California Workers’ Compensation Case Law

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FRANK TORRES vs. COUNTY OF KERN; PROBATION DEPARTMENT, Permissibly Self-insured

and ADJ4407215 (BAK 0151114) is a case in which Frank Torres, an applicant, sought reconsideration of a Findings and Award issued in ADJ4407215 on September 5, 2012, in which a workers’ compensation administrative law judge (WCJ) found applicant sustained 1% permanent disability as a result of an industrial cumulative trauma injury to his left knee over the period of his employment as a probation officer through November 26, 2004. The WCJ found applicant did not sustain injury to his right ankle and was not in need of further medical treatment to cure and relieve him from the effects of the injury to his left knee. The WCJ granted reconsideration to amend the Findings and Award to award further medical

JOSE RIVAS vs. CALIFORNIA CARPET, LLC And ICW GROUP

In this case, Jose Rivas, an employee of California Carpet, LLC and ICW Group, filed a claim for workers’ compensation after sustaining an industrial injury to his lumbar spine and back. The treating physician recommended decompression along the posterior aspect of the L5-S1 level, but the defendants denied the surgery after utilization review. The Medical Unit of the Division of Workers’ Compensation assigned a second opinion physician, who recommended no surgery. After an expedited hearing, the WCJ found that applicant is entitled to the surgery requested by his primary treating physician. The defendants filed a Petition for Removal, requesting that the Appeals Board rescind the Findings and Award, and the Appeals Board granted the petition, rescinding the Find

SHAWNTAE PATT vs. FOOD 4 LESS; SEDGWICK CMS

In this case, the Workers’ Compensation Appeals Board granted the defendant’s petition for removal and rescinded the order dated June 28, 2012, which would have deprived the defendant of the opportunity to obtain an evaluation by a qualified medical evaluator. The Board ordered the applicant to make an appointment with the remaining QME and returned the matter to the trial level for further proceedings.

DIONE HERNANDEZ vs. ENTERPRISE RENT A CAR; Permissibly Self-Insured, Administered By AVIZENT ANAHEIM

In this case, the Workers’ Compensation Appeals Board denied the defendant’s Petition for Reconsideration of the August 30, 2012 Findings of Fact, which found that the applicant sustained injury arising out of and in the course of the employment to her back and right lower extremity on January 3, 2011. The Board found that the WCJ’s findings were supported by solid, credible evidence and were to be accorded great weight by the Appeals Board. The Board also noted that the employee bears the burden of proving, by a preponderance of the evidence, that his or her injury was sustained in the course of employment. The Board found that the medical records and testimony of the applicant’s supervisor corroborated the injury on January 3,

HORTENCIA GARCIA vs. WHITE APRON, INC.; ZURICH NORTH AMERICA

In this case, Hortencia Garcia (applicant) sought reconsideration of the Findings and Order (F&O) issued in this case by the workers’ compensation administrative law judge (WCJ) on August 20, 2012, which found that applicant did not sustain injury to her left wrist on August 31, 2010. The Workers’ Compensation Appeals Board denied the petition for reconsideration, finding that the presumption of compensability in section 5402, subdivision (b) does not apply to applicant’s claimed injury to her left wrist, and that applicant did not present substantial medical evidence to support injury to her left wrist.

DONNA FUNCHEON vs. SAN LEANDRO HOSPITAL; CNA CLAIMS PLUS; AMERICAN CASUALTY; ZURICH AMERICAN INSURANCE CO.

In this case, Donna Fucheon was found permanently totally disabled and the Workers’ Compensation Appeals Board ordered defendant Zurich American Insurance to pay her counsel, Brian J. Thornton, fees of $181,883.97. Zurich American Insurance petitioned for reconsideration of the Order for Attorney Fees, arguing that filing a Petition for Writ on September 10, 2012 stayed the effect of the WCJ’s earlier August 16, 2012 Order. The Workers’ Compensation Appeals Board denied the Petition for Reconsideration, noting that filing a writ petition does not stay or suspend the effect of the disputed WCAB decision. The Board also noted that even without a court-ordered stay, applicant would require a certified copy of the Amended Findings, Award and Order

EVA ERDOHEGYESI vs. ARTHUR J. GALLAGHER & COMPANY; Administered By GALLAGHER BASSETT SERVICES

This case is about a lien claimant, the Law Offices of Graiwer & Kaplan, LLP, petitioning for reconsideration of an August 31, 2012 Order Dismissing Liens. The workers’ compensation administrative law judge dismissed the liens for failure to object to an August 1, 2012 Notice of Intention to Dismiss. The lien claimant argued that it accepted an offer from applicant’s present counsel, Boxer and Gerson, LLP, on August 27, 2012, thereby settling Graiwer & Kaplan’s claim for attorneys’ fees. The Petition for Reconsideration was dismissed because it was not clear how lien claimant believed that it had been aggrieved.

ANA CARRANZA vs. PALACE HOLDINGS, INC.; STATE COMPENSATION INSURANCE FUND

is a case involving Palace Holdings, Inc. and the State Compensation Insurance Fund. The Workers’ Compensation Appeals Board dismissed the Petition for Reconsideration as untimely, as it was not filed within 25 days of the decision. The Board also stated that, had the petition been timely-filed, it would have been denied on the merits.

YURI BARAJAS vs. KIMCO STAFFING SERVICES, Permissibly Self-Insured

; ADJ6779034KIMCO STAFFING SERVICES, Permissibly Self-Insured, appealed a decision by the workers’ compensation administrative law judge (WCJ) to take the issue of reasonableness/necessity of treatment off calendar. The Appeals Board granted the petition for removal and rescinded the WCJ’s decision, returning the matter to the trial level for further proceedings and decisions by the WCJ. The Board noted that the parties had had sufficient opportunity to discover and present evidence to support their claims, and that the WCJ should decide the case on the basis of the evidence provided.

PATRICIA ARRUDA vs. GOODWILL INDUSTRIES OF SANTA CLARA; ALASKA NATIONAL INSURANCE COMPANY

This case involves a lien claimant, Safety Works Medical, who filed an objection to the dismissal of their lien for medical services ordered by a QME. The underlying claim of injury was settled by an Order Approving Compromise and Release on October 25, 2011. On June 29, 2012, lien claimant filed a Declaration of Readiness to Proceed (DOR) requesting a lien conference. A notice of hearing issued on July 2, 2012 setting the matter for a lien conference on July 30, 2012. However, lien claimant failed to appear at the July 30, 2012 conference and the WCJ issued a Notice of Intention to Dismiss Lien of Safety Works Medical (NIT) for failure to appear absent a

Maria Campos, vs. Cola/martin Luther King Hospital #125 C/o Tristar Risk Management,

(LAO 0859849) is a case involving Maria Campos and Cola/Martin Luther King Hospital #125 c/o Tristar Risk Management. The Workers’ Compensation Appeals Board granted reconsideration and amended the Amended Findings and Award of August 20, 2009 to include the permanent and stationary date as February 2, 2007 and to defer the calculation of the permanent disability indemnity award, attorney’s fees, and commutation pending further proceedings and new determination by the WCJ.

JOSE SILVA vs. ENTERTAINMENT PARTNERS, Et. Al.; CHARTIS

ADJ4304736 (LAO0882888)In this case, the Workers’ Compensation Appeals Board granted reconsideration to delete the finding of injury to the right lower extremity and affirmed the August 22, 2012 Findings, Award and Order, except that the decision was amended to reflect that the right lower extremity was deleted from the finding of injury. The Board also denied a credit for overpayment of temporary disability benefits.

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