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

Case No. ADJ6886760
Regular
Mar 13, 2017

JOSE RUBIO NUNEZ vs. MACON CONSTRUCTION, INC., CYPRESS INSURANCE COMPANY c/o BERKSHIRE HATHAWAY HOMESTATE

This case concerns applicant Jose Rubio Nunez's claim for industrial injury to his neck, back, and right shoulder. The defendant employer sought reconsideration of a finding of 75% permanent disability without apportionment, arguing for 20% apportionment to non-industrial causes. The Board affirmed the original award but deferred the issues of permanent disability and attorney's fees for further proceedings. This decision allows for further development of the record regarding apportionment, as the prior opinions lacked specific explanation on how pre-existing degeneration translated to the proposed apportionment percentage.

ApportionmentPermanent DisabilitySubstantial EvidenceMedical OpinionTreating PhysicianPQMEAMA GuidesDRE CategoryDegenerationFusion
References
Case No. ADJ1337074 (GRO 0034564) ADJ1286218 (GRO 0034565)
Regular
Jun 24, 2009

Dave Gerletti vs. SANTA MARIA AIRPORT DISTRICT, GREGORY BRAGG STOCKTON

The Workers' Compensation Appeals Board denied Dave Gerletti's petition for reconsideration of an award for a cumulative trauma injury to his cervical spine and lungs. The original award found 35% permanent disability, apportioning 50% of the cervical spine disability to non-industrial factors based on a Qualified Medical Evaluator's opinion of degenerative changes. The majority affirmed the WCJ's reliance on this opinion, finding it adequately explained. A dissenting opinion argued the QME's apportionment was speculative and improperly based on age and genetics, recommending an unapportioned award for the cervical spine injury.

Workers' Compensation Appeals Boardcumulative traumacervical spinelungspermanent disabilityapportionmentQualified Medical EvaluatorAgreed Medical Examinerarthritic degenerationnon-industrial factors
References
Case No. ADJ15875626
Regular
Jun 30, 2025

Evyette Gaines vs. Riverside University Health System

Defendant sought reconsideration of the April 11, 2025 Findings, Award, and Orders (FA&O), where the WCJ found the reporting of PQME, Dr. Albert Simpkins, to be substantial medical evidence, with the exception of apportionment. Applicant, Evyette Gaines, was found to have sustained injury AOE/COE to the cervical spine, lumbar spine, and psyche, resulting in 38% permanent disability. Defendant contended that Dr. Simpkins' apportionment findings constituted substantial medical evidence and that the WCJ misapplied legal precedents. After considering the petition and the WCJ's report, the Appeals Board denied the Petition for Reconsideration.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrdersQualified Medical EvaluatorPQMEAlbert SimpkinsApportionmentSubstantial Medical EvidenceAOE/COECervical Spine
References
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