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

Case No. ADJ7261203
Regular
Oct 11, 2012

ANGELINA KENDRICK McGEE vs. STATE OF CALIFORNIA, DEPARTMENT OF JUSTICE, Legally Uninsured, Administered by STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

The defendant sought reconsideration of a workers' compensation award, challenging the inclusion of a grip strength rating for the applicant's left hand. The Appeals Board granted reconsideration, finding the Agreed Medical Examiner did not adequately justify departing from the AMA Guides' limitations on rating grip strength. Consequently, the applicant's permanent disability rating was reduced from 56% to 51% by excluding the grip strength impairment. The award for permanent disability indemnity and attorney fees was amended accordingly.

Workers' Compensation Appeals BoardAngelina Kendrick McGeeState of California Department of JusticeState Compensation Insurance FundOpinion and Order Granting ReconsiderationFindings and AwardOffice Assistant SupervisorPermanent DisabilityCervical SpineLeft Hand and Wrist
References
Case No. ADJ834041
Regular
Jan 24, 2011

DAWN DEANS vs. PALMDALE WATER DISTRICT; Permissibly Self-Insured, Administered by ACWA/JPIA

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding 13% permanent disability for the applicant's right elbow and wrist injury. Defendant argued the award was not supported by substantial medical evidence. The Board found the Qualified Medical Evaluator's (PQME) report deficient due to inadequate grip strength testing, misinterpretation of AMA Guides on grip strength differences, and failure to explain why grip loss was the primary rating factor. Consequently, the prior award was rescinded, and the case was returned to the trial level for further medical development and a new decision.

Workers' Compensation Appeals BoardPalmdale Water DistrictPermissibly Self-InsuredACWA/JPIAFindings and AwardPermanent Disability RatingSubstantial Medical EvidenceQualified Medical EvaluatorAMA GuidesGrip Strength
References
Case No. ADJ9526635
Regular
Feb 21, 2017

SISSON STEWART vs. CALIFORNIA STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and affirmed the original award, but remanded the case to defer the issue of permanent disability. This decision arose because the treating physician's permanent disability rating, based on grip strength loss, was deemed not substantial medical evidence under AMA Guides. The Appeals Board found that the doctor failed to adequately justify the use of grip strength over range of motion or other objective findings, and further development of the medical record is required. Consequently, the case returns to the trial level for further proceedings on permanent disability.

Workers' Compensation Appeals BoardPermanent DisabilityMedical EvidenceTreating PhysicianQualified Medical EvaluatorAMA GuidesGrip StrengthRange of MotionFindings and AwardPetition for Reconsideration
References
Case No. ADJ2453188 (LBO 0391424)
Regular
Jul 20, 2009

WILLIAM GILBERT vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award, finding the medical evidence insufficient. The applicant sought a higher permanent disability rating than the $12\%$ awarded, arguing the judge erred in calculating impairment and omitting pain and grip strength adjustments recommended by the Agreed Medical Evaluator. The Board returned the case to the trial level for further development of the medical record, requiring the evaluator to fully explain their findings on impairment, pain, and grip strength, and to consider *Almaraz* principles regarding equitable permanent disability awards.

Workers' Compensation Appeals BoardCumulative InjuryPermanent DisabilityLeft Median Sensory NeuropathyLeft Ulnar Motor NeuropathyAgreed Medical EvaluatorOrthopedistAMA GuidesImpairment RatingGrip Strength
References
Case No. ADJ6757080
Regular
Jul 23, 2012

GRACE AOKI vs. CITY OF TORRANCE

This case concerns a library page's permanent disability rating for a right shoulder injury. The agreed medical evaluator combined ratings for loss of motion and weakness/grip strength, exceeding AMA Guides limitations for combining such impairments. The Appeals Board found the physician's report insufficient to rebut AMA Guide standards or explain the combined rating. Consequently, the permanent disability award was reduced from 46% to 20%.

Workers' Compensation Appeals BoardGrace AokiCity of TorrancePermissibly Self-InsuredReconsiderationJoint Findings and AwardPermanent DisabilityAgreed Medical EvaluatorSeymour L. AlbanPetition for Reconsideration
References
Case No. ADJ10440533
Regular
Apr 20, 2020

SUMUDU JAYASURIYA vs. SAN FRANCISCO BAY AREA RAPID TRANSIT DISTRICT

The Workers' Compensation Appeals Board (WCAB) rescinded the original Findings and Award due to insufficient substantial evidence. The WCAB found that the chiropractor QME's reports did not adequately explain the basis for combining wrist range of motion impairment with grip strength impairment, particularly in relation to the AMA Guides. The case is returned to the WCJ for further development of the record, likely through an evaluation by an orthopedic hand specialist, to properly assess the applicant's permanent disability.

Workers' Compensation Appeals BoardSan Francisco Bay Area Rapid Transit DistrictSumudu JayasuriyaQualified Medical Examiner (QME)Dennis M. SosineD.C.left upper extremity injurypermanent partial disabilityrange of motiongrip strength
References
Case No. ADJ11699310
Regular
Dec 18, 2020

JACQUELYN OTT vs. COUNTY OF VENTURA - HEALTH CARE AGENCY

Both applicant and defendant sought reconsideration of a prior award. The Appeals Board granted reconsideration, rescinded the award, and returned the case to the WCJ for further proceedings. The Board found that the Qualified Medical Examiner's (QME) reports regarding permanent disability were not substantial evidence because they did not adequately explain the reasoning for using grip strength as the primary impairment factor, especially given the applicant's reported pain. The Board also noted that the QME reports did not sufficiently summarize the reviewed medical records.

Workers' Compensation Appeals BoardPermanent Disability RatingQualified Medical ExaminerAMA GuidesWrist InjuryGrip StrengthImpairment RatingReconsiderationFindings of Fact and AwardSubstantial Evidence
References
Case No. ADJ6998138
Regular
Feb 13, 2012

WAI CHIU LI vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board denied the County of Los Angeles' Petition for Reconsideration. The Board upheld its prior decision to increase applicant Wai Chiu Li's permanent disability rating from 15% to 36% for a left forearm injury. This increase was based on the agreed medical examiner's use of clinical judgment to incorporate grip strength loss, consistent with the AMA Guides. The Board emphasized that physician judgment is crucial in accurately assessing impairment according to the Guides.

Workers' Compensation Appeals BoardDeputy SheriffIndustrial InjuryPermanent DisabilityReconsiderationAmerican Medical Association GuidesAMA GuidesAgreed Medical ExaminerAMEGrip Strength
References
Case No. SJO 0261668
Regular
Aug 18, 2008

MARI J. MOLLO vs. SANTA CLARA COUNTY SUPERIOR COURT, aka SANTA CLARA-JBWCP, PSI, adjusted by TRISTAR RISK MANAGEMENT

The Appeals Board granted the defendant's petition for reconsideration, finding that the trial judge's permanent disability rating was not supported by substantial evidence. The primary issue was the rating of the applicant's grip strength loss, which the agreed medical evaluator stated could not be rated under the AMA Guides due to certain conditions. The Board amended the award to defer the issues of permanent disability and attorney's fees, returning the matter to the trial level for further development of the record. This includes obtaining a supplemental report from the medical evaluator to clarify rating issues and thoroughly address the applicant's activities of daily living.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent DisabilityAgreed Medical EvaluatorAMA GuidesGrip StrengthActivities of Daily LivingWhole Person ImpairmentDeposition Testimony
References
Case No. ADJ8718778
Regular
Jul 06, 2015

BETOEL GOMEZ vs. UNITED PALLET SERVICES, CIGA

This case concerns applicant Betoel Gomez's claim for permanent disability due to a right hand and bilateral wrist injury. The defendant, United Pallet Services, sought reconsideration of a $21\%$ permanent disability award, arguing the Qualified Medical Evaluator (QME) improperly used an analogical rating rather than AMA Guides' scheduled ratings. The Appeals Board granted reconsideration, agreeing the QME failed to adequately justify the analogical rating in his supplemental report. Ultimately, the Board amended the award to $10\%$ permanent disability, based on the QME's initial report which applied the AMA Guides to grip strength loss.

Workers' Compensation Appeals BoardCIGAUllico Casualty Companyliquidationpermanent disabilityWhole Person ImpairmentWPIAMA GuidesAlmaraz/GuzmanQualified Medical Evaluator
References
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