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

Case No. ADJ8772254
Regular
Jul 20, 2017

Lorenzo Hernandez vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION, NORTH KERN STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Lorenzo Hernandez's petition for reconsideration, upholding the original award of 24% permanent disability for a right shoulder injury. The applicant argued that a vocational expert's report should have rebutted the scheduled disability rating, but the Board found this report insufficient. Relying on *Ogilvie* and *Dahl*, the Board determined that an applicant's amenability to vocational rehabilitation precludes using vocational expert testimony to challenge a scheduled rating based on lost earning capacity. Therefore, the vocational expert's opinion was deemed not substantial evidence to overcome the QME's scheduled rating.

Workers' Compensation Appeals BoardPermanent DisabilityVocational ExpertQualified Medical EvaluatorScheduled RatingReconsiderationLabor Code §4660.1AMA Guides 5th EditionAmenability to Vocational RehabilitationDiminished Future Earning Capacity
References
3
Case No. MISSING
Regular Panel Decision
Dec 21, 1995

In re Jordan Rehabilitation Service, Inc.

Jordan Rehabilitation Service, Inc., providing medical and vocational rehabilitative services, appealed a decision by the Unemployment Insurance Appeal Board. The Board assessed additional unemployment insurance contributions, finding that specialists hired by Jordan were employees, not independent contractors, between 1989 and 1991. The court reviewed whether there was substantial evidence to support the Board's conclusion of an employer-employee relationship. Key factors included Jordan's control over recruitment, screening, compensation, billing, and contractual restrictions on specialists. Ultimately, the court affirmed the Board's decision, determining that Jordan exercised sufficient overall control to establish an employer-employee relationship and thus was liable for the contributions.

Unemployment InsuranceEmployer-Employee RelationshipIndependent ContractorRehabilitation ServicesLabor LawSubstantial EvidenceControl TestJudicial ReviewAdministrative Law JudgeDepartment of Labor
References
8
Case No. ADJ8189392
Regular
Jan 19, 2015

KATHRYN JOHNSON vs. STATE OF CALIFORNIA DEPARTMENT OF DEVELOPMENTAL SERVICES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration regarding an award of permanent total disability. The defendant argued the vocational rehabilitation expert's report lacked substantial evidence and failed to apportion the injury. The Board found the vocational expert's opinion that the applicant was not amenable to vocational rehabilitation and had a complete loss of earning capacity was supported by medical evidence. This analysis was unaffected by the *Dahl* decision, leading to the denial of the petition.

Petition for ReconsiderationFindings and AwardNotice of IntentionVocational Rehabilitation ExpertSubstantial EvidenceApportionmentPermanent Total DisabilityLoss of Earnings CapacityDahl holdingContra Costa County v. Workers' Comp. Appeals Bd.
References
2
Case No. ADJ3677747 (ANA 0406009) ADJ6794905
Regular
Jul 17, 2017

GREGORY FRITZ vs. SERVICE FIRST LIGHTING AND ELECTRIC, CASTLEPOINT NATIONAL INSURANCE COMPANY

This Workers' Compensation Appeals Board decision rescinds a prior award of total permanent disability due to insufficient evidence on the applicant's amenability to vocational rehabilitation. While vocational experts opined the applicant couldn't compete in the labor market, their reports did not adequately address rehabilitation potential. The case is remanded to the trial level for further development of the record on rehabilitation and a new decision regarding permanent disability, either by rebutting the scheduled rating or proving total disability under Labor Code section 4662(b).

Workers Compensation Appeals BoardIndustrial InjuryTotal Permanent DisabilityLabor Code Section 4662ReconsiderationVocational ExpertsAmenability to RehabilitationPermanent Disability Rating ScheduleApportionmentQualified Medical Evaluator
References
10
Case No. ADJ9025732
Regular
Apr 07, 2023

ALBERT MATA vs. STATE OF CALIFORNIA - DEPARTMENT OF CORRECTIONS & REHABILITATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding of 100% permanent total disability for the applicant, Albert Mata. The defendant argued that the applicant's vocational counselor's reports and medical reports did not constitute substantial evidence for total disability. However, the Board affirmed the Administrative Law Judge's decision, finding the vocational expert's opinions were substantial evidence, not based on speculation, and correctly applied California's 2005 Permanent Disability Rating Schedule for psychiatric impairments. Therefore, the Board concluded the applicant was precluded from vocational rehabilitation and participating in the labor force.

Permanent total disabilityPsychiatric injuryVocational Rehabilitation CounselorAmerican Medical Association GuidesGlobal Assessment of FunctioningPermanent Disability Rating ScheduleSubstantial evidencePetition for ReconsiderationAdministrative Law JudgeAgreed Medical Examiner
References
7
Case No. ADJ7817116
Regular
Dec 17, 2019

KAREN SWANSON vs. FRESNO UNIFIED SCHOOL DISTRICT

In this workers' compensation case, the Board affirmed the trial judge's finding of permanent total disability for applicant Karen Swanson due to a February 17, 2004 industrial injury. The defendant school district sought reconsideration, contesting the total disability finding and arguing for apportionment. Crucially, both the applicant's and the defendant's vocational experts independently concluded that the applicant was unemployable and not amenable to vocational rehabilitation due to her injury. The Board found substantial evidence supported the total disability award, exceeding the scheduled rating based on the unanimous vocational expert opinions.

Permanent total disabilityAgreed Medical ExaminerOrthopedicsApportionmentVocational expertsLabor market preclusionVocational rehabilitationDiminished future earning capacityScheduled ratingIndustrial injury
References
2
Case No. ADJ8903652
Regular
Nov 30, 2017

Deric Hobson vs. BECHTEL GROUP, INC.

The Workers' Compensation Appeals Board granted reconsideration, amending the original award to find applicant permanently totally disabled (100% permanent disability). This decision overturned the trial judge's finding of 88% permanent disability, accepting the applicant's argument that his admitted Valley Fever injury rendered him unemployable. The Board found persuasive the vocational expert's opinion that the applicant's chronic pain, fatigue, and concentration issues made him unemployable and not amenable to vocational rehabilitation, despite the defense's vocational expert's opposing view. The case was returned for a new award reflecting 100% permanent disability.

Valley FeverCoccidiomycosiscumulative traumapermanent total disabilityvocational expertAMA GuidesWhole Person Impairmentsemi-sedentary workactivities of daily livingvocational rehabilitation
References
2
Case No. MISSING
Regular Panel Decision
May 14, 2014

Forest Rehabilitation Medicine PC v. Allstate Insurance

Plaintiff Forest Rehabilitation Medicine PC sued defendant Allstate to recover $3,490 for no-fault medical benefits provided to assignor Tracy Fertitta. The core issue was the medical necessity of "Calmare pain therapy" (scrambler therapy), a novel treatment. The court conducted a bench trial, hearing expert testimony from both sides. Dr. Ayman Hadhoud, for the defense, argued the treatment was not medically necessary, not cost-effective, and essentially a form of physical therapy. Dr. Jack D’Angelo, for the plaintiff, countered that the therapy, though new, had FDA approval, was used by the military, and reduced the assignor's pain levels. Applying the Frye standard, the court found the evidence regarding Calmare scrambler therapy reliable and ruled it was medically necessary for Ms. Fertitta's pain management. Consequently, judgment was awarded to the plaintiff, Forest Rehabilitation Medicine PC, for $3,490 plus attorney's fees and interest.

No-Fault InsuranceMedical NecessityCalmare Pain TherapyScrambler TherapyNovel TreatmentFrye StandardExpert TestimonyPain ManagementFDA ApprovalCervical Radiculopathy
References
14
Case No. ADJ2860436
Regular
Dec 02, 2011

HAROLD DAVID WATSON vs. VANCE INTERNATIONAL, NATIONAL FIRE CO. OF PITTSBURGH PENNSYLVANIA

The applicant seeks reconsideration of a prior decision finding the employer's appeal of a vocational rehabilitation benefits determination was timely filed. The Appeals Board upheld its prior finding, determining that the employer filed its appeal on December 11, 2008, which was before the January 1, 2009 repeal of the vocational rehabilitation statute. Because the appeal was timely and the right to benefits was not vested prior to the repeal, the applicant is not entitled to vocational rehabilitation benefits.

Rehabilitation UnitVocational rehabilitation benefitsLabor Code section 139.5Appeal PetitionDeclaration of Readiness to ProceedPersonal serviceService by mailDocument Cover SheetWCAB District OfficeProof of service
References
50
Case No. ADJ2862114
Regular
Oct 30, 2008

PATRICIA TRUJILLO vs. EARTHLINK, INC., CHUBB INSURANCE SERVICES

The Workers' Compensation Appeals Board affirmed a prior ruling that the defendant, Earthlink, Inc., owes vocational rehabilitation benefits to the applicant, Patricia Trujillo. The court found that the defendant failed to provide legally required notices when the applicant deferred vocational rehabilitation services. This failure meant the deferral was invalid, making the defendant liable for vocational rehabilitation maintenance allowance (VRMA) from the date of the notice breach.

Vocational rehabilitationAD Rule 9813(a)(4)VRMAdeferral of servicesnotice requirementsclaims administratorinterrupted servicesreinstatement of servicesstatute of limitationsemployer's duty
References
6
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