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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ9020574
Regular
Jan 03, 2020

Antonio Hernandez vs. TS STAFFING SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LUMBERMEN'S UNDERWRITING ALLIANCE in Liquidation, SEDGWICK CLAIMS MANAGEMENT SERVICES (Claims Administrator)

This case concerns an applicant seeking reconsideration of a permanent disability award in a workers' compensation claim. The Administrative Law Judge (WCJ) apportioned the applicant's permanent disability based on Labor Code Section 4663, which the applicant argued was incorrect. The applicant contended that Section 4664(b) should have applied due to a prior award, requiring a different apportionment method. The Appeals Board affirmed the WCJ's decision, finding that the applicant failed to establish the necessary prerequisites for Section 4664(b) apportionment. Specifically, the prior award lacked sufficient detail regarding the basis of its rating, and medical opinions attempting to apply Section 4664(b) were not based on substantial medical evidence.

Labor Code Section 4663Labor Code Section 4664(b)apportionmentpermanent disabilitysubstantial medical evidenceAgreed Medical Evaluator (AME)Panel Qualified Medical Evaluator (PQME)prior awardoverlapfactors of disability
References
10
Case No. ADJ3416937 (SRO 0141443) ADJ4476347 (SRO 0118020)
Regular
Apr 25, 2011

TIMOTHY ROBINSON vs. COUNTY OF SONOMA, Permissibly Self-Insured

This case concerns apportionment of permanent disability for an injured correctional officer. The applicant sustained an admitted industrial injury to his neck, resulting in a 12% permanent disability after initial apportionment. The WCJ calculated a total permanent disability of 43%, then apportioned 20% to non-industrial factors under Labor Code section 4663. Further apportionment occurred for a prior low back injury under Labor Code section 4664, using a converted rating from the old schedule to the new AMA Guides. The Appeals Board affirmed the WCJ's decision, finding no prohibition against applying both section 4663 and section 4664 apportionment, and deeming the prior injury properly converted and subtracted. A dissenting opinion argued that the older rating schedule's "overlap" concept is incompatible with the current AMA Guides method, and that the defendant failed to prove overlap for the prior injury.

Workers' Compensation Appeals BoardCounty of SonomaTimothy RobinsonCorrectional OfficerIndustrial InjuryNeck InjuryPermanent DisabilityApportionmentLabor Code Section 4663Labor Code Section 4664
References
6
Case No. ADJ637242 [SFO 0410171] ADJ2482512 [SFO 0430921]
Regular
Sep 23, 2008

JULIE ANN KAUS vs. STATE OF CALIFORNIA, CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

Reconsideration granted; matter returned to trial level for adequate trial record and further proceedings to address apportionment under sections 4663 and 4664.

WCABJulie Ann KausCalifornia Highway PatrolState Compensation Insurance FundFindings Award and Orderreconsiderationapportionmentpermanent disabilityLabor Code sections 46634664
References
9
Case No. MON 0307506
En Banc
Oct 26, 2005

VIRGINIA SANCHEZ vs. COUNTY OF LOS ANGELES, TRISTAR RISK MANAGEMENT

The Board holds that Labor Code section 4664 requires apportionment of overlapping permanent disabilities from a prior award for the same body region, with the defendant bearing the burden of proving the prior award and the applicant bearing the burden of disproving overlap.

SB 899Labor Code section 4664apportionmentprior industrial injurypermanent disabilityoverlapping disabilitiesen banc decisionpresumption of prior disabilityburden of proofmedical rehabilitation
References
60
Case No. SFO 0479038
Significant
Oct 26, 2005

JACK C. STRONG, Applicant vs. CITY & COUNTY OF SAN FRANCISCO, Permissibly Self-Insured

The Board holds that under Labor Code section 4664, where an employee has a prior permanent disability award for one body region and suffers a new industrial injury causing permanent disability to another region, the apportionment of overlapping disabilities is required.

SB 899apportionmentLabor Code section 4664prior permanent disabilityoverlapping disabilitiesemployer burden of proofconclusive presumptionmedical rehabilitationrebuttable presumptionfactors of disability
References
55
Case No. MON 0307506
Significant
Oct 26, 2005

Virginia Sanchez vs. County of Los Angeles, Tristar Risk Management (Adjusting Agent)

This en banc decision clarifies the issue of apportionment of permanent disability under Labor Code section 4664, holding that where a prior permanent disability award exists for the same body region, it is conclusively presumed to exist, and apportionment is required if the prior and current disabilities overlap.

SB 899ApportionmentLabor Code Section 4664Prior Permanent DisabilityOverlapping DisabilitiesConclusive PresumptionBurden of ProofMedical RehabilitationAbilities to Compete and EarnSame Region of the Body
References
57
Case No. GRO 0028123, GRO 0028394
En Banc
Feb 27, 2006

ERIC PASQUOTTO vs. HAYWARD LUMBER, CONNECTICUT INDEMNITY INSURANCE COMPANY, ATHENS ADMINISTRATORS

The Appeals Board held that a prior injury settlement via a compromise and release agreement does not constitute a 'prior award of permanent disability' under Labor Code section 4664(b) for apportionment purposes. However, evidence from the prior injury may still be relevant to determine apportionment based on causation under section 4663.

SB 899apportionmentcompromise and releaseprior awardpermanent disabilityLabor Code sections 46634664en banc decisionmedical rehabilitationother factors
References
58
Case No. GRO 0028123, GRO 0028394
Significant
Feb 27, 2006

Eric Pasquotto, Applicant vs. Hayward Lumber, Connecticut Indemnity Insurance Company, and Athens Administrators (Adjusting Agent)

This case holds that an order approving a compromise and release agreement is not a 'prior award of permanent disability' under Labor Code section 4664(b), but evidence from the prior injury may still be relevant for apportionment under section 4663. It also affirms that medical rehabilitation from a prior disability remains a viable concept under section 4663.

SB 899ApportionmentCompromise and ReleasePrior AwardPermanent DisabilityMedical RehabilitationOther FactorsLabor Code Sections 4663 and 4664En Banc DecisionWorkers' Compensation Appeals Board
References
57
Case No. ADJ1396117 (MON 0355549)
Regular
Dec 04, 2008

MARK SNELGROVE vs. RAYTHEON SYSTEMS COMPANY, LIBERTY MUTUAL INSURANCE

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration of a prior award. The defendant argued the judge erred in apportioning permanent disability under Labor Code section 4663, instead of section 4664, due to a prior injury. The Board found the defendant failed to meet its burden to prove overlap between the prior and current disabilities, thus upholding the original apportionment.

Workers' Compensation Appeals BoardPetition for ReconsiderationIndustrial InjuryApportionmentLabor Code Section 4663Labor Code Section 4664Permanent DisabilityAgreed Medical Evaluator (AME)American Medical Association Guides (AMA Guides)Overlap
References
2
Case No. OAK 0321116
Regular
Jun 25, 2008

RANDALL MINVIELLE vs. COUNTY OF CONTRA COSTA / CONTRA COSTA FIRE

The Workers' Compensation Appeals Board rescinded the prior award because the defendant failed to prove overlap between the applicant's 2004 and 1992 back injuries. Apportionment under Labor Code section 4664 was improper as the permanent disability from each injury was rated under different standards (1950 schedule vs. AMA Guides). The case was returned to the trial level to determine if both injuries could be rated under the same standard for proper apportionment.

Workers' Compensation Appeals BoardRandall MinvielleCounty of Contra CostaContra Costa Firelegally uninsuredOAK 0321116Opinion and Decision After Reconsiderationindustrial injuryfirefighterback injury
References
10
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