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

Case No. ADJ6721939
Regular
Mar 01, 2010

BERTHA NORIEGA GARCIA vs. PATRICK L. HINRICHSEN, CIVIL SERVICE EMPLOYEES INSURANCE COMPANY

This case is remanded for further proceedings because the Administrative Law Judge (ALJ) did not fully analyze the Diminished Future Earning Capacity (DFEC) adjustment factor under the *Ogilvie* decisions. The ALJ improperly relied solely on applicant's testimony for lost earnings without a proper *Ogilvie* analysis, including the duration of post-injury earnings and consideration of other factors affecting earning capacity. The ALJ must conduct a complete *Ogilvie* analysis, weigh the evidence, and explain how the adjusted DFEC factor reflects the applicant's actual earning capacity compared to the scheduled rating. The Board also clarified that temporary disability indemnity is not to be treated as post-injury earnings.

Diminished Future Earning CapacityDFECOgilvie analysisRebuttalScheduled Permanent Disability RatingPost-injury earningsEarnings lossTemporary disability indemnityPermanent and stationary dateTriers-of-fact
References
3
Case No. ADJ2110739 (MON 0313927)
Regular
Oct 01, 2010

Rosalind Eskridge (Vallery) vs. TARGET STORES, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

This case returns to the trial level for a comprehensive re-analysis of applicant's permanent disability rating, specifically focusing on the Diminished Future Earning Capacity (DFEC) adjustment factor. The Board rescinded the prior award because the judge's decision did not fully adhere to the *Ogilvie* en banc decisions, which mandate a specific four-step analysis for rebutting the DFEC. The judge must now conduct a complete *Ogilvie* analysis, potentially developing the record further, to determine if the applicant's demonstrated earning loss and other relevant factors, including *Montana* factors, justify an individualized DFEC adjustment over the scheduled rating. The applicant bears the burden of proving that her evidence substantially overcomes the prima facie validity of the scheduled DFEC.

Workers' Compensation Appeals BoardDiminished Future Earning CapacityDFECPermanent Disability Rating Schedule2005 PDRSOgilvie analysisAgreed Medical ExaminerDisability Evaluation UnitDEUAgreed Medical Examiner
References
6
Case No. ADJ7971001
Regular
Apr 16, 2013

DARRYL OYAS vs. CALIFORNIA STATE DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

This case involves a dispute over the attorney's fees awarded in a workers' compensation claim for a 100% permanent disability award. The applicant's attorney argues the administrative law judge erred by excluding the State Average Weekly Wage (SAWW) adjustment factor and by using the Uniform Reduction method for commutation instead of the Uniform Increasing Reduction (UIR) method. The Appeals Board granted reconsideration to allow the judge to recalculate the attorney's fees, incorporating a reasonable SAWW adjustment and applying the UIR commutation method, while still considering factors for determining the fee's reasonableness. The Board emphasized separating the calculation of the award's commuted value from the determination of the attorney's fee percentage.

State Compensation Insurance FundWorkers' Compensation Appeals BoardFindings and AwardAttorney's FeePermanent DisabilityState Average Weekly Wage (SAWW)Uniform Increasing Reduction (UIR) methodCommutationStipulations with Request for AwardCorrectional Officer
References
5
Case No. 06 Civ. 2279
Regular Panel Decision

Dessert Beauty, Inc. v. Platinum Funding Corp.

This case involves a dispute stemming from a factoring agreement between Dessert Beauty, Inc. (DBI), a Barbados corporation manufacturing cosmetics, and Platinum Funding Corp., a New Jersey financing company. DBI initiated the action to recover funds it alleges were wrongfully withheld by Platinum, while Platinum counterclaimed against DBI and filed a third-party complaint against Neil and Randi Shinder and Dessert Beauty Holdings, Inc. (DBH) as guarantors. The central issues revolve around the enforceability of an 'adjustment fee' provision and an attorney's fees clause in the factoring agreement. The court denied DBI’s motion for partial summary judgment on conversion, money had and received, and unjust enrichment claims. It granted Platinum's motion for partial summary judgment on the money had and received and unjust enrichment claims but denied its motions regarding the adjustment fee and attorney’s fees, pending resolution of DBI’s fraudulent inducement claim.

Factoring AgreementSummary JudgmentContract DisputeFraudulent InducementConversion ClaimMoney Had and ReceivedUnjust EnrichmentAttorney's Fees ProvisionNew Jersey LawChoice of Law
References
52
Case No. MISSING
Regular Panel Decision

Greece Support Service Employees Ass'n v. Public Employment Relations Board

This case concerns an appeal regarding the proper application of Civil Service Law § 209-a (1) (e) to salary provisions in an expired collective bargaining agreement between an unnamed petitioner and the Greece Central School District. The agreement, from July 1992 to June 1995, included cost-of-living adjustments for salary schedules during its term. After the agreement expired, the District continued existing salary schedules but ceased further cost-of-living adjustments for 1995-1996, prompting the petitioner to file an improper practice charge. The Public Employment Relations Board (PERB) reversed an Administrative Law Judge's decision, concluding that the agreement did not mandate continued cost-of-living adjustments post-expiration. The Supreme Court dismissed the petitioner's subsequent CPLR article 78 petition seeking annulment of PERB's determination. The Appellate Division affirmed the Supreme Court's judgment, deferring to PERB's expertise and finding its interpretation that the adjustments were limited to the agreement's term to be reasonable and legally permissible.

Collective Bargaining AgreementSalary AdjustmentCost-of-Living AdjustmentPublic EmployerImproper Practice ChargeCivil Service LawPublic Employment Relations BoardJudicial ReviewCPLR Article 78Statutory Interpretation
References
6
Case No. MISSING
Regular Panel Decision

Claim of Bruzzese v. Guardsman Elevator Co.

In 1994, the claimant sustained head, neck, and back injuries at work, leading to an award for permanent partial disability, which included a wage expectancy adjustment under Workers’ Compensation Law § 14 (5). Following back surgery in 1998, the case was reopened, and the claimant was found to be temporarily totally disabled. Benefits for this temporary total disability were calculated based on the claimant's average weekly wage at the time of injury, without applying the wage expectancy adjustment. The claimant appealed, arguing that since the permanent partial disability preceded the temporary total disability, the wage expectancy adjustment should also apply to the latter period. The court disagreed, affirming the Workers’ Compensation Board's decision, citing established case law that Workers’ Compensation Law § 14 (5) is applicable only to awards for permanent partial disability and not temporary disability.

Wage expectancyTemporary total disabilityPermanent partial disabilityWorkers' Compensation benefitsBack injuryAppellate reviewDisability calculationWorkers' Compensation BoardAverage weekly wage
References
1
Case No. ADJ312652 (STK 0204453)
Regular
Nov 14, 2008

AMADOR CISNEROS vs. CBC FRAMING and VIRGINIA SURETY, adjusted by CAMBRIDGE INTEGRATED RESOURCES

This case involves a dispute over a Workers' Compensation Appeals Board (WCAB) decision to set aside a prior order and require the defendant to produce the claims adjuster for testimony. The WCAB denied the defendant's petition for removal, finding no abuse of discretion by the judge who properly used WCAB Rule § 10859 to rescind the prior order and allow for further proceedings. The defendant's arguments regarding the applicant's failure to produce the adjuster at trial were deemed premature as no order compelling appearance had been issued.

WCABPetition for RemovalOrder Setting Aside FindingsWCJ DiscretionWCAB Rule 10859Claims AdjusterMandatory Settlement ConferencePetition for ReconsiderationWCAB Rule 10843(b)AOE/COE
References
1
Case No. ADJ9103955
Regular
Aug 25, 2014

EMMANUEL BRISENO vs. CALTRANS, Permissibly Self-Insured, Adjusted By STATE COMPENSATION INSURANCE FUND

This case concerns a workers' compensation appeal where the defendant, Caltrans, sought reconsideration of an award of temporary disability benefits. Caltrans argued the award should credit benefits already paid by the Employment Development Department (EDD) to prevent double recovery. The Appeals Board granted reconsideration, agreeing that the award needed adjustment for the EDD's potential lien. Consequently, the Board amended the award to require the parties to adjust the benefit amount, taking into account the EDD's potential lien interest.

Workers' Compensation Appeals BoardADJ9103955Emmanuel BrisenoCALTRANSPermissibly Self-InsuredState Compensation Insurance FundTemporary Disability IndemnityEmployment Development Department (EDD)EDD LienDouble Recovery
References
0
Case No. ADJ8701916
Regular
Jan 30, 2015

CHRISTOPHER RICE vs. CITY OF JACKSON, Permissibly Self-Insured, Adjusted by YORK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board granted reconsideration to review the administrative law judge's apportionment of the applicant's permanent disability. The applicant, a police officer injured on the job, argued that the Qualified Medical Evaluator's apportionment to genetic factors was not supported by substantial evidence. The Board agreed, finding that apportionment to immutable genetic factors was impermissible and that the QME's opinion lacked sufficient reasoning on the specific causation of the disability. Consequently, the Board amended the decision to defer the issue of permanent disability and returned the matter for an unapportioned award.

Workers' Compensation Appeals BoardChristopher RiceCity of JacksonYork Services GroupCumulative traumaNeck injuryPolice officerPermanent disabilityApportionmentPanel Qualified Medical Evaluator (QME)
References
0
Case No. ADJ10116932
Regular
Jul 15, 2019

KRIS WILSON vs. STATE OF CA CAL FIRE; legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration regarding a catastrophic injury determination. The Board affirmed that the definition of "catastrophic injury" under Labor Code section 4660.1(c)(2)(B) focuses on the nature of the injury, not solely the immediate mechanism or condition after onset. The Board also rejected the argument that it exceeded its authority by outlining factors for assessing catastrophic injuries, stating these factors provide a helpful analytical framework. The defendant's petition did not dispute that the applicant sustained a catastrophic injury, raising questions about their standing as an aggrieved party.

Labor Code section 4660.1(c)(2)(B)catastrophic injuryincreased impairment ratingpsychiatric injurymechanism of injuryfact-driven inquiryen banc decisionPetition for Reconsiderationtrier of factlegislative history
References
14
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