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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ758842 (VNO 0559214)
Regular
Dec 17, 2010

JOHN PATCHETT vs. CITY OF LOS ANGELES

The Appeals Board denied the applicant's petition for removal, affirming the WCJ's decision to vacate the submission. This action was based on the DEU evaluator's testimony, which revealed deficiencies in the AMEs' reports concerning the AMA Guides. The Board found the applicant waived any objection to this testimony by failing to object at trial, and that the evaluator's expert opinion was permissible per *Blackledge v. Bank of America*. Defendant's objection, though not styled as a motion to strike, sufficiently raised the issues leading to the vacation of the rating.

Petition for RemovalOrder Vacating SubmissionDEU evaluatorAMA Guidesagreed medical evaluators (AMEs)rating instructionssubstantial evidenceobjective factors of disabilitywhole person impairmentformal rating
References
Case No. ADJ4258585 (OXN 0130492) ADJ220258 (OXN 0130487)
Regular
Apr 17, 2018

ENRIQUE HERRERA vs. MAPLE LEAF FOODS, U.S. FIRE INSURANCE COMPANY, ALEA NORTH AMERICAN INSURANCE COMPANY

This notice informs parties that the Workers' Compensation Appeals Board (WCAB) intends to admit its rating instructions and a disability rater's recommended permanent disability rating into evidence. The WCAB previously granted reconsideration for further study. Parties have seven days to object to the rating instructions or the recommended rating, with specific procedures for addressing objections. If no timely objection is filed, the matters will be submitted for decision thirty days after service.

WORKERS' COMPENSATION APPEALS BOARDPermanent Disability RatingDisability Evaluation UnitRating InstructionsRecommended Permanent Disability RatingJoint RatingReconsiderationObjectionRater Cross-ExaminationRebuttal Evidence
References
Case No. ADJ6674613
Regular
Mar 16, 2011

Donald Kusar vs. CITY OF LOS ANGELES

The Appeals Board granted reconsideration to address issues with the applicant's permanent disability rating after an admitted left elbow injury. The WCJ had found no permanent disability but vacated submission in companion cases involving other injuries for clarification from the Agreed Medical Examiner (AME). The applicant argued the WCJ erred by striking ratings and vacating submission in consolidated cases and that the DEU rater improperly substituted her own judgment for the AME's findings. The Board rescinded the Findings and Award, returning the matter to the trial level to rate all three consolidated cases together, and to reconsider the permanent disability rating in light of the *Blackledge* decision regarding the rater's role.

Agreed Medical ExaminerAppeals BoardConsolidated casesDEU raterDisability evaluationEn banc decisionFindings and AwardImpairment ratingMedical evidencePermanent disability
References
Case No. ADJ11368246
Regular
Mar 03, 2020

Marta Ubillus vs. One Stop Employment Services, LLC/Vensure Employer Services, Security National Insurance Company, State National Insurance Company

The Workers' Compensation Appeals Board (WCAB) denied the lien claimant's petition for reconsideration regarding the valuation of interpreter services. The WCAB adopted the Administrative Law Judge's (ALJ) report, which found that while the defendant did not present rebuttal evidence, the ALJ had substantial evidence to make a determination. The ALJ determined a market rate of $114.97 per hour but noted the lien claimant failed to provide sufficient evidence of the duration of services on most dates, preventing application of the market rate. Consequently, the statutory rate was applied for those services.

WCABPetition for ReconsiderationDeniedLien ClaimantInterpreter ServicesMarket RateStatutory RateWCJ ReportSubstantial EvidenceFindings and Award
References
Case No. ADJ1799490 VNO 0531984 ADJ1619817 VNO 1619817
Regular
Feb 01, 2013

TONI PARKER vs. WARNER BROTHERS STUDIOS, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

In Case No. ADJ1799490, the Appeals Board granted reconsideration and rescinded the WCJ's award, returning the case for further proceedings because Warner Brothers' due process rights were violated by a lack of service of rating instructions and the DEU rating. In Case No. ADJ1619817, the Board dismissed Warner Brothers' reconsideration petition as untimely but granted removal on its own motion to clarify administrative responsibility. The Board affirmed the WCJ's findings in ADJ1619817 but deferred the designation of the administering defendant, also returning it for trial-level determination.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardDue ProcessRating InstructionsDisability Evaluation UnitDEUPermanent DisabilityIndustrial InjuryBilateral Upper Extremities
References
Case No. ADJ10187704, ADJ10924724
Regular
May 17, 2018

STEVEN CASE vs. GOLDEN GATE BRIDGE HIGHWAY AND TRANSPORTATION DISTRICT

The Workers' Compensation Appeals Board granted reconsideration to increase applicant's permanent disability rating for bilateral shoulder injury from 9% to 38%. The Board found the Agreed Medical Evaluator's (AME) alternative rating, based on strength loss, was substantial medical evidence and properly considered within the AMA Guides. The WCJ erred in applying an overly restrictive interpretation of "complex or extraordinary" cases for deviating from strict AMA Guides ratings. The AME's use of strength loss data from the AMA Guides, even for an age outside the specified range, was permissible under the *Almaraz-Guzman* line of cases when justified by clinical judgment.

Workers' Compensation Appeals BoardJoint Findings and AwardPetition for ReconsiderationAgreed Medical Evaluator (AME)permanent disability ratingbilateral shouldersorthopedic AMEAMA GuidesAlmaraz-Guzmanstrength loss index
References
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
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
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
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