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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
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. 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. ADJ7261203
Regular
Oct 11, 2012

ANGELINA KENDRICK McGEE vs. STATE OF CALIFORNIA, DEPARTMENT OF JUSTICE, Legally Uninsured, Administered by STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

The defendant sought reconsideration of a workers' compensation award, challenging the inclusion of a grip strength rating for the applicant's left hand. The Appeals Board granted reconsideration, finding the Agreed Medical Examiner did not adequately justify departing from the AMA Guides' limitations on rating grip strength. Consequently, the applicant's permanent disability rating was reduced from 56% to 51% by excluding the grip strength impairment. The award for permanent disability indemnity and attorney fees was amended accordingly.

Workers' Compensation Appeals BoardAngelina Kendrick McGeeState of California Department of JusticeState Compensation Insurance FundOpinion and Order Granting ReconsiderationFindings and AwardOffice Assistant SupervisorPermanent DisabilityCervical SpineLeft Hand and Wrist
References
Case No. ADJ7713711
Regular
Mar 11, 2016

JULIANA MASTERS vs. STATE OF CALIFORNIA, DEPARTMENT OF MOTOR VEHICLES

The Appeals Board denied reconsideration of the WCJ's decision, upholding the finding that applicant's sleep impairment, though present, was subsumed by the physical upper extremity impairments and thus not separately ratable. The Board found the Agreed Medical Examiner's opinion on sleep disorder impairment was not substantial evidence as it was predicated on pain already accounted for in the physical injury ratings per the AMA Guides. Therefore, the applicant's permanent disability rating remained at 69%. A dissenting opinion argued the Agreed Medical Examiner's opinion should be followed, as it addressed distinct impairments beyond pain and was supported by relevant case law.

Workers' Compensation Appeals BoardAmended Findings of Fact and AwardsIndustrial InjuryUpper ExtremitiesPsycheBook BinderSleep ImpairmentAMA GuidesPermanent DisabilityAgreed Medical Examiner
References
Case No. SAC 0345394
Regular
Feb 22, 2008

DIANA RICHMOND vs. STATE OF CALIFORNIA, DEPARTMENT OF JUSTICE, legally uninsured

The Workers' Compensation Appeals Board denied reconsideration of a decision that applied the 2005 Permanent Disability Rating Schedule. The applicant argued that a pre-2005 MRI and subsequent medical opinions indicated permanent disability, thus triggering the older 1997 Schedule. The Board found that the MRI report alone was insufficient and that the AME's opinion on prior permanent disability was too late to qualify for the exception.

Workers' Compensation Appeals BoardDiana RichmondState of California Department of Justicelegally uninsuredSAC 0345394Opinion and Order Denying ReconsiderationFindings and AwardFebruary 222008industrial injury
References
Case No. ADJ10243412
Regular
Jun 10, 2019

DEBRA LUX vs. COUNTY OF SANTA BARBARA

This case involves an injured firefighter seeking workers' compensation for a right knee injury. The defendant sought reconsideration of a finding of 17% permanent disability, arguing the administrative law judge erred by combining range of motion and diagnosis-based impairments, and by not apportioning the diagnosis-based impairment. The Appeals Board denied reconsideration, finding the medical evaluator adequately explained the departure from standard AMA Guides methodology for rating the combined impairments. The Board also affirmed no apportionment of the diagnosis-based impairment as no substantial evidence showed non-industrial factors contributed to the need for surgery.

Workers' Compensation Appeals BoardApplicantDefendantPermissibly Self-InsuredAdministered by CORVELFirefighterIndustrial InjuryRight KneePermanent DisabilityWhole Person Impairment
References
Case No. ADJ7560161
Regular
Feb 16, 2017

Julie Cagle vs. Bank of America, ACE AMERICAN INSURANCE COMPANY

This case involves Julie Cagle's workers' compensation claim against Bank of America for admitted industrial injuries to her psyche and abdomen. The Appeals Board reconsidered a prior award, increasing the applicant's permanent disability rating. The key dispute centered on the proper rating for internal injuries under the AMA Guides, with the applicant arguing for a higher WPI rating based on a Class 3 classification. The Board ultimately determined the applicant's internal system impairment warranted a 25% WPI, leading to a total of 49% permanent disability. The award was also clarified to allow the defendant credit for permanent disability advances already paid.

Workers' Compensation Appeals BoardJulie CagleBank of AmericaAce American Insurance CompanyCorvelPetition for ReconsiderationFindings of Fact and AwardInternal Systems InjuryPsyche InjuryPermanent Disability
References
Case No. ADJ2419502 (MON 0329358) ADJ4501373 (MON 0326365)
Regular
Oct 24, 2011

MACK JARAMILLO vs. COCA COLA BOTTLING CO., Permissibly Self-Insured

This case involves a warehouseman seeking workers' compensation for cumulative and specific injuries resulting in severe physical and psychological impairments. The applicant was awarded 100 percent permanent disability, including further medical treatment, for his specific injury. The defendant sought reconsideration, arguing the 100 percent permanent disability rating was improperly calculated by disregarding the AMA Guides' Combined Values Chart. The Appeals Board denied reconsideration, finding the WCJ properly determined the applicant was totally disabled "in accordance with the fact" under Labor Code Section 4662, supported by substantial evidence of total loss of earning capacity.

WCABPetition for ReconsiderationFindings and OrderFindings and Awardstipulationindustrial injurycervical spinelumbar spinepsycheseizure disorder
References
Case No. ADJ10815810
Regular
May 06, 2019

Derrell Meek vs. Corcoran State Prison, State Compensation Insurance Fund

The Workers' Compensation Appeals Board granted reconsideration of an administrative law judge's decision, overturning the finding of 86% permanent disability. The Board found that the physician's initial assessment of 75% whole person impairment for hypertensive cardiovascular disease, as per the AMA Guides, was appropriate. This 75% impairment was then adjusted to permanent total disability, recognizing that the scheduled rating adequately addressed the applicant's condition. The decision ultimately awarded permanent total disability indemnity and ongoing medical treatment.

Workers' Compensation Appeals BoardCorcoran State PrisonState Compensation Insurance FundDerrell Meekcorrectional officercirculatory systempermanent disabilityMilpitas Unified School District v. Workers' Comp. Appeals Bd. (Guzman)alternative impairment analysisAMA Guides
References
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