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

Case No. SAL 0116965
Regular
Nov 06, 2007

Valentine Ushakoff vs. MONTEREY GOURMET FOODS, SENTRY CLAIMS COMPANY, SENTRY CLAIMS SERVICE

The applicant sought reconsideration, arguing a total disk replacement constituted an amputation and thus entitled them to extended temporary disability benefits beyond the 104-week limit. The Appeals Board affirmed the WCJ's finding that the surgery was not an amputation under Labor Code section 4656(c)(2)(C), as it involved internal body parts. The Board deferred issues regarding credit for overpayment of temporary disability and an EDD lien for further determination.

Workers' Compensation Appeals BoardOpinion and Decision After Reconsiderationindustrial injuryroute driverthoracolumbar spineCharité total disk replacementamputationLabor Code section 4656(c)(2)(C)temporary disability indemnitydeferred issues
References
Case No. ADJ8134312
Regular
Sep 15, 2016

ERNIE GALLEGOS vs. GROTH BROTHERS CHEVROLET, AUTO DEALERS COMPENSATION OF CALIFORNIA, CORVEL

The applicant sustained a right knee injury, leading to a total knee replacement. The original award granted permanent disability without apportionment, which the defendant appealed. The Appeals Board granted reconsideration, finding that apportionment to pre-existing knee conditions was legally permissible even after total knee replacement. The case is remanded for a new award based on the Qualified Medical Evaluator's 50% apportionment to pre-existing pathology. A dissenting opinion argues the medical evidence lacked sufficient reasoning to support apportionment.

WORKERS' COMPENSATION APPEALS BOARDERNE GALLEGOSGROTH BROTHERS CHEVROLETAUTO DEALERS COMPENSATION OF CALIFORNIACORVELADJ8134312PETITION FOR RECONSIDERATIONFINDINGS AND AWARDPERMANENT DISABILITYAPPORTIONMENT
References
Case No. ADJ14244909
Regular
Apr 25, 2025

YONGQUAN HU vs. AMERICAN ALLIANCE LOGISTICS, INC., LIANG YE, UNINSURED EMPLOYERS BENEFITS TRUST FUND

Applicant Yongquan Hu and defendant Uninsured Employers Benefits Trust Fund (UEBTF) both petitioned for reconsideration of an Amended Findings and Award. The WCJ's initial decision found an industrial injury resulting in permanent total disability and calculated average weekly earnings based on multiple employers. Applicant disputed the wage calculation method, while UEBTF identified an inadvertently omitted week of wages. The Appeals Board granted both petitions, adopting the WCJ's report and amending the decision to reflect corrected average weekly earnings of $1,462.15, leading to a temporary and permanent total disability rate of $974.77 per week.

Workers' Compensation Appeals BoardYongquan HuAmerican Alliance LogisticsInc.Uninsured Employers Benefits Trust FundAdjudication NumberVan Nuys District OfficeOpinion and OrderGranting Petitions for ReconsiderationDecision After Reconsideration
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ9387304
Regular
Jan 20, 2023

Juan Guzman vs. ADP TOTAL SOURCE, INC./DURACITE, HELMSMAN MANAGEMENT SERVICES

Applicant sought reconsideration of a Workers' Compensation Appeals Board decision finding a 45% permanent partial disability for a 2013 injury. Applicant contended the injury caused permanent total disability, not partial. The Board granted reconsideration and the parties subsequently reached a settlement via a Compromise and Release agreement. The Board rescinded the original decision and remanded the case to the WCJ to consider the settlement, reserving judgment on the merits of the reconsideration petition.

Workers' Compensation Appeals BoardJuan GuzmanADP Total SourceHelmsman Management Serviceslumbar spine injuryhead injurypsyche injurygranite edge fabricatorpermanent partial disabilitypermanent total disability
References
Case No. ADJ6948621 ADJ7946738
Regular
Apr 22, 2013

STEFANO MUSETTI vs. GOLDEN GATE DISPOSAL & RECYCLING dba RECOLOGY, permissibly self-insured, administered by CORVEL CORP.

In this workers' compensation case, the employer sought reconsideration of an award ordering a total knee replacement. The applicant's treating physician recommended the surgery, but the employer argued the award was premature as a panel qualified medical evaluator's report was pending and the treating physician's report lacked proper authorization markings. The Appeals Board denied reconsideration, finding the employer had sufficient time to obtain the PQME report and that the treating physician's report constituted substantial medical evidence supporting the surgery. The Board also noted that the employer failed to initiate utilization review despite being aware of the treatment request.

Workers' Compensation Appeals Boardindustrial injuryright kneegarbage collectortotal knee replacementsupplemental reportpanel qualified medical evaluator (PQME)treating physiciansubstantial medical evidencePetition for Reconsideration
References
Case No. ADJ4642991
Regular
Mar 09, 2011

RICHARD ANTONETTE vs. VOLT INFORMATION SCIENCES, MAJESTIC INSURANCE COMPANY, GALLAGHER BASSETT CLAIMS SERVICES

The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for removal, finding it an extraordinary remedy not warranted here. The defendant sought removal to challenge a prior award of spinal disk replacement surgery, alleging fraud and misrepresentation. The WCAB treated the defendant's petition as one for reconsideration and granted it. This allows the WCAB to further review the case's factual and legal issues before issuing a final decision.

Workers' Compensation Appeals BoardPetition for RemovalPetition for ReconsiderationFindings of Fact and Awardspinal disk replacement surgeryfraudmisrepresentationadministrative law judgeextraordinary remedysubstantial prejudice
References
Case No. ADJ8489468
Regular
Jun 15, 2018

ROLE BRODIE vs. AEROTEK COMMERCIAL STAFFING, ACE AMERICAN INSURANCE COMPANY

This case involves a workers' compensation claim by Roly Brodie against Aerotek Commercial Staffing and its insurer. The applicant was found to have sustained injuries to multiple body parts, including bilateral wrists, back, shoulders, neck, psyche, and hands, resulting in temporary total disability and a need for further medical treatment. The defendant petitioned for reconsideration, challenging only the finding of permanent and total disability ($100\%$) due to alleged lack of applicant credibility. The Workers' Compensation Appeals Board affirmed the original award, upholding the finding of permanent and total disability.

Findings of FactAward and OrdersPetition for ReconsiderationWCJcumulative periodtemporary total disabilitypermanent and total disabilitysubstantial evidenceapplicant's lack of credibilityReport and Recommendation on Petition for Reconsideration
References
Case No. ADJ9466180
Regular
Sep 28, 2017

Erin Inman vs. VENTURA REGIONAL SANITATION DISTRICT

The applicant, Erin Inman, seeks reconsideration of a prior award finding 73% permanent disability due to a cumulative trauma injury to her left wrist resulting in reflex sympathetic dystrophy (RSD). She contends she is totally disabled, citing the Agreed Medical Examiner (AME) Dr. Sohn's opinion that she cannot use either hand and is therefore conclusively presumed totally disabled under Labor Code section 4662(a). The Workers' Compensation Appeals Board granted reconsideration to further develop the medical record. The Board found Dr. Sohn's opinion on total disability was not yet definitive as he repeatedly recommended a pain management evaluation and reserved judgment pending its outcome. Therefore, the determination of permanent disability and attorney fees is deferred pending a pain management evaluation and subsequent opinion from the AME.

Reflex Sympathetic DystrophyCumulative TraumaPermanent Total DisabilityAgreed Medical ExaminerPain Management PhysicianBody Parts AffectedLabor Code Section 4662Permanent Disability RatingMedical Record DevelopmentPetition for Reconsideration
References
Case No. ADJ802221
Significant
May 21, 2014

Warren Brower, Applicant vs. David Jones Construction, State Compensation Insurance Fund

This en banc decision holds that when temporary disability payments cease due to the statutory 104-week cap, permanent disability indemnity payments must commence based on a reasonable estimate, even if the injured worker is not yet permanent and stationary. If the worker is later found to be permanently totally disabled, the payments are adjusted retroactively to the permanent total disability rate.

En banc decisionReconsiderationFindings and AwardTemporary total disabilityPermanent total disabilityLabor Code section 4656(c)(1)Labor Code section 4650(b)Cost of living adjustments (COLAs)Agreed medical evaluator (AME)Treating physician
References
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