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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ4258585 (OXN 0130492) ADJ220258 (OXN 0130487)
Regular
Apr 17, 2018

ENRIQUE HERRERA vs. MAPLE LEAF FOODS, U.S. FIRE INSURANCE COMPANY, ALEA NORTH AMERICAN INSURANCE COMPANY

This notice informs parties that the Workers' Compensation Appeals Board (WCAB) intends to admit its rating instructions and a disability rater's recommended permanent disability rating into evidence. The WCAB previously granted reconsideration for further study. Parties have seven days to object to the rating instructions or the recommended rating, with specific procedures for addressing objections. If no timely objection is filed, the matters will be submitted for decision thirty days after service.

WORKERS' COMPENSATION APPEALS BOARDPermanent Disability RatingDisability Evaluation UnitRating InstructionsRecommended Permanent Disability RatingJoint RatingReconsiderationObjectionRater Cross-ExaminationRebuttal Evidence
References
Case No. ADJ758842 (VNO 0559214)
Regular
Dec 17, 2010

JOHN PATCHETT vs. CITY OF LOS ANGELES

The Appeals Board denied the applicant's petition for removal, affirming the WCJ's decision to vacate the submission. This action was based on the DEU evaluator's testimony, which revealed deficiencies in the AMEs' reports concerning the AMA Guides. The Board found the applicant waived any objection to this testimony by failing to object at trial, and that the evaluator's expert opinion was permissible per *Blackledge v. Bank of America*. Defendant's objection, though not styled as a motion to strike, sufficiently raised the issues leading to the vacation of the rating.

Petition for RemovalOrder Vacating SubmissionDEU evaluatorAMA Guidesagreed medical evaluators (AMEs)rating instructionssubstantial evidenceobjective factors of disabilitywhole person impairmentformal rating
References
Case No. ADJ8587912
Regular
Oct 06, 2020

EDNA EVAZYAN vs. COUNTY OF LOS ANGELES/OLIVEVIEW MEDICAL CENTER

The Workers' Compensation Appeals Board granted reconsideration of a prior award. The Board found the WCJ erred by issuing inconsistent findings and an inconsistent award regarding temporary disability rates. While the defendant did not prove mutual mistake of fact, the Board noted conflicting indemnity rates in the original decision. Therefore, the Board deferred the issue of temporary disability and rescinded the award of temporary disability, otherwise affirming the original findings.

WORKERS' COMPENSATION APPEALS BOARDEDNA EVAZYANCOUNTY OF LOS ANGELES/OLIVEVIEW MEDICAL CENTERADJ8587912OPINION AND ORDER GRANTING PETITION FOR RECONSIDERATIONFINDINGS AND AWARDINDUSTRIAL INJURYMULTIPLE BODY PARTSPHARMACISTTEMPORARY DISABILITY WEEKLY INDEMNITY RATE
References
Case No. ADJ11368246
Regular
Mar 03, 2020

Marta Ubillus vs. One Stop Employment Services, LLC/Vensure Employer Services, Security National Insurance Company, State National Insurance Company

The Workers' Compensation Appeals Board (WCAB) denied the lien claimant's petition for reconsideration regarding the valuation of interpreter services. The WCAB adopted the Administrative Law Judge's (ALJ) report, which found that while the defendant did not present rebuttal evidence, the ALJ had substantial evidence to make a determination. The ALJ determined a market rate of $114.97 per hour but noted the lien claimant failed to provide sufficient evidence of the duration of services on most dates, preventing application of the market rate. Consequently, the statutory rate was applied for those services.

WCABPetition for ReconsiderationDeniedLien ClaimantInterpreter ServicesMarket RateStatutory RateWCJ ReportSubstantial EvidenceFindings and Award
References
Case No. ADJ10553459
Regular
Feb 23, 2018

JAMES CRAIG SILLERS vs. CITY OF PLEASANT HILL, MUNICIPAL POOLING AUTHORITY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, affirming the administrative law judge's award of 47% permanent disability benefits to applicant James Sillers. The central dispute concerned whether Sillers was entitled to the maximum disability indemnity rate under Labor Code section 4458.5. The Board majority held that Sillers, a retired police officer with orthopedic injuries, qualified for the maximum rate, interpreting section 4458.5 to apply to any public safety member injured within the timeframes specified in listed presumption statutes, not solely to injuries covered by those specific presumptions. A dissenting opinion argued that only injuries falling under the explicitly enumerated presumptions in section 4458.5 qualified for the maximum rate, citing precedent that non-listed presumptions, like cancer under section 3212.1, did not grant this benefit.

Workers' Compensation Appeals BoardCity of Pleasant HillMunicipal Pooling AuthorityCumulative Trauma InjuryCervical SpineLumbar SpineBilateral Cubital TunnelsPolice OfficerStatute of LimitationsLabor Code Section 4458.5
References
Case No. ADJ10187704, ADJ10924724
Regular
May 17, 2018

STEVEN CASE vs. GOLDEN GATE BRIDGE HIGHWAY AND TRANSPORTATION DISTRICT

The Workers' Compensation Appeals Board granted reconsideration to increase applicant's permanent disability rating for bilateral shoulder injury from 9% to 38%. The Board found the Agreed Medical Evaluator's (AME) alternative rating, based on strength loss, was substantial medical evidence and properly considered within the AMA Guides. The WCJ erred in applying an overly restrictive interpretation of "complex or extraordinary" cases for deviating from strict AMA Guides ratings. The AME's use of strength loss data from the AMA Guides, even for an age outside the specified range, was permissible under the *Almaraz-Guzman* line of cases when justified by clinical judgment.

Workers' Compensation Appeals BoardJoint Findings and AwardPetition for ReconsiderationAgreed Medical Evaluator (AME)permanent disability ratingbilateral shouldersorthopedic AMEAMA GuidesAlmaraz-Guzmanstrength loss index
References
Case No. OAK 0280463
Regular
Dec 12, 2007

MICHAEL ELDERKIN vs. RCC CONSTRUCTORS AND CIGA BY BROADSPIRE SERVICES FOR LEGION INSURANCE COMPANY, IN LIQUIDATION

This case concerns a worker's compensation applicant seeking reconsideration of an award that set his average weekly wage below the maximum rate. The Appeals Board granted reconsideration, finding that the defendant failed to demonstrate good cause to withdraw from a prior stipulation between the parties establishing the applicant's earnings at the maximum rate. The Board emphasized that stipulations should be upheld unless there is clear evidence of mistake or inadvertence, not simply an unfavorable outcome for a party.

Workers' Compensation Appeals BoardMichael ElderkinRCC ConstructorsCIGABroadspire ServicesLegion Insurance CompanyIron FabricatorIndustrial InjuryBack InjuryHip Injury
References
Case No. ADJ9196537
Regular
Nov 10, 2015

PHYLLIS HAREN vs. CITY OF SACRAMENTO, self-insured and self-administered

This case involves a reserve police officer injured on duty whose average weekly earnings were only $84.38. The applicant successfully argued that under Labor Code sections 3362.5 and 4458.2, her temporary and permanent disability indemnity should be calculated at the maximum rate, not based on her actual earnings. The Appeals Board amended the WCJ's decision to award these benefits at the maximum statutory rates. The applicant's attorney was awarded a fee of $4500.00 for securing this increased compensation.

WORKERS' COMPENSATION APPEALS BOARDReserve Police OfficerIndustrial InjuryRight ShoulderTemporary Disability IndemnityPermanent Disability IndemnityMaximum RateLabor Code Sections3362.54458.2
References
Case No. SDO 0321444 SDO 0321446
Regular
Jun 28, 2007

MARY BLOEMSMA vs. SAN DIEGO UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied reconsideration, upholding the use of the revised permanent disability rating schedule for applicant's pre-January 1, 2005 injury. The Board found that the treating physician's reports did not explicitly state the applicant was "permanent and stationary" with a ratable disability, a prerequisite for applying the older rating schedule under Labor Code § 4660(d). Therefore, the revised schedule was correctly applied, resulting in a 22% permanent disability rating.

Workers' Compensation Appeals BoardPermanent Disability Rating ScheduleRevised Rating SchedulePrior Rating ScheduleLabor Code Section 4660(d)Permanent and Stationary StatusTreating Physician's ReportComprehensive Medical-Legal ReportIndustrial InjuryHerniated Disc
References
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