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

Case No. ADJ6712588
Regular
Aug 12, 2010

MARIA NAVARRO vs. STAFF CHEX, AIG INSURANCE

The Workers' Compensation Appeals Board granted reconsideration for Applicant Maria Navarro, rescinding a prior award. The Board found a potential due process violation because the Applicant claimed she was never served with the Disability Evaluation Unit's (DEU) rating. As the DEU rating was not found in the official record of proceedings, the Board returned the case for further proceedings, ordering the DEU rating be properly added to the record and served on all parties. This ensures the Applicant has an opportunity to challenge the rating and exercise her due process rights.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilityDue ProcessNoticeCross-examinationDisability Evaluation UnitDEUProof of Service
References
5
Case No. VNO 514162, VNO 514164, VNO 514165, VNO 542022
Regular
Mar 17, 2008

MIA DOEVE vs. COUNTY OF LOS ANGELES

This case involves an applicant who sustained multiple admitted industrial injuries while employed as a deputy sheriff. The Workers' Compensation Appeals Board granted reconsideration because the WCJ's finding of 0% permanent disability was not adequately supported by the evidence, particularly the DEU rater's conclusions. The Board rescinded the prior award and returned the case for further proceedings, including cross-examination of the DEU rater and reconsideration of which permanent disability rating schedule applies.

Workers' Compensation Appeals BoardDeputy SheriffIndustrial InjuriesPermanent DisabilityAgreed Medical Evaluator1997 Schedule2005 ScheduleLabor Code Section 4061Wilkinson doctrineDisability Evaluation Unit
References
3
Case No. ADJ6544795
Regular
Mar 28, 2011

JENNIFER GONZALEZ vs. CAL POLY POMONA ASI, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a defendant seeking reconsideration of a workers' compensation award due to a due process violation. The administrative law judge issued a decision without allowing the defendant to object to or cross-examine the Disability Evaluation Unit (DEU) rater. The Appeals Board granted reconsideration, rescinded the original award, and returned the matter to the trial level. This is to allow the defendant the opportunity to cross-examine the DEU evaluator, thereby ensuring due process.

WCABPetition for ReconsiderationFindings and AwardDEU RatingCross-examinationDisability Evaluation UnitDue ProcessIndustrial InjuryPermanent DisabilityMedical Treatment
References
4
Case No. ADJ3057272 (RDG 0125821)
Regular
Dec 03, 2010

FIDEL NAZARENO vs. OLD DURHAM WOOD COMPANY, STATE COMPENSATION INSURANCE FUND

This case involves a defendant's petition for reconsideration of a permanent disability award, arguing the Agreed Medical Evaluator's (AME) impairment rating was inconsistent with AMA Guides. The Appeals Board granted reconsideration, rescinded the award, and returned the matter for further development of the record. Issues include the DEU rater improperly separating AME's combined whole person impairment and the AME needing to clarify his reasoning on grip loss and potential overlap with other impairments. The AME will also re-evaluate impairment without referencing prior DEU ratings.

WORKERS' COMPENSATION APPEALS BOARDAgreed Medical EvaluatorAMEpermanent disabilityAMA GuidesDEU raterrating instructionswhole person impairmentFindings and AwardPetition for Reconsideration
References
1
Case No. ADJ892742 (SJO 0240973) MF ADJ6718849
Regular
Jul 21, 2000

SALLY MACKIN vs. SANTA CLARA COUNTY FAIRGROUNDS

Here's a summary of the case for a lawyer in four sentences: The applicant sought reconsideration of a WCJ's decision finding industrial injuries to her shoulders, neck, and wrists, resulting in 43% and 9% permanent disability respectively, and awarded future medical treatment but denied claims for hypertension and psychological injury. Applicant contended the WCJ erred in permanent disability ratings, the application of the PDRS, and the DEU rater's methodology. The Board denied reconsideration, adopting the WCJ's report which found the 1997 PDRS was not applicable to the cumulative injury and that the DEU rater acted within her expertise. A dissenting commissioner argued the 1997 PDRS should apply to the cumulative injury and that the record needed further development regarding permanent disability.

Workers' Compensation Appeals BoardSally MackinSanta Clara County FairgroundsADJ892742ADJ6718849Findings Awards and Orderspermanent disabilitycumulative injuryhypertension injuryfuture medical treatment
References
12
Case No. ADJ2266211 (GOL 0101534)
Regular
Dec 28, 2009

Miles Wallace vs. BELLAGIO & BACK DOOR BOARD SHOP, CNA CLAIMPLUS for VALLEY FORGE (PORTLAND)

Reconsideration granted; case returned to trial level to re-rate applicant's permanent disability and address other issues due to inadequate explanation of the basis of the original decision and lack of cross-examination of the DEU rater.

Permanent Disability RatingOccupational Group NumberFactors of DisabilityWork RestrictionsDEU RaterCross-examinationMedical ReportingWorkers' Compensation Appeals BoardFindings and AwardReconsideration
References
1
Case No. AHM 0136908
Regular
Mar 07, 2008

JUAN JESUS GARCIA vs. ALEXIS CONSTRUCTION CLEANUP INC., GRANITE STATE INSURANCE COMPANY, AIG CLAIMS SERVICES

The Workers' Compensation Appeals Board granted reconsideration, rescinding the prior award of no permanent disability. The Board found that the medical reports were not ratable by the Disability Evaluation Unit. The case is returned to the trial level to allow examination of the DEU rater, aiming to develop the record and ensure a decision on the merits.

Workers' Compensation Appeals BoardAlexis Construction Cleanup Inc.Granite State Insurance CompanyAIG Claims ServicesJuan Jesus Garcialabor contractindustrial injuryback injurypermanent disabilityratable permanent disability
References
4
Case No. ADJ3107039 (SAL 0114548) ADJ1050422 (SAL 0104052)
Regular
Jan 19, 2012

ESTELA LUIS vs. COMMUNITY BRIDGES, STATE COMPENSATION INSURANCE FUND

The Appeals Board denied reconsideration of an Amended Findings and Award, affirming the judge's decision. The Board rejected a request to increase the applicant's attorney's fee due to untimeliness and failure to provide required notice to the applicant. The defendant's petition for reconsideration was denied because they failed to meet their burden to rebut the DEU's use of a 4.6% COLA for calculating permanent disability and attorney fees, as it's a reasonable methodology based on a 50-year average.

Petition for ReconsiderationWorkers' Compensation Appeals BoardAmended Findings and Awardattorney's feeuntimelyWCAB Rule 10778independent counseljurisdictionCost of Living Adjustment (COLA)State Average Weekly Wage (SAWW)
References
5
Case No. ADJ1503980 (GRO 0034241)
Regular
Mar 24, 2010

HAI GRIFFIN vs. CALIFORNIA MEN'S COLONY EAST, SCIF STATE EMPLOYEES EXNARD (Adjusting Agency)

The Appeals Board dismissed the defendant's petition for reconsideration, finding their prior order was not a final decision and thus not subject to reconsideration. The Board also denied the defendant's petition for removal, upholding their authority to develop the record further. This was based on inconsistencies and lack of explanation in the Agreed Medical Evaluator's (AME) reports regarding the applicant's impairment. The AME will be provided with the complete formal DEU rating and a discussion of substantial medical evidence principles to issue a supplemental report.

Workers' Compensation Appeals BoardReconsiderationRemovalFinal OrderInterlocutory OrderDiscoveryMandatory Settlement ConferenceAgreed Medical EvaluatorDEU RatingPermanent Disability
References
17
Case No. ADJ13757266, ADJ13757284
Regular
Jan 31, 2023

ARLEEN KETELES vs. COUNTY OF ALAMEDA, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding of 70% permanent disability for the applicant's cumulative trauma injury. The Board adopted the judge's reasoning that the defendant's arguments lacked merit. Specifically, the Board found Dr. Brose's medical opinions constituted substantial evidence and that the DEU rating was better reasoned than the defendant's rater's opinion. The defendant's contention that Dr. Brose's opinions were inconsistent with the AMA Guides was also rejected.

Workers' Compensation Appeals BoardCumulative InjuryPermanent DisabilityQualified Medical ExaminerAMA GuidesLabor Code Section 5313Findings and AwardPetition for ReconsiderationMedical OpinionImpairment Rating
References
8
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