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

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
0
Case No. MISSING
Regular Panel Decision

Lyublinsky v. Barnhart

A 73-year-old disabled plaintiff, who has received Social Security Disability (SSD) benefits since 1993, brought this action to review the Commissioner's final determination concerning his benefit rate calculation. The plaintiff argued that his benefit rate was improperly calculated, citing discrepancies in earnings records and claims of discrimination. The case has a lengthy procedural history, including multiple remands from the District Court due to issues like denial of a fair hearing and lack of legal representation. The Court conducted a de novo review of the Social Security Administration's (SSA) benefit calculations, utilizing the Average Indexed Monthly Earnings (AIME) method, and found no mathematical errors. Ultimately, the plaintiff failed to present compelling evidence to disprove the SSA's records, which are considered conclusive after a statutory period. Consequently, the Commissioner's motion for judgment on the pleadings was granted, the complaint was dismissed, and the Administrative Law Judge's (ALJ) decision was affirmed.

Social Security DisabilityBenefit CalculationAIME MethodAdministrative Law JudgePro Se PlaintiffFederal Court ReviewEarnings RecordsBurden of ProofRemandJudgment on the Pleadings
References
3
Case No. MISSING
Regular Panel Decision
Oct 14, 1999

Claim of Williams v. New York State Department of Transportation

The claimant, who suffered a work-related injury in 1988, initially received permanent partial disability benefits at a mild rate in May 1996. Dissatisfied with this assessment, the claimant appealed, presenting medical evidence suggesting a more severe disability. This led the Workers’ Compensation Board to restore the case to the trial calendar for further development of the record concerning the degree of disability post-May 6, 1996. Although two physicians testified, with one indicating a moderate disability and another a total disability, the Workers’ Compensation Law Judge (WCLJ) ultimately awarded benefits at a moderate partial disability rate. Upon the claimant's subsequent appeal, the Board ruled that the claimant was precluded from raising the issue of their degree of disability, citing regulatory provisions. The appellate court found that the Board had abused its discretion, as the issue was explicitly remanded by the Board previously, and the claimant was still aggrieved by the WCLJ's award despite an increase in benefits. Consequently, the court reversed the Board's decision and remitted the matter for further proceedings.

Workers' CompensationDisability AssessmentAppellate ReviewAbuse of DiscretionProcedural ErrorMedical EvidenceDegree of DisabilityRemittalNew York LawAdministrative Appeal
References
0
Case No. MISSING
Regular Panel Decision

Linger v. Anchor Motor Freight, Inc.

Claimant sustained permanent partial disabilities from two 1977 accidents and one 1980 accident, leading to separate awards from different employers and their respective insurance carriers. Initially, the claimant received concurrent benefits exceeding the statutory maximum rate. Upon discovering these concurrent payments, a joint hearing was held. An Administrative Law Judge apportioned the award, which was subsequently affirmed by the Workers' Compensation Board, stating that concurrent awards exceeding the statutory maximum for a permanent partial disability were impermissible. The claimant appealed this decision, arguing for a per-accident application of the statutory maximum. However, the appellate court affirmed the Board's decision, asserting that the Workers' Compensation Law establishes an overall maximum rate for permanent partial disability regardless of the number of accidents or employments.

Permanent Partial DisabilityConcurrent AwardsStatutory MaximumApportionmentMultiple AccidentsWage LossJudicial PrecedentAdministrative Law JudgeWorkers' Compensation BoardInsurance Carriers
References
2
Case No. MISSING
Regular Panel Decision
Nov 29, 2001

Claim of Caiazza v. Eastman Kodak Co.

The claimant, a former machinist, developed skin cancer in 1990 and later lung and brain cancers in 2000, attributed to occupational exposure. Following his retirement in 2001, the employer conceded the lung and brain cancers were consequential to the initial skin cancer. A Workers' Compensation Law Judge (WCLJ) found the claimant permanently totally disabled and awarded weekly benefits of $300, based on the original skin cancer disablement date of February 27, 1986. The claimant sought Workers' Compensation Board review, arguing for an April 24, 2000 disablement date (diagnosis of lung/brain cancers) to receive higher benefits of $400/week. The Board affirmed the WCLJ's decision, citing the claimant's prior stipulation to modify the original claim for consequential injuries and established law that such awards are measured by rates at the time of the original injury. The appellate court affirmed the Board's decision, finding it was not unreasonable to rely on the claimant's agreement and that the award rate was supported by substantial evidence.

Occupational DiseaseWorkers' Compensation BenefitsDate of DisablementBenefit Rate CalculationConsequential InjurySkin CancerLung CancerBrain CancerPermanent Total DisabilityAppellate Review
References
4
Case No. ADJ7873101
Regular
Apr 11, 2017

SHERY FRANKLIN vs. STATE OF CALIFORNIA

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the prior award, finding that the administrative law judge erred in several permanent disability ratings. Specifically, the WCAB will allow for further proceedings to re-rate permanent disability, incorporating the agreed medical examiner's findings for hypertension and sleep disorder, and rating psyche disability without apportionment. Issues regarding the method of rating cervical spine disability, industrial injury to the upper digestive tract, and entitlement to a Labor Code section 4658(d) increase will also be further developed and decided. The WCAB affirmed the findings on temporary disability and further medical treatment.

WCA BReconsiderationIndustrial InjuryPermanent DisabilityApportionmentAgreed Medical EvaluatorAMEWhole Person ImpairmentWPISleep Disorder
References
11
Case No. ADJ7936482
Regular
Apr 20, 2020

EXTELA MONTIEL vs. MICRO SOLUTIONS, ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board granted reconsideration to further study factual and legal issues concerning an applicant's permanent disability award. Key disputes involve the correct permanent disability indemnity rate, with the defendant arguing for a lower weekly rate based on the injury date, and the validity of the $60\%$ permanent disability finding due to conflicting medical opinions. The Board found deficiencies in the medical evidence regarding psychiatric permanent disability and issues with the apportionment of that disability. Consequently, the Board deferred resolution of temporary disability, the EDD lien, permanent disability, apportionment, and the permanent disability rate pending further record development.

Petition for ReconsiderationFindings and AwardSupervising assemblerAdmitted industrial injuryNon-admitted injuryCervical spinePsychePermanent disabilityLabor Code section 4658(d)GAF
References
10
Case No. MISSING
Regular Panel Decision

Claim of Kowalchyk v. Wade Lupe Construction Co.

The claimant, a carpenter over 60 with an 11th-grade education, fractured his back and wrist in August 1985 while on a construction jobsite. Initially, his physician, Dr. James Slavin, considered him totally disabled, and he received total disability benefits from his employer's carrier. However, in December 1985, the employer reduced benefits to a partial disability rate, relying on a report from their consultant, Dr. Edward Pasquarella. The claimant subsequently filed for compensation, leading to a determination by the Workers’ Compensation Law Judge and ultimately the Workers’ Compensation Board that he had a total industrial disability. The employer appealed this decision, arguing it lacked substantial evidence. The court affirmed the Board's decision, considering the claimant’s physical limitations, age, work experience, and limited education, concluding he had no marketable skills outside carpentry.

Workers' CompensationTotal Industrial DisabilityPartial DisabilityMedical Testimony ConflictEarning Capacity AssessmentAppellate ReviewVocational RehabilitationAge & Education FactorsCarpenter InjuryScaffold Accident
References
3
Case No. ADJ4481004
Regular
Mar 04, 2010

Ararat Sarkisian vs. VAHAN ENGIBARIAN DBA VAHAN'S ROYAL TOURS, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The applicant sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision regarding his permanent disability rating following an industrial injury. The applicant argued his $98\%$ permanent disability rating was too low, specifically contesting the WCJ's characterization of his headaches. The WCAB granted reconsideration and amended the award to reflect a $99\%$ permanent disability rating. The Board affirmed the WCJ's reasoning, declining to award total permanent disability despite the high rating and rejecting a supplemental medical report.

WCABUninsured Employers Benefits Trust Fundpermanent disability ratingcervical spinelumbar spineribsright wristright ankleheadright tibia
References
0
Case No. ADJ2073428 (VNO 0465400) ADJ1610465 (VNO 0540972) ADJ3247765 (VNO 00384869)
Regular
Apr 04, 2011

JAY ZAVERI vs. STATE COMPENSATION INSURANCE FUND; Legally Uninsured

The applicant sought reconsideration of a workers' compensation award, arguing for a 100% permanent disability rating and challenging the permanent disability start date used for attorney fee commutation. The Appeals Board denied the petition, finding insufficient evidence to establish total permanent disability, as the applicant was currently employed and medical opinions did not definitively support such a rating. The Board also ruled that the applicant waived arguments regarding the rating of specific injuries by failing to properly object, and that even if considered, separate ratings for back, knee, and plantar fasciitis conditions would not result in a higher award due to fibromyalgia being the primary cause and rating higher. Finally, the Board clarified that the July 2, 2000 date was only relevant to the attorney fee commutation calculation and not to the determination of permanent disability indemnity payments.

WCABPetition for ReconsiderationJoint Findings and AwardWorkers' Compensation Judge (WCJ)Industrial InjuryBack InjuryHip InjuryBilateral Knee InjuryBilateral Foot InjuryBilateral Plantar Fasciitis
References
7
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