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

Case No. ADJ6630817
Regular
Dec 27, 2010

NADINE WHITEEAGLE vs. CENTRAL RECRIGERATOR SERVICES, GREAT WEST CASUALTY

This case concerns an applicant's shoulder injury resulting in 12% permanent disability. The defendant argued the Permanent Medical Evaluator (PQME) found 0% impairment and objected to the rater's consideration of surgery. However, the Appeals Board affirmed the WCJ's decision, finding the rating instruction was properly based on substantial medical evidence from the PQME's report, which included the applicant's shoulder surgery. The Board also noted the defendant's objection to the rating was untimely.

Workers' Compensation Appeals BoardReconsiderationFindings Award and OrderPermanent DisabilityPanel Qualified Medical Evaluator (PQME)Whole Person Impairment (WPI)AMA Guides to the Evaluation of Permanent ImpairmentDistal Clavicle ResectionRater InstructionsDEU Rater
References
Case No. LAO 0854553
Regular
Oct 01, 2007

DANIEL A. LONG vs. RYANS EXPRESS MOTORCOACH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration, upholding the finding that the applicant's temporary disability payments for a right shoulder injury terminated on February 28, 2007. The Board ruled that the surgical removal of a distal clavicle spur does not constitute an "amputation" under Labor Code Section 4656(c)(2), which requires severance of an external body part. Therefore, the applicant is not entitled to extended temporary disability benefits beyond the statutory 104-week limit.

Distal clavicleAmputation exceptionSection 4656(c)(2)Temporary disability termination104-week limitation240-week limitationRight shoulder surgeryRotator cuff tearJacob Tauber M.D.Hawkins v. Amberwood Products
References
Case No. OAK 0326623
Regular
Jan 22, 2008

HENRIETTA BARCLAY vs. RITE AID, TRAVELERS INSURANCE COMPANY

The applicant's claim that the excision of her distal clavicle constitutes an "amputation" under Labor Code section 4656(c)(2)(C) was denied, as the Board held that term refers to external body parts. However, the Board deferred the issue of temporary disability indemnity, allowing further proceedings on the applicant's claims of unreasonable medical treatment delays estopping the defendant from asserting the statutory limits. The Board also declined to rule on the constitutionality of the statute, citing lack of jurisdiction.

Workers' Compensation Appeals BoardRite AidTravelers Insurance CompanyReconsiderationIndustrial InjuryRight ShoulderSurgeryExcisionDistal ClavicleAmputation
References
Case No. SRO 0132150
Regular
Sep 11, 2007

DAVID BLOOMQUIST vs. SIRI GRADING & PAVING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to address the defendant's argument that temporary disability payments exceeded the statutory 104-week limit. The Board clarified that the applicant's shoulder surgery did not constitute an "amputation" as defined by Labor Code section 4656(c)(2)(C), which is an exception to the limit. Consequently, the case is returned to the trial level to determine the exact date temporary disability payments first commenced, as this is crucial for calculating the applicable 104-week cap.

Petition for ReconsiderationFindings and Awardcumulative traumatemporary disability indemnitydate of commencementLabor Code section 4656(c)amputationtwo-year/104-week capseverancelimb
References
Case No. ADJ1022165
Regular
Jul 07, 2014

TIMETHY SMITH vs. WEST COAST AGGREGATES, INC., STATE COMPENSATION INSURANCE FUND

This case involves an applicant who sustained industrial injuries to his right clavicle and elbow, and the Workers' Compensation Appeals Board (WCAB) amended an award after reconsideration. The WCAB found the applicant also sustained injury to his lumbar spine and internal systems, but not his thoracic spine or psyche. Defendants were granted credit for temporary disability overpayments against both permanent disability and life pension awards. Issues regarding attorney's fees and the precise calculation of future benefits were deferred.

Workers' Compensation Appeals BoardSupplemental Findings of Fact and AwardReconsiderationIndustrial InjuryLumbar SpineInternal InjuryRight ClavicleRight ElbowChronic PainTemporary Disability Indemnity
References
Case No. ADJ6814665
Regular
Oct 29, 2010

JULIO GARCIA vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's (WCJ) findings. The WCJ determined the applicant sustained admitted industrial injury to his left knee and non-admitted industrial injury to his right second toe, resulting in 25% permanent disability. The WCJ found the right second toe injury industrial based on hospital records indicating a fracture, despite the Agreed Medical Evaluator's (AME) opinion that it was not industrial. The defendant also challenged the attorney's fee, but the Board found they lacked standing.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeFindings Award and OrdersIndustrial InjuryPermanent DisabilityAgreed Medical EvaluatorOrthopedistCausationRancho Los Amigos Hospital Records
References
Case No. ADJ3090848
Regular
Jan 27, 2010

BOB CROUSE vs. ALADDIN'S ELECTRIC COMPANY, STATE COMPENSATION INSURANCE FUND

The Board granted reconsideration of the WCJ's award, which found applicant 100% permanently disabled following an industrial injury. Defendant argued against the 100% disability finding, citing insufficient medical evidence and procedural errors. While affirming the 100% disability finding as supported by substantial evidence, the Board amended the award to explicitly state applicant failed to prove industrial injury to his heart or for diabetes. The Board also clarified that a prior petition for reconsideration by the defendant was already addressed and granted in 2007.

Petition for ReconsiderationFindings and Awardshop supervisorindustrial injuryleft shoulderleft clavicleright elbowright handheadneck
References
Case No. ADJ3371597 (AHM 0141522)
Regular
Apr 03, 2012

DARRELL MEYERS vs. JOSEPH R. SCOTT, INC., STATE COMPENSATION INSURANCE FUND

Applicant sought reconsideration of a WCJ's finding that the employer did not commit serious and willful misconduct causing his industrial injury. The applicant argues the employer violated safety orders and failed to provide a safe workplace, entitling him to increased benefits under Labor Code Section 4553. Due to the delay in obtaining the trial transcript, which is crucial for a complete review, the Appeals Board granted reconsideration. This allows time for the transcript to be prepared and reviewed to ensure a just decision.

Workers' Compensation Appeals Boardserious and willful misconductLabor Code § 4553industrial injurypipefitterlaborerlow back injurychest injuryrib injuryclavicle injury
References
Case No. ADJ7709630
Regular
Feb 21, 2012

CARLOS RUIZ vs. VULCAN MATERIAL COMPANY, OLD REPUBLIC INSURANCE

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration regarding temporary disability benefits, finding no exception applied to the 104-week limit. However, the Board granted the applicant's Petition for Removal, rescinded the Order Compelling a medical examination, and returned the matter for further proceedings. This action was taken due to allegations of defendant's violation of Labor Code section 4062.3(c) and potential prejudice to the applicant.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFindings and OrderOrder Compelling Medical ExaminationLabor Code section 4656(c)(2)Labor Code section 4656(c)(3)temporary disability benefitsstatutory limitamputation exception
References
Case No. SDO 0340101
Regular
Sep 10, 2007

RITA CORDOVA vs. SAN DIEGO UNIFIED PORT DISTRICT, AMERICAN HOME ASSURANCE COMPANY

This case concerns the application of the 2005 permanent disability rating schedule (PDRS) over the older 1997 PDRS for an applicant injured in 2004. The applicant argued that exceptions in Labor Code section 4660(d) should trigger the 1997 schedule, primarily based on a physician's report predating the schedule change. The Workers' Compensation Appeals Board affirmed the original award, finding that recent appellate decisions clarified that the older schedule only applies if a report indicating permanent disability exists prior to January 1, 2005, and the employer was not required to provide notice under Labor Code section 4061 before that date. Therefore, the 2005 PDRS was correctly applied.

Workers' Compensation Appeals BoardReconsiderationPermanent Disability Rating ScheduleLabor Code section 4660(d)Labor Code section 4061Medical-legal reportTreating physician's reportPermanent and stationary statusTemporary disability indemnityIndustrial injury
References
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