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

Case No. ADJ1939549
Regular
Dec 14, 2009

MATTHEW KELLEHER vs. STATE COMPENSATION INSURANCE FUND

The WCAB denied defendant's petition for reconsideration of the September 15, 2009 Findings and Award. The WCAB found that the AME's report complied with *Almaraz/Guzman II*, and that the AME did not go outside the four corners of the AMA Guides.

WCABPetition for ReconsiderationFindings and Awardindustrial injurypermanent disabilityAgreed Medical Evaluator (AME)American Medical Association Guides (AMA Guides)Whole Person Impairment (WPI)Almaraz/Guzman IAlmaraz/Guzman II
References
Case No. ADJ1078163, ADJ3341185
En Banc
Sep 03, 2009

MARIO ALMARAZ, JOYCE GUZMAN vs. ENVIRONMENTAL RECOVERY SERVICES, STATE COMPENSATION INSURANCE FUND, MILPITAS UNIFIED SCHOOL DISTRICT, KEENAN & ASSOCIATES

This en banc decision clarifies that a permanent disability rating established by the Schedule is rebuttable, but any evidence to rebut the Whole Person Impairment (WPI) component must be based within the four corners of the AMA Guides.

AlmarazGuzmanWorkers' Compensation Appeals Boarden bancprecedentAMA Guides2005 Schedulepermanent disabilityrebuttableprima facie evidence
References
Case No. ADJ9385114
Regular
Feb 03, 2023

MICHELLE RICHMOND vs. SANTA ROSA TILE SUPPLY, PROCENTURY INSURANCE, ILLINOIS MIDWEST

The Workers' Compensation Appeals Board denied Santa Rosa Tile Supply's petition for reconsideration. The defendant argued the Administrative Law Judge erred in awarding 77% permanent disability and in not applying apportionment for a prior 1991 award. The Board adopted the WCJ's report, affirming that the physician properly rebutted the AMA Guides rating using Almaraz/Guzman principles by considering the applicant's limitations in activities of daily living. The Board also upheld the WCJ's decision to apply apportionment solely under Labor Code section 4663, as the defendant failed to demonstrate overlap with the prior award under section 4664.

WCABPetition for ReconsiderationFindings and AwardPermanent DisabilityAMA GuidesMilpitas Unified School District v. Workers' Comp. Appeals Bd. (Guzman)Labor Code section 4663Labor Code section 4664Almaraz/GuzmanPQME
References
Case No. ADJ3311649 (LAO 0871212)
Regular
Apr 20, 2009

MILTON JEOVANY LOPEZ vs. LAZAR TRUCK LINES, NOVAPRO RISK SOLUTIONS FOR CTSA

The Workers' Compensation Appeals Board granted reconsideration of a decision that awarded the applicant 2% permanent disability for a knee injury. The applicant argued the rating was inaccurate based on the AMA Guides and sought recalculation under *Almaraz/Guzman*. The Board found the permanent disability issue was properly raised and that the medical record needed further development. Therefore, the matter was returned to the trial level to re-evaluate permanent disability consistent with the *Almaraz/Guzman* ruling.

Workers' Compensation Appeals BoardMilton Jeovany LopezLazar Truck LinesNovapro Risk SolutionsADJ3311649LAO 0871212ReconsiderationFindings and AwardPermanent DisabilityAMA Guides
References
Case No. ADJ480092 (SFO 0498380) ADJ2934310 (SFO 0498381)
Regular
Apr 26, 2009

TONI MORGAN vs. REDWOOD CREDIT UNION, ZENITH INSURANCE COMPANY, UNITED STATES FIRE INSURANCE CO.

This case concerns an applicant's petition for reconsideration of a workers' compensation judge's finding that the 2005 Permanent Disability Rating Schedule (PDRS) should apply to two cumulative trauma injuries. The applicant argued for the 1997 PDRS, asserting a defendant's termination of temporary disability payments triggered a Labor Code notice requirement. Alternatively, the applicant contended the $15\%$ permanent disability rating was too low, citing *Almaraz/Guzman* regarding disparities between AMA Guides impairment ratings and actual employability. The Appeals Board granted reconsideration, agreeing the medical record needed further development under *Almaraz/Guzman*, and deferred the permanent disability issue for trial level review. A dissenting opinion argued the applicant waived the AMA Guides impairment issue by not raising it earlier.

WCABRedwood Credit UnionZenith Insurance CompanyUnited States Fire Insurance Co.cumulative traumapermanent disability rating schedule2005 PDRS1997 PDRSLabor Code section 4061Labor Code section 4660
References
Case No. ADJ823138 (OXN 0142604)
Regular
Oct 25, 2010

CHERYL PEET vs. COUNTY OF VENTURA, Permissibly SelfInsured, Administered By CORVEL CORPORATION

The Workers' Compensation Appeals Board is reconsidering a prior decision that found a deputy probation officer sustained industrial injuries resulting in 78% permanent disability. The defendant sought reconsideration, arguing the Qualified Medical Examiner's (QME) opinion, which formed the basis of the award, was ambiguous and unsubstantiated. The Board agrees that the QME's assessment of 60% whole person impairment is not adequately supported by the record, particularly in light of the applicant's own testimony regarding her daily activities. Therefore, the case is returned to the trial level for further evidence development and a new decision, with consideration for cost of living adjustments if a life pension is awarded.

Workers Compensation Appeals BoardCheryl PeetCounty of VenturaCORVEL CORPORATIONADJ823138OXN 0142604Opinion and Decision After Reconsiderationdeputy probation officerindustrial injuryright upper extremity
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. ADJ6571055
Regular
Mar 11, 2010

GERMAN QUIROGA vs. YANKEE CANDLE COMPANY, TRAVELERS ORANGE

The Appeals Board denied the applicant's petition for reconsideration but granted the defendant's. The Board rescinded the original award and returned the case to the trial level for a decision on permanent disability benefits. This action was taken because the applicant failed to adequately develop the record regarding an *Almaraz-Guzman* analysis, despite having ample opportunity. Therefore, the permanent disability finding should be based on the existing medical reports from the conclusion of the prior trial.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award OrderIndustrial InjuryLumbar SpineCandle MakerPermanent DisabilityPermanent and StationaryAlmaraz-GuzmanSupplemental Report
References
Case No. ADJ4337031 (SAC 0363533)
Regular
Aug 19, 2011

CHARLOTTE HUDSON vs. EMG CHILDREN & FAMILY SERVICES, EVEREST NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior decision, rescinding the judge's award of 11% permanent disability. The case is returned to the trial level to further develop the medical record regarding the applicant's gait derangement impairment and its valuation under *Almaraz/Guzman* principles. The judge must also address the vocational expert's entitlement to fees and consider the recent *Ogilvie* decision's impact on permanent disability determination.

Workers' Compensation Appeals BoardFindings and AwardPermanent DisabilityVocational ExpertAgreed Medical ExaminerAlmaraz/GuzmanOgilvieGait DerangementAntalgic GaitAMA Guides 5th Edition
References
Case No. ADJ6631464
Regular
Oct 01, 2013

MANUEL FLORES vs. CITY OF STOCKTON

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration. The applicant argued for a higher permanent disability rating, citing Dr. Pang's opinion regarding an additional impairment for the right knee based on *Almaraz/Guzman II*. However, the Board found Dr. Pang's report lacked sufficient reasoning to support the proposed additional rating. Therefore, the Board adopted the WCJ's report and denied reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJAlmaraz-GuzmanAgreed Medical ExaminerPermanent DisabilityReportRight KneeLow BackStation and Gait Abnormality
References
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