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

Case No. GRO 0020213
Regular
May 28, 2008

Sandra K. Carnahan vs. Albertsons Stores, Inc., Specialty Risk Services

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration as it was not a final order, but granted removal. The Board found substantial evidence, including the primary treating physician's report and a utilization review certification, supported the applicant's need for a urological consultation due to urinary problems secondary to her industrial back injury. Therefore, the Board rescinded the WCJ's decision and ordered the defendant to provide the applicant with a urological consultation.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalWCJFindings of FactUrological consultationLumbar injuryNeural innervationUrinary tract infectionsUtilization review
References
10
Case No. MISSING
Regular Panel Decision
Aug 18, 1971

Claim of Bernsley v. Telemarine Communications Co.

Appeal from a decision of the Workmen’s Compensation Board which allowed a claim for death benefits. The decedent, a principal in the appellant corporation, died from cardiac failure during an emotional discussion about a vault tax assessed against a related corporation and paid by the appellant. The board found that the tax problems arose from decedent's employment with the appellant and that the emotional strain caused his death. The court affirmed the board’s finding that the problems over the vault tax arose out of and during the course of decedent’s employment and that the emotional strain and anxiety from dealing with the tax problems caused decedent’s death.

Death benefitsCardiac failureEmotional strainEmployment-related deathVault taxWorkmen's Compensation Board appealCausationSubstantial evidenceEmployer liability
References
2
Case No. ADJ4317262 (ANA 0327568)
Regular
Apr 13, 2009

JOSE GONZALEZ vs. BURR ROOFING, INC., SCIF INSURED SANTA ANA

The applicant sought reconsideration of a workers' compensation award, primarily arguing the permanent disability rating undervalued his urological condition and the WCJ erred in not crediting vocational rehabilitation expert opinion. The Appeals Board granted reconsideration solely to award additional attorney fees for temporary disability benefits. While the majority affirmed the WCJ's original findings on permanent disability, a dissenting commissioner argued the urological condition was significantly underestimated and requested a new rating.

Workers Compensation Appeals BoardJose GonzalezBurr RoofingSCIF Insured Santa Anapermanent disabilityapportionmentrooferupper back injurymid back injurylow back injury
References
0
Case No. ADJ11451772
Regular
Apr 03, 2023

EDUARDO CASELIN HUERTA vs. MONTIE WAYNE SHEET METAL, CALIFORNIA INSURANCE COMPANY, APPLIED RISK SERVICES, INC.

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration and deferred the issue of permanent disability. The Board affirmed the finding of temporary disability through August 9, 2020, based on medical opinions stating the applicant remained unable to work due to his urological condition. However, the Board requires the Administrative Law Judge to clarify how permanent disability ratings were calculated (addition versus combination) and to further analyze the applicability of Labor Code section 4660.1(c) to the applicant's sexual dysfunction and urological impairments. The Board took no position on the ultimate resolution of these permanent disability issues.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary DisabilityPermanent DisabilityLumbar SpineSexual DysfunctionUrological ImpairmentCombined Values ChartLabor Code Section 4660.1(c)Qualified Medical Evaluator
References
3
Case No. MISSING
Regular Panel Decision

Adamski v. Barnhart

Plaintiff Richard M. Adamski sued the Commissioner of Social Security under 42 U.S.C. §§ 405(g) and 1383(c) to review the denial of Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits. Adamski, born in 1952 with a history of back problems and surgeries, alleged disability since 1998 due to recurrent back problems. An Administrative Law Judge (ALJ) found him not disabled, a decision affirmed by the Appeals Council. The court reviewed the ALJ's five-step disability evaluation, concluding that the ALJ correctly applied legal standards and that her decision is supported by substantial evidence regarding Adamski's residual functional capacity for light work, his treating physician's opinions, and his pain complaints. Consequently, the Commissioner's motion for judgment on the pleadings was granted, and Adamski's motion was denied, leading to the dismissal of the action with prejudice.

Disability BenefitsSocial Security ActALJ Decision ReviewResidual Functional CapacityTreating Physician RuleVocational Expert TestimonyCredibility AssessmentBack DisorderKnee DisorderLight Work
References
38
Case No. MISSING
Regular Panel Decision

Romanelli v. Long Island Railroad

Frank Romanelli sued his employer, the Long Island Railroad Company (LIRR), under the Federal Employers Liability Act (FELA), alleging that his work as a track worker exposed him to hazardous environmental contaminants, causing pulmonary and cardiac problems. LIRR filed three motions in limine to preclude Romanelli's medical experts from testifying on causation, Romanelli from testifying about exposure to toxins at unsafe levels, and Romanelli from testifying that LIRR had a duty to provide a respirator. The court granted the motions in part and denied in part. It allowed treating physicians to testify on the causation of respiratory issues by workplace exposures due to common knowledge, but not on the link between pulmonary and cardiac problems without demonstrated methodology. Romanelli was permitted to testify about his first-hand exposure to dust, fumes, and chemicals but not to label them as 'hazardous contaminants' or at 'unsafe' levels. Lastly, Romanelli could not testify about LIRR's legal duty to provide a respirator, but could testify about not being provided one despite requests and that its absence caused him to ingest more harmful substances.

FELAMotions in LimineExpert Witness TestimonyLay Witness TestimonyCausationEvidentiary StandardsWorkplace ExposurePulmonary ConditionsCardiac ConditionsRespirator Requirements
References
18
Case No. ANA 0385835 ANA 0385836
Regular
Nov 09, 2007

HERMILO RINCON vs. PETERSON HARDWARE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of an order that refused to authorize a urological consultation. The denial was based on the judge's report, which found no immediate medical need for the consultation and noted the applicant's stated complaints were back pain, with the urethral stricture possibly being non-industrial. Additionally, the petition for reconsideration contained improperly filed documents.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ ReportFuture Medical CareExpedited HearingPrimary Treating PhysicianUtilization ReviewUrological ConsultationUrethral StrictureNon-Industrial
References
0
Case No. ADJ3880125
Regular
Nov 01, 2014

SOKPHEAP PEN vs. THE ENSIGN GROUP, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to amend a prior finding. The Board found that the applicant sustained industrial injury to her spine only, deferring the issue of injury to the psyche, uterus, and urological system. This was because the applicant's claims for these latter body parts were not properly raised as trial issues, thus denying the defendant due process. The Board otherwise affirmed the original decision.

Petition for ReconsiderationFindings and OrderCertified Nursing AssistantSpine InjuryPsyche InjuryUterus InjuryUrological System InjuryQualified Medical EvaluatorDr. CremataDr. Brandeis
References
4
Case No. ADJ8166088
Regular
Apr 10, 2015

GUILLERMO GARCIA vs. QUETICO LOGISTICS, LLC, TOKIO MARINE MANAGEMENT, INC.

Applicant sought removal from an order continuing his workers' compensation case to trial, arguing his condition was not permanent and stationary and required further medical development on urological, sexual, and sleep issues. The Appeals Board denied the petition for removal. They adopted the WCJ's reasoning but noted discrepancies regarding applicant's ongoing treatment. Therefore, the applicant's request to rescind the order and continue the case was denied.

Petition for Removalrescinding Ordercontinued to trialpermanent and stationarymedical record developmenturological complaintssexual dysfunctionsleep disordermedical treatment reportsMandatory Settlement Conference
References
0
Case No. ADJ1644999 (LAO0880435)
Regular
Dec 11, 2012

, MANUEL FERNIZA, vs. , RENT A CENTER, INC.; FIREMAN'S FUND INSURANCE COMPANY/ASSOCIATED INDEMNITY,

The Workers' Compensation Appeals Board (WCAB) vacated its prior order granting reconsideration and dismissed the applicant's petition. The WCAB determined that the applicant's petition sought reconsideration of an interim procedural order, not a final decision, which is not appealable. Even if the merits were considered, the WCAB would have affirmed the judge's decision, finding the QME report timely and deferring a decision on treatment authorization until a PQME urological report was issued.

Workers' Compensation Appeals BoardReconsiderationFinal OrderInterim OrdersPanel Qualified Medical ExaminerMedical Provider NetworkUrological ConditionIndustrial InjuryAdministrative DirectorWCJ Report
References
1
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