California Workers' Comp Case Roundup (12/1/2013)

CALIFORNIA COMPENSATION CASES

Vol. 78 No. 11 November 2013

A Report of En Banc and Significant Panel Decisions of the WCAB and Selected Court Opinions of Related Interest, With a Digest of WCAB Decisions Denied Judicial Review

CONTENTS OF THIS ISSUE

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Supreme Court Compensation Case

Valdez (Elayne) v. W.C.A.B., 78 Cal. Comp. Cases 1209 (lexis.com), 78 Cal. Comp. Cases 1209 (Lexis Advance)

Medical Provider Networks—Treatment Outside Networks—Medical Reports—Admissibility—California Supreme Court, affirming Court of Appeal’s judgment, held that Labor Code § 4616.6 restricts admission of medical reports in only proceedings to resolve disputes over diagnosis and treatment within medical provider networks, when Supreme Court found that…

Federal District Court Order

Angelotti Chiropractic, Inc. v. Baker, 78 Cal. Comp. Cases 1218 (lexis.com), 78 Cal. Comp. Cases 1218 (Lexis Advance)

Liens—Activation Fee—Preliminary Injunction—United States District Court, Central District of California, granting plaintiffs’ motion for preliminary injunction, enjoined defendants, California Department of Industrial Relations, from enforcing lien activation fee provisions of SB 863, codified at Labor Code § 4903.06, against any workers’ compensation lien holder, including subjecting any existing workers’ compensation lien holder to…

Digests of WCAB Decisions Denied Judicial Review

Editorial Board members Hon. David Hettick, Robert G. Heywood, Kenneth B. Peterson, and Robert G. Rassp recommended the following writ denied cases for summarization in this issue.

Advanced Orthopedics v. W.C.A.B. (Halaby, Arif), 78 Cal. Comp. Cases 1222 (lexis.com), 78 Cal. Comp. Cases 1222 (Lexis Advance)

Liens—Medical Treatment—Laches—WCAB affirmed WCJ’s finding that medical provider’s lien for medical services rendered to applicant/police officer during period 1993, which was date medical provider entered PPO contract with Blue Cross of California, through date medical provider sold his business in 2008, was barred by doctrine of laches, when WCAB found that…

Gambina (Ralph) v. W.C.A.B., 78 Cal. Comp. Cases 1225 (lexis.com), 78 Cal. Comp. Cases 1225 (Lexis Advance)

Psychiatric Injury—Burden of Proof—WCAB affirmed WCJ’s finding that applicant/liquor store clerk did not meet burden of proving that he suffered compensable psychiatric injury pursuant to Labor Code § 3208.3(b)(2), when WCAB found that…

Stipulations—WCAB held that WCJ correctly relied on parties’ factual stipulations made at trial with regard to applicant/liquor store clerk’s injured parts of body, rather than on pre-trial stipulations, when WCAB found that…

Oday (Jack) v. W.C.A.B., 78 Cal. Comp. Cases 1231 (lexis.com), 78 Cal. Comp. Cases 1231 (Lexis Advance)

Medical Treatment—Resolution of Treatment Disputes—WCAB, in split panel decision, rescinded WCJ’s findings and order requiring defendant to provide medical treatment as recommended by applicant’s primary treating physician pursuant to stipulated award approved in 1980, under which applicant was awarded future medical treatment for 1979 injury to his back and coccyx, when…

Walton (Rose) v. W.C.A.B., 78 Cal. Comp. Cases 1236 (lexis.com), 78 Cal. Comp. Cases 1236 (Lexis Advance)

Permanent Disability—Rating—AMA Guides—WCAB affirmed WCJ’s finding that applicant/correctional lieutenant suffered 65 percent permanent disability, after apportionment, as result of admitted cumulative trauma to her back, psyche, gastrointestinal system, and in forms of hypertension, sleep disturbance, esophageal reflux, and headaches, based on… Permanent Disability—Apportionment—Non-Industrial Factors—WCAB upheld WCJ’s finding that 60 percent of applicant/correctional lieutenant’s gastrointestinal permanent disability was caused by industrial cumulative trauma injury, and that 40 percent was due to non-industrial factors, including hiatal hernia and reflux esophagitis, when WCAB concluded that…

Wells Fargo Bank, N.A. v. W.C.A.B. (Blutcher, Catherine), 78 Cal. Comp. Cases 1241 (lexis.com), 78 Cal. Comp. Cases 1241 (Lexis Advance)

Psychiatric Injury—Predominant Cause—WCAB, affirming WCJ, held that applicant/bank branch manager suffered compensable psychiatric injury, as well as injuries to her internal system and in form of sleep disorder, based on reporting of agreed medical evaluator establishing that…

Psychiatric Injury—Good Faith Personnel Actions—WCAB, affirming WCJ, held that applicant/bank branch manager’s claim for psychiatric injury was not barred by good faith personnel actions defense in Labor Code § 3208.3(h), when WCAB found that…

Zurich North America v. W.C.A.B. (Nash, Christopher), 78 Cal. Comp. Cases 1247 (lexis.com), 78 Cal. Comp. Cases 1247 (Lexis Advance)

Civil Actions Against Employer—Fair Employment and Housing Act Claims—Effect of Civil Settlement on Workers' Compensation Claims—WCAB, affirming WCJ, held that settlement agreement, under which applicant/journey lineman with cumulative trauma to his back, neck, shoulders, and wrists settled his Fair Employment and Housing Act claim against employer, did not preclude applicant’s entitlement to…

Other WCAB Decisions Denied Judicial Review

Azzolin (David) v. W.C.A.B., 78 Cal. Comp. Cases 1250 (lexis.com), 78 Cal. Comp. Cases 1250 (Lexis Advance)

Injury AOE/COE—WCAB held that applicant county range safety officer did not sustain burden of proving cumulative trauma injury AOE/COE from 2/13/2009 through 2/13/2010 to his body system, ear and brain (seizures), or nervous system, when WCAB found that…

WCAB's Duty to Develop Record—WCAB held that it did not have duty to develop record on injury AOE/COE issue, when it found that…

Gagne (Joseph) v. W.C.A.B., 78 Cal. Comp. Cases 1252 (lexis.com), 78 Cal. Comp. Cases 1252 (Lexis Advance)

Temporary Total Disabiliy—WCAB awarded applicant temporary total disability benefits from 6/1/2007 (date applicant/pipefitter stopped working after 7/23/2001 industrial right knee injury) through 7/23/2007 (date applicant recovered from total knee replacement surgery) and denied applicant’s claim for…

Costs—Travel Expenses—WCAB denied applicant’s request for further reimbursement of travel expenses to attend…

Southwest Transportation Agency v. W.C.A.B. (Scranton, Charles), 78 Cal. Comp. Cases 1254 (lexis.com), 78 Cal. Comp. Cases 1254 (Lexis Advance)

Statute of Limitations—Cumulative Trauma Injury—Date of Injury—WCAB, affirming WCJ, held that applicant/bus driver’s claim for cumulative trauma to his back and in form of sleep disorder during period 12/6/85 to 8/15/2005 was not barred by one-year statute of limitations, notwithstanding that…

Von Ritzhoff (Kristian) v. W.C.A.B., 78 Cal. Comp. Cases 1255 (lexis.com), 78 Cal. Comp. Cases 1255 (Lexis Advance)

Petitions for Writ of Review—Contents of Petitions—Final Orders—Court of Appeal dismissed petition for writ of review because (1) petition failed to comply with…

Young (Marjorie) v. W.C.A.B., 78 Cal. Comp. Cases 1256 (lexis.com), 78 Cal. Comp. Cases 1256 (Lexis Advance)

Awards—Accrual of Interest—WCAB, affirming WCJ, held that interest under Labor Code § 5800 on applicant/county clerk’s retroactive award of temporary disability for period 5/7/90 to 7/17/98, awarded after applicant’s original 5/7/90 award for 1/19/89 back and neck injury was reopened, did not accrue from date of original 5/7/90 award, as contended by applicant, but rather from…

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