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

Case No. ADJ10307426
Regular
Dec 10, 2018

CHRISTOPHER DEVEREUX vs. STATE COMPENSATION INSURANCE FUND

This case involves applicant Christopher Devereux seeking reconsideration of a 90% permanent disability award for cumulative trauma, primarily hypertension and cognitive impairment, as an attorney. The defendant contested the award, arguing the permanent disability rating should have been calculated using the Combined Value Chart (CVC) instead of simple addition. The Board granted applicant's reconsideration to amend the award for future medical treatment and to include annual increases based on the state average weekly wage. Ultimately, the Board affirmed the 90% permanent disability rating, finding the additive method was appropriate based on medical expert opinions, and denied the defendant's petition.

WCABPermanent Disability RatingCumulative TraumaHypertensionDiabetesHeart ImpairmentCirculatory ImpairmentCognitive ImpairmentApportionmentAddition Method
References
Case No. ADJ9344211
Regular
Dec 01, 2017

Patricia Preston vs. Los Angeles Unified School District, SEDGWICK CLAIMS MANAGEMENT SERVICES

The applicant sought reconsideration of a workers' compensation award, challenging the permanent disability rating primarily based on the chosen medical evaluation method. The applicant argued the Range-of-Motion (ROM) method, favored by her treating physician, should have been used instead of the Diagnosis-Related Estimates (DRE) method employed by a Qualified Medical Evaluator (QME). Additionally, she contended that her vocational expert's opinion supported a finding of total permanent disability. The Board denied reconsideration, affirming the administrative law judge's decision, finding the QME's DRE rating supported by substantial evidence and the applicant's vocational evidence insufficient to prove total disability. A dissenting opinion argued that findings of multi-level spinal involvement supported the use of the ROM method for a potentially higher rating and questioned the QME's justification for choosing DRE.

Workers' Compensation Appeals BoardPatricia PrestonLos Angeles Unified School DistrictSedgwick Claims Management ServicesADJ9344211Permanent Disability RatingRange-of-Motion MethodDiagnosis-Related Estimates MethodApportionmentDr. Fenton
References
Case No. ADJ8240882; ADJ8240881; ADJ8615401
Regular
Apr 21, 2025

ROBERT S. HAPPENY vs. STATE OF CALIFORNIA, CALIFORNIA INSTITUTE FOR WOMEN

Applicant Robert S. Happeny sustained industrial injuries during his employment as a correctional officer, leading to a finding of permanent and total disability by the WCJ due to his inability for vocational retraining. The WCJ also issued an unapportioned award, concluding that apportionment to nonindustrial factors was not proven. Defendant challenged this decision via a petition for reconsideration, disputing the method of combining disabilities and the reliability of vocational reports. The Appeals Board granted reconsideration, affirming the WCJ's determination of permanent and total disability based on vocational infeasibility and the lack of established apportionment, ultimately rescinding the original decision and substituting new findings of fact.

ADJ8240882ADJ8240881ADJ8615401correctional officerindustrial injuryheartpsycheright wristrespiratory systemlumbar spine
References
Case No. ADJ11183558
Regular
Feb 14, 2020

JAMES P. MARTINEZ vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

This case concerns an admitted cumulative trauma injury to a correctional officer's neck, back, knees, shoulders, and hypertension. The Workers' Compensation Appeals Board granted reconsideration, finding the original award improperly added hypertension disability to orthopedic disability. The Board determined substantial medical evidence was lacking to justify this additive method over the standard Combined Values Chart (CVC). Consequently, the permanent disability rating was revised from 79% to 72% using the CVC.

Workers' Compensation Appeals BoardCumulative traumaPermanent disability ratingCombined Values ChartAdditive methodOrthopedic disabilitiesHypertensionSubstantial medical evidenceLabor Code sections 4664Labor Code section 4663
References
Case No. ADJ2970937 (VNO 0504765)
Regular
Nov 21, 2017

Joel De La Cerda vs. Martin Selko & Co., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the previous award, and returned the case for further proceedings. Applicant contested a 93% permanent disability award, arguing the Agreed Medical Examiner (AME) should have directed impairments to be added rather than combined, which would result in 100% disability. The Board found the trial judge erred in rejecting the AME's opinion solely due to the potential for a rating exceeding 100%, which is legally permissible. The matter was remanded for the AME to clarify their reasoning for the additive rating method.

Agreed Medical ExaminerPermanent DisabilityApportionmentCombined Value ChartVocational ExpertFindings of Fact and AwardPetition for ReconsiderationSynergistic EffectAdditive MethodWhole Person Impairment
References
Case No. ADJ10166138
Regular
Apr 07, 2023

MICHAEL DOWLING vs. MANPOWERGROUP, NEW HAMPSHIRE INSURANCE COMPANY, GALLAGHER BASSETT SERVICES

The Workers' Compensation Appeals Board denied the defendants' petition for reconsideration. The defendants contended the Administrative Law Judge erred by stating applicant required medical treatment for his left shoulder and wrist, and by finding an $83\%$ permanent disability with a lifetime pension. The Board adopted the WCJ's report, which corrected the clerical error regarding the shoulder and wrist treatment but upheld the permanent disability finding. The WCJ determined the "addition method," rather than the Combined Values Chart, was the most accurate way to combine the applicant's orthopedic and psychiatric impairments based on substantial medical evidence.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ ReportDenying ReconsiderationAdjudication NumberAdmitted Industrial InjuryCompensable ConsequencesNervous SystemPsycheExcretory System
References
Case No. ADJ7917390 ADJ8109606
Regular
Apr 08, 2015

ARLENE ZENDEL vs. COUNTY OF LOS ANGELES, Permissibly Self-Insured, Adjusted By INTERCARE INSURANCE SERVICES

The Appeals Board granted the defendant's petition for reconsideration and affirmed the WCJ's original Findings and Awards, with modifications. The Board corrected clerical errors regarding the date of injury for cumulative trauma in ADJ8109606 and amended the temporary disability finding in ADJ7917390 to include credit for days worked. The Board found that the Agreed Medical Evaluator's use of the range of motion method for rating spinal impairments, based on MRI and EMG results, constituted substantial evidence and rejected the defendant's arguments otherwise. Finally, the Board dismissed applicant's untimely raised issue regarding the "additive method."

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardsApplicantDefendantIndustrial InjuryPsycheBilateral WristsBackNeck
References
Case No. ADJ6972640
Regular
Jul 25, 2016

JAVIER VENTURA vs. AMERICAN COPAK CORPORATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and returned the case to the trial level for further proceedings. The WCAB found the original decision lacked sufficient explanation for its findings, particularly regarding the occupational group number and the chosen method for rating lumbar spine impairment. Furthermore, the WCAB requires a specific medical opinion on the appropriate method to assess the applicant's lumbar spine disability under the AMA Guides. The WCAB also directed further development of the record concerning the applicant's claimed lung injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryPermanent DisabilityDRE MethodROM MethodOccupational Group NumberAMA GuidesLumbar Spine Impairment
References
Case No. ADJ8181938; ADJ8702275
Regular
Apr 10, 2023

KAREN MILLER vs. STATE OF CALIFORNIA, VENTURA YOUTH CORRECTIONAL FACILITY, STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant argued against the statutory 15% increase, the method of evaluating spine impairment, and the inclusion of a sleep disorder. The Board adopted the WCJ's report, finding no error in the application of the 15% increase or the evaluation of the spine impairment using the ROM method as deemed appropriate by the agreed medical examiner. Furthermore, the Board upheld the finding of an industrially caused sleep disorder, noting that formal sleep studies are not always required for diagnosis and that the physician's rating falls within the AMA Guides.

WCABPetition for ReconsiderationDeniedVentura Youth Correctional FacilityAdjudication NumbersOccupational Group 214Cervical SpineLumbar SpineBilateral ShouldersGastrointestinal System
References
Case No. MON 0339411
Regular
Jul 21, 2008

Dionisio Jimenez vs. NUPAC APARTMENTS, STATE COMPENSATION INSURANCE FUND

This case involves a dispute over the proper method used to rate the applicant's permanent disability following a back and leg injury. The defendant contends the Agreed Medical Examiner improperly used the Range of Motion (ROM) method instead of the Diagnosis-Related Estimate (DRE) method per the AMA Guides. The Appeals Board rescinded the prior award and returned the case to the trial level for further development of the record. This development will address why the ROM method was used and clarify the appropriate rating methodology.

Workers' Compensation Appeals BoardDionisio JimenezNupac ApartmentsState Compensation Insurance FundMON 0339411Opinion and Decision After ReconsiderationFindings and AwardIndustrial InjuryBack InjuryRight Leg Injury
References
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