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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. 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The Appeals Board rescinded the prior award due to the physician's flawed methodology in determining permanent disability.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. ADJ8599111
Regular
May 24, 2018

PAUL CHIN vs. EVEREST COLLEGE, AMERICAN ZURICH INSURANCE COMPANY

This Workers' Compensation Appeals Board decision grants reconsideration and affirms the applicant's award of 53% permanent disability, with adjustments for benefits paid and attorney fees. The Board rejected the defendant's attempt to challenge the *Almaraz/Guzman III* analysis, finding it was raised too late. The Board also refused to consider the defendant's supplemental pleading. The award is finalized with jurisdiction reserved for any disputes regarding benefit adjustments.

Petition for ReconsiderationAlmaraz/Guzman III analysisPanel Qualified Medical ExaminerPQMEPermanent DisabilityApportionmentAttorney FeeAppeals Board Rule 10848Supplemental PleadingTimely Manner
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. 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. ADJ773007 (MON 0355112)
Regular
Nov 19, 2018

PAUL LOGAN vs. GREYHOUND LINES, INC.; GALLAGHER BASSETT SERVICES; administered by ACE USA

The Workers' Compensation Appeals Board denied the petition for reconsideration, affirming the WCJ's finding of 24% permanent disability for a cumulative trauma injury. The Board rejected the applicant's argument to rely on the Agreed Medical Examiner's *Almaraz/Guzman* analysis, deeming it unsubstantiated and not within the AMA Guides. The Board also denied a requested 15% increase for failure to offer work and found no basis for a 100% permanent disability award. The Board's final order affirmed the original WCJ decision.

Workers' Compensation Appeals BoardPaul LoganGreyhound LinesInc.Gallagher Bassett ServicesACE USAcumulative traumacervical spineleft shoulderleft wrist
References
Case No. ADJ1576904 (MON 0349581) ADJ4588351 (MON 0349580)
Regular
Jul 02, 2013

MICHAEL DANKS vs. WARNER BROTHERS ENTERTAINMENT, INC.

This case involves applicant Michael Danks' petition to limit the scope of a workers' compensation trial, arguing only discovery and transportation expenses should be litigated. The Appeals Board denied the petition, upholding the WCJ's decision to allow trial on all issues. The Board recommended the WCJ consider applicant's financial hardship, potentially allowing telephone appearance and coordinating medical evaluations to minimize travel costs. It also noted that Almaraz-Guzman analysis is optional and other issues may be decided even if permanent disability isn't resolved.

Petition for RemovalTransportation ExpensesMedical EvaluationQualified Medical EvaluatorAgreed Medical EvaluatorAMA GuidesAlmaraz-GuzmanPermanent DisabilityDiscovery IssuesContinual Trial
References
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