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

Case No. ADJ1528752 (FRE 0238108) ADJ2715270 (FRE 0238107) ADJ4356655 (FRE 0238106)
Regular
Mar 10, 2014

JUANITA GUZMAN vs. BEST BUY, GALLAHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board found that the applicant's orthopedic injuries were established, resulting in a $29\%$ permanent disability rating. However, the applicant failed to provide substantial medical evidence that her industrial injuries caused or contributed to her alleged cardiovascular system issues, sleep apnea, GERD, or hypertension. Specifically, the opinion of the applicant's expert, Dr. Cayton, was deemed not substantial evidence due to reliance on an inaccurate and unverified history of the applicant's weight.

Workers' Compensation Appeals BoardJoint Findings of Fact and AwardPetition for ReconsiderationAdministrative Law JudgeBest BuyGallaher Bassett ServicesInc.Permanent DisabilityIndustrial InjuriesOrthopedics
References
Case No. ADJ2007189 (LAO 0857899)
Regular
Nov 01, 2019

Monica Bernasani vs. International Filing Company, U.S. Fire Insurance Company, Crum & Forster

This case involves Monica Bernasani's workers' compensation claim against International Filing Company for cumulative trauma injury. The Administrative Law Judge (ALJ) found Bernasani permanently totally disabled due to industrial injuries to her back, neck, shoulders, wrists, knees, psyche, headaches, weight gain, hypertension, and gastrointestinal system, awarding lifetime benefits. The defendant appealed, arguing the Agreed Medical Examiner's (AME) opinion was insufficient to support total disability and that a vocational report by Enrique Vega was improperly admitted. The Appeals Board denied the defendant's petition, affirming the ALJ's decision and finding the vocational report admissible due to the defendant's waiver of objection. The Board found substantial medical and vocational evidence supported the finding of permanent total disability.

Workers' Compensation Appeals BoardMonica BernasaniInternational Filing CompanyU.S. Fire Insurance CompanyPetition for ReconsiderationFindings Award and OrderAdministrative Law JudgeWCJIndustrial Cumulative Trauma InjuryPermanently Totally Disabled
References
Case No. ADJ7258268
Regular
Dec 20, 2013

PATRICIA SMITH vs. WELLPOINT HEALTH NETWORKS, INC.; and ZURICH NORTH AMERICA INSURANCE CO.

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the original award. The Board found substantial evidence supported the necessity of a Jenny Craig weight loss program, including special diet food products, as reasonably necessary treatment. This was based on the applicant's need to lose weight for industrial back surgery and the program's proven success, evidenced by the applicant's 54-pound weight loss. The Board adopted the administrative law judge's report and recommendation in its entirety.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationDENIEDJenny Craigweight loss programspecial diet food productsreasonably necessary treatmentindustrial back surgerysubstantial evidencemedical treatment
References
Case No. ADJ6436254
Regular
Feb 16, 2018

RAMON GOMEZ vs. ALLIED WASTE INDUSTRIES, AMERICAN HOME ASSURANCE

In this workers' compensation case, the Appeals Board rescinded a previous Findings and Award that found the applicant sustained industrial injuries resulting in 70% permanent disability. Both the applicant and defendant had sought reconsideration of that award. The rescission was ordered because the parties now wish to enter into a Compromise and Release agreement. The matter is returned to the WCJ for further proceedings.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardAdministrative Law JudgeLumbar Spine InjuryKnee InjuryPsyche InjuryWeight GainSleep DisturbanceSexual Dysfunction
References
Case No. ADJ7926763
Regular
Aug 07, 2015

Victor Dumo vs. Abbott Laboratories, Fidelity & Guaranty Insurance Company, Matrix Absence Management, Inc.

The Workers' Compensation Appeals Board granted the applicant's Petition for Reconsideration. The original decision finding no cumulative trauma injury to most of the applicant's body parts was affirmed. However, the issue of injury to orthopedic claims, including back, shoulders, and extremities, was deferred for further proceedings and potential record development. The case is returned to the WCJ for further action on these orthopedic claims.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderCumulative TraumaOrthopedic ClaimsRespiratory SystemNervous SystemPsycheSexual DysfunctionWeight Gain
References
Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ8382115
Regular
Aug 13, 2013

OBDULIA HERNANDEZ vs. ARAMARK, ACE/USA

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior finding that the defendant neglected medical treatment. The Board found that while there was conflicting evidence regarding initial MPN notice, the defendant provided notice to the applicant's attorneys post-injury. Crucially, the applicant did receive treatment within the MPN for three months, demonstrating no denial of care. Therefore, the defendant did not neglect, refuse, or deny reasonable medical treatment as required.

MPNcompensable consequence injuriespsychiatric injurysleep deprivationaltered gaitinternal injuriesweight gaingastrointestinal injuriessexual dysfunctioncognitive impairment
References
Case No. ADJ2001631 (LAO 0876091)
Regular
Oct 01, 2010

SALVADOR AGUAYO, JR. vs. AMERICAN GOLF CORPORATION, ARCH INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to address an attorney's fee award of $4,500.00. This fee was awarded for services related to alleged prohibited ex parte communications with Qualified Medical Evaluators (QMEs), as per Labor Code section 4062.3. The Board rescinded the award, finding no explicit determination of prohibited communication occurred as the prior WCJ's orders were voided. The matter was returned to the trial level to first determine if prohibited ex parte communication occurred, and if so, to award fees based on incurred costs and attorney fees for related discovery.

Salvador Aguayo Jr.American Golf CorporationArch Insurance CompanyWorkers' Compensation Appeals BoardreconsiderationFindings and Awardattorney's feeprohibited communicationsQualified Medical EvaluatorsQME
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ8223604
Regular
Nov 14, 2013

DEEANNA FOBBS vs. UC DAVIS MEDICAL CENTER

The Workers' Compensation Appeals Board denied Dee Anna Fobbs' petition for reconsideration. The Board adopted the Workers' Compensation Administrative Law Judge's report and recommendations, finding that the applicant did not sustain an injury to her right knee arising out of and in the course of employment. The Board gave great weight to the WCJ's credibility findings and concluded that the overwhelming weight of the evidence supported the WCJ's decision. Applicant's claims of impeachment errors, improper denial of testimony, and adverse inference for destroyed evidence were rejected.

DEEANNA FOBBSUC DAVIS MEDICAL CENTERSEDGWICK CMSPETITION FOR RECONSIDERATIONDENIEDWCJ REPORTGARZA V. WORKMEN'S COMP. APPEALS BD.WITNESS STATEMENTSIMPEACHMENTADMISSIBILITY
References
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