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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. ADJ6820630
Regular
Mar 19, 2018

MARK COLLINS vs. ENTERTAINMENT PARTNERS, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

The WCAB dismissed the Defendant's Petition for Reconsideration because it was not filed from a final order. The Board granted the Defendant's Petition for Removal to rescind the WCJ's order vacating submission and appointing a new physician. The WCJ erred by refusing to accept the AME's rating based on the Diagnosis-Related Estimate (DRE) method, as physicians have discretion to use the most accurate method. However, the AME's own deposition testimony indicated that the Range of Motion (ROM) method, mandated by the WCJ, would yield a higher impairment rating. Therefore, the matter is returned to the trial level for the WCJ to obtain a permanent disability rating using the existing record and potentially consulting a DEU rater.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalAgreed Medical Examiner (AME)Range of Motion (ROM) methodDiagnosis-Related Estimates (DRE) methodAmerican Medical Association's Guides (AMA Guides)Whole Person Impairment (WPI)cumulative traumaspinal injury
References
Case No. ADJ15533922
Regular
Mar 10, 2025

FRANK DERRICK vs. RONALD L. WOLFE & ASSOCIATES, INSURANCE COMPANY OF THE WEST

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration, adopting the report of the workers' compensation administrative law judge. The defendant challenged the WCJ's findings regarding the Qualified Medical Evaluator's opinion on permanent disability determination methods, the application of apportionment, and the combining versus adding of impairments. The Board affirmed that the defendant failed to provide substantial medical evidence for apportionment and that the impairments were correctly combined as per legal principles. The decision emphasized the importance of comprehensive medical reports for apportionment and accurate impairment calculations.

WCABPetition for ReconsiderationLabor Code section 5909Electronic Adjudication Management System (EAMS)transmission60-day periodnoticeSection 4663apportionmentpermanent disability
References
Case No. ADJ9890148
Regular
Feb 02, 2017

Timothy Bedford vs. CITY OF LOS ANGELES

This Workers' Compensation Appeals Board case denies reconsideration of a permanent disability rating. The Board affirmed the use of Figure 15-19 of the AMA Guides, finding it permissible to use any chapter or method within the Guides that most accurately reflects impairment. The Agreed Medical Evaluator's opinion was deemed substantial, as he explained how Figure 15-19 was used to derive a more accurate rating based on the applicant's specific spinal condition. The decision also distinguished the current case from prior panel decisions regarding the application of the AMA Guides and work limitations.

AMA Guidespermanent disability ratingrebuttable presumptionwhole person impairmentAlmaraz/Guzman IIclinical judgmentagreed medical evaluator (AME)Figure 15-19functional losssurgical-grade disc herniations
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. 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
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