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

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
3
Case No. ADJ2786471 (AHM 0131083) ADJ1723308 (AHM 0131186) ADJ1776217 (AHM 0131184)
Regular
Jul 12, 2011

RENE GARCIA vs. CITY OF ANAHEIM

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior decision regarding applicant Rene Garcia's industrial injury to his low back and knees. The Board found that the treating physician's impairment rating was not substantial evidence because it impermissibly considered the applicant's ability to compete in the open labor market, in addition to Activities of Daily Living (ADLs), deviating from *Almaraz/Guzman* guidelines. The matter was returned to the trial level for further proceedings, including a supplemental report or deposition from the physician, to clarify the *Almaraz/Guzman* analysis solely on ADLs.

Workers Compensation Appeals BoardCity of Anaheimfirefightercumulative traumapermanent disability awardapportionmentAMA GuidesAlmaraz v. Environmental Recovery ServicesMilpitas Unified School Dist. v. Workers' Comp. Appeals Bd.Whole Person Impairment
References
7
Case No. ADJ763837 (RDG 0127177) ADJ3894868 (RDG 0129247) ADJ2280504 (RDG 0129248)
Regular
Mar 29, 2011

JONI LAMKIN vs. DEPARTMENT OF TRANSPORTATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of a decision finding applicant sustained three industrial injuries. The Board found the original decision flawed due to inadequate reasoning by the judge and the Qualified Medical Examiner regarding disability ratings under *Almaraz/Guzman*. The Court rescinded the prior order and returned the case to the trial level for further proceedings and a new decision, citing insufficient explanation for deviation from AMA Guides and a lack of clear findings on separate injuries. This decision mandates that future reports and awards must provide detailed justifications for disability ratings and clearly delineate findings for distinct injuries.

Workers Compensation Appeals BoardJoni LamkinDepartment of TransportationState Compensation Insurance FundADJ763837ADJ3894868ADJ2280504ReconsiderationPermanent DisabilityPanel Qualified Medical Evaluator
References
8
Case No. ADJ2802696 (STK 0206161)
Regular
Mar 23, 2009

PAM ELLIOTT vs. MOSAIC SALES SOLUTIONS, THE HARTFORD

The Workers' Compensation Appeals Board (WCAB) rescinded a prior award and returned the case to the trial level for further proceedings. The applicant, injured in 2004, argued the 2005 permanent disability schedule inadequately addressed her diminished future earning capacity. Citing its recent en banc decisions in *Almaraz/Guzman* and *Ogilvie*, the WCAB found these decisions established that both the AMA Guides and the diminished future earning capacity (DFEC) portions of the 2005 Schedule are rebuttable. The case was remanded for further consideration of the applicant's arguments in light of these binding precedents.

Workers' Compensation Appeals BoardPetition for ReconsiderationPermanent Disability Rating2005 ScheduleAMA GuidesDiminished Future Earning CapacityVocational Rehabilitation ExpertRebuttable PresumptionStare DecisisAlmaraz/Guzman
References
5
Case No. ADJ3622491 (AHM 0147660)
Regular
Jun 30, 2010

FRANCISCO HERRERA vs. CORESTAFF SERVICES, AMERICAN HOME ASSURANCE

This case involves a workers' compensation applicant claiming bilateral forearm and hand injury. The administrative law judge (WCJ) previously found $0\%$ permanent disability, but the applicant sought reconsideration, arguing for a $12\%$ permanent disability rating based on the Agreed Medical Examiner's (AME) report. The Appeals Board rescinded the WCJ's decision and remanded the case for further proceedings because the AME's report lacked sufficient explanation for its impairment conclusions, especially in light of the *Almaraz/Guzman II* decision. The Board also noted that the issue of attorney's fees would be addressed during the further proceedings.

Workers' Compensation Appeals BoardPermanent Disability RatingWhole Person ImpairmentAMA GuidesAgreed Medical ExaminerDisability Evaluation SpecialistReconsiderationMedical ReportsLegal TheorySubstantial Evidence
References
8
Case No. ADJ4337031 (SAC 0363533)
Regular
Aug 19, 2011

CHARLOTTE HUDSON vs. EMG CHILDREN & FAMILY SERVICES, EVEREST NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior decision, rescinding the judge's award of 11% permanent disability. The case is returned to the trial level to further develop the medical record regarding the applicant's gait derangement impairment and its valuation under *Almaraz/Guzman* principles. The judge must also address the vocational expert's entitlement to fees and consider the recent *Ogilvie* decision's impact on permanent disability determination.

Workers' Compensation Appeals BoardFindings and AwardPermanent DisabilityVocational ExpertAgreed Medical ExaminerAlmaraz/GuzmanOgilvieGait DerangementAntalgic GaitAMA Guides 5th Edition
References
9
Case No. ADJ1449074 (SAL 0116875)
Regular
Aug 10, 2009

GIRNIE BROWN vs. TRUCK RACKS BY RACK-IT, INC., STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the applicant sustained admitted injuries to his back, neck, spine, shoulders, and extremities. The defendant seeks reconsideration of a $100\%$ permanent disability award, arguing the rating is excessive and misapplied Almaraz. The Appeals Board granted reconsideration to await further decisions in pending Almaraz and Ogilvie cases. The matter is returned to the WCJ for further proceedings and a new decision after those binding decisions are issued, and to address the commencement date of indemnity.

AlmarazOgilviepermanent disabilitypermanent total disabilityvocational expertQMEDREfailed back surgerymicrodiskectomyindustrial injury
References
5
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
9
Case No. ADJ9311285
Regular
Jan 12, 2018

Herbert Schmitz vs. Westlands Water District, Liberty Mutual Insurance Company/Wausau

The Workers' Compensation Appeals Board (WCAB) reconsidered a decision awarding 74% permanent disability. The defendant argued the Qualified Medical Evaluator (QME), Dr. Deshmukh, improperly used the hernia chapter of the AMA Guides for impairment rating, violating *Almaraz-Guzman* principles. The WCAB agreed that Dr. Deshmukh's rating lacked sufficient explanation for deviating from standard orthopedic evaluations. Consequently, the WCAB rescinded the permanent disability and attorney's fees findings, returning the case for further proceedings, potentially including a supplemental report or deposition from Dr. Deshmukh, to properly address impairment rating.

Workers Compensation Appeals BoardPermanent DisabilityQualified Medical EvaluatorWhole Person ImpairmentAMA GuidesAlmaraz-GuzmanIndustrial InjuryMedical TreatmentLabor CodeFindings and Award
References
6
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
49
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