Jose Reyes vs. Hart Plastering; Fremont Compensation Insurance Company, In Liquidation; California Insurance Guarantee Association; And Cambridge Integrated Services, Inc. (Servicing Facility)

.opn.doc In this case, Jose Reyes, an employee of Hart Plastering, fell from a scaffold while on the job and sustained severe injuries. The employer rejected liability for the injury, and the Workers' Compensation Appeals Board determined that the injury was caused by a pre-existing seizure disorder. However, the Board held that the injury was still compensable under the principles set forth in Employers Mutual Liability Ins. Co. of Wisconsin v. Industrial Acc. Com. (Gideon), which states that an idiopathic seizure is not compensable, but the injuries sustained from hitting the ground at work are compensable. The Board rescinded the decision of the WCJ and substituted a finding that the injury

Hart Plastering; Fremont Compensation Insurance Company, in liquidation; California Insurance Guarantee Association; and Cambridge Integrated Services, Inc. (Servicing Facility) Jose Reyes WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAJOSE REYES, Applicant,vs.HART PLASTERING; FREMONT COMPENSATION INSURANCE COMPANY, in liquidation; CALIFORNIA INSURANCE GUARANTEE ASSOCIATION; and CAMBRIDGE INTEGRATED SERVICES, INC. (Servicing Facility), Defendant(s).Case No. POM 261149OPINION AND DECISION AFTER RECONSIDERATION            On December 3, 2004, we granted applicant’s Petition for Reconsideration of the Findings and Order issued by a workers’ compensation administrative law judge (WCJ) on September 16, 2004. In that decision, the WCJ found that applicant did not sustain an industrial injury to various parts of his body when, while employed as a plasterer on May 22, 2000, he fell from a scaffold following a non-industrial seizure. In his Opinion on Decision, the WCJ stated that, based on the opinions of Robert Kounang, M.D., and Ronald Kent, M.D., applicant’s fall was “caused by pre-existing seizure activity.”            Applicant contends, in substance, that the finding of no industrial injury was erroneous and unjustified, asserting under the principles set forth in Employers Mutual Liability Ins. Co. of Wisconsin v. Industrial Acc. Com. (Gideon) (1953) 41 Cal.2d 676 [18 Cal.Comp.Cases 286] that, although an idiopathic seizure is not compensable, the injuries sustained from hitting the ground at work are compensable. Defendant filed an answer to the petition for reconsideration.            In his Report and Recommendation on Petition for Reconsideration, the WCJ opined that , Labor Code section 4663,1, as amended by Senate Bill (SB) 899 (Stats. 2004, ch. 34, §34), “requires a physician to address the issue of apportionment of causation”; that applicant’s injury was precipitated by his preexisting seizure disorder; and, therefore, that the petition should

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