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

Case No. ADJ8434148
Regular
Apr 27, 2015

RUTH RITZ vs. COUNTY OF RIVERSIDE

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, amending the original award. The Board found that the applicant sustained industrial injuries to her psyche and bilateral shoulders, in addition to the back injury previously acknowledged. This amendment corrected the administrative law judge's initial error in excluding the psyche and shoulder injuries. The Board adopted the judge's reasoning and also included a finding of $0\%$ impairment for the psychiatric injury.

Petition for ReconsiderationFindings and AwardWCJindustrial injurypsycheshouldersstipulation0% impairmentbilateral shouldersCounty of Riverside
References
Case No. ADJ7555409
Regular
Mar 04, 2014

JESUS ESCANUELA vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the defendant's Petition for Reconsideration and dismissed the applicant's untimely petition. The WCAB found that the Agreed Medical Examiner's (AME) opinion regarding psychiatric permanent disability was not supported by substantial evidence, as it did not properly address causation under the current PDRS. Consequently, the case is remanded to the trial level for further development of the record concerning psychiatric permanent disability. The WCAB deferred the issue of permanent disability and attorney's fees pending this further development.

Workers' Compensation Appeals BoardJesus EscanuelaCalifornia Department of Correctionslegally uninsuredState Compensation Insurance FundADJ7555409Fresno District OfficeOpinion and OrderPetition for ReconsiderationFindings and Award
References
Case No. ADJ10765191
Regular
May 18, 2018

LARHONISH CAREY vs. MOLINA HEALTHCARE, TRAVELERS PROPERTY CASUALTY COMPANY

Applicant's attorneys seek reconsideration of a $0.00 attorney's fee award where their Compromise and Release contemplated a $1,350.00 fee. The Board granted reconsideration, finding procedural errors in the attorney's fee disclosure forms and the signing of the C&R by a non-attorney representative. The Board will affirm the $0.00 fee award unless the attorneys correct these deficiencies within 15 days.

WCABPetition for ReconsiderationCompromise and ReleaseAttorney FeesLabor Code section 4906WCAB Rule 10773Non-attorney Hearing RepresentativeFee Disclosure StatementAttorney DisclosureExpedited Trial Hearing
References
Case No. ADJ9648781
Regular
Oct 19, 2020

VERONICA HERNANDEZ vs. GRAIWER & KAPLAN, LLP, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration regarding a lien claimant's disallowed lien. The WCAB rescinded the prior order, finding that the initial dispute may not have been about the "amount of payment" but rather about whether an invoice was a duplicate. Consequently, the WCAB deferred the issue of the lien claimant's entitlement to further payment. The matter was returned to the trial level for further proceedings with admitted exhibits.

Workers' Compensation Appeals BoardReconsiderationLien ClaimantFindings and OrderSecond Bill ReviewDuplicate InvoiceLabor Code section 4603.6(a)Explanation of Review (EOR)Admitted EvidenceDeferred Issue
References
Case No. ADJ6796006
Regular
Feb 18, 2011

MIGUEL ESPINOZA vs. SOUTHWEST AIRLINES, ACE AMERICAN INSURANCE

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding 12% permanent disability for cervical and thoracic spine injuries. The Board rescinded the prior award, finding the medical opinion supporting the 12% disability was not substantial evidence as it unreasonably departed from AMA Guides criteria. Consequently, the Board issued a new award finding 0% permanent disability and no attorney fees.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent DisabilityDRE Cervical Category IDRE Thoracic Category IAMA Guides Fifth EditionWhole Person ImpairmentSubstantial Medical EvidenceDisability Evaluation Unit
References
Case No. ADJ6609941
Regular
Jun 07, 2013

DELTON CARTER vs. FACILITIES ENGINEERING, STATE COMPENSATION INSURANCE FUND, STATE EMPLOYEES

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration. The applicant, unrepresented, sought a new disability rating based on current guidelines, disagreeing with the prior $0\%$ permanent disability finding. The Board found the petition "skeletal" as it lacked specific references to the record or legal principles, thus violating Board Rule 10846. Consequently, the petition was dismissed without addressing the merits of the applicant's claim.

Petition for ReconsiderationFindings and AwardPermanent DisabilityAME standard guidelinesWCAB Rule 10846Skeletal petitionDismissed petitionReport and RecommendationWorkers' Compensation Appeals Board
References
Case No. VNO 514162, VNO 514164, VNO 514165, VNO 542022
Regular
Mar 17, 2008

MIA DOEVE vs. COUNTY OF LOS ANGELES

This case involves an applicant who sustained multiple admitted industrial injuries while employed as a deputy sheriff. The Workers' Compensation Appeals Board granted reconsideration because the WCJ's finding of 0% permanent disability was not adequately supported by the evidence, particularly the DEU rater's conclusions. The Board rescinded the prior award and returned the case for further proceedings, including cross-examination of the DEU rater and reconsideration of which permanent disability rating schedule applies.

Workers' Compensation Appeals BoardDeputy SheriffIndustrial InjuriesPermanent DisabilityAgreed Medical Evaluator1997 Schedule2005 ScheduleLabor Code Section 4061Wilkinson doctrineDisability Evaluation Unit
References
Case No. ADJ6630817
Regular
Dec 27, 2010

NADINE WHITEEAGLE vs. CENTRAL RECRIGERATOR SERVICES, GREAT WEST CASUALTY

This case concerns an applicant's shoulder injury resulting in 12% permanent disability. The defendant argued the Permanent Medical Evaluator (PQME) found 0% impairment and objected to the rater's consideration of surgery. However, the Appeals Board affirmed the WCJ's decision, finding the rating instruction was properly based on substantial medical evidence from the PQME's report, which included the applicant's shoulder surgery. The Board also noted the defendant's objection to the rating was untimely.

Workers' Compensation Appeals BoardReconsiderationFindings Award and OrderPermanent DisabilityPanel Qualified Medical Evaluator (PQME)Whole Person Impairment (WPI)AMA Guides to the Evaluation of Permanent ImpairmentDistal Clavicle ResectionRater InstructionsDEU Rater
References
Case No. ADJ7277215
Regular
Sep 07, 2010

KRISTIN DALE vs. LAWNDALE SCHOOL DISTRICT

The defendant sought removal of a case where the Workers' Compensation Appeals Board (WCAB) ALJ refused to approve a 0% permanent disability stipulation. The WCAB denied the removal petition because the defendant's petition was not verified, violating procedural rules. However, the WCAB clarified that removal is appropriate for actions causing significant prejudice, even without a final order. The WCAB remanded the case to the ALJ to properly consider the adequacy of the settlement, requiring written notice of any concerns.

Petition for RemovalStipulated AwardPermanent DisabilityLabor Code Section 4658(d)Instructional AideWorkers' Compensation Appeals BoardWCJReport and RecommendationLabor Code Section 5310Significant Prejudice
References
Case No. ADJ561917 (SBR 0341722)
Regular
Oct 04, 2010

CARL KILLEBREW, JR. vs. JAMES SHIRLEY CONSTRUCTION, APPLIED RISK

The Workers' Compensation Appeals Board granted reconsideration of a prior decision that found 0% permanent disability for an industrial injury to the applicant's right elbow and shoulder. The Board found that the Qualified Medical Evaluator's (QME) report was not substantial medical evidence as it failed to adequately explain the methodology used to arrive at the permanent disability rating within the AMA Guides. Consequently, the Board rescinded the original award and returned the case to the trial level for further development of the medical record.

Almaraz/Guzman IIPanel QMEWhole Person ImpairmentAMA GuidesReconsiderationPermanent DisabilityIndustrial InjuryRight ElbowRight ShoulderFunctional Capacity Loss
References
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