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

Case No. SJO 238655 SJO 238656 SJO 238657
Regular
Apr 02, 2008

JAMES BEENE vs. ANDERSON CHEVROLET/AUTONATION, INC., ACE-USA, UNIVERSAL UNDERWRITERS GROUP

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award because the Agreed Medical Examiner's opinion was based on an incorrect legal theory regarding industrial causation. The Board found that the AME's opinion that the applicant's vascular condition was not industrially caused or aggravated was not substantial evidence, requiring further development of the record. Therefore, the case was returned to the trial level for the AME to provide a supplemental opinion on whether the vascular condition was industrially caused or a consequence of the admitted injury.

workers compensationindustrial injuryvascular systemagreed medical evaluatorAMEreconsiderationtemporary disability indemnityTDIlien claimsubrogation
References
Case No. ADJ12491336
Regular
May 15, 2025

ANDRES APODACA vs. BOBCAT CENTRAL, INC.; INSURANCE COMPANY OF THE WEST

The Workers' Compensation Appeals Board granted defendant's petition for reconsideration. The Board subsequently affirmed, with amendments, the original Findings, Award, and Order issued by a WCJ on February 14, 2025. Specifically, the Board struck a $10,000 penalty against the defendant, concluding their actions were not unreasonable given a treating physician's opinion. The Board also upheld the WCJ's finding that applicant was entitled to retroactive temporary disability benefits until October 10, 2023, based on a later maximum medical improvement date determined by a QME. Commissioner Razo dissented regarding the majority's conclusion on the substantial medical evidence of apportionment.

AOE/COEsubstantial medical evidencepetition for reconsiderationFindings Award and OrderNotice of Intention to Impose Sanctionstemporary disability benefitspenaltyqualified medical evaluatorpermanent disability awardLabor Code sections 5813 and 5814
References
Case No. ADJ4225526 (GOL 0092072)
Regular
Apr 20, 2017

JESUS ARROYO vs. JOHN CRAVENS PLASTERING, STATE COMPENSATION INSURANCE FUND

This case involves Jesus Arroyo's petition for reconsideration of a Workers' Compensation Appeals Board decision. The Board denied reconsideration, adopting the reasoning of the workers' compensation administrative law judge. Medical evidence from Dr. Markovitz established that Arroyo suffered a total and permanent disability resulting from industrial injuries, including an aortic aneurysm repair and subsequent strokes. The Board found Dr. Markovitz's opinions constituted substantial medical evidence, despite conflicting defense opinions, and affirmed that all necessary medical care and permanent disability were industrially caused.

Workers' Compensation Appeals BoardJesus ArroyoJohn Cravens PlasteringState Compensation Insurance FundPetition for ReconsiderationAgreed Medical ExaminerGerald Markovitzechocardiogramaortic root dilationexpanding aortic aneurysm
References
Case No. SDO 355322
Regular
Feb 06, 2008

Jocelyn Dubbs vs. Abbott Vascular, ACE USA c/o MATRIX ABSENCE MANAGEMENT, INC.

The Workers' Compensation Appeals Board denied reconsideration of a Finding and Award that determined applicant sustained an industrial injury to her right upper extremity. The Board clarified that the temporary disability rate in the award should be corrected to $626.35 per week to align with the Findings of Fact, despite the defendant's arguments regarding concurrent employment and average weekly earnings. The defendant's petition for reconsideration was denied as the Board adopted the Workers' Compensation Judge's report and recommendation.

Workers' Compensation Appeals BoardJocelyn DubbsAbbott VascularACE USASDO 355322Reconsideration DeniedClerical Error CorrectionIndustrial InjuryRight Upper ExtremityAverage Weekly Earnings
References
Case No. ADJ1443846 (AHM 0145673)
Regular
May 26, 2009

Barry Rawlins vs. Acker-Stone Industries, STATE COMPENSATION INSURANCE FUND, BERKSHIRE HATHAWAY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding that Barry Rawlins sustained an industrial cumulative trauma injury to his cerebral vascular system and brain. The Board found that the defendant, State Compensation Insurance Fund, failed to diligently pursue its discovery rights and timely utilize the medical dispute resolution process. Dr. Araneta's opinion, establishing a causal link between Rawlins' employment stress and his stroke, was deemed substantial medical evidence supporting the injury finding. Therefore, the Board affirmed the WCJ's decision and denied the defendant's petition.

Cumulative traumaCerebral vascular system injuryIndustrial injurySale representativePetition for reconsiderationDue processDeposition transcriptMedical recordsSubstantial medical evidenceLabor Code section 4062.2
References
Case No. ADJ1634978 / LAO 794002
Regular
Nov 04, 2009

RANDY SPENCER vs. RALPHS GROCERY COMPANY, Permissibly Self-Insured

Reconsideration denied. WCJ's decision supported by substantial evidence. Apportionment not warranted; applicant's testimony credible.

Brodie v. Workers' Compensation Appeals BoardLabor Code section 4663Labor Code section 5903apportionmentavascular necrosisindustrial injurypermanent disabilitysubstantial evidencemedical opinionaverage weekly wage
References
Case No. LBO 0370243
Regular
May 19, 2008

JOEL GRIMALDO vs. ABBEY EVENT SERVICES / STELLAR EVENT \& PRESENTATION, AMERICAN HOME INSURANCE, AIG CLAIMS SERVICES

The Workers' Compensation Appeals Board granted reconsideration and reversed a previous finding, ruling that the applicant's diabetes was not industrially caused. While the applicant sustained an admitted industrial injury to his left foot, the Board found substantial medical evidence indicating his diabetes was a pre-existing condition that complicated the foot injury rather than being caused by it. Consequently, the decision was amended to exclude diabetes as an industrial injury.

Workers' Compensation Appeals Boardindustrial injurydiabetesfoot injuryosteomyelitisamputationcausationmedical evidencereconsiderationapportionment
References
Case No. SFO 474449
Regular
May 14, 2008

TEREASA HU vs. SALVATION ARMY, GALLAGIER BASSETT SERVICES, INC.

This case involves an applicant who suffered a stroke and psychiatric injury, allegedly due to her employment as a Salvation Army corps officer. The Appeals Board granted reconsideration to address contentions including insufficient evidence of industrial injury, bad faith, and constitutional violations. While upholding the finding of industrial injury, the Board amended the WCJ's decision to defer issues of temporary and permanent disability, apportionment, and attorney's fees, remanding the case for further proceedings.

Workers Compensation Appeals BoardSFO 474449industrial injurypsychevascular systemstroketemporary disabilitypermanent and stationarypermanent disabilityapportionment
References
Case No. ADJ4462136 (MON 0357470)
Regular
Dec 14, 2015

MARTIN REYES vs. CVS CAREMARK CORPORATION/CVS PHARMACY, AMERICAN HOME ASSURANCE

This Workers' Compensation Appeals Board decision reversed a prior finding of 98% permanent partial disability for Martin Reyes, awarding him 100% permanent total disability after a stroke. The Board found error in the exclusion of applicant's treating physician reports and determined that psychiatric disability, even with a 5% non-industrial apportionment, combined with other impairments, resulted in total disability. The decision also addressed the admissibility of medical reports and the mootness of vocational rehabilitation arguments given the ultimate finding of permanent total disability.

Permanent Total DisabilityPsychiatric InjuryApportionmentSubstantial EvidenceMedical OpinionQualified Medical ExaminerVocational RehabilitationSelf-Procured TreatmentStrokeVascular Dementia
References
Case No. ADJ9157780
Regular
Jun 13, 2019

GEORGE GALLARDO vs. AT&T MOBILITY SERVICES, LLC., OLD REPUBLIC INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) partially affirmed a prior award, finding that the applicant sustained industrial injuries to his neck, back, psyche, hips, and knees. However, the WCAB deferred the issues of injury in the form of diabetes, the applicant's overall permanent disability, and his average weekly wage. This deferral stems from insufficient substantial evidence regarding the industrial causation of diabetes and the applicant's full earnings from all concurrent employments. The case is returned to the Workers' Compensation Judge for further proceedings to develop the record on these deferred issues.

AOE/COEPetition for ReconsiderationFindings Award and Ordertemporary disability indemnityaverage weekly wageorthopedic examinationdiabetic neuropathyvascular diseaseadjustment disordercontinuous trauma
References
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