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

Case No. ADJ6976775
Regular
Jul 20, 2015

STEPHANIE HOBBS vs. COUNTY OF LOS ANGELES

This case involves an applicant whose permanent disability rating was challenged. The administrative law judge (WCJ) found a combined permanent disability of 61%, but the applicant argued the WCJ erred by not adopting an agreed medical evaluator's "alternative manner" of calculating cervical spine impairment. While the WCJ correctly rejected the evaluator's method as lacking substantial evidence under *Guzman*, the Appeals Board granted reconsideration. The Board rescinded the award to allow the medical evaluator to provide a revised opinion that fully complies with *Guzman* standards for establishing cervical spine impairment.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryCumulative TraumaCustody AssistantPermanent DisabilityApportionmentNeck InjuryPsyche Injury
References
9
Case No. MISSING
Regular Panel Decision

Clemente v. Schweiker

The plaintiff initiated an action under 42 U.S.C. § 405 to appeal a final decision by the defendant, which had denied his application for a period of disability and disability insurance benefits. An Administrative Law Judge (ALJ) previously concluded in May 1982 that the 62-year-old plaintiff, a longshoreman suffering from chronic bronchitis, emphysema, arthritis, and other severe conditions, was not disabled, deeming his impairments mild and resulting from the aging process. The District Judge found that the ALJ had misapplied 20 C.F.R. § 404.1521 by focusing on the plaintiff's ability to perform 'most jobs' rather than assessing whether his impairments significantly limited his ability to perform 'basic work activities,' such as lifting. Medical reports from treating physician Dr. Harold Coppersmith and consulting neurologist Dr. Stephen Gilbert consistently indicated the plaintiff's inability to perform heavy work and, in Dr. Gilbert's opinion, rendered him totally disabled due to conditions like cervical spondylosis, labyrinthine disturbance, and cervical radiculitis. Consequently, the case was remanded for further proceedings within 120 days, instructing the ALJ to properly consider the plaintiff's residual functional capacity, age, education, and past work experience as required by law.

Disability Insurance BenefitsSocial Security ActAdministrative Law JudgeSevere ImpairmentBasic Work ActivitiesResidual Functional CapacityLongshoremanCervical SpondylosisLabyrinthine DisturbanceVocational Factors
References
1
Case No. ADJ10550274
Regular
Mar 24, 2023

MEENA CHANDOK vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of a prior award finding the applicant permanently totally disabled due to a subsequent industrial injury combined with pre-existing disabilities. SIBTF argued that an elective tubal ligation and pre-existing cervical and thoracic spine impairments were improperly rated. The Workers' Compensation Appeals Board (WCAB) denied reconsideration, finding that the tubal ligation constituted a ratable impairment under the AMA Guides, and evidence of prior treatment for the spinal conditions predated the industrial injury. The WCAB adopted the reasoning of the Workers' Compensation Judge (WCJ), who found no legal basis to exclude an elective surgery from impairment rating and that SIBTF failed to rebut the applicant's medical evidence.

Subsequent Injuries Benefits Trust FundPre-existing disabilityRatable impairmentElective tubal ligationCervical spineThoracic spineAMA GuidesLabor Code section 4751FergusonProphylactic work restriction
References
12
Case No. 528952
Regular Panel Decision
Feb 27, 2020

Matter of Saputo v. Newsday, LLC

Claimant John Saputo suffered work-related neck and shoulder injuries in 2016, leading to a workers' compensation claim. Initially, a Workers' Compensation Law Judge awarded him a schedule loss of use for his arms, finding no permanent neck impairment, but the Workers' Compensation Board later rescinded this award due to a possible residual neck impairment and remitted for further development of the record. On appeal, the Appellate Division modified the Board's decision, clarifying that a claimant can receive a schedule loss of use award for schedule injuries even if they also have a nonschedule permanent partial disability classification, provided they returned to work at pre-injury wages and receive no award for the nonschedule injury. However, the Court affirmed the Board's finding of substantial evidence for the claimant's residual cervical spine impairment of an unknown severity. The matter was ultimately remitted to the Workers' Compensation Board for further proceedings consistent with the Appellate Division's decision.

Workers' Compensation LawSchedule Loss of Use (SLU)Permanent Partial DisabilityCervical Spine InjuryShoulder InjuryMaximum Medical Improvement (MMI)Wage-Earning CapacityMedical Expert TestimonyAppellate ReviewRemittal
References
6
Case No. ADJ9709071
Regular
Apr 26, 2023

MAGGIE LUQUIN vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to study the case of Maggie Luquin against the City of Los Angeles. The Board rescinded the previous Amended Findings and Award and returned the matter to the trial level for further discovery. This decision specifically addresses the defendant's contentions regarding the adequacy of the Agreed Medical Evaluator's (AME) report for the cervical spine's pain add-on and the impairment to the applicant's right knee. The WCAB found the AME's report substantial evidence for the cervical spine and other body parts but remanded for further evaluation of the knee injuries.

AOE/COEAgreed Medical Evaluator (AME)substantial medical evidenceAMA Guidespermanent disability ratingcervical spinebilateral elbowsbilateral kneespain add-onorthopedic impairment
References
7
Case No. MISSING
Regular Panel Decision

the Claim of Brigandi v. Town & Country Linoleum & Carpet

This case involves an appeal by an employer and its compensation carrier against decisions made by the Workers’ Compensation Board. The decedent, a carpet layer, died from cardiac arrest during work, with an autopsy revealing underlying coronary atherosclerotic disease. His widow was awarded death benefits. The employer’s carrier sought reimbursement from the Special Disability Fund under Workers’ Compensation Law § 15 (8), asserting a preexisting permanent physical impairment. However, the Board determined that there was no evidence that the decedent’s heart condition hindered his job potential before his death, thus releasing the Special Disability Fund from liability and holding the compensation carrier responsible. The employer's subsequent application for reconsideration was denied by the Board, leading to these appeals. The appellate court affirmed the Board's decisions, concluding that the Board rationally found no proof that the decedent's heart disease impaired his job potential, a necessary condition for reimbursement under WCL § 15 (8) (d).

Special Disability FundPreexisting Permanent ImpairmentCardiac ArrestCoronary Atherosclerotic DiseaseDeath Benefits ClaimEmployer ReimbursementCarrier LiabilityBoard Decision ReviewAppellate AffirmationMedical Evidence Interpretation
References
2
Case No. MISSING
Regular Panel Decision

Claim of Milner v. Country Developers, Inc.

The Special Disability Fund appealed decisions by the Workmen’s Compensation Board which imposed liability on the Fund for a claimant's injuries. The Board found that the employer, Country Developers, continued to employ the claimant, a carpenter, with knowledge of his pre-existing permanent physical impairment, triggering liability under subdivision 8 of section 15 of the Workmen’s Compensation Law. The claimant suffered a fracture of the nose and a hip dislocation in 1964, having a history of three ruptured disc surgeries and other conditions. The appeal centered on whether the employer had sufficient knowledge of the claimant’s permanent condition. Testimony from the employer’s foreman, Mr. Pahlck, indicated awareness of the claimant's back issues, including wearing a back brace and being favored by co-workers. The court affirmed the Board’s decision, reiterating that employer knowledge is a question of fact for the Board, and its findings, if supported by substantial evidence, will not be disturbed.

Workers' Compensation LawSpecial Disability FundEmployer LiabilityPre-existing Permanent ImpairmentEmployer KnowledgeSubstantial EvidencePermanent Partial DisabilityFracture of NoseHip DislocationRuptured Discs
References
3
Case No. ADJ6899677
Regular
Oct 11, 2011

MARIA FLORES CANDELARIO vs. JOHN CHIANG STATE CONTROLLER, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration because the defendant's medical expert failed to adequately explain the basis for the applicant's permanent disability rating, specifically for cervical spine impairment. The Board found the Workers' Compensation Judge erred in relying on this opinion without proper justification under the AMA Guides. Consequently, the prior award was rescinded, and the case was returned for further proceedings to develop the medical record with a new judge.

Workers' Compensation Appeals BoardPermanent DisabilityMedical OpinionTreating ChiropractorAMA GuidesDRE Category IICervical ImpairmentWhole Person ImpairmentCumulative TraumaReconsideration
References
0
Case No. ADJ7369877, ADJ7369872
Regular
Jan 20, 2016

SAMUEL DEBONE vs. CEMEX, INC., AMERICAN HOME ASSURANCE COMPANY, INC., GALLAGHER BASSETT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to correct errors in a previous permanent disability rating. The WCJ incorrectly applied the Agreed Medical Examiner's (AME) WPI ratings, conflating cervical and lumbar spine impairments and miscalculating lower extremity to WPI conversions for the hips. The case is returned to the trial level for a new rating based on correct WPI values and to clarify the basis for any departure from AMA Guides ratings. The apportionment of disability was found to be correct.

Workers' Compensation Appeals BoardPetition for ReconsiderationPermanent DisabilityApportionmentAgreed Medical Examiner (AME)Cumulative TraumaCervical SpineLumbar SpineHipsDRE Method
References
1
Case No. SJO 0252147, SJO 0265611
Regular
Feb 27, 2008

HAL McKAY vs. CITY OF MONTEREY

This case concerns a firefighter seeking workers' compensation for multiple injuries, including a back, hips, gastrointestinal, and hearing impairment, as well as a prior sinus injury. The defendant sought to apportion the awarded permanent disability based on an earlier stipulated award for a cervical spine injury. The Appeals Board denied the petition for reconsideration, affirming the WCJ's finding that apportionment was not appropriate because the defendant failed to demonstrate overlap between the prior subjective disability and the current work-preclusion-based disability.

Workers Compensation Appeals BoardReconsideration DeniedApportionmentLabor Code Sections 46634664Cumulative TraumaIndustrial InjuryPermanent DisabilityFirefighterStipulated Award
References
2
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