Cal. Comp. Cases August 2010 Advanced Postings (8/25/2010)

Cal. Comp. Cases August 2010 Advanced Postings (8/25/2010)

Here's the fourth batch of advanced postings for the August 2010 issue of Cal. Comp. Cases. subscribers can link to the cases below to read the complete headnotes and full case summaries.

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Contra Costa County Fire Protection District, legally uninsured, Petitioner v. Workers' Compensation Appeals Board, Randall Minvielle, Respondents

75 Cal. Comp. Cases ***, 2010 Cal. Wrk. Comp. LEXIS 144

Permanent Disability--Apportionment--Prior Awards--Overlap--WCAB upheld WCJ's finding that applicant/firefighter suffered 31-percent permanent disability as result of 11/22/2004 back injury and that there was no basis for Labor Code § 4664 apportionment of prior 27.5-percent permanent disability award stemming from 10/8/92 back injury, when ...

El Aguila Food Products, Safeco Insurance Company, Petitioners v. Workers' Compensation Appeals Board, Jesus Cervantes), Respondents

75 Cal. Comp. Cases ***, 2010 Cal. Wrk. Comp. LEXIS 145

Medical Treatment--Spinal Surgery--WCAB en banc, rescinding WCJ's Findings and Order that determined that applicant was entitled to lumbar spinal fusion surgery, held that procedures and timelines governing objections to treating physician's recommendation for spinal surgery are contained in Labor Code §§ 4610 and 4062 and 8 Cal. Code Reg. §§ 9788.1, 9788.11, and 9792.6(o), and that they are...

Medical Treatment--Spinal Surgery--WCAB  en banc disapproved of Brasher v. Nationwide Studio Fund (Brasher) (2006) 71 Cal. Comp. Cases 1282 (Appeals Board significant panel decision) to extent that it holds that (1) defendant may opt out of utilization review and instead dispute requested spinal surgery using only procedure specified in Labor Code § 4062(b), and (2) if defendant's utilization review denies spinal surgery, it is employee who must object under Labor Code § 4062(a), when WCAB en banc found that ...

John Hodgman, Ruth Ann Prokosch (Guardian ad Litem), Petitioners v. Workers' Compensation Appeals Board, Community Care Center, Inc., St. Paul Travelers Insurance Company, Respondents

75 Cal. Comp. Cases ***, 2010 Cal. Wrk. Comp. LEXIS 146

Medical Treatment --Conservatorships--Costs--WCAB held that applicant was not entitled to be reimbursed for costs incidental to obtaining and maintaining conservatorship of estate and person as ancillary to medical treatment for industrial injury, when WCAB relied on holding in Hodgman v. Workers' Comp. Appeals Bd. (2008) 155 Cal. App. 4th 44, 65 Cal. Rptr. 3d 687, 72 Cal. Comp. Cases 1202, that actual care giving services are reimbursable but services related to conservatorship itself are not reimbursable (applicant had severe industrial injury with award for 100-percent permanent disability and lifetime medical treatment).

Albus-Keefe & Associates, Inc., Saint Paul Fire & Marine Insurance Company v. W.C.A.B., Trammel Crow Residential, American Maintenance, ESIS Chatsworth, Sedgwick 14442 Orange, (Raul Aguilar)

75 Cal. Comp. Cases ***, 2010 Cal. Wrk. Comp. LEXIS 147

Employment Relationship--WCAB held that petitioner was applicant construction laborer's employer on date of applicant's spine injury, when WCAB found that general contractor was hired to work on construction site, that petitioner was sub-contractor company performing soil testing at job site, that ...

Downey Regional Medical Center, PSI, administered by York Insurance Services Group v. W.C.A.B., Maria Preciado

75 Cal. Comp. Cases ***, 2010 Cal. Wrk. Comp. LEXIS 148

Injury AOE/COE--WCAB held that applicant certified nurse's assistant sustained cumulative trauma injury AOE/COE to her cervical and lumbar spine, based on opinions from applicant's primary treating physician, which opinions WCAB found were substantial evidence and more persuasive than opinions from panel QME, and also based on job description and applicant's testimony about her job duties and her symptoms of headache, neck, and low back pain that began several months after beginning work for defendant and became more severe over time.

Evidence--WCAB found no basis to give preferential weight to opinions of panel QME over those of primary treating physician and found that Lab. C. §§ 4060 and 4062.2 provided mandatory procedure for obtaining medical-legal reports on injury AOE/COE issue but did not create presumption that reports from panel QME were correct.

 Stays--Bankruptcy--WCAB denied defendant's request to stay WCAB proceedings because employer had filed petition for Chapter 11 bankruptcy, when defendant notified WCAB about this filing after F&O and Opinion and Decision were filed and served, and did not provide WCAB with bankruptcy stay order.

Carlos Novillo v. W.C.A.B., Sun Microsystems, Inc., PSI, adjusted by Matrix Absence Management

75 Cal. Comp. Cases ***, 2010 Cal. Wrk. Comp. LEXIS 149

Injury AOE/COE--WCAB held that applicant laboratory manager sustained injury AOE/COE to his back but not to his hand or psyche, based on opinions from orthopedic and psychiatric panel QMEs, and WCAB also held that claimed injury to psyche was barred under Lab. C § 3208.3(h) because injury to psyche was caused by employer's lawful, nondiscriminatory, good faith personnel action.

Permanent Disability--Medical Treatment--WCAB held that applicant was not entitled to further PD or medical treatment for industrial back injury, based on opinions from orthopedic panel QME.