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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Claim of Harrington v. L.C. Whitford Co.

The claimant, a construction worker, experienced a severe exacerbation of pre-existing asthma after exposure to burning lead paint fumes in June 1996. A certified pulmonologist, Richard Evans, determined the exposure caused a permanent and total disability. A Workers' Compensation Law Judge (WCLJ) found an accidental injury causing permanent and total disability, which the Workers' Compensation Board affirmed in August 2001. The employer and carrier appealed, arguing the condition was pre-existing and only temporarily aggravated. The appellate court affirmed the Board's decision, finding substantial evidence to support that the work-site exposure significantly exacerbated the claimant's stabilized asthma, leading to a permanent and total disability.

Workers' CompensationPermanent Total DisabilityAsthma ExacerbationOccupational ExposureLead Paint FumesPre-existing ConditionMedical Expert TestimonySubstantial EvidenceAppellate ReviewIndustrial Accident
References
14
Case No. MISSING
Regular Panel Decision

Claim of Milner v. Country Developers, Inc.

The Special Disability Fund appealed decisions by the Workmen’s Compensation Board which imposed liability on the Fund for a claimant's injuries. The Board found that the employer, Country Developers, continued to employ the claimant, a carpenter, with knowledge of his pre-existing permanent physical impairment, triggering liability under subdivision 8 of section 15 of the Workmen’s Compensation Law. The claimant suffered a fracture of the nose and a hip dislocation in 1964, having a history of three ruptured disc surgeries and other conditions. The appeal centered on whether the employer had sufficient knowledge of the claimant’s permanent condition. Testimony from the employer’s foreman, Mr. Pahlck, indicated awareness of the claimant's back issues, including wearing a back brace and being favored by co-workers. The court affirmed the Board’s decision, reiterating that employer knowledge is a question of fact for the Board, and its findings, if supported by substantial evidence, will not be disturbed.

Workers' Compensation LawSpecial Disability FundEmployer LiabilityPre-existing Permanent ImpairmentEmployer KnowledgeSubstantial EvidencePermanent Partial DisabilityFracture of NoseHip DislocationRuptured Discs
References
3
Case No. MISSING
Regular Panel Decision

Claim of Martone v. Niagara Frontier Transportation Authority-Metro

In 2005 and 2007, a bus driver (claimant) suffered work-related neck and back injuries. Initially, a Workers’ Compensation Law Judge found him permanently totally disabled. However, the Workers’ Compensation Board modified this, determining he had a permanent partial disability with a 75% loss of wage-earning capacity based on medical evidence and other factors. The claimant appealed this decision, arguing a lack of substantial evidence for the partial disability finding. The Appellate Division affirmed the Board's decision, noting medical reports indicating submaximal efforts, high medication dosages, symptom magnification, and the ability to ambulate, which supported the finding of partial disability. The court also upheld the 75% loss of wage-earning capacity, finding it supported by substantial evidence after considering the claimant's impairment, work restrictions, age, education, and work experience.

Permanent Partial DisabilityWage-Earning CapacityChronic Pain SyndromeLumbar Spine SurgeryMedical EvidenceSubmaximal EffortsSymptom MagnificationAppellate ReviewBoard DecisionMedical Treatment Guidelines
References
2
Case No. ADJ285099 (SFO 0496940) ADJ224856 (SFO 0496941)
Regular
Nov 13, 2008

PATRA NESSETH-STEFFES vs. HAYWARD UNIFIED SCHOOL DISTRICT, SCHOOLS INSURANCE GROUP

The Appeals Board affirmed the WCJ's decision, finding that the applicant's right knee injury did not have an indicated permanent disability in 2004 based on treating physician reports, thus requiring the use of the 2005 Permanent Disability Rating Schedule. The majority concluded that Dr. Lim's MRI report, while showing tears, did not explicitly state the existence of permanent disability from the industrial injury, and the treating physician's report at the time showed no physical evidence of permanent impairment. A dissenting opinion argued that Dr. Lim's MRI report, supported by subsequent medical findings and the applicant's ongoing restrictions, indicated permanent disability in 2004, warranting application of the older 1997 rating schedule.

Workers' Compensation Appeals BoardReconsiderationPermanent Disability Rating ScheduleMedical-Legal EvaluationTreating Physician ReportPermanent and StationaryLabor Code Section 4660(d)American Medical Association GuidesZenith Insurance Co. v. Workers' Comp. Appeals Bd. (Cugini)Genlyte Group v. Workers' Comp. Appeals Bd. (Zavala)
References
2
Case No. OAK 313422
Regular
Mar 11, 2008

JOHN SILVA vs. BMD PLUMBING, INC., STATE FARM

The Appeals Board granted reconsideration to clarify the applicability of the 2005 Permanent Disability Rating Schedule. The Board affirmed its prior decision rescinding the original award and remanding for new findings using the 2005 schedule, concluding that no report pre-dating 2005 indicated the existence of permanent disability. This ruling aligns with recent appellate court decisions holding that specific P&S statements are not required if a report indicates permanent disability.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilityPDRSVera v. Workers' Comp. Appeals Bd.Genlyte Group v. Workers' Comp. Appeals Bd.Zenith Insurance Co. v. Workers' Comp. Appeals Bd.Labor Code Section 4660(d)Medical-Legal Report
References
6
Case No. RDG 120102
Regular
Jul 30, 2007

Dominic Watkins vs. Outback Steakhouse, State Compensation Insurance Fund

This case concerns the application of the correct permanent disability rating schedule for an industrial injury occurring between 2003 and 2004. The applicant argued that the pre-2005 schedule should apply due to treating physician reports from November 2004 indicating permanent disability. The Workers' Compensation Appeals Board reversed the initial decision, agreeing that the doctor's reports, which noted a "chronic problem" and imposed significant work restrictions, sufficiently "indicated the existence of permanent disability" to trigger the older 1997 Schedule.

Rating Schedule2005 Schedule1997 SchedulePermanent DisabilityTreating PhysicianMedical-Legal ReportLabor Code Section 4660(d)Prospective ApplicationCumulative InjuryIndustrial Injury
References
1
Case No. ADJ1584272
Regular
Dec 03, 2010

RICHARD SILVA vs. PAZIN & MYERS, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding of 100% permanent disability for the applicant's back and psyche injuries. The Board found that the workers' compensation judge properly applied the 1997 Schedule for Rating Permanent Disabilities due to pre-existing medical reports indicating permanent disability. Substantial evidence, including the Agreed Medical Examiner's opinion on permanent total disability and the applicant's treating psychologist's opinion, supported the 100% disability rating. The defendant failed to meet its burden to prove apportionment of the disability.

ADJ1584272FRE 0244029Pazin & MyersInc.State Compensation Insurance FundFindings and AwardSeptember 142010industrial injuryback
References
8
Case No. ADJ4698127 (SJO 0257241)
Regular
Aug 05, 2014

Jacqueline Molis vs. Bay 101, State Compensation Insurance Fund

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and reversed a prior decision, finding that the 1997 Permanent Disability Rating Schedule (PDRS) does not apply to this applicant's case. The WCAB concluded that there was no pre-January 1, 2005 treating physician report that substantially indicated the existence of permanent disability. Specifically, Dr. Ware's report, relied upon by the applicant, was deemed inconsistent and speculative regarding permanent disability. Therefore, the 2005 PDRS will apply in determining applicant's permanent disability.

References
3
Case No. ADJ3834810 (SRO 0121550)
Regular
Sep 03, 2009

MICHAEL RISCH vs. AT HOME NURSING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's finding of 100% permanent disability for the applicant. The Board found substantial evidence supported the total permanent disability rating and the applicant's average weekly earnings. The 1997 Permanent Disability Rating Schedule was correctly applied due to pre-January 1, 2005 medical reporting indicating permanent disability. The Board also affirmed the WCJ's rejection of apportionment to pre-existing conditions, as the applicant had fully recovered and returned to strenuous work.

Workers' Compensation Appeals BoardMichael RischAt Home NursingState Compensation Insurance FundADJ3834810Opinion and Order Denying Petition for ReconsiderationFindings and Awardadministrative law judgecumulative traumaindustrial injury
References
17
Case No. SRO 116945
Regular
Mar 14, 2008

RHONDA BAUWENS vs. VILLAGE RETREAT, STATE COMPENSATION INSURANCE FUND

The Appeals Board denied reconsideration, affirming its prior decision that the 1997 Schedule, not the 2005 Schedule, applies to the applicant's permanent disability rating. The Board found that the medical report indicated the existence of permanent disability under the reasoning of *Zavala*, even though the applicant's condition was not yet permanent and stationary. Therefore, the applicant's industrial injury on July 7, 2001, is subject to the 1997 permanent disability rating schedule.

1997 Schedule2005 SchedulePetition for ReconsiderationDecision after Reconsiderationpermanent disabilityindustrial injuryspinepsycheagreed medical evaluatorcomprehensive medical-legal report
References
8
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