Significant Cases

Defendant ignored injured worker's treatment requests for 6 months after the WCAB found injury.  WCAB indicated that the defendant had a duty to reach back in the medical file, send all requests for authorization to UR  and provide the injured worker's medical treatment.   

The applicant had developed complex regional pain syndrome (CRPS) as a result of failed surgery, which was authorized by her employer, Costco, to treat the industrial carpal tunnel injury to her hands.  The WCJ found that although the CRPS was the sole cause of the permanent disability leaving the applicant totally disabled, because the AME in orthopedics had found 10% apportionment to non-in...

The WCAB upheld a finding by the WCJ of entitlement to 24/7 home health care.  The defendant had been authorizing 8 hours of home care 5 days per week through an agency for some time, but there had been medical reporting by the treating physicians through the years indicating that 24/7 home care was medically necessary.  Her adult son had been providing the rest of the home care that was...

While working as a candle maker for the employer, the applicant got her right index finger stuck in the machine, resulting in a partial amputation of the finger.  The date of injury was post-1/1/2013.  The WCJ found that the injury to applicant’s psyche constituted a “violent act” exception under Labor Code 4660.1(c), applying the Larsen and Madson cases.  Therefor...

The Defendant sought reconsideration of a Workers’ Compensation Appeals Board due to a dispute of PD in the amount of 98% because the injured worker continued her employment with the Los Angeles Unified School District and the employer argued that the injured worker’s arthritis was not related to work.  The WCAB ruled the Award for 98% was supported by the medical evidence, granti...

Defendant argued that the permanent disability for chronic pain should be apportioned as found by the orthopedic panel qualified medical evaluator.  The rheumatology panel qualified medical examiner and psychiatric found 100% permanent total disability due to the injured worker’s chronic pain, psychological condition and other symptoms related to chronic pain.  Rowen, Gurvey &...

Defendant agreed to provide home health care services and then stopped providing them without showing a change in the injured workers’ circumstances or condition.  The WCAB determined the Defendant must provide home health care for 24 hours a day/7days a week. 

Defendant claimed the injured worker could not select a new primary treating physician and ignored the new primary treating physician’s timely, valid requests for authorization.  The WCAB sided with the injured worker and Rowen, Gurvey & Win that the original medical reporting at discharge found the need for future medical care.  The WCAB allowed the injured worker to select a...

Parties had each separately requested supplemental reporting from the PQME.  Six months after the defendant’s initial request, defendant objected to the PQME as untimely and requested a replacement panel.  However, two days before the request was made, the PQME had issued the supplemental report in response to both parties’ requests.  WCJ denied defendant’s request...

The WCAB overturned the Workers' Compensastion Judge, indicating that he should not have discounted the internal AME’s medical opinion whereby the doctor found that the addition of the applicant’s disabilities together more accurately represented the totality of disability, rather than using the Combined Values Chart, which effectively compacts the overall disability.   That...