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Case Law Database

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

Case No. ADJ6884562
Regular
Oct 04, 2010

ERIC KRUSE vs. CITY OF SAN RAFAEL, Permissibly Self-Insured

This case concerns whether a 15% reduction in permanent disability indemnity applies when an employer offers an injured employee regular work after their condition is permanent and stationary. The applicant, a parking enforcement officer, sustained a neck and elbow injury and was temporarily disabled before returning to his regular job. The employer offered regular work after the applicant's condition became permanent and stationary, but the applicant had already returned to his normal duties. The majority found that since there was no indication of permanent disability prior to the employer's offer, all permanent indemnity was payable after the offer, entitling the employer to the reduction. However, a dissenting commissioner argued that the offer lacked practical meaning as the applicant had already returned to work and that no weekly payments remained after the offer to be reduced.

Workers' Compensation Appeals BoardEric KruseCity of San Rafaelparking enforcement officerindustrial injuryneck injuryright elbow injurytemporary total disabilitypermanent and stationaryoffer of regular work
References
0
Case No. ADJ2346178 (VNO 0504730) MF ADJ862555 (VNO 0504735)
Regular
Jul 31, 2014

REBECCA DUARTE vs. MOTION PICTURE \& TV FUND, Permissibly Self-Insured, ZURICH NORTH AMERICA

This case concerns an applicant's 1990 specific industrial injury that caused temporary total disability from August 2004 to September 2010. The defendant argued that the injury could not have caused this later period of disability as the applicant had returned to work and her condition was previously deemed permanent and stationary. The Workers' Compensation Appeals Board affirmed its prior decision, finding that the 1990 injury did contribute to the temporary disability period. The Board relied on medical opinions stating the specific injury and a later cumulative trauma both contributed to the applicant's condition. The court clarified legal precedent, holding that prior return to work or permanent and stationary declarations do not preclude liability for subsequent temporary disability if the original injury is a contributing factor.

Workers' Compensation Appeals BoardMotion Picture & TV FundZurich North AmericaSpecific Industrial InjuryTemporary Total DisabilityPermanent and StationaryQualified Medical ExaminerCumulative TraumaTemporary Disability IndemnityApportionment
References
3
Case No. ADJ7486913, ADJ7486895
Regular
Dec 18, 2013

EMMA RECINOS vs. DONUT DELIGHT, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award. The Board found that the original decision incorrectly failed to apportion permanent disability between two distinct industrial injuries sustained by the applicant. Consequently, the case was returned to the trial level for further proceedings and a new decision, to address issues including apportionment and whether the applicant's condition is permanent and stationary. The Board did not rule on the permanence of the applicant's condition, deferring that to the trial level.

Uninsured Employers Benefits Trust FundPetition for ReconsiderationFindings and Awardindustrial injuryapportionmentpermanent disabilitytemporary disabilitypermanent and stationaryrescindedreturned to trial level
References
1
Case No. ADJ8641626
Regular
Oct 06, 2014

SYLVIA ESPINOZA vs. SALINAS VALLEY MEMORIAL HEALTHCARE

This case concerns whether an employer's offer of work triggers a decrease in permanent disability benefits. The applicant initially became permanent and stationary (P&S) in November 2012, and the employer made a timely offer of regular work. However, the applicant's condition later worsened, and she was declared P&S again in July 2013 with new restrictions. The Appeals Board found that while the applicant did not qualify for an increase in benefits, the employer could not rely on the prior offer for a decrease because her condition and restrictions had significantly changed. Therefore, no adjustment to the permanent disability rate was applied.

Workers' Compensation Appeals BoardSylvia EspinozaSalinas Valley Memorial HealthcareAcclamation Insurance Management ServicesPermanent and Stationary (P&S) reportLabor Code section 4658(d)(3)(A)Agreed Medical Examiner (AME)Robert SteinerM.D.permanent disability rate
References
4
Case No. ADJ3134805 (BAK 0148440)
Regular
Feb 11, 2011

VELGRACE SMITH vs. KERN COUNTY SUPERIOR COURT

This case concerns a defendant seeking reconsideration of a decision that awarded a 15% increase in permanent disability indemnity payments. The administrative law judge (WCJ) found the employer failed to offer modified work within 60 days of the applicant's condition becoming permanent and stationary, as required by Labor Code section 4658(d)(2). The Appeals Board granted reconsideration, finding the WCJ's literal interpretation of the statute would lead to absurd consequences given the retroactive nature of medical findings and delayed service of reports. The Board held the 60-day period begins when the employer has knowledge of both the permanent and stationary status and work restrictions, and remanded the case to determine if the employer's modified work offer remained consistent with updated restrictions.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityModified WorkLabor Code Section 4658(d)AggravationCumulative InjuryAgreed Medical EvaluatorPermanent and Stationary DateWork Restrictions
References
3
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. ADJ6814430; ADJ6816290
Regular
Jun 13, 2013

JOSEFINA GARCIA vs. LIZ CLAIBORNE, BROADSPIRE

The Appeals Board granted the defendant's Petition for Removal to rescind the WCJ's order taking the case off calendar. Despite the applicant's claims, medical evaluators, including an AME and QMEs, have deemed her condition permanent and stationary. The Board found no reason to delay disposition, stating that any disagreement on the permanent and stationary date can be addressed at trial. The case is returned to the trial level for further proceedings, including a new MSC and potential trial if settlement is not reached.

Petition for RemovalWorkers' Compensation Appeals BoardAgreed Medical EvaluatorQualified Medical EvaluatorPermanent and StationaryDeclaration of Readiness to ProceedMotion for ContinuanceDiscoveryTrial Setting ConferenceIndustrial Injury
References
1
Case No. ADJ11297621
Regular
Apr 30, 2019

MICHAEL NEUFELD vs. COUNTY OF SAN BERNARDINO FIRE DEPARTMENT

This case concerns a firefighter injured on January 1, 2018, who was awarded temporary disability benefits. The defendant sought reconsideration, arguing benefits should terminate based on a QME's report, not solely the primary treating physician's determination of permanent and stationary status. The Appeals Board granted reconsideration to clarify the termination conditions for temporary disability benefits. The Board affirmed the WCJ's award but amended the findings to allow termination of benefits upon a properly supported QME determination of permanent and stationary status, as well as by the PTP.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardTemporary Disability IndemnityLabor Code Section 4850Primary Treating PhysicianPermanent and Stationary StatusQualified Medical EvaluatorAdministrative Law JudgeAverage Weekly Wage
References
0
Case No. ADJ6653777
Regular
Jan 26, 2011

MARIA COLORADO vs. COSTCO WHOLESALE, SEDGWICK CMS

This case concerns an applicant who sustained an industrial injury to her right elbow, with the primary dispute revolving around the permanent and stationary (P&S) date and subsequent credit for overpaid temporary disability benefits. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, overturning the original decision. The WCAB found the applicant's condition became permanent and stationary on June 8, 2009, based on the Agreed Medical Evaluator's (AME) report, not March 1, 2009, as previously determined. Consequently, the defendant is not entitled to a credit for overpaid temporary disability indemnity, as the applicant was unable to return to work until released by her physician.

Agreed Medical EvaluatorPermanent and Stationary DateTemporary Disability IndemnityCredit for OverpaymentReconsiderationPetition for ReconsiderationFindings and AwardWCJTreating PhysicianReturn to Work Release
References
6
Case No. ADJ7541603
Regular
Sep 24, 2013

REGINALD SLATER vs. MINNESOTA TIMBERWOLVES, FEDERAL INSURANCE CO./CHUBB GROUP

This case involves a professional basketball player's workers' compensation claim against the Minnesota Timberwolves. The applicant sustained cumulative injuries to multiple body parts during his career. The primary issue on reconsideration was jurisdiction, with the defendant arguing California lacked jurisdiction as the applicant was not regularly employed or hired in the state, and his permanent disability was determined after he left California. The Appeals Board affirmed the original decision, finding that the WCAB has jurisdiction because a portion of the injurious exposure occurred in California, regardless of the applicant's location when his condition became permanent and stationary or when he was diagnosed with his condition. The Board also affirmed the applicant's occupational group rating based on his role at the time of injury.

Workers' Compensation Appeals BoardMinnesota TimberwolvesFederal Insurance Companyindustrial injurycumulative traumaoccupational groupjurisdictionLabor Code section 5412permanent disabilityagreed medical evaluator
References
14
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