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

Case No. ADJ11054646, ADJ11055389, ADJ10719681
Regular
Apr 07, 2025

ALAN NEWELL vs. METROPOLITAN WATER DISTRICT

Applicant Alan Newell sought reconsideration of a WCJ's Findings and Awards from January 3, 2025, concerning two industrial injuries. The WCJ had rated permanent disability by combining all impairments, contrary to the Agreed Medical Evaluator Dr. Chester A. Hasday's opinion on how to combine impairments based on overlapping Activities of Daily Living (ADLs). The Appeals Board granted reconsideration, finding that Dr. Hasday's pre-Vigil decision rebuttal analysis for combining impairments based on ADL overlap was valid, and the record needed further development. The case was remanded to defer the issues of permanent disability and apportionment for further analysis.

Petition for ReconsiderationPermanent DisabilityApportionmentCombined Values ChartActivities of Daily Living (ADLs)Medical TreatmentAgreed Medical EvaluatorOrthopedistLabor Code Section 4663Rebuttal
References
Case No. ADJ8996451
Regular
Mar 25, 2016

ROGELIO VELASQUEZ vs. MOLOFSKY BUILDERS, INC., EVEREST NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the Petition for Reconsideration, upholding the Workers' Compensation Judge's decision. The Judge correctly excluded permanent disability for sleep disturbance as the QME failed to provide an apportionment opinion as required by statute. Furthermore, the Judge properly rejected the QME's *Almaraz/Guzman* rating for the left knee injury, finding it unpersuasive and lacking in specific ADL deficits. Therefore, the Judge's original findings on permanent disability were affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ reportEpworth Scalesleep disturbancepermanent disabilityQualified Medical Evaluator (QME)apportionmentleft knee injuryAlmaraz/Guzman
References
Case No. ADJ8716925
Regular
May 27, 2025

MARCO VILLA vs. SHULTZ STEEL COMPANY INC, TRAVELERS DIAMOND BAR

Applicant Marco Villa petitioned for reconsideration of a February 19, 2025, Findings and Award (F&A) that found his permanent disability to be 61% and did not categorize his injury as catastrophic. The Appeals Board, after reviewing the petition, defendant's answer, and the WCJ's report, determined that the record was not adequately developed, specifically concerning medical evidence on Activities of Daily Living (ADLs) and the proper evaluation of sub-rosa videos in the context of catastrophic injury. The Board granted the petition for reconsideration but deferred a final decision on the merits, indicating further review and proceedings are necessary to ensure a just and reasoned outcome.

Petition for ReconsiderationFindings and AwardCatastrophic InjuryPermanent DisabilitySubstantial EvidenceMedical OpinionActivities of Daily Living (ADLs)Sub-rosa VideoVocational ExpertDEU Rating
References
Case No. ADJ7827606
Regular
Feb 11, 2015

GILBERT LOPEZ vs. CITY AND COUNTY OF SAN FRANCISCO, SUBSEQUENT INJURIES BENEFITS TRUST FUND OF THE STATE OF CALIFORNIA

The Workers' Compensation Appeals Board affirmed a prior award granting Gilbert Lopez benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). The SIBTF contended that adjustments for diminished future earning capacity should be excluded when calculating the threshold percentage of permanent disability from the subsequent injury. The Board majority, adopting the judge's reasoning, found that these adjustments are permissible under current law, affirming eligibility. A dissenting opinion argued that such adjustments should be excluded, which would have rendered the applicant ineligible.

Subsequent Injuries Benefits Trust FundSIBTFdiminished future earning capacitypermanent disability ratingLabor Code section 4751Whole Person ImpairmentADLSB899cumulative traumaWCJ
References
Case No. ADJ2786471 (AHM 0131183)
Regular
Feb 12, 2013

RENEGARCIA vs. CITY OF ANAHEIM, PRESSURE

The Appeals Board rescinded the prior award due to the physician's flawed methodology in determining permanent disability. The physician improperly used the *Almaraz/Guzman* analysis by considering both functional capacity and ability to compete in the labor market. Furthermore, the physician's supplemental report failed to correct this error and used speculative cumulative losses. The matter is returned for a new rating strictly applying the AMA Guides.

Workers' Compensation Appeals BoardCity of AnaheimRene GarciaReconsiderationJoint Findings and AwardPermanent DisabilityCumulative TraumaLeft KneeRight KneeBack Injury
References
Case No. ADJ8171213
Regular
Jun 01, 2015

ELOY GARCIA vs. MEK AIR TECH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of a prior decision ordering home health care services. The Board found that the treating physician's report lacked substantial evidence because the underlying reports supporting it were not submitted into evidence. Without these, the Board could not determine if the home health care services were medically reasonable or necessary. Therefore, the case was returned to the Workers' Compensation Judge for further evidence development and a new decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and Orderhome health care servicestreating physicianQMEsubstantial evidencereasonable medical probabilitydue processstipulation
References
Case No. ADJ6796021
Regular
Jan 14, 2017

BONITA VINSON vs. COUNTY OF ALAMEDA, SEDGWICK CMS

The Workers' Compensation Appeals Board granted reconsideration and rescinded the original award due to issues with medical evidence and the trial record. The Board found that the Qualified Medical Examiner's opinion regarding permanent disability was inconsistent with the applicant's testimony and did not adequately comply with legal standards. The case is remanded for further proceedings to fully develop the medical record and provide a new decision.

Occupational codeDivision directorPeace officerIndustrial injuryBack injuryPermanent disabilityTemporary disabilityPermanent and stationaryPanel qualified medical examinerPQME
References
Case No. ADJ9713798
Regular
Dec 20, 2019

BRIGETTE LEONARD vs. SANTA MONICA-MALIBU UNIFIED SCHOOL DISTRICT

The Appeals Board denied the defendant's petition for reconsideration, upholding the finding that the applicant sustained a catastrophic injury under Labor Code section 4660.1(c)(2)(B). While rejecting the WCJ's reliance on psychiatric injury to deem the physical injury catastrophic, the Board found sufficient independent evidence. Applicant's industrial thyroid cancer, requiring lifelong treatment including thyroidectomy and radioactive iodine, alongside GERD and hypertension, supports the catastrophic designation. This designation allows for an increased impairment rating for her psychiatric disability.

Labor Code section 4660.1(c)(2)(B)catastrophic injurypsychiatric injuryimpairment ratingthyroid cancerWilson v. State of CA Cal FireADLscumulative exposuretotal thyroidectomyradioactive iodine therapy
References
Case No. ADJ14789657
Regular
Oct 24, 2025

EDWAR VANEGAS GERENA vs. COMMERCIAL TREE CARE, BARRETT BUSINESS SERVICES, INC., ACE AMERICAN INSURANCE COMPANY

Applicant, Edwar Vanegas Gerena, a tree trimmer, sustained a severe injury to his left hand, neck, right shoulder, right arm, right upper extremity, and psyche. The Workers' Compensation Appeals Board denied defendant's petition for reconsideration of the July 16, 2025 Findings and Award. The WCAB affirmed the finding of permanent total disability, agreeing that the medical opinions from QMEs Dr. Rakkar and Dr. Alvarellos constituted substantial medical evidence and that the orthopedic and psychiatric impairments should be added due to a lack of overlap in their impact on daily living activities. The decision also addressed the applicability of Labor Code section 5909 regarding the timeliness of the Appeals Board's action on the petition.

WCABPetition for ReconsiderationFindings and Awardpermanent total disabilityQualified Medical ExaminerQMEDr. RakkarCRPSComplex Regional Pain SyndromeMajor Depressive Disorder
References
Case No. ADJ1793931 (OAK 0336568)
Regular
Apr 12, 2010

MICHAEL KESTEL vs. CAPITOL BUICK PONTIAC GMC, ZENITH, REPUBLIC INDEMNITY

This case concerns an appeal regarding the applicant's permanent disability rating for upper extremity injury. The defendants contended that the original $24\%$ rating was improperly calculated, specifically challenging the inclusion of grip loss as a factor. The Appeals Board found the Agreed Medical Evaluator's opinion on grip loss to be speculative and not substantial evidence under the *Almaraz II* decision. Consequently, the Board granted reconsideration, amended the award to $16\%$ permanent disability, and affirmed the remainder of the original findings.

AMEAgreed Medical EvaluatorAMA Guidespermanent disability ratingWPIwhole person impairmentgrip lossupper extremity impairmentAlmaraz IIsubstantial evidence
References
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