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

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. 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. 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. ADJ2269231 (OXN 0139900)
Regular
Apr 13, 2008

CAROLE KRAL vs. ST. JOHN'S REGIONAL MEDICAL CENTER, Permissibly Self-Insured OCTAGON RISK SERVICES

This case concerns an applicant challenging a WCJ's denial to reopen a prior finding that the 2005 permanent disability rating schedule applied. The Appeals Board affirmed the WCJ's decision, holding that the April 18, 2007 decision on the rating schedule was a "final order" because it addressed a "threshold issue" fundamental to permanent disability benefits. Applicant's failure to timely seek reconsideration of this final order means the rating schedule issue is now conclusively determined. Therefore, the November 25, 2008 Findings, Award and Orders, which incorporated the 2005 schedule, were properly affirmed.

Workers' Compensation Appeals BoardReconsiderationFindings and OrdersPermanent Disability Rating ScheduleThreshold IssueFinal OrderReopeningSupplemental PleadingsOccupational TherapistIndustrial Injury
References
15
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. LAO 0842819
Regular
Sep 04, 2007

JUAN M. VILLALOBOS vs. ANCRA INTERNATIONAL, GALLAGHER BASSETT SERVICES, INC.

This case concerns the application of the correct permanent disability rating schedule for an industrial injury occurring before January 1, 2005. The applicant sought to apply the prior rating schedule, arguing specific medical reports indicated permanent disability. However, the Workers' Compensation Appeals Board denied reconsideration, affirming the use of the revised rating schedule. The Board found no qualifying pre-January 1, 2005 medical report indicating the applicant was permanent and stationary, nor was the employer required to issue notice under Labor Code § 4061 until after that date.

WCABReconsiderationSupplemental Findings and AwardIndustrial InjuryLower BackPermanent DisabilityRevised Rating SchedulePrior Rating ScheduleLabor Code Section 4061Labor Code Section 4660(d)
References
4
Case No. ADJ4099888 (WCK 0066521)
Regular
Nov 16, 2011

SALLY MERDIAN vs. AIG CLAIMS SERVICES, CHARTIS INSURANCE

This case concerns the proper permanent disability rating schedule to apply for an injury sustained in 2002. The Workers' Compensation Appeals Board (WCAB) found that the primary treating physician's December 20, 2004 report, when considered with the entire record, provided substantial evidence of permanent disability prior to January 1, 2005. Therefore, the WCAB rescinded the trial judge's decision and returned the case to the trial level to rate the permanent disability using the 1997 Schedule, not the 2005 Schedule. The WCAB clarified that the magnitude of the injury or disability is immaterial to determining if a pre-2005 report "indicates" permanent disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent DisabilityRating SchedulePrimary Treating PhysicianMedical-Legal ReportLabor Code Section 4660(d)Industrial InjuryNeck Injury
References
9
Case No. SBR 0330847
Regular
Apr 28, 2008

PEDRO SANDOVAL vs. UNITED TRANSMISSION EXCHANGE, AKA, RK SERVICES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and returned the case to the trial level, rescinding the previous decision. The Board found that the vocational expert's testimony did not adequately explain why the 2005 Permanent Disability Rating Schedule was inadequate, nor did it demonstrate how diminished future earning capacity rebutted the schedule. Therefore, the case requires further development of the record to determine the appropriate rating schedule and whether the applicant sufficiently rebutted the 2005 Schedule.

Workers' Compensation Appeals BoardSB 899Labor Code section 46602005 Schedule1997 Schedulepermanent disability ratingdiminished future earning capacityDFECvocational expertrebuttal evidence
References
4
Case No. AHM 118785
Regular
Aug 09, 2007

LISABETH BLACK vs. WAL-MART, AIG, FRANK GATES SERVICE CO.

This case concerns a dispute over which permanent disability rating schedule applies to an applicant injured before January 1, 2005. The defendant argues the WCJ improperly applied the 1997 schedule, while the WCJ believes a pre-2005 treating physician's report indicating permanent disability triggers the exception to using the new schedule. The Appeals Board granted reconsideration to allow applicant to submit the missing treating physician's reports to determine the applicable rating schedule.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and Awardpermanent disabilityrating scheduleLabor Code section 4660treating physician's reportAMA GuidesmeniscectomyQualified Medical Evaluator
References
3
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