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

Case No. VNO 0386181
Regular
Apr 05, 2007

SUSAN PASCALE vs. BLUE CROSS/WELLPOINT DENTAL, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION on behalf of FREMONT INDEMNITY

This case concerns applicant Susan Pascale's claim for workers' compensation benefits due to industrial injuries resulting in fibromyalgia and other conditions. The WCJ awarded 80% permanent disability, apportioning 20% to applicant's pre-existing personality traits based on medical opinions. The Appeals Board affirmed this decision, finding the apportionment was supported by substantial medical evidence of causation, as allowed by recent statutory changes.

Workers' Compensation Appeals BoardSusan PascaleBlue Cross/Wellpoint DentalCalifornia Insurance Guarantee AssociationFremont IndemnityVNO 0386181Opinion and Decision After ReconsiderationApplicantDefendantWCJ
References
Case No. ADJ9431348 ADJ9439654
Regular
May 13, 2015

BLADIMIRO MEJIA JUAREZ vs. CAVALIER LANDSCAPE & DESIGN, FLORISTS' MUTUAL INSURANCE COMPANY D/B/A HORTICA

The Workers' Compensation Appeals Board granted applicant's petition for reconsideration, rescinding its prior order that dismissed the applicant's petition as untimely. The Board found the applicant's initial petition for reconsideration was timely filed. However, upon reviewing the merits, the Board affirmed the original decision denying the applicant's claim, finding the applicant lacked credibility and the medical reports were not substantial evidence due to reliance on the applicant's self-reporting and lack of objective findings.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and AwardWCJsubstantial evidencemedical causationcredibilitytimelinessLabor CodeGarza v. Workers' Comp. Appeals Bd.
References
Case No. ADJ2515407 (OXN 0138411)
Regular
Sep 16, 2013

ROBERT VOELTZ vs. THE KROGER COMPANY dba RALPH'S GROCERY COMPANY permissibly self-insured and administered by SEDGWICK

The Workers' Compensation Appeals Board granted Defendant's Petition for Reconsideration, increasing Applicant's permanent disability from 82% to 89%. The Board found the WCJ erred in the calculation using the Multiple Disabilities Table and in the apportionment of psychiatric disability. Specifically, 10% of the psychiatric disability was apportioned to non-industrial factors per Dr. Charuvastra's opinion. The Board also affirmed the use of the 1997 Permanent Disability Rating Schedule and the admission of Dr. Liker's reports.

VOELTZROBERTKROGER COMPANYRALPH'S GROCERY COMPANYSEDGWICKADJ2515407OXN 0138411WORKERS' COMPENSATION APPEALS BOARDRECONSIDERATIONFINDINGS AND AWARD
References
Case No. SJO 0235006
Regular
Apr 04, 2008

Geronimo Vasquez vs. RAMOS BUILDING MAINTENANCE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board reconsidered a prior award for Geronimo Vasquez's back injury, adjusting the permanent disability. The Board found that 20% of the applicant's permanent disability should be apportioned to a pre-existing condition, reducing the overall award. The weekly indemnity rate was also corrected from $230.00 to $93.33.

Workers Compensation Appeals BoardGeronimo VasquezRamos Building MaintenanceState Compensation Insurance FundSJO 0235006ReconsiderationPermanent DisabilityApportionmentPre-existing ConditionQualified Medical Evaluator
References
Case No. ADJ1926394 (POM 0267363)
Regular
Jul 20, 2009

Francisco Costa vs. Ralph's Grocery Company

The Workers' Compensation Appeals Board granted reconsideration of a $100\%$ permanent disability award to Francisco Costa. Defendant Ralph's Grocery Company argued that $20\%$ of the disability should be apportioned to Costa's pre-existing congenital spinal stenosis, citing medical opinions. The Board found that the medical record justified apportionment but lacked sufficient detail on the basis for the physicians' opinions. Consequently, the Board rescinded the award and returned the case to the trial level for further development of the medical record regarding apportionment.

WCABRalph's Grocery CompanyFrancisco Costapermanent disabilityapportionmentcongenital spinal stenosiscauda equina syndromedecompression surgeryQMEsubstantial medical evidence
References
Case No. SRO 0277261
Regular
Aug 10, 2007

Luis M. Mariscal vs. Blakeley Construction, State Compensation Insurance Fund

This case involves a workers' compensation claim for a back injury where the defendant seeks reconsideration of the permanent disability rating. The core issue is whether to apportion a portion of the disability to the applicant's pre-existing pathological condition, despite the evaluating physician's potentially contradictory opinion. The Appeals Board granted reconsideration, rescinded the prior award, and returned the matter for a new rating consistent with apportionment principles established in recent case law.

Workers' Compensation Appeals BoardReconsiderationApportionmentPermanent DisabilityQualified Medical EvaluatorLabor Code section 4663CausationSubstantial Medical EvidenceGattenEscobedo
References
Case No. ADJ1817589 (POM 0209340)
Regular
Feb 22, 2011

MARIAM HASAN vs. GUADALUPE HOMES, SEDGWICK CIGA GLENDALE

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding 100% permanent disability due to industrial injuries sustained in 1991. The defendant sought apportionment based on pre-existing degenerative spinal conditions. While the Agreed Medical Evaluator opined some apportionment was warranted, their report lacked sufficient detail to meet legal standards for causation and apportionment. Consequently, the case is returned to the trial level for further development of the medical record regarding permanent disability and apportionment.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderPermanent DisabilityApportionmentAgreed Medical EvaluatorWCJLabor Code Section 4663EscobedoGatten
References
Case No. ADJ4649587 (OAK 0314357)
Regular
Nov 10, 2009

LEITRISS ROMINE vs. COUNTY OF ALAMEDA

The WCAB affirmed the WCJ's decision awarding applicant 42% permanent disability for an industrial injury, rejecting the defendant's argument for apportionment based on a QME's opinion. The Board found the QME's report lacked a full explanation of the apportionment.

ApportionmentWCABFindings Award and OrderReconsiderationLumbar SpineOrthopedistQualified Medical EvaluatorNon-industrial FactorsSB 899Escobedo v. Marshalls
References
Case No. ADJ3310998 (SBR 0339242)
Regular
Aug 09, 2017

DENNIS WHITE vs. GOLDEN WEST FRUIT COMPANY, OAK RIVER INSURANCE COMPANY, BERKSHIRE HATHAWAY HOME STATE COMPANIES

This case involves an appeal regarding the apportionment of permanent disability for applicant Dennis White. The Workers' Compensation Appeals Board granted reconsideration, rescinded the original award, and remanded the case for a new rating. The Board found that the Qualified Medical Evaluator, Dr. Sofia, provided substantial medical evidence supporting apportionment of applicant's permanent disability to pre-existing degenerative conditions, as required by current law. This decision overturns the trial judge's finding that apportionment was not established.

ApportionmentQualified Medical EvaluatorPermanent DisabilityReconsiderationFindings and AwardSubstantial Medical EvidenceEscobedoGattenDegenerative ChangesCausation
References
Case No. SFO 0494473
Regular
Apr 15, 2008

ROBERT HARRISON vs. ACADEMY OF ART COLLEGE, LIBERTY MUTUAL INSURANCE COMPANY

The Appeals Board granted reconsideration and rescinded the prior award because the Agreed Medical Evaluator's apportionment opinions lacked sufficient explanation regarding causation and calculation methodology. The Board remanded the case for further development of the medical record. The trial judge must then issue a new decision on permanent disability and apportionment after reviewing further medical evidence.

Workers' Compensation Appeals BoardRobert HarrisonAcademy of Art CollegeLiberty Mutual Insurance CompanyOpinion and Order Granting ReconsiderationFindings and AwardIndustrial InjuryShuttle VanRear-endedNeck Injury
References
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