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

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
2
Case No. ADJ1401919
Regular
Oct 19, 2011

LUIS TORRES vs. LEW WEBB'S TOYOTA OF BUENA PARK, SEDGWICK CLAIMS MANAGEMENT, CALIFORNIA COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board affirmed the finding of a mechanic's industrial injury to his right shoulder, wrist, teeth, and gastrointestinal system, resulting in 100% permanent disability. The Board adopted the WCJ's reliance on Dr. Markovitz's opinion that the gastrointestinal condition, leading to total disability, was entirely industrial. However, the issue of psychiatric injury was deferred for further consideration as the WCJ had not addressed statutory requirements. The decision also corrected a clerical error regarding the temporary disability end date.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardTemporary DisabilityPermanent DisabilityApportionmentCausationGastro paresisPsychiatric InjuryMedical Evidence
References
4
Case No. ADJ6675568
Regular
May 01, 2015

GERALD KEYES vs. B&L MECHANICAL, LINCOLN GENERAL INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, affirming the finding of industrial injury to the applicant's teeth. This injury was found to be a consequence of medications prescribed for a prior industrial back injury, which caused dry mouth and accelerated tooth decay. While the apportionment of industrial versus non-industrial causation was debated, the Board found substantial medical evidence supporting that the industrial medications contributed to the dental condition. The decision focused on causation of injury, not permanent disability apportionment.

Workers' Compensation Appeals BoardGerald KeyesB&L MechanicalLincoln General Insurance CompanyADJ6675568dental injuryhyposalivationPQMEDr. Gregory StephensDr. Dennis Shamlian
References
1
Case No. ADJ7688671
Regular
Jun 14, 2016

ZACHARY BAZILIUS vs. CITY OF TORRANCE

The Workers' Compensation Appeals Board granted reconsideration to amend a prior award. The amendment corrected a clerical error finding injury to the applicant's left elbow and adjusted the reimbursement rate for lien claimant CLEA. The Board affirmed the remaining findings of injury to the applicant's back, neck, circulatory system, heart, gastrointestinal system, sleep disorder, urological system, and teeth, along with the awarded permanent disability. The Board also confirmed the applicant's entitlement to future medical treatment for the established injuries.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAdministrative Law JudgePolice OfficerSpecific InjuryPermanent DisabilityTemporary DisabilityQualified Medical EvaluationHypertensive Heart Disease
References
0
Case No. ADJ289201 (SAL 0090881)
Regular
Oct 06, 2017

TIMOTHY C. HOPCROFT vs. RAY'S AUTO PARTS, CIGA for CALIFORNIA COMPENSATION INSURANCE in liquidation, administered by TRISTAR

This case involves a defendant seeking reconsideration of an award for an applicant's lumbar spine, internal systems, psyche, and teeth injury. The defendant argued the administrative law judge erred by not granting a credit for overpaid temporary disability benefits against permanent disability. The Appeals Board granted reconsideration, finding discretion to allow such a credit under Labor Code section 4909. While upholding the original award, the Board amended it to allow a partial credit of $230 per week against permanent disability for temporary disability payments made after a specific date.

Workers' Compensation Appeals BoardIndustrial injuryLumbar spineInternal systemsPsycheTeethPermanent disabilityTemporary disabilityCredit for overpaymentPetition to terminate liability
References
4
Case No. ADJ9402316
Regular
Aug 02, 2019

OSCAR SANDOVAL vs. THE STRIP JOINT, INC., STATE COMPENSATION INSURANCE FUND

This case involves applicant Oscar Sandoval seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that denied his claim for injury to his head, jaw/teeth, psyche, and sleep disorder. The WCAB denied reconsideration, affirming the WCJ's finding that the medical reports submitted by applicant's physicians lacked substantial evidence. Specifically, the WCAB found that Dr. Schames' report was based on an inadequate medical history, Dr. Reichwald's report was internally inconsistent and lacked review of sufficient medical records, and Dr. Saeid's report did not sufficiently explain his diagnosis of insomnia.

AOE/COEPetition for ReconsiderationFindings and AwardWCJmedical-legal reportssubstantial evidenceorthopedicpsychologicalinternal medicinecervical spine
References
9
Case No. ADJ3882013
Regular
Mar 22, 2023

TERESA LARA vs. DAUGHTERS OF MARY AND JOSEPH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Dental Trauma Center's petition for reconsideration, upholding the finding that the lien claimant failed to prove applicant sustained industrial injury to the psyche, headaches, or TMJ/mouth/jaw/teeth. The Board adopted the WCJ's reasoning that Dental Trauma Center did not meet its burden of proof as it failed to present substantial medical evidence supporting these claims. Consequently, the burden never shifted to the defendant to provide rebuttal evidence. The Board also addressed and rejected the petitioner's arguments regarding proper referral, lack of incorporation, and the binding nature of the Compromise and Release.

Petition for ReconsiderationWorkers' Compensation Appeals BoardLien ClaimantStatute of LimitationsBurden of ProofSubstantial Medical EvidencePrima Facie CaseRebuttal EvidenceProper ReferralCompromise and Release
References
5
Case No. MISSING
Regular Panel Decision
Sep 17, 1981

Claim of Grimaldi v. Shop Rite Big V

The case involves an appeal by an employer and its insurance carrier against a Workers' Compensation Board decision. The Board had ruled that an 18-year-old stock clerk, who fell and sustained a concussion, a cut chin, and two broken teeth after punching out and speaking with his supervisor, suffered an accidental injury in the course of his employment. The employer contended the fall was idiopathic and not causally related to employment. The court affirmed the Board's decision, citing the presumption under Workers’ Compensation Law § 21 that an injury occurring in the course of employment also arises out of employment, especially when an unexplained fall happens in the presence of witnesses. The court found no substantial evidence to rebut this presumption.

Workers' CompensationAccidental InjuryCourse of EmploymentArising Out of EmploymentStatutory PresumptionIdiopathic FallSyncope EpisodeEmployer LiabilityInsurance Carrier AppealMedical Causation
References
6
Case No. MISSING
Regular Panel Decision
Jul 11, 1985

People v. Bass

The defendant appealed a judgment from the County Court, Nassau County, convicting him of multiple counts of murder, rape, and sodomy. The appeal challenged the People's proof of identity beyond a reasonable doubt and the denial of a motion to suppress physical evidence. The court affirmed the judgment, finding the evidence legally sufficient, the verdict not against the weight of the evidence, and no merit to contentions regarding probable cause for arrest or the 'no inference' charge. Key evidence included a blood-stained poncho matching the victim's blood, bite marks consistent with the defendant's teeth, and a fetal monitor strap (similar to one used at his daughter's birth) found at the crime scene.

Murder Second DegreeRape First DegreeSodomy First DegreeJury VerdictPhysical Evidence SuppressionSufficiency of EvidenceWeight of EvidenceProbable Cause for ArrestNo Inference ChargeHarmless Error
References
4
Case No. MISSING
Regular Panel Decision

MacCormack v. Hudson City School District Board of Education

Plaintiff, MacCormack's mother, brought a negligence action against the Hudson City School District and its Board of Education after her son, Bryan MacCormack, was struck by another student, James Cántele, at school, resulting in the loss of two teeth. The Supreme Court denied the defendants' motion for summary judgment. On appeal, the court reversed this decision, finding that the school authorities could not have reasonably anticipated the dangerous conduct because they lacked sufficiently specific knowledge of Cántele's violent propensities towards MacCormack. Furthermore, the court determined that Cántele's act of striking MacCormack was so sudden and spontaneous that no amount of supervision would have prevented it, thus lacking the element of proximate cause. Consequently, the defendants' motion for summary judgment was granted, and the complaint against them was dismissed.

School NegligenceStudent AssaultInadequate SupervisionSummary JudgmentForeseeabilityProximate CauseAppealSchool LiabilityPersonal InjuryEducation Law
References
8
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