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Case Law Database

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

Case No. ADJ1078163, ADJ3341185

Significant

Sep 03, 2009

Applicant vs. Workers' Compensation Appeals Board

The court holds that a permanent disability rating under the 2005 Schedule is rebuttable, but any rebuttal evidence concerning Whole Person Impairment (WPI) must be founded within the four corners of the AMA Guides.

AMA GuidesPermanent Disability RatingRebuttablePrima Facie EvidenceWhole Person ImpairmentScheduleLabor Code Section 4660SB 899En Banc DecisionWorkers' Compensation Appeals Board

References

Case No. GRO 0029816, GRO 0029817

Significant

Marlene Escobedo vs. Marshalls, CNA Insurance Co.

The Appeals Board affirmed the WCJ's decision to apportion 50% of the applicant's permanent disability to a preexisting degenerative arthritis, holding that Labor Code section 4663, as amended by SB 899, permits apportionment based on causation from non-industrial factors supported by substantial medical evidence.

SB 899apportionmentcausationpermanent disabilitypreexisting arthritismedical evidencesubstantial evidenceLabor Code section 4663compensable consequenceQME

References

Case No. GRO 0029816, GRO 0029817

En Banc

Marlene Escobedo vs. Marshalls, CNA Insurance Co.

The Appeals Board affirmed the WCJ's decision, holding that under Labor Code section 4663 as amended by SB 899, apportionment of permanent disability is based on causation and may include pre-existing, non-industrial conditions like degenerative arthritis, provided there is substantial medical evidence to support the percentage of non-industrial causation.

SB 899ApportionmentCausationPermanent DisabilityPreexisting ConditionDegenerative ArthritisSubstantial Medical EvidenceMedical ProbabilityLabor Code Section 4663Compensable Consequence

References

Case No. GRO 0028123, GRO 0028394

En Banc

Feb 27, 2006

ERIC PASQUOTTO vs. HAYWARD LUMBER, CONNECTICUT INDEMNITY INSURANCE COMPANY, ATHENS ADMINISTRATORS

The Appeals Board held that a prior injury settlement via a compromise and release agreement does not constitute a 'prior award of permanent disability' under Labor Code section 4664(b) for apportionment purposes. However, evidence from the prior injury may still be relevant to determine apportionment based on causation under section 4663.

SB 899apportionmentcompromise and releaseprior awardpermanent disabilityLabor Code sections 46634664en banc decisionmedical rehabilitationother factors

References

Case No. GRO 0028123, GRO 0028394

Significant

Feb 27, 2006

Eric Pasquotto, Applicant vs. Hayward Lumber, Connecticut Indemnity Insurance Company, and Athens Administrators (Adjusting Agent)

This case holds that an order approving a compromise and release agreement is not a 'prior award of permanent disability' under Labor Code section 4664(b), but evidence from the prior injury may still be relevant for apportionment under section 4663. It also affirms that medical rehabilitation from a prior disability remains a viable concept under section 4663.

SB 899ApportionmentCompromise and ReleasePrior AwardPermanent DisabilityMedical RehabilitationOther FactorsLabor Code Sections 4663 and 4664En Banc DecisionWorkers' Compensation Appeals Board

References

Case No. ADJ2295331 (ANA 0397551)

En Banc

Jun 18, 2013

Wesley Carroll vs. Cincinnati Bengals, New Orleans Saints, Louisiana Workers' Compensation Corporation, Travelers Insurance

The Appeals Board held that under Labor Code § 3600.5(b), an employee hired outside California is exempt from the state's workers' compensation laws if they are temporarily in the state for work, the employer provides coverage from another state, and that state has reciprocal exemption provisions, leading to the dismissal of the Cincinnati Bengals from the case.

WCABEn BancReconsiderationLabor Code § 3600.5(b)ExemptionExtraterritorial ProvisionsOhio Workers' CompensationSelf-Insured EmployerTemporary EmploymentCumulative Injury

References

Case No. ADJ1177048

Significant

Sep 03, 2009

Wanda Ogilvie, Applicant vs. City and County of San Francisco, Permissibly Self-Insured

This en banc decision clarifies that a permanent disability rating established by the 2005 Schedule is rebuttable, the burden of rebuttal rests with the party disputing the rating, and a rating may be rebutted by challenging one of its components, such as the Diminished Future Earning Capacity (DFEC) adjustment factor.

Permanent DisabilityDiminished Future Earning CapacityDFECSchedulePrima Facie EvidenceRebuttableBurden of ProofRAND DataAMA GuidesOccupational Group

References

Case No. ADJ11017003

Regular

May 19, 2025

ABEL VAZQUEZ vs. INOCENSIO RENTERIA, ZENITH INSURANCE CO.

The Appeals Board, in an en banc decision, addressed the replacement of a Qualified Medical Evaluator (QME) when unable to schedule a re-evaluation within 120 days. It clarified that while Administrative Director Rules provide guidance, the Appeals Board retains discretionary power to order QME replacement for good cause, based on factors like delay, prejudice, and efforts to remedy unavailability. The Board granted the applicant's petition for reconsideration, rescinded the prior Findings and Order by the WCJ, and returned the matter for further proceedings, applying its new interpretation prospectively.

WCABen bancQME replacementAD Rule 31.3good causeprocedural issueremoval standardreconsiderationthreshold issuepermanent impairment

References

Case No. ADJ2295331 (ANA 0397551)

Significant

Jun 18, 2013

Wesley Carroll vs. Cincinnati Bengals, New Orleans Saints, Louisiana Workers' Compensation Corporation, Travelers Insurance

The Appeals Board held that an out-of-state employee and employer are exempt from California's workers' compensation system under Labor Code section 3600.5(b) when the employee is only temporarily in California, the employer provides coverage under another state's similar laws, and that state offers reciprocal exemption to California employers. Consequently, the Cincinnati Bengals were dismissed as a defendant.

Workers' Compensation Appeals BoardEn Banc DecisionLabor Code § 3600.5(b)Extraterritorial CoverageTemporary EmploymentSelf-Insured EmployerOhio Workers' Compensation LawReciprocityCumulative InjuryHire Outside of California

References

Case No. ADJ1177048

En Banc

Sep 03, 2009

WANDA OGILVIE vs. CITY AND COUNTY OF SAN FRANCISCO

This en banc decision clarifies that a permanent disability rating established by the Schedule is rebuttable, the burden of which rests with the disputing party. It affirms that a primary method of rebuttal is to challenge a component element, such as the Diminished Future Earning Capacity (DFEC) adjustment factor, by providing an individualized factor consistent with statutory requirements.

Diminished Future Earning CapacityDFEC2005 ScheduleRebuttablePrima Facie EvidencePermanent Disability RatingLabor Code section 4660RAND dataIndividualized Adjustment FactorWhole Person Impairment

References

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Updated Daily

Case Law Database

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

Case No. ADJ1078163, ADJ3341185

Significant

Sep 03, 2009

Applicant vs. Workers' Compensation Appeals Board

AMA GuidesPermanent Disability RatingRebuttablePrima Facie EvidenceWhole Person ImpairmentScheduleLabor Code Section 4660SB 899En Banc DecisionWorkers' Compensation Appeals Board

References

Case No. GRO 0029816, GRO 0029817

Significant

Marlene Escobedo vs. Marshalls, CNA Insurance Co.

SB 899apportionmentcausationpermanent disabilitypreexisting arthritismedical evidencesubstantial evidenceLabor Code section 4663compensable consequenceQME

References

Case No. GRO 0029816, GRO 0029817

En Banc

Marlene Escobedo vs. Marshalls, CNA Insurance Co.

SB 899ApportionmentCausationPermanent DisabilityPreexisting ConditionDegenerative ArthritisSubstantial Medical EvidenceMedical ProbabilityLabor Code Section 4663Compensable Consequence

References

Case No. GRO 0028123, GRO 0028394

En Banc

Feb 27, 2006

ERIC PASQUOTTO vs. HAYWARD LUMBER, CONNECTICUT INDEMNITY INSURANCE COMPANY, ATHENS ADMINISTRATORS

SB 899apportionmentcompromise and releaseprior awardpermanent disabilityLabor Code sections 46634664en banc decisionmedical rehabilitationother factors

References

Case No. GRO 0028123, GRO 0028394

Significant

Feb 27, 2006

Eric Pasquotto, Applicant vs. Hayward Lumber, Connecticut Indemnity Insurance Company, and Athens Administrators (Adjusting Agent)

SB 899ApportionmentCompromise and ReleasePrior AwardPermanent DisabilityMedical RehabilitationOther FactorsLabor Code Sections 4663 and 4664En Banc DecisionWorkers' Compensation Appeals Board

References

Case No. ADJ2295331 (ANA 0397551)

En Banc

Jun 18, 2013

Wesley Carroll vs. Cincinnati Bengals, New Orleans Saints, Louisiana Workers' Compensation Corporation, Travelers Insurance

WCABEn BancReconsiderationLabor Code § 3600.5(b)ExemptionExtraterritorial ProvisionsOhio Workers' CompensationSelf-Insured EmployerTemporary EmploymentCumulative Injury

References

Case No. ADJ1177048

Significant

Sep 03, 2009

Wanda Ogilvie, Applicant vs. City and County of San Francisco, Permissibly Self-Insured

Permanent DisabilityDiminished Future Earning CapacityDFECSchedulePrima Facie EvidenceRebuttableBurden of ProofRAND DataAMA GuidesOccupational Group

References

Case No. ADJ11017003

Regular

May 19, 2025

ABEL VAZQUEZ vs. INOCENSIO RENTERIA, ZENITH INSURANCE CO.

WCABen bancQME replacementAD Rule 31.3good causeprocedural issueremoval standardreconsiderationthreshold issuepermanent impairment

References

Case No. ADJ2295331 (ANA 0397551)

Significant

Jun 18, 2013

Wesley Carroll vs. Cincinnati Bengals, New Orleans Saints, Louisiana Workers' Compensation Corporation, Travelers Insurance

References

Case No. ADJ1177048

En Banc

Sep 03, 2009

WANDA OGILVIE vs. CITY AND COUNTY OF SAN FRANCISCO

Diminished Future Earning CapacityDFEC2005 ScheduleRebuttablePrima Facie EvidencePermanent Disability RatingLabor Code section 4660RAND dataIndividualized Adjustment FactorWhole Person Impairment

References

Showing 1-10 of 17,065 results

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