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Case Law Database

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

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 The Board rescinded the prior award and returned the case for further proceedings, including cross-examination of the DEU rater and reconsideration of which permanent disability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

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

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

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. 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. 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. 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

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

Case No. ADJ3711842 (ANA 0409880)

Regular

Jun 21, 2013

SEAN GILBERT vs. OAKLAND RAIDERS, ACE USA

This case concerns disputed attorney fees in a workers' compensation claim. The applicant seeks to correct a clerical error in the award regarding the distribution of permanent disability benefits between himself and his counsel. The defendant challenges the calculation of attorney fees, arguing they should be based on the present value of the award, not its full value, and claims improper ex parte communication by a DEU rater. The Appeals Board granted reconsideration, rescinded the prior award, and returned the case for further proceedings to address these issues and ensure proper calculation and distribution of fees.

Workers' Compensation Appeals BoardReconsiderationPermanent Disability IndemnityAttorney's FeesPresent ValueEx Parte CommunicationDEU RaterCross-examinationClerical ErrorLife Pension

References

Case No. ADJ6820630

Regular

Mar 19, 2018

MARK COLLINS vs. ENTERTAINMENT PARTNERS, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

The WCAB dismissed the Defendant's Petition for Reconsideration because it was not filed from a final order. The Board granted the Defendant's Petition for Removal to rescind the WCJ's order vacating submission and appointing a new physician. The WCJ erred by refusing to accept the AME's rating based on the Diagnosis-Related Estimate (DRE) method, as physicians have discretion to use the most accurate method. However, the AME's own deposition testimony indicated that the Range of Motion (ROM) method, mandated by the WCJ, would yield a higher impairment rating. Therefore, the matter is returned to the trial level for the WCJ to obtain a permanent disability rating using the existing record and potentially consulting a DEU rater.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalAgreed Medical Examiner (AME)Range of Motion (ROM) methodDiagnosis-Related Estimates (DRE) methodAmerican Medical Association's Guides (AMA Guides)Whole Person Impairment (WPI)cumulative traumaspinal injury

References

Showing 1-10 of 45 results

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Updated Daily

Case Law Database

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

Case No. VNO 514162, VNO 514164, VNO 514165, VNO 542022

Regular

Mar 17, 2008

MIA DOEVE vs. COUNTY OF LOS ANGELES

References

Case No. ADJ892742 (SJO 0240973) MF ADJ6718849

Regular

Jul 21, 2000

SALLY MACKIN vs. SANTA CLARA COUNTY FAIRGROUNDS

References

Case No. ADJ6544795

Regular

Mar 28, 2011

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

WCABPetition for ReconsiderationFindings and AwardDEU RatingCross-examinationDisability Evaluation UnitDue ProcessIndustrial InjuryPermanent DisabilityMedical Treatment

References

Case No. ADJ3057272 (RDG 0125821)

Regular

Dec 03, 2010

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

WORKERS' COMPENSATION APPEALS BOARDAgreed Medical EvaluatorAMEpermanent disabilityAMA GuidesDEU raterrating instructionswhole person impairmentFindings and AwardPetition for Reconsideration

References

Case No. ADJ6674613

Regular

Mar 16, 2011

Donald Kusar vs. CITY OF LOS ANGELES

Agreed Medical ExaminerAppeals BoardConsolidated casesDEU raterDisability evaluationEn banc decisionFindings and AwardImpairment ratingMedical evidencePermanent disability

References

Case No. ADJ2266211 (GOL 0101534)

Regular

Dec 28, 2009

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

References

Case No. AHM 0136908

Regular

Mar 07, 2008

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

References

Case No. ADJ13757266, ADJ13757284

Regular

Jan 31, 2023

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

References

Case No. ADJ3711842 (ANA 0409880)

Regular

Jun 21, 2013

SEAN GILBERT vs. OAKLAND RAIDERS, ACE USA

Workers' Compensation Appeals BoardReconsiderationPermanent Disability IndemnityAttorney's FeesPresent ValueEx Parte CommunicationDEU RaterCross-examinationClerical ErrorLife Pension

References

Case No. ADJ6820630

Regular

Mar 19, 2018

MARK COLLINS vs. ENTERTAINMENT PARTNERS, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

References

Showing 1-10 of 45 results

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