied Camilo Morales's petition for reconsideration of a finding of no injury. The judge found the applicant lacked credibility, noting he failed to return to work after being asked for a doctor's note, despite claiming he needed the job and could perform modified duties. Medical reports were deemed unsubstantial due to a lack of signatures and potentially false history. The supervisor's credible testimony further supported the employer's denial of injury.

WCABPetition for ReconsiderationAOE/COEcredibilitycontinuous traumacar washerdoctor's notemodified workunsigned medical reportsfalse history
References
Case No. ADJ4050950
Regular
Apr 09, 2009

EdME PILONA vs. THE EDWARD THOMAS HOSPITALITY CORP., ARCH INSURANCE GROUP

The Workers' Compensation Appeals Board granted reconsideration and reversed a judge's finding of industrial injury. The applicant's testimony regarding a back and knee injury at work was found to be inconsistent and not credible, especially when contrasted with employer evidence. This evidence included a supervisor's report and an email stating the applicant injured his knee while laying tile at another job. Ultimately, the Board determined the applicant failed to meet his burden of proof for industrial causation.

Edme PilonaEdward Thomas Hospitality Corp.Gallagher Bassettindustrial injuryback injuryknee injurypsychiatric injurycompensable consequencereconsiderationfindings of fact
References
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