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

Case No. SRO 0135735
Regular
Nov 06, 2007

ROBERT ANUSEWICZ vs. JOINT INDUSTRY BOARD OF PLUMBING, dba KONOCTI HARBOR INN AND RESORT, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's entitlement to temporary disability indemnity beyond the standard 104-week limit. The Appeals Board rescinded the prior award, ruling that the applicant's hip and knee replacement surgeries did not constitute "amputations" as defined by Labor Code section 4656(c)(2)(C). Therefore, the applicant is limited to 104 weeks of temporary disability indemnity from the commencement of payments, precluding indemnity beyond January 31, 2007.

Workers' Compensation Appeals BoardRobert AnusewiczJoint Industry Board of PlumbingKonocti Harbor Inn and ResortState Compensation Insurance FundSRO 0135735Opinion and Decision After Reconsiderationtemporary disability indemnityindustrial injuryleft knee
References
Case No. OAK 0334678, OAK 0334680
Regular
Jul 21, 2008

KENNY AUBREY vs. COLOR TECH CORPORATION

This case involves an applicant who sustained industrial injuries to both knees, resulting in concurrent temporary total disability. The Workers' Compensation Appeals Board (WCAB) affirmed a prior award of temporary disability indemnity, applying the 104-week/two-year limitation under Labor Code section 4656(c)(1). This application was justified by the AME's finding that both injuries contributed to the applicant's concurrent temporary disability, aligning with precedent established in *Foster v. Workers' Comp. Appeals Bd.*.

Workers' Compensation Appeals BoardColor Tech Corporationindustrial injuriesboth kneesarthroscopic surgeriesleft kneeright kneejoint replacementtemporarily totally disabledaggregate disability payments
References
Case No. ADJ10443669
Regular
Oct 04, 2017

Donna Carter vs. Rose International Group, OneBeacon Insurance Group

The Appeals Board affirmed the Workers' Compensation Judge's finding that Donna Carter sustained an industrial injury to her right knee and left wrist on May 18, 2016. Despite inconsistencies in the applicant's testimony regarding a slip and fall incident, her account was corroborated by a witness who found her on the floor. Medical records from the day of the incident also supported the applicant's claim, establishing a clear mechanism of injury. The Board found that the common sense nature of a slip and fall does not require expert medical opinion to establish industrial causation for the incident itself.

ADJ10443669Rose International GroupOneBeacon Insurance GroupDonna CarterWorkers' Compensation Appeals BoardOpinion and Decision After Reconsiderationslip and fallindustrial injuryright kneeleft wrist
References
Case No. AHM 112796 AHM 112797
Regular
Jul 07, 2008

CHARLES GARBARINO vs. CON AGRA FOODS

This case involves an applicant seeking reconsideration of a workers' compensation award that apportioned $40\%$ of his left knee disability to a pre-existing arthritic condition. The applicant argued the Agreed Medical Examiner's apportionment was not medically probable and that disability from knee replacement surgery should not be apportioned. The Board denied reconsideration, affirming the award, but one Commissioner dissented, arguing apportionment of disability from surgery is improper under Labor Code section 4663.

Workers' Compensation Appeals BoardCon Agra FoodsCharles GarbarinoPetition for ReconsiderationFindings Award and OrderAgreed Medical Examinerspecific traumacumulative traumaleft knee injurypermanent disability
References
Case No. ADJ3727929
Regular
Jul 17, 2013

JOE GAGNE vs. FRU CON CONSTRUCTION, ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration. The Board adopted the WCJ's report, which found that the applicant was only temporarily disabled from June 1, 2007, to July 23, 2007, and was not entitled to further travel expense reimbursement. The WCJ determined that while one physician's opinion could constitute substantial evidence, that opinion lacked sufficient clarity and consistency to support the applicant's broader claims of temporary disability and cumulative trauma to the left knee and back. The Board affirmed that a single physician's considered opinion can be substantial evidence, even if inconsistent with other medical opinions.

Petition for ReconsiderationDeniedSubstantial EvidencePlace v. Workmen's Comp. Appeals Bd.Fru Con ConstructionZurich North AmericaADJ3727929SAC 0315536ApplicantTemporarily Disabled
References
Case No. ADJ8134312
Regular
Sep 15, 2016

ERNIE GALLEGOS vs. GROTH BROTHERS CHEVROLET, AUTO DEALERS COMPENSATION OF CALIFORNIA, CORVEL

The applicant sustained a right knee injury, leading to a total knee replacement. The original award granted permanent disability without apportionment, which the defendant appealed. The Appeals Board granted reconsideration, finding that apportionment to pre-existing knee conditions was legally permissible even after total knee replacement. The case is remanded for a new award based on the Qualified Medical Evaluator's 50% apportionment to pre-existing pathology. A dissenting opinion argues the medical evidence lacked sufficient reasoning to support apportionment.

WORKERS' COMPENSATION APPEALS BOARDERNE GALLEGOSGROTH BROTHERS CHEVROLETAUTO DEALERS COMPENSATION OF CALIFORNIACORVELADJ8134312PETITION FOR RECONSIDERATIONFINDINGS AND AWARDPERMANENT DISABILITYAPPORTIONMENT
References
Case No. VNO 482752, VNO 482753
Regular
Jul 10, 2007

JESUS SANJORO vs. MOTION PICTURE AND TELEVISION FUND, Permissibly Self-Insured, Adjusted By ROYAL INDEMNITY CO.

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's award of 46% permanent disability. The Board found, consistent with prior precedent in *Steinkamp*, that medical treatment itself is not apportionable, even if non-industrial factors contributed to the need for that treatment. Therefore, the applicant's permanent disability resulting from knee replacement surgery was not subject to apportionment based on the underlying non-industrial arthritis.

Workers' Compensation Appeals BoardSanjoroMotion Picture and Television FundRoyal Indemnity Co.VNO 482752VNO 482753Petition for ReconsiderationFindings Award and OrderSecurity OfficerBilateral Knees
References
Case No. LAO 0850067
Regular
Sep 24, 2007

JULIE RAMIREZ vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, PAROLE COMMUNITY SERVICES, Legally Uninsured, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and reversed a prior WCJ finding, ruling that total knee replacement surgery does not constitute an "amputation" for the purpose of extending temporary disability indemnity beyond the 104-week statutory limit. The Board clarified that "amputation" under Labor Code section 4656(c)(2)(C) applies only to the severance or removal of external limbs or appendages, not internal body parts. Therefore, the applicant's claim for additional temporary disability indemnity was denied.

Labor Code section 4656(c)(2)(C)Amputation exceptionTemporary disability indemnity104-week capReconsiderationRemovalInterim Findings and AwardKnee replacement surgeryBilateral kneesIndustrial injury
References
Case No. ADJ6948621 ADJ7946738
Regular
Apr 22, 2013

STEFANO MUSETTI vs. GOLDEN GATE DISPOSAL & RECYCLING dba RECOLOGY, permissibly self-insured, administered by CORVEL CORP.

In this workers' compensation case, the employer sought reconsideration of an award ordering a total knee replacement. The applicant's treating physician recommended the surgery, but the employer argued the award was premature as a panel qualified medical evaluator's report was pending and the treating physician's report lacked proper authorization markings. The Appeals Board denied reconsideration, finding the employer had sufficient time to obtain the PQME report and that the treating physician's report constituted substantial medical evidence supporting the surgery. The Board also noted that the employer failed to initiate utilization review despite being aware of the treatment request.

Workers' Compensation Appeals Boardindustrial injuryright kneegarbage collectortotal knee replacementsupplemental reportpanel qualified medical evaluator (PQME)treating physiciansubstantial medical evidencePetition for Reconsideration
References
Case No. ADJ3566472 (SFO 04633189)
Regular
Apr 05, 2010

MAURICE EDWARDS vs. CALIFORNIA PACIFIC MEDICAL CENTER

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant argued the judge erred by combining work restrictions for the left knee and subjective pain for the right knee. The Board found the rating justified, noting the Agreed Medical Examiner stated the applicant was more disabled due to right knee pain. The Board concluded the rater's testimony supported the combined rating without improper addition of disability percentages.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryLeft KneeRight KneePsycheApportioned Permanent Partial DisabilityBilateral Knee DisabilityWork Restrictions
References
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