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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. 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. ADJ6598413
Regular
May 11, 2010

SUSAN TOSTE vs. KERMAN UNIFIED SCHOOL DISTRICT, TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award. The Board found the Agreed Medical Evaluator's (AME) impairment rating was based on an outdated legal standard rejected in *Almaraz/Guzman II*. Since the AME's report predated the controlling precedent and the evaluator wasn't given a chance to supplement their opinion under the correct legal framework, the case is returned to the trial level for further medical record development.

ADJ6598413Kerman Unified School DistrictTristar Risk ManagementSusan TosteWorkers' Compensation Appeals BoardOpinion and Order Granting ReconsiderationFindings and AwardIndustrial InjuryRight ShoulderPermanent Disability
References
Case No. ADJ383172 (STK 0200826)
Regular
Nov 17, 2010

ENRIQUE CASTANEDA vs. BARRETT BUSINESS SERVICES

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration because it was filed one day late. The defendant argued the administrative law judge erred in applying the Almaraz/Guzman II standards to calculate the applicant's permanent disability. However, the Board found the petition was untimely and therefore must be dismissed, noting it would have been denied on the merits otherwise. The deadline for filing was October 4, 2010, and the petition was received on October 5, 2010.

Almaraz/Guzman IIAMA GuidesPermanent DisabilityFindings and AwardPetition for ReconsiderationTimelinessJurisdictional Time LimitWCJ ReportWorkers' Compensation Appeals BoardLabor Code Section 5903
References
Case No. ADJ7504860
Regular
Nov 06, 2015

DENISE BATTON vs. STATE OF CALIFORNIA, CDCRCORRECTIONAL INSTITUTE, STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration to amend the original Findings and Award. The Board affirmed the use of *Almaraz-Guzman II* to determine the applicant's permanent disability rating of 24%. Crucially, the Board found that the applicant was entitled to a 15% increase in permanent disability benefits under Labor Code section 4658(d) due to the defendant's failure to offer work post-injury, which also adjusted the attorney's fees accordingly.

Workers' Compensation Appeals BoardReconsiderationFindings of Fact and AwardLabor Code section 4658(d)Almaraz-Guzman IIPermanent DisabilityIndemnityPermanent and Stationary DateAgreed Medical ExaminerAttorney's Fees
References
Case No. ADJ2766944 (SAC 0350871)
Regular
Jul 08, 2014

Randy White vs. Heritage Park Apartments, State Compensation Insurance Fund

The Workers' Compensation Appeals Board granted reconsideration and rescinded the original Findings and Award. The Board found that further development of the record was needed regarding the applicant's orthopedic permanent disability, specifically clarifying Dr. Bray's opinion on impairment and the application of *Almaraz/Guzman II*. Additionally, the Board determined that 10% of the psychiatric disability attributed to medication use should be considered industrial, reducing non-industrial apportionment from 30% to 20%. The matter was returned to the WCJ for further proceedings and a new decision on the deferred issues of permanent disability and attorney's fees.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardAdministrative Law JudgeQualified Medical EvaluatorAgreed Medical EvaluatorPermanent DisabilityApportionmentOrthopedic InjuryPsychiatric Injury
References
Case No. ADJ7904815
Regular
Apr 10, 2014

TED MARTINEZ vs. CITY OF BAKERSFIELD

This case concerns Ted Martinez's workers' compensation claim against the City of Bakersfield for industrial psychiatric and Valley Fever injuries. The Board granted reconsideration to review the $41\%$ permanent disability award, which the defendant argued was based on an Agreed Medical Examiner's (AME) opinion that failed to comply with *Almaraz/Guzman II* guidelines. The Board found the AME's opinion lacked sufficient explanation for deviating from the AMA Guides and thus was not substantial evidence. Consequently, the Board affirmed the initial findings of injury but deferred permanent disability and attorney fees for further development of the record at the trial level.

Workers' Compensation Appeals BoardPsychiatric injuryValley FeverCoccidioidomycosisContinuous traumaPermanent disability ratingAgreed Medical Examiner (AME)Whole Person Impairment (WPI)Almaraz/Guzman IIAMA Guides
References
Case No. ADJ6957361
Regular
Jan 12, 2012

ROBERTO BARAJAS vs. FRESNO UNIFIED SCHOOL DISTRICT

This case concerns a petition for reconsideration by Fresno Unified School District regarding a workers' compensation award for Roberto Barajas. The District challenged the permanent disability rating, arguing the Agreed Medical Examiner improperly included grip strength loss alongside range of motion limitations, contrary to AMA Guides guidelines. Additionally, the District contested a 10% penalty for delayed permanent disability advances and sought a reduction in benefits based on an offer of regular work. The Workers' Compensation Appeals Board denied reconsideration, affirming the WCJ's findings on the permanent disability rating by finding the AME appropriately applied *Almaraz/Guzman II* principles for calculating impairment. The Board also upheld the penalty for delayed advances and rejected the District's claim regarding work offer reductions.

Workers' Compensation Appeals BoardFresno Unified School DistrictRoberto BarajasFindings of Fact and Awardpermanent disabilityright wrist injuryright hand injuryright finger injurygroundskeeper/gardenerLabor Code section 4650
References
Case No. ADJ10934545
Regular
Aug 23, 2019

Richard Rodriguez vs. CPG FOODS, LLC/GALA FOOD, Cannon Cochran Management Services Inc.

The Appeals Board granted reconsideration and modified the original award, finding that the Qualified Medical Examiner's (QME) apportionment opinion lacked substantial evidence. The Board reversed the original 12% permanent disability finding, awarding 16% based on the QME's impairment rating after reviewing surveillance video evidence. The Board also clarified that treating physician reports from Dr. Mahboubian and Dr. Ahmed are admitted into evidence and may be relied upon. Finally, the Board affirmed the original findings regarding the injured body parts and the permanent and stationary date.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardApplicantDefendantsInjury AOE/COEUpper BackHipsKneesTemporary Total Disability
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
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