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

Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ8433732
Regular
Jan 25, 2013

GU YEON LEE vs. PULMUONE FOODS USA, INC., SEABRIGHT INSURANCE

The applicant, Gu Yeon Lee, suffered a work injury and was found to have temporary total disability. Despite voluntarily resigning, the Board affirmed the applicant's entitlement to temporary disability benefits, as there was no credible evidence of an actual offer of modified work prior to his resignation. However, reconsideration was granted to correct the weekly indemnity rate based on the applicant's verified payroll records. The applicant's weekly temporary disability indemnity was adjusted to $244.81.

Temporary disabilityvoluntary resignationmodified workcredible testimonyvoluntary disablementearning capacitypayroll recordsmedical treatmentemployer coercionreturn to work
References
Case No. ADJ7298811
Regular
Dec 21, 2012

JONATHAN WYCINSKY vs. CITY OF CITRUS HEIGHTS, Permissibly Self-Insured, Adjusted by YORK RISK SERVICES GROUP, INC.

Here's a concise summary for a lawyer: Applicant, a police officer, sustained an industrial shoulder injury and was initially paid full salary under Labor Code § 4850. He later voluntarily resigned for financial reasons unrelated to his injury to accept a position with another city. The Board found that a voluntary, non-medical resignation terminates the employment relationship required for a § 4850 leave of absence. Therefore, the defendant is not liable for continued full salary payments post-resignation, despite the applicant remaining employed as a police officer elsewhere.

Labor Code section 4850police officervoluntary resignationnonmedical reasonsleave of absencefull salarytemporary disabilityindustrial injurytermination of employmentCity of Citrus Heights
References
Case No. ADJ11399627
Regular
Nov 25, 2019

ISAI CHILEL vs. KISHO, INC. dba SUSHI CALIFORNIA, EMPLOYERS ASSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant sought to overturn a finding that the applicant sustained a work-related injury and that it was not barred by the post-termination defense. The Board found that the defendant failed to meet its burden of proof to establish termination or layoff under Labor Code section 3600(a)(10). Evidence regarding the applicant's departure from employment was ambiguous, not clearly establishing a termination rather than a voluntary resignation.

Workers' Compensation Appeals BoardLabor Code Section 3600(a)(10)post-termination defensepetition for reconsiderationfindings and orderapplicantdefendantinjuryleft handsubstantial medical evidence
References
Case No. BAK 144423
Regular
Nov 13, 2007

Martha Gallegos vs. WELLPOINT HEALTH NETWORKS, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, reversing the prior award of temporary disability indemnity for Martha Gallegos after June 4, 2004. The Board found that Gallegos' resignation was due to her extended commute, not her industrial injury, thus disqualifying her from further temporary disability benefits. However, the Board affirmed the finding of 17% permanent disability, finding the treating physician's reports substantial evidence despite the defendant's arguments.

Workers Compensation Appeals BoardIndustrial InjuryCarpal TunnelUpper ExtremitiesTemporary Disability IndemnityPermanent DisabilityEmployment Development DepartmentReconsiderationMedical CareQualified Medical Examiner
References
Case No. ADJ5806281
Regular
Jul 03, 2012

DEBBIE SCHLATER vs. NORTH COAST DRIVERS, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's petition to reopen for new and further disability after an initial award became final. The Workers' Compensation Appeals Board (WCAB) granted removal to review an administrative law judge's denial of a voluntary arbitration request. The WCAB clarified that while arbitration is generally prohibited after testimony is taken, it is permissible for issues not decided in a final award. Therefore, the WCAB rescinded the denial, allowing the parties to arbitrate the new and further disability claim.

Petition for RemovalVoluntary ArbitrationWCAB Rule 10997Labor Code section 5275(b)Court Administrator Rule 10296(a)Findings and AwardNew and Further DisabilityReopen CaseDisability Evaluator TestimonyFinal Award
References
Case No. ADJ2653693
Regular
Jul 12, 2012

TIMETHY PORTEOUS vs. REAL ROCK INDUSTRIES, LUMBERMENS MUTUAL INSURANCE COMPANY

This case involves a dispute over voluntary arbitration after a prior Workers' Compensation Appeals Board (WCAB) award. The WCJ initially denied arbitration based on WCAB Rule 10997, which generally prohibits arbitration after testimony has been taken. However, the Appeals Board granted removal, reversing the WCJ's decision. They clarified that Rule 10997 only bars arbitration for issues previously decided in a final award after testimony, allowing parties to voluntarily arbitrate any *remaining, undecided* issues. Therefore, the parties were permitted to proceed with arbitration for outstanding matters.

Petition for RemovalVoluntary ArbitrationWCAB Rule 10997Labor Code section 5275(b)Court Administrator Rule 10296(a)Order Denying Request for Submittal to Voluntary ArbitrationFindings and Awardcumulative traumaindustrial injurytemporary disability indemnity
References
Case No. ADJ7009927
Regular
Aug 10, 2010

BATOOL NULWALA vs. COTTAGE HOSPITAL, KEENAN & ASSOCIATES

The defendant hospital sought reconsideration of an award granting temporary disability benefits. The Appeals Board granted reconsideration and reversed the original finding, determining the applicant was not entitled to benefits from August 12, 2009, onwards. This was because the applicant resigned to move out of state for her husband's job, and the employer had offered, and would have continued to offer, modified work had she not resigned. Consequently, the award of temporary disability benefits and an attorney's fee based on those benefits was rescinded.

Workers' Compensation Appeals BoardIndustrial InjuryNeck InjuryShoulder InjuryX-ray TechnicianTemporary Disability BenefitsModified WorkSelf-Procured Medical TreatmentFindings and AwardReconsideration
References
Case No. ADJ11433638
Regular
May 30, 2019

SHACAREY ROOTERS vs. ST. AGNES MEDICAL CENTER/CHE TRINITY INC.

This case involves a workers' compensation applicant who claimed injury to her knees and low back. The defendant sought reconsideration of an award of temporary total disability benefits, arguing the applicant was released to work without restrictions and resigned. The Appeals Board denied reconsideration, finding the applicant's treating physician's report lacked substantial evidence, while QME and subsequent PTP opinions supported temporary total disability. The Board further held that the applicant's resignation due to ongoing symptoms and safety concerns did not preclude temporary disability benefits.

Petition for ReconsiderationTemporary Total DisabilityPrimary Treating PhysicianQualified Medical ExaminerSubstantial EvidenceReturn to WorkResignationLabor MarketMedical ImprovementWork Restrictions
References
Case No. ADJ10298988
Regular
Jan 31, 2018

BRIAN BERRY vs. HOSPICE OF THE FOOTHILLS, ALPHA FUND

The Appeals Board rescinded the prior decision and returned the case to the trial level for further proceedings. The Board found that the record was insufficient to determine if the applicant voluntarily retired or was constructively terminated from his employment. Further development of evidence is needed to establish whether the applicant intended to permanently leave the labor force or if his industrial injury prevented him from continuing to work. This determination is crucial for assessing his entitlement to additional temporary disability benefits and potentially permanent disability benefits.

Workers' Compensation Appeals Boardindustrial injuryright shouldertemporary disability indemnityvoluntarily retiredlabor forcedue processself-representedadmission of evidenceexclusion of evidence
References
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