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

Case No. 92
Regular Panel Decision
Nov 24, 2025

In the Matter of the Claim of Frank Aungst

Claimant Frank Aungst, a store manager for Family Dollar, contracted COVID-19 in April 2020 and subsequently suffered a stroke. He filed a workers' compensation claim, alleging work-related exposure due to his frequent public contact in an essential retail role with inadequate protective measures. The Workers' Compensation Board established the claim, applying a "prevalence" framework for COVID-19 exposure, which assesses significantly elevated hazards in the workplace. The employer argued this framework was inconsistent with the Workers’ Compensation Law. The Court of Appeals affirmed the Board's decision, finding the "prevalence" framework compatible with current interpretations of the law, and that the Board's findings of work-related COVID-19 and consequential stroke were supported by substantial evidence.

COVID-19Workers' CompensationAccidental InjuryCausal RelationshipWorkplace ExposurePrevalence FrameworkStrokeEssential WorkerRetailNew York Court of Appeals
References
15
Case No. ADJ3867236 (LAO 0817551)
Regular
Jan 20, 2012

RODNEY LIDDELL vs. LOS ANGELES COUNTY PARKS & RECREATION, Permissibly Self-Insured c/o INTERCARE INSURANCE

The Appeals Board affirmed the WCJ's decision finding applicant entitled to vocational rehabilitation services and VRMA. The defendant argued that jurisdiction had expired and no procedural framework existed for completing a vocational rehabilitation plan. However, the Board found the defendant failed to comply with interruption notice requirements, thereby preserving the applicant's right to services. The Board suggested parties agree to a QRR or return to the WCJ for dispute resolution, confirming an adequate framework remains.

Workers' Compensation Appeals BoardReconsiderationFindings Order and AwardVocational RehabilitationVRMALabor Code Section 5410Rehabilitation UnitQualified Rehabilitation RepresentativeAdministrative Director Rule 9813Interruption Notice
References
0
Case No. ADJ10116932
Significant
Jul 15, 2019

KRIS WILSON, Applicant vs. STATE OF CA CAL FIRE; legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Appeals Board denied the defendant's Petition for Reconsideration, upholding its authority to establish an analytical framework with five non-exhaustive factors for determining what constitutes a 'catastrophic injury' under Labor Code section 4660.1(c)(2)(B).

Catastrophic injuryLabor Code section 4660.1(c)(2)(B)Psychiatric injuryImpairment ratingMechanism of injuryTemporal restrictionsLegislative intentSB 863En Banc decisionPrecedent decision
References
15
Case No. ADJ6598413
Regular
May 11, 2010

SUSAN TOSTE vs. KERMAN UNIFIED SCHOOL DISTRICT, TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award. The Board found the Agreed Medical Evaluator's (AME) impairment rating was based on an outdated legal standard rejected in *Almaraz/Guzman II*. Since the AME's report predated the controlling precedent and the evaluator wasn't given a chance to supplement their opinion under the correct legal framework, the case is returned to the trial level for further medical record development.

ADJ6598413Kerman Unified School DistrictTristar Risk ManagementSusan TosteWorkers' Compensation Appeals BoardOpinion and Order Granting ReconsiderationFindings and AwardIndustrial InjuryRight ShoulderPermanent Disability
References
6
Case No. ADJ9981379 ADJ10049541
Regular
Oct 08, 2020

ULISES AVILA vs. LARRY GONZALES dba LARRY GONZALES FARM LABOR, STAR INSURANCE COMPANY

The Appeals Board reversed a WCJ's finding that a lien claimant's services ended on March 16, 2015, determining instead that services extended to June 8, 2015. This decision makes the lien timely filed under Labor Code section 4903.5(a). The Board affirmed the WCJ's orders except to find the lien timely filed and to defer the lien's allowance. The matter is returned to the WCJ for further proceedings consistent with the Board's decision and to assess the lien under the framework of *Colamonico*.

Workers' Compensation Appeals BoardLien ClaimantStatute of LimitationsSubpoena Duces TecumMedical-Legal ServicesReconsiderationFindings of Fact and OrdersLabor Code Section 4903.5(a)Timely FiledDeferred Issue
References
4
Case No. ADJ1030139 (STK 0203781)
Regular
Nov 19, 2014

GERALD REESE vs. MICRODENTAL LABORATORIES, AMERICAN HOME ASSURANCE, AIG CLAIMS SERVICES

The Appeals Board granted reconsideration to review the permanent disability rating for applicant Gerald Reese, who sustained an industrial injury in 2006. The primary issue was whether to include a deconditioning impairment, rated by a PQME using analogy, into the permanent disability award. The Board affirmed the WCJ's decision but amended it to defer the issue of permanent disability for further proceedings. This deferral is to allow the WCJ to issue rating instructions based on the established legal framework for incorporating AMA Guides impairments, even those addressed by analogy.

PQMEdeconditioningAMA Guideswhole person impairmentanalogyLabor Code section 4660Almaraz/Guzman IIMilpitas Unified School Dist.City of Sacramento v. Workers' Comp. Appeals Bd.rating instructions
References
3
Case No. ADJ6975049
Regular
Jun 05, 2018

CONSUELO VIEYRA vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board (WCAB) rescinded a prior decision and returned the case for further proceedings, finding that the defendant's utilization review denials were not timely communicated to the physician. While the initial WCJ found the UR timely, the WCAB disagreed, asserting jurisdiction to determine medical necessity. Crucially, the WCAB found that the 2009 Medical Treatment Utilization Schedule (MTUS) guideline used for the denial was an invalid regulation. The matter was returned for further development of the record regarding medical necessity, considering the proper legal framework for treatment requests.

Workers' Compensation Appeals BoardConsuelo VieyraCounty of Los AngelesUtilization ReviewRequest for AuthorizationHome Health CareReasonable and Necessary TreatmentMedical TreatmentIndependent Medical ReviewMTUS Chronic Pain Medical Treatment Guidelines
References
17
Case No. ADJ10116932
Regular
Jul 15, 2019

KRIS WILSON vs. STATE OF CA CAL FIRE; legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration regarding a catastrophic injury determination. The Board affirmed that the definition of "catastrophic injury" under Labor Code section 4660.1(c)(2)(B) focuses on the nature of the injury, not solely the immediate mechanism or condition after onset. The Board also rejected the argument that it exceeded its authority by outlining factors for assessing catastrophic injuries, stating these factors provide a helpful analytical framework. The defendant's petition did not dispute that the applicant sustained a catastrophic injury, raising questions about their standing as an aggrieved party.

Labor Code section 4660.1(c)(2)(B)catastrophic injuryincreased impairment ratingpsychiatric injurymechanism of injuryfact-driven inquiryen banc decisionPetition for Reconsiderationtrier of factlegislative history
References
14
Case No. ADJ4609262
Regular
Mar 13, 2009

TERRY KING vs. GREAT PACIFIC, THE NEWS GROUP, ZURICH AMERICAN INSURANCE

This case involves a truck driver who sustained a knee injury. The original award found 25% permanent disability, which the defendant argued was unsupported and that the applicant's expert witness fees were improperly awarded. The Appeals Board granted reconsideration to clarify the legal framework for rebutting the 2005 permanent disability rating schedule. Consequently, the Board rescinded the original award and returned the case for further proceedings to apply guidance from recent en banc decisions on rebutting impairment and diminished future earning capacity ratings. The issue of expert witness fees was deferred for later consideration.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardIndustrial InjuryPermanent DisabilityDiminished Future Earning CapacityExpert Witness FeesAgreed Medical ExaminerAMA GuidesAlmaraz
References
2
Case No. ADJ2290172
Regular
Apr 26, 2011

LINDA JENKINS vs. FAMILY PRACTICE MEDICAL ASSOCIATES, EMPLOYERS COMPENSATION INSURANCE COMPANY

This case involved applicant Linda Jenkins seeking to reopen her workers' compensation award based on a change in the law following the *Ogilvie* decisions. The WCJ found good cause to reopen, ruling that *Ogilvie* established a new framework for rebutting the diminished future earning capacity (DFEC) component of permanent disability ratings. The defendant argued *res judicata* barred reopening and that *Ogilvie* was merely a clarification, not a change in law. The Appeals Board affirmed the WCJ's decision, holding that *Ogilvie* did indeed represent a significant change in law regarding DFEC rebuttal and permitted the reopening of applicant's case.

Workers' Compensation Appeals BoardReconsiderationFindings & OrderChange in LawOgilvieDiminished Future Earning Capacity (DFEC)RebuttalRes JudicataPermanent DisabilityAMA Guides
References
8
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