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

Case No. ADJ7279904
Regular
Jan 26, 2017

JORGE URIBE vs. DS WATERS OF AMERICA, INC., ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant argued the $69\%$ permanent disability finding for psychiatric injury lacked substantial evidence because the treating physician's GAF score correction was unexplained. The Board found the physician adequately explained the correction by detailing how the proper application of GAF criteria resulted in a revised score. Furthermore, the defendant failed to pursue discovery or object to the revised report, which was admitted into evidence. Therefore, the WCJ's finding on psychiatric permanent disability was upheld.

GAF scorepermanent disabilitypsychiatric injurylumbar spinecervical spinesubstantial evidencePetition for ReconsiderationFindings and AwardWCJprimary treating physician
References
Case No. ADJ8530656, ADJ8553993
Regular
May 03, 2019

Feliciano Hernandez vs. Fresh Express, Inc., Federal Insurance Company, Sedgwick Claims Management Services

The Workers' Compensation Appeals Board granted reconsideration of a prior award, amending the applicant's permanent disability rating. The Board disagreed with the initial finding of 67% permanent disability, determining that the psychiatric impairment rating should be increased based on the Agreed Medical Examiner's opinion. This adjustment, utilizing an analogical rating method and considering the applicant's GAF score of 50, increased the total permanent disability to 73% and will include a life pension. The Board upheld the rejection of the vocational expert's total disability finding due to improper consideration of the applicant's age.

Agreed Medical ExaminerAlmaraz/GuzmanGAF scorepermanent disability ratingvocational expertsubstantial medical evidencerebuttal of scheduled ratingindustrial injuryspecific injurycumulative trauma injury
References
Case No. ADJ7527781; ADJ7527786
Regular
Feb 05, 2016

OCTAVIO ESPINOZA vs. TORRES FARM LABOR, SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, amending the original award to defer the finding of permanent disability and attorney's fees. The Board denied the defendant's petition for reconsideration, affirming the original award regarding future medical treatment for internal injuries. The case is returned to the WCJ for further proceedings, including consideration of a sleep study report and development of the record concerning permanent disability. The Board agreed that substantial evidence supported the finding of industrial injury to internal organs and the need for future medical treatment.

Workers' Compensation Appeals BoardIndustrial InjuryPermanent DisabilityTemporary Total DisabilityFuture Medical TreatmentPetition for ReconsiderationFindings of FactJoint AwardWCJSubstantial Evidence
References
Case No. ADJ18498378
Regular
Oct 27, 2025

MARIA VENEGAS vs. MARATHON PETROLEUM COMPANY, ACE AMERICAN INSURANCE

Lien claimant, Premier Psychological Services, sought reconsideration of a Findings and Order from July 30, 2025, which denied its lien for medical-legal and medical treatment expenses. The Workers' Compensation Appeals Board (WCAB) granted the petition for reconsideration, rescinded the original F&O, and returned the matter to the trial level for further proceedings. The Board found that the medical-legal expenses were incurred for a contested claim and that the medical report from Dr. Mark Michaels constituted substantial medical evidence for an injury arising out of and in the course of employment, despite some curable deficiencies regarding interpreter information. The WCAB ordered further consideration of the medical treatment expenses and a potential updated utilization review.

Premier Psychological ServicesAdjudication Number ADJ18498378Opinion and Order Granting Petition for ReconsiderationDecision After ReconsiderationLien ClaimantPrimary Treating Physician (PTP)Dr. Mark MichaelsInjury Arising Out of and In the Course of Employment (AOE/COE)PsycheMedical-Legal Report
References
Case No. ADJ7927652
Regular
Oct 25, 2016

Bozenna Kasperowicz vs. Metropolitan State Hospital, State Compensation Insurance Fund

This case involves an industrial injury to the applicant, a psychiatric technician, sustained on June 14, 2011, from a patient strike to the head. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address disputes over psychiatric impairment and a sleep disorder rating. The WCAB affirmed the original award but reduced the permanent disability rating from 76% to 70% by excluding the sleep dysfunction impairment. The WCAB found Dr. O'Brien's opinion on psychiatric impairment more persuasive than conflicting medical evaluations and determined Dr. Matos's opinion on sleep impairment lacked substantial medical evidence due to staleness.

WCABReconsiderationPsychiatric ImpairmentWhole Person ImpairmentGAF ScoreSleep DisorderSubstantial Medical EvidencePermanent DisabilityQualified Medical EvaluatorInsomnia
References
Case No. ADJ600916 (SDO 0348725)
Regular
Apr 06, 2020

DAVID GWIN vs. TOYOTA LIFT, INC., ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board rescinded the prior award and remanded the case for further development of the record. The applicant appealed a $66\%$ permanent disability rating, arguing his diminished future earning capacity was greater due to an inability to benefit from vocational rehabilitation. The Board found that the original record was insufficient to determine if the applicant's medication side effects impacted his ability to work in the open labor market or engage in vocational rehabilitation. Further medical and vocational evaluations are required to address these issues before a final determination can be made on the disability rating.

Permanent Disability RatingDiminished Future Earning CapacityVocational RehabilitationReconsiderationMedical EvaluatorsOpen Labor MarketCrush InjuryOsteomyelitisChronic PainMajor Depressive Disorder
References
Case No. ADJ6999838, ADJ6999863
Regular
Oct 17, 2019

JEFFREY DAVIS vs. PACIFIC BELL TELEPHONE CO., SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

Applicant Jeffrey Davis sought reconsideration of a 74% permanent disability award, arguing vocational expert testimony supported 100% disability. The Appeals Board denied reconsideration, finding the vocational expert's reports were not substantial evidence. The WCJ properly concluded the applicant failed to meet his burden to rebut the scheduled rating. Therefore, the WCJ's original findings and award were affirmed.

Workers' Compensation Appeals BoardPermanent Disability RatingPetition for ReconsiderationVocational ExpertSubstantial EvidenceRebuttalScheduled RatingAmenable to RehabilitationFurther Development of RecordStipulated Rating
References
Case No. ADJ3970034 (SRO 0141364)
Regular
Mar 26, 2012

JOSEPH MENEKTOS vs. DISCOVERY OFFICE SYSTEMS, TRAVELERS, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded the Supplemental Findings and Orders. The Board found that the existing record was insufficient to determine if the applicant's subsequent industrial injury, standing alone, met the 35% permanent disability threshold required for benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). The case is returned to the trial level for further medical record development to clarify the applicant's permanent disability from the subsequent injury without regard to prior awards.

Subsequent Injuries Benefits Trust FundSIBTFLabor Code section 4751permanent disability threshold35% ratingprior industrial injurysubsequent industrial injurycumulative effectApportionmentmedical reports
References
Case No. ADJ8811286
Regular
Feb 03, 2017

Roy Lehman vs. Walgreens, Zurich American Insurance Company

In this workers' compensation case, the Appeals Board affirmed the finding that Roy Lehman is permanently and totally disabled due to an industrial injury to his low back and psyche. Defendant Walgreens appealed, arguing the finding of permanent total disability was improper due to a lack of apportionment and reliance on incorrect rating schedules. The Board found substantial medical and vocational evidence supported the total disability finding, including expert opinions that Lehman was unemployable and not amenable to rehabilitation even after considering apportionment. The Board also found the vocational expert's reports met the substantial evidence standard despite defense challenges.

Workers' Compensation Appeals BoardWalgreensZurich American Insurance CompanySedgwick Claims Management ServicesRoy LehmanOpinion and Decision After ReconsiderationFindings Award and Orderpermanent total disabilityapportionmentLabor Code Section 4663
References
Case No. ADJ8205957
Regular
Dec 05, 2018

Margaret Marti Foxworthy vs. STATE OF CALIFORNIA, DEPARTMENT OF PARKS AND RECREATION, STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

This case involves a State Park Ranger's workers' compensation claim for injury to her low back, hypertension, and psyche. The primary dispute centered on calculating her permanent disability rating, with the employer arguing for the Combined Values Chart (CVC) and the applicant preferring simple addition of impairments. The Appeals Board ultimately ruled that the CVC should be applied, resulting in a $67\%$ permanent disability rating, and clarified the timing of a $15\%$ "bump-up" in indemnity payments. The dissenting opinion argued against the CVC's application and challenged apportionment of hypertension disability due to lack of substantial evidence.

Workers' Compensation Appeals BoardPermanent Disability Rating ScheduleCombined Values ChartApportionmentIndustrial InjuryState Park RangerHypertensionPsycheSexual DysfunctionDRE Lumbar Category III
References
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