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

Case No. ADJ7555409
Regular
Mar 04, 2014

JESUS ESCANUELA vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the defendant's Petition for Reconsideration and dismissed the applicant's untimely petition. The WCAB found that the Agreed Medical Examiner's (AME) opinion regarding psychiatric permanent disability was not supported by substantial evidence, as it did not properly address causation under the current PDRS. Consequently, the case is remanded to the trial level for further development of the record concerning psychiatric permanent disability. The WCAB deferred the issue of permanent disability and attorney's fees pending this further development.

Workers' Compensation Appeals BoardJesus EscanuelaCalifornia Department of Correctionslegally uninsuredState Compensation Insurance FundADJ7555409Fresno District OfficeOpinion and OrderPetition for ReconsiderationFindings and Award
References
Case No. ADJ2450523 (MON 0361699), ADJ3686785 (MON 0361700), ADJ6526089, ADJ6527240, ADJ6527336
Regular
Nov 07, 2013

NINA IGLESIAS vs. ORIENT TALLY COMPANY, NATIONAL INTERSTATE INSURANCE COMPANY

In *Iglesias v. Orient Tally Company*, the Workers' Compensation Appeals Board (WCAB) issued an order dismissing a petition for removal. The petitioner filed the petition for removal and subsequently withdrew it. Due to this withdrawal, the WCAB deemed the petition dismissed and will take no further action.

WORKERS' COMPENSATION APPEALS BOARDPetition for RemovalDismissedWithdrawnNina IglesiasOrient Tally CompanyNational Interstate Insurance CompanyADJ2450523Long Beach District OfficeMarina del Rey District Office
References
Case No. ADJ8067157
Regular
Nov 30, 2012

MARISOL PERALTA vs. FROZEN YOGURT OF VALLEY VILLAGE, INC., STAR INSURANCE CO.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to further develop the record regarding applicant Marisol Peralta's alleged industrial injury. The WCAB rescinded the prior decision finding an injury, citing that the medical opinions were not substantial evidence as they lacked definitive causation findings and weren't based on complete medical histories. Crucially, neither physician reviewed applicant's full medical records, and one deferred causation due to pregnancy while the other awaited X-ray results. The case is returned to the trial level for further proceedings and a new decision by the WCJ.

Workers' Compensation Appeals BoardMarisol PeraltaFrozen Yogurt of Valley VillageInc.Star Insurance Co.Illinois Midwest Insurance AgencyLLCADJ8067157Opinion and Order Granting ReconsiderationDecision After Reconsideration
References
Case No. ADJ3674012 (ANA 0386342)
Regular
Feb 17, 2015

Richard Hoover vs. Trading Places International, Clarendon Insurance Company, Subsequent Injuries Benefits Trust Fund

Here is a summary of the case in four sentences for a lawyer: The Workers' Compensation Appeals Board granted reconsideration to further develop the record regarding the applicant's eligibility for Subsequent Injuries Benefits Trust Fund (SIBTF) benefits. The core issue is whether the applicant had a "labor disabling" pre-existing condition before his October 2, 2002 industrial injury, a requirement for SIBTF benefits. The Board found the previous administrative law judge erred by finding no pre-existing disability without sufficient exploration of the applicant's residual pain symptoms from prior back surgeries. Jurisdiction is reserved to determine if these symptoms constituted a ratable, labor-disabling permanent disability entitling the applicant to SIBTF benefits.

Subsequent Injuries Benefits Trust FundSIBTFpre-existing disabilitylabor disablingapportionmentSB 899retroactive prophylactic work restrictioncongenial work settingresidual pain symptomsmedical evaluator
References
Case No. ADJ9094120
Regular
Nov 09, 2020

JAIME MORALES vs. SENIOR OPERATIONS, LLC, ARCH INSURANCE COMPANY

This case involves a defendant's petition for reconsideration of a finding that applicant sustained an industrial injury to his shoulders. The defendant argued the administrative law judge erred in this finding, but the Workers' Compensation Appeals Board (WCAB) denied the petition. The WCAB found that medical evidence supported the applicant's injury being consistent with his work duties. The defendant failed to present evidence to impeach the applicant's description of his work.

Petition for ReconsiderationFindings of Factindustrial injuryshoulderscumulative periodcertified metal fitterspinepsycheLabor Code section 5412date of injury
References
Case No. STK 166227
Regular
Jan 25, 2008

Celestino Aguilar-Maldonado vs. GALLO WINERY, Permissibly Self-Insured

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of the finding that he did not sustain new and further psychological disability. The Board found that substantial evidence, including expert opinions from Drs. Mendel and Panzarella, did not support a finding of compensable psychiatric injury, noting significant exaggeration of symptoms by the applicant. Furthermore, the Board concluded that any psychological issues predated the original stipulated award and thus did not constitute "new and further" disability.

Workers' Compensation Appeals BoardNew and Further DisabilityPsyche InjuryBack InjuryStipulations with Request for AwardPetition to ReopenQualified Medical Examiner (QME)Symptom MagnificationMalingeringPredominant Cause
References
Case No. ADJ1128865 (VNO 0244369), ADJ1909887 (VNO 0181430)
Regular
Jan 09, 2012

JOE NAVARRO vs. LOCKHEED MARTIN

The Workers' Compensation Appeals Board denied reconsideration of a decision regarding Joe Navarro's claims against Lockheed Martin. The Board adopted the Workers' Compensation Administrative Law Judge's report, which found Navarro to be an unreliable historian with significant symptom magnification. Consequently, the Board denied injury claims for heart and high blood pressure, and upheld a 27% permanent disability award for a psyche injury, based on the judge's credibility findings.

ADJ1128865ADJ1909887plastic parts fabricatorplastic parts fabricator supervisorcontinuous traumapsyche injurypermanent disabilitynon-industrial apportionmentcredible historiansymptom magnification
References
Case No. ADJ7351006 ADJ8177613
Regular
Jan 11, 2016

YVETTE MCLAMB vs. UNITED PARCEL SERVICE, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Yvette McLamb's petition for reconsideration, affirming the finding that she did not sustain industrial injuries during her brief employment with United Parcel Service. Applicant argued that the medical evaluator's opinion on causation was equivocal and should be reconsidered in light of her trial testimony regarding pain symptoms during employment. The majority found the WCJ's report sufficient, while one commissioner dissented, believing the record should be further developed to allow the medical evaluator to clarify causation after reviewing the applicant's testimony.

Petition for ReconsiderationDeniedCumulative Trauma InjuryIndustrial InjuriesDelivery Driver HelperEquivocal OpinionCausationMedical Record ReopeningQualified Medical EvaluatorChronological Relationship
References
Case No. ADJ2434971 (OAK 0238163)
Regular
Dec 02, 2010

ANA RODRIGUEZ vs. SHERATON PALACE HOTEL, TOKIO MARINE

The Workers' Compensation Appeals Board denied reconsideration of a finding that the applicant, Ana Rodriguez, did not sustain new and further permanent disability subsequent to a 1997 stipulated award. The judge found her testimony regarding increased orthopedic and psychiatric symptoms to be not credible. Medical evidence from Dr. Edington indicated no orthopedic increase in disability since the award, and the psychiatric disability became permanent and stationary concurrently with the orthopedic condition. Therefore, the judge concluded there was no "new and further" disability as defined by Labor Code Section 5410.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedCredibility FindingGarza v. Workers' Comp. Appeals Bd.Stipulated AwardPetition to ReopenNew and Further DisabilityOrthopedic DisabilityPsychiatric Disability
References
Case No. ADJ237483
Regular
Nov 13, 2012

RAYEK J. FAHOUM vs. KAISER FOUNDATION HOSPITAL

The Workers' Compensation Appeals Board denied Rayek J. Fahoum's petition for reconsideration, upholding the findings of the Workers' Compensation Judge. The Judge's report found Fahoum sustained industrial injury to his neck and low back with secondary chronic pain syndrome, awarding 41% permanent disability. This decision relied on the opinions of the Agreed Medical Examiner and Dr. Renee Rinaldi, who concluded Fahoum experienced symptom magnification and that his condition was chronic pain syndrome, not fibromyalgia as claimed by Dr. Allen Salick. The Board extended great weight to the Judge's credibility findings regarding the medical opinions.

Workers' Compensation Appeals BoardReconsideration DeniedAgreed Medical ExaminerSubstantial Medical EvidenceFibromyalgiaChronic Pain SyndromeSymptom MagnificationOrthopedic InjuryLumbosacral StrainCervical Strain
References
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