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

Case No. AHM 0116452 AHM 0116457 AHM 0116470
Regular
Jul 21, 2008

BRUCE SERVISS vs. RALPH'S GROCERY, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration and amended the award to clarify that the applicant is not entitled to duplicative temporary disability and vocational rehabilitation maintenance allowance payments for the same period. The Board found the defendant breached its duty to provide timely vocational rehabilitation notices after the applicant's January 16, 2004 permanent and stationary date. Consequently, the defendant remains liable for vocational rehabilitation maintenance allowance from that date, adjusted for prior payments.

Workers' Compensation Appeals BoardReconsiderationVocational RehabilitationMaintenance AllowanceTemporary DisabilityIndustrial InjuryMeat CutterRalph's GrocerySedgwick Claims Management ServicesPermanent and Stationary
References
Case No. SFO 0500209
Regular
Jul 01, 2008

LAVENDER GALVAO vs. KINKO'S, ZURICH AMERICAN INSURANCE COMPANY

The Appeals Board granted reconsideration, amending the prior award to allow the employer a credit against Vocational Rehabilitation Maintenance Allowance (VRMA) for wages earned by the applicant from subsequent employment. While the applicant was found to be a Qualified Injured Worker (QIW) entitled to vocational rehabilitation services and VRMA, the Board distinguished this case from *Gamble v. Workers' Comp. Appeals Bd.*, finding that the applicant's subsequent employment replaced her injured position rather than being concurrent. Therefore, allowing the credit prevents the applicant from receiving a windfall and is consistent with the wage-loss basis of temporary disability indemnity.

Qualified Injured WorkerVocational Rehabilitation ServicesVocational Rehabilitation Maintenance AllowanceVRMATemporary Disability RateCredit for Wages EarnedWage Loss BasisRehabilitation UnitFindings Order AwardPetition for Reconsideration
References
Case No. VNO 382502; VNO 382503 VNO 382504; VNO 382505
Regular
May 15, 2008

DOREEN JONES vs. DAVID & BARBARA SALKIN, SPECIALTY RISK SERVICES, ALLSTATE INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to amend a previous decision regarding retroactive vocational rehabilitation maintenance allowance (VRMA). The Board affirmed the applicant's entitlement to VRMA but modified the order to allow the defendant credit for VRMA paid during a specific period. The issue of a potential penalty for unreasonable delay was deferred pending further record development.

Vocational Rehabilitation Maintenance AllowanceVRMARehabilitation UnitReconsiderationFindings and OrderWorkers' Compensation Appeals BoardWCJPenaltyLabor Code Section 5814(a)Credit
References
Case No. ADJ3638741
Regular
Apr 24, 2009

NORMAN HOSKIN vs. SUN HEALTHCARE GROUP and CONTINENTAL CASUALTY COMPANY, administered by CNA CLAIM PLUS

The Workers' Compensation Appeals Board granted reconsideration to thoroughly review a WCJ's order allowing defendants credit for a four-year-old temporary disability indemnity overpayment against vocational rehabilitation maintenance allowance. The applicant argued against the credit and sought attorney fees for services related to retroactive VRMA. Reconsideration is necessary to ensure a complete understanding of the facts and law before issuing a final decision.

WCABReconsiderationTemporary Disability IndemnityVocational Rehabilitation Maintenance AllowanceOverpaymentCreditAttorney FeesAdministrative Law JudgePetition for ReconsiderationCNA Claim Plus
References
Case No. MON 0305426 (ADJ347040)
Regular
May 07, 2009

Daniel Anaya vs. Ralphs Company

This case involves a petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision regarding vocational rehabilitation maintenance allowance (VRMA) and a penalty for unreasonable delay. The WCAB granted reconsideration, rescinded the WCJ's findings, and returned the case to the trial level for further proceedings. This action was taken to allow the parties to consider a related en banc decision concerning the jurisdiction of a WCJ to enforce Rehabilitation Unit determinations after the repeal of Labor Code Section 139.5. The WCAB encourages informal resolution of the disputed issues.

EAMSShipley v. Workers' Comp. Appeals Bd.Vocational Rehabilitation Maintenance AllowanceVRMALabor Code section 5814(a)penaltyattorney's feesLawrence Weiner v. Ralphs CompanyRehabilitation UnitLC 139.5
References
Case No. ADJ295449 (EUR 0039208)
Regular
Mar 09, 2009

LISA CASAGRANDE vs. COUNTY OF HUMBOLDT

The Appeals Board granted reconsideration to partially reverse the WCJ's decision, affirming the award of Vocational Rehabilitation Maintenance Allowance (VRMA) but rescinding the Labor Code section 5814 penalty on VRMA and attorney's fees under section 5814.5. While the Board agreed VRMA was owed due to changed circumstances, it found the employer's delay was not unreasonable, thus negating grounds for penalties or additional fees. The Board also upheld the allowance of the Employment Development Department's lien.

Workers' Compensation Appeals BoardVocational Rehabilitation Maintenance Allowance (VRMA)Labor Code section 5814Labor Code section 5814.5Employment Development Department (EDD) lienmodified employmentRU-94RU-105unreasonable delaychanged circumstances
References
Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ347040
En Banc
Aug 17, 2009

Lawrence Weiner vs. Ralphs Company, Sedgwick Claims Management Services, Inc.

The Appeals Board denied the applicant's petition for reconsideration, affirming its prior en banc decision that the legislative repeal of Labor Code section 139.5 extinguished any non-vested rights to retroactive vocational rehabilitation maintenance allowance (VRMA) benefits.

Workers' Compensation Appeals BoardVocational Rehabilitation Maintenance AllowanceVRMATemporary Disability IndemnityTDLabor Code section 139.5Qualified Injured WorkerQIWVested RightsInchoate Rights
References
Case No. STK 178713
Regular
Sep 17, 2007

FRED VAN DYKEN vs. FRAGOMEN, DEL RAY, BERNSEN & LOWERY, ATLANTIC MUTUAL FIRE INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and amended a prior decision. While affirming the apportionment of permanent disability and the credit for overpaid indemnity, the Board found the employer unreasonably delayed vocational rehabilitation benefits. The applicant is now entitled to retroactive vocational rehabilitation maintenance allowance at the temporary disability rate for the period of that delay.

Vocational RehabilitationApportionmentQualified Medical ExaminerPermanent DisabilityTemporary DisabilityEMG/NCV StudiesRehabilitation UnitDelay of BenefitsThird Party CreditVocational Rehabilitation Maintenance Allowance
References
Case No. ADJ1898212 (LAO 0671427) ADJ957820 (LAO 0688269)
Regular
Oct 07, 2008

SAMSON BOGANIM vs. BEVERLY HILLS HILTON, HILTON HOTELS CORPORATION

In this workers' compensation case, the Appeals Board affirmed a prior award finding the applicant entitled to retroactive vocational rehabilitation maintenance allowance. The applicant sustained industrial injuries to his neck and back, and a hernia, resulting in a combined permanent disability of 9.25%. The defendant's appeal was denied, upholding the finding that the applicant was a qualified injured worker entitled to benefits.

BoganimBeverly Hills HiltonHilton Hotels Corporationvocational rehabilitation maintenance allowancetemporary disability ratequalified rehabilitation representativesecurity guardsupervisorcumulative injuryindustrial injury
References
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