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

Case No. MON 0318706
Regular
Jul 11, 2008

EDGAR BENITEZ vs. IRISH COMMUNICATIONS, AIG CLAIMS SERVICES, INC.

This case concerns the appropriate permanent disability rating schedule. The applicant argues the 1997 schedule applies due to his physician indicating permanent disability before January 1, 2005, an exception to the 2005 schedule's use. The Board granted reconsideration, agreeing that the physician's report finding the applicant eligible for vocational rehabilitation constituted an indication of permanent disability, thus triggering the 1997 schedule. The matter is returned to the trial level for rating under the 1997 schedule and subsequent issuance of a decision.

Permanent Disability Rating ScheduleLabor Code Section 4660(d)Primary Treating PhysicianVocational RehabilitationComprehensive Medical-Legal ReportPermanent and Stationary StatusGenlyte Group v. ZavalaZenith v. CuginiVera v. Workers' Comp. Appeals Bd.Agreed Medical Evaluator
References
3
Case No. ADJ6879193
Regular
Feb 10, 2012

KATHERINE LAU vs. CUPERTINO UNION SCHOOL DISTRICT, KEENAN and ASSOCIATES

The Workers' Compensation Appeals Board granted reconsideration to review the application of the 1997 vs. 2005 Permanent Disability Rating Schedules. The Board reversed the WCJ's finding, determining there was insufficient pre-2005 medical evidence of permanent disability to apply the 1997 schedule. Consequently, the Board applied the 2005 schedule, reducing the applicant's permanent disability rating from 29% to 12%. One Commissioner dissented, arguing the record supported the use of the 1997 schedule based on pre-2005 indications of permanent disability.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent Disability Rating1997 Schedule2005 ScheduleLabor Code Section 4660(d)Comprehensive Medical-Legal ReportTreating Physician ReportIndustrial Injury
References
4
Case No. ADJ1357359 (ANA 0384919) ADJ2070955 (ANA 0381261) ADJ2274268 (ANA 0381264) ADJ1962006 (ANA 0381265)
Regular
Oct 04, 2011

JOSE RIVERA vs. CENTRAL FREIGHT LINES, ARROWWOOD INDEMNITY COMPANY

This case concerns the proper rating schedule for Jose Rivera's multiple industrial injuries. The Workers' Compensation Appeals Board granted reconsideration, finding that the administrative law judge erred by applying the 1997 rating schedule to all injuries. Specifically, the Board determined that the 2005 rating schedule should apply to the lumbar spine injury, as the medical report cited did not indicate permanent disability. However, a report from November 2004 did indicate permanent disability for the left lower extremity injury, thus allowing the use of the 1997 schedule for that specific injury. The Board rescinded the prior award and remanded the case for further proceedings and a new decision.

Workers' Compensation Appeals BoardJose RiveraCentral Freight LinesArrowwood IndemnityJoint Findings and AwardPermanent DisabilityLumbar SpinePsycheLeft WristLeft Foot
References
2
Case No. SJO 0262198
Regular
Aug 17, 2007

ANTHONY LAYTON vs. CITY OF SANTA CLARA

The Workers' Compensation Appeals Board granted reconsideration and reversed its prior decision, holding that the 1997 permanent disability rating schedule, not the 2005 schedule, applies to this case. This decision was based on two exceptions to the 2005 schedule's applicability: the treating physician indicated permanent disability before January 1, 2005, and the employer provided proper notice of rights before the 2005 schedule became effective. Consequently, the applicant's permanent disability is rated at 37% under the 1997 schedule, totaling $38,950.00.

Workers' Compensation Appeals BoardReconsideration2005 Schedule1997 ScheduleLabor Code Section 4660(d)ExceptionsTreating Physician ReportSection 4061 NoticePermanent Disability RatingPolice Officer
References
2
Case No. SJO 243795
Regular
Sep 17, 2007

BAIRO SISIC vs. VASONA MANAGEMENT, INC., UNITED STATES FIRE INSURANCE COMPANY

The Appeals Board granted reconsideration because the administrative law judge (WCJ) incorrectly applied the 1997 Permanent Disability Rating Schedule. The WCJ's reasoning for using the older schedule, based on pre-existing pathology and unadmitted medical reports, was flawed. The case is remanded for a new decision on which rating schedule applies, considering Labor Code § 4660(d) and whether specific reports or prior temporary disability payments trigger the 1997 schedule.

Workers' Compensation Appeals BoardVasona ManagementInc.United States Fire Insurance CompanyCrum & Forsterpermanent disability rating1997 Schedule2005 Schedulepre-existing pathologydegenerative disc disease
References
5
Case No. ADJ1099369
Regular
Jul 01, 2009

SANDRA SMULLEN vs. CITY OF SAN DIEGO, PERMISSIBLY SELF-INSURED

The Workers' Compensation Appeals Board granted reconsideration of a prior award, finding that the applicant's pre-2005 treating physician reports sufficiently indicated permanent disability. Consequently, the Board applied the 1997 permanent disability rating schedule instead of the 2005 schedule. This resulted in an amended award of 56 percent permanent disability based on the stipulated rating under the 1997 schedule. The decision reversed the prior award that had utilized the 2005 schedule and awarded 35 percent permanent disability.

Workers' Compensation Appeals BoardPermanent Disability Rating Schedule2005 Rating Schedule1997 Rating ScheduleLabor Code section 4660(d)Petition for ReconsiderationIndustrial InjuryPolice OfficerBack InjuryTreating Physician
References
6
Case No. ADJ160544 (LBO 0359144), ADJ4209690 (LBO 0372848), ADJ4666278 (LBO 0389220)
Regular
Mar 09, 2009

THELMA MORALES vs. CEDARS SINAI HEALTH SYSTEM

This case concerns whether the 1997 or 2005 Permanent Disability Rating Schedule applies. The defendant argued the WCJ erred by using the 1997 Schedule. The Board found that Dr. Lane's 2004 report did not indicate permanent disability as required to trigger the older schedule. Additionally, the final temporary disability payment occurred after January 1, 2005, meaning the Labor Code § 4061 notice exception did not apply. Consequently, the Board granted reconsideration, rescinded the previous findings, and remanded the cases for rating under the 2005 Schedule.

Permanent Disability Rating Schedule1997 Schedule2005 ScheduleLabor Code § 4660(d)Medical-Legal ReportTreating PhysicianPermanent and Stationary StatusCubital Tunnel SyndromeTemporary Disability IndemnityLabor Code § 4061 Notice
References
12
Case No. SAC 0315996, SAC 0313749
Regular
Feb 13, 2008

MICHAEL BEIN vs. TOWN OF HILLSBOROUGH

The Appeals Board granted the applicant's petition and denied the defendant's petition, amending the prior order. The Board determined that the 1997 Permanent Disability Rating Schedule applies to the applicant's cancer claim, not the 2005 schedule. The case is returned for further proceedings to issue rating instructions and a decision on permanent disability consistent with the 1997 schedule.

Workers' Compensation Appeals BoardIndustrial InjuryCancerHeart InjuryPermanent DisabilityRating ScheduleAMA GuidesLabor Code Section 4660(d)Labor Code Section 4664Apportionment
References
0
Case No. SRO 116945
Regular
Mar 14, 2008

RHONDA BAUWENS vs. VILLAGE RETREAT, STATE COMPENSATION INSURANCE FUND

The Appeals Board denied reconsideration, affirming its prior decision that the 1997 Schedule, not the 2005 Schedule, applies to the applicant's permanent disability rating. The Board found that the medical report indicated the existence of permanent disability under the reasoning of *Zavala*, even though the applicant's condition was not yet permanent and stationary. Therefore, the applicant's industrial injury on July 7, 2001, is subject to the 1997 permanent disability rating schedule.

1997 Schedule2005 SchedulePetition for ReconsiderationDecision after Reconsiderationpermanent disabilityindustrial injuryspinepsycheagreed medical evaluatorcomprehensive medical-legal report
References
8
Case No. SJO 0242650
Regular
Nov 06, 2007

MARTHA LEROY vs. PERMANENTE MEDICAL GROUP

The Workers' Compensation Appeals Board granted reconsideration to address whether the 1997 or 2005 Permanent Disability Rating Schedule applies. The Board found good cause to relieve the defendant from its prior stipulation to the 1997 Schedule due to a subsequent change in controlling law interpreting the "comprehensive medical-legal report" exception. The matter is returned to the trial level for a new decision on the applicable schedule and permanent disability rating.

Permanent Disability Rating1997 Schedule2005 ScheduleLabor Code section 4660(d)Comprehensive Medical-Legal ReportStipulationGood CauseReconsiderationBaglione IBaglione II
References
4
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