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

Case No. ADJ800932 (OAK 0299866) ADJ2725270 (OAK 0299867) ADJ635812 (OAK 0299868) ADJ4541817 (OAK 0308810)
Regular
Feb 16, 2010

JOAN STEPP vs. COUNTY OF CONTRA COSTA

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, rescinded the previous award, and returned the case for further proceedings. The Board found the prior decision to be insufficient regarding apportionment of disability among multiple injuries as required by *Benson*. Additionally, the Board questioned the vocational expert's analysis for a finding of total permanent disability, as it did not adequately address retraining feasibility per *LeBoeuf*. The matter is remanded for the Agreed Medical Evaluator to provide clarified apportionment opinions and for a new decision consistent with *Benson* and *LeBoeuf*.

Workers' Compensation Appeals BoardPetition for ReconsiderationIndustrial InjuriesCumulative TraumaPermanent Total DisabilityApportionmentAgreed Medical EvaluatorBensonLeBoeufVocational Expert
References
Case No. ANA 0369239 ANA 0369240 ANA 0369241
Regular
Oct 03, 2007

STEVEN A. BANKS vs. COCO'S RESTAURANT, CNA

The Workers' Compensation Appeals Board granted reconsideration because the administrative law judge's finding of 100% total disability was based on a legally deficient medical record and an improper application of the *LeBoeuf* doctrine. The Board found the Agreed Medical Examiner's report failed to properly address apportionment and accurate medical history, necessitating further medical development. Consequently, the prior decision was rescinded and the case returned to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardReconsiderationJoint Findings and AwardIndustrial InjuryLow BackPsycheTotal DisabilityVocational RehabilitationCommutationAttorney's Fees
References
Case No. ADJ591293 (GRO 0031424) ADJ3541062 (GRO 0031102)
Regular
Oct 16, 2014

GENE FREITAS vs. THE KROGER COMPANY DBA RALPHS GROCERY COMPANY, SEDGWICK CMS

This case concerns an applicant's appeal challenging his permanent disability rating. The applicant argued his vocational expert demonstrated 100% disability, seeking to rebut the standard 2005 Permanent Disability Rating Schedule (PDRS). The Workers' Compensation Appeals Board (WCAB) affirmed the initial findings, holding the applicant failed to prove his industrial injury was the sole cause of his inability to participate in rehabilitation. The WCAB emphasized that factors like lack of education or general aptitude, rather than solely the industrial injury, must be demonstrably absent for a successful rebuttal under *LeBoeuf* principles.

Workers' Compensation Appeals BoardGene FreitasThe Kroger CompanyRalphs Grocery CompanySEDGWICK CMSOpinion and Decision After ReconsiderationFindings and AwardPermanent Disability Rating ScheduleVocational ExpertOgilvie
References
Case No. ADJ4496653 (SJO 0211862) ADJ1988083
Regular
Nov 17, 2015

MICHAEL ROSILES vs. COUNTY OF SANTA CLARA

Both the applicant and the defendant sought reconsideration of a workers' compensation award finding the applicant 88% permanently disabled due to multiple industrial injuries. The applicant argued for 100% permanent disability, citing vocational expert testimony and preclusion from the open labor market under *LeBoeuf*. The defendant contested the rating, disputing findings of vertigo, sleep disorder, and cognitive disability. The Appeals Board denied both petitions, adopting the judge's report and affirming the 88% disability rating. A dissenting commissioner would have granted the applicant's petition for total permanent disability, emphasizing medical and vocational evidence of unemployability.

RosilesCounty of Santa ClaraPermanent DisabilityVocational ExpertLeBoeufVertigoNeuro-opthamologyGainful EmploymentTotal Permanent DisabilityLabor Market Preclusion
References
Case No. ADJ869605
Regular
Nov 19, 2012

MILES GRAY vs. AT&T, permissibly self-insured, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves an applicant who sustained a severe right lower extremity injury, leading to multiple surgeries, significant leg length discrepancy, and fused ankle/foot, requiring constant mobility aids. The Agreed Medical Evaluator (AME) provided opinions on impairment, and vocational experts testified regarding the applicant's ability to return to work. The Workers' Compensation Appeals Board denied reconsideration of the prior award, finding substantial evidence supporting the applicant's unsuitability for rehabilitation. Defendant's supplemental reply did not alter this decision.

Agreed Medical EvaluatorVocational ExpertPetition for ReconsiderationDeniedRight Lower Extremity InjuryMultiple FracturesLeg Length DiscrepancyShoe LiftAnkle FusionGait Derangement
References
Case No. SRO 0123390
Regular
Mar 28, 2008

BOB CROUSE vs. ALADDIN'S ELECTRIC COMPANY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to review a WCJ's 100% permanent disability award based on a LeBoeuf application, which the defendant argued was unsupported by medical evidence. The Board rescinded the award and remanded the case to the trial level for further proceedings. This action was taken to first address applicant's newly filed Petition to Reopen, alleging new and further disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryPermanent DisabilityApportionmentLeBoeuf situationVocational Rehabilitation CounselorPetition to ReopenNew and Further Disability
References
Case No. OAK 300340 OAK 300393
Regular
Aug 12, 2008

MARTHA PENSE vs. HOLY CROSS CEMETERY, ROYAL SUNALLIANCE

The Workers' Compensation Appeals Board granted reconsideration of a decision that apportioned 1/3 of the applicant's permanent disability to non-industrial factors. The Board found the original judge erred in how she interpreted medical opinions and applied apportionment rules. The case is returned to the trial level for further proceedings to clarify permanent disability, apportionment, and attorney's fees, ensuring proper findings and reasoning are provided.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent DisabilityApportionmentIndustrial InjuryWCJUnemployableOpen Labor MarketDr. Jamasbi
References
Case No. ADJ1909369 (LAO 0760509)
Regular
Mar 24, 2010

SANTOS MORALES vs. ASSOCIATED ROOFERS, INC., CENTRE INSURANCE COMPANY, RISK ENTERPRISE 600 BREA

The Workers' Compensation Appeals Board granted reconsideration of a prior award concerning applicant Santos Morales' industrial injuries. The Board found the applicant's petition timely and that the Workers' Compensation Judge (WCJ) miscalculated the life pension. The case is returned to the trial level for further proceedings and a new decision, as the WCJ must revisit permanent disability, apportionment, and the costs of the vocational rehabilitation expert in light of controlling legal precedent. The WCJ should re-evaluate the vocational rehabilitation expert's costs based on the Appeals Board's en banc decisions in *Costa I* and *II*.

Workers' Compensation Appeals BoardIndustrial InjuryPsycheCervical SpineShoulder InjuryPermanent Partial DisabilityDisability IndemnityLife PensionVocational Rehabilitation ExpertReconsideration
References
Case No. FRE 0179942
Regular
Feb 22, 2008

DON L. KETTERING vs. DME ELECTRIC & FIRE PROTECTION, PAULA INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award, finding the record insufficient to determine the impact of applicant's pain medication on his future earning capacity. While the Board agreed that the prior Supreme Court holding on permanent disability remained valid, it required further medical evidence to assess the disabling effects of medication. The case was returned to the trial level for development of this record, specifically requesting reports from the Agreed Medical Examiner and applicant's treating physician on medication's effect on alertness and mental functioning.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilityBilateral Upper ExtremitiesIndustrial InjuryPsycheLabor Code Section 3208.3(d)LeBoeufSenate Bill 899
References
Case No. ADJ5836774
Regular
Nov 04, 2015

Benjamin Mesanovic vs. Specialty Termite, National Liability and Fire Insurance Company

In this workers' compensation case, the applicant sought reconsideration of a decision denying his claim to rebut the Permanent Disability Rating Schedule (PDRS). The applicant argued his diminished future earning capacity (DFEC) was greater than the PDRS accounted for, citing vocational expert testimony. The Workers' Compensation Appeals Board (WCAB) denied the petition, finding the applicant failed to prove his industrial injury precluded vocational rehabilitation, a requirement to rebut the PDRS. The WCAB concluded that the applicant's vocational expert's opinion did not meet the legal standards for rebuttal as established in *Ogilvie v. City and County of San Francisco*.

Diminished Future Earning CapacityPDRSOgilvie IIIVocational RehabilitationRebuttalAMA GuidesPermanent DisabilityApportionmentIndustrial InjuryWCJ
References
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