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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. ADJ2073428 (VNO 0465400) ADJ1610465 (VNO 0540972) ADJ3247765 (VNO 00384869)
Regular
Apr 04, 2011

JAY ZAVERI vs. STATE COMPENSATION INSURANCE FUND; Legally Uninsured

The applicant sought reconsideration of a workers' compensation award, arguing for a 100% permanent disability rating and challenging the permanent disability start date used for attorney fee commutation. The Appeals Board denied the petition, finding insufficient evidence to establish total permanent disability, as the applicant was currently employed and medical opinions did not definitively support such a rating. The Board also ruled that the applicant waived arguments regarding the rating of specific injuries by failing to properly object, and that even if considered, separate ratings for back, knee, and plantar fasciitis conditions would not result in a higher award due to fibromyalgia being the primary cause and rating higher. Finally, the Board clarified that the July 2, 2000 date was only relevant to the attorney fee commutation calculation and not to the determination of permanent disability indemnity payments.

WCABPetition for ReconsiderationJoint Findings and AwardWorkers' Compensation Judge (WCJ)Industrial InjuryBack InjuryHip InjuryBilateral Knee InjuryBilateral Foot InjuryBilateral Plantar Fasciitis
References
Case No. ADJ3134805 (BAK 0148440)
Regular
Feb 11, 2011

VELGRACE SMITH vs. KERN COUNTY SUPERIOR COURT

This case concerns a defendant seeking reconsideration of a decision that awarded a 15% increase in permanent disability indemnity payments. The administrative law judge (WCJ) found the employer failed to offer modified work within 60 days of the applicant's condition becoming permanent and stationary, as required by Labor Code section 4658(d)(2). The Appeals Board granted reconsideration, finding the WCJ's literal interpretation of the statute would lead to absurd consequences given the retroactive nature of medical findings and delayed service of reports. The Board held the 60-day period begins when the employer has knowledge of both the permanent and stationary status and work restrictions, and remanded the case to determine if the employer's modified work offer remained consistent with updated restrictions.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityModified WorkLabor Code Section 4658(d)AggravationCumulative InjuryAgreed Medical EvaluatorPermanent and Stationary DateWork Restrictions
References
Case No. ADJ10647045
Regular
Mar 19, 2018

EDDIE GRIJALVA vs. BARRETT BUSINESS SERVICES, INC., ACE AMERICAN INSURANCE CO.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the prior Findings and Order. The WCAB found the record insufficiently developed to determine entitlement to temporary disability benefits, particularly regarding the availability and nature of modified work offered. Conflicting testimony exists regarding whether applicant was terminated or refused modified work, necessitating further development of the record. The case is returned to the trial level for additional proceedings to address these issues.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and OrderTemporary Total DisabilityTemporary Partial DisabilityModified WorkBurden of ProofAdmitted EvidenceModified Work OfferRefusal of Work
References
Case No. ADJ10079944
Regular
Feb 26, 2019

Robert Fndkyan vs. Opus One Labs, Employers Compensation Insurance Company

This case concerns an applicant's entitlement to a Supplemental Job Displacement Voucher (SJDV). The original decision denied the SJDV due to the absence of a specific Physician's Return-to-Work form. However, the Appeals Board granted reconsideration, finding that the employer was sufficiently informed of the applicant's permanent disability status and work restrictions through a Qualified Medical Evaluator's report. Therefore, the Board determined that the applicant substantially complied with the requirements and is entitled to the SJDV, prioritizing substance over strict adherence to a particular form.

Supplemental Job Displacement VoucherPhysician's Return-To-Work and Voucher formQualified Medical Evaluation ReportLabor Code section 4658.7(b)permanent and stationary statuspermanent partial disabilityvocational statuswork capacitysubstantial complianceform over substance
References
Case No. ADJ12394877
Regular
Dec 14, 2020

SABINA RAMOS vs. GLOBAL FOOD SERVICES, FEDERAL INSURANCE

The applicant was injured and subsequently offered modified work within her restrictions, which she initially performed. However, the applicant then abandoned her employment after suitable modified work was provided by the employer. The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the finding that she was not entitled to temporary disability indemnity due to job abandonment. This denial is based on legal precedent that an employee may be estopped from claiming temporary disability for periods where they refuse or abandon suitable modified work without good cause.

Modified workAbandonment of workTemporary disability indemnityPetition for reconsiderationCredibility determinationsPrimary treating physicianWork restrictionsLabor Code section 4062EstoppelOdd lot doctrine
References
Case No. VNO 523244
Regular
Aug 04, 2008

ANGIE JAUREGUI vs. MERCY SOUTHWEST HOSPITAL

This case involves an employer seeking reconsideration of a workers' compensation award for an injured nurse. The employer argued their modified work offer should have reduced the permanent disability award, but the Board denied reconsideration. The Board determined the employer's work offer was not a bona fide modified work offer, and thus did not qualify for the statutory reduction.

Permanent and stationaryMedical-legal reportWork restrictionsModified workAlternative workLabor Code Section 4658(d)Permanent disability awardPetition for reconsiderationFindings and AwardWCJ
References
Case No. ADJ8336161
Regular
Dec 31, 2012

Patrick Despres vs. Pacific Titan, Inc., Seabright Insurance Company

The Workers' Compensation Appeals Board granted reconsideration and amended a previous award. The applicant, a painter injured in 2011, was found to have unreasonably refused modified work offered by the defendant. Consequently, the applicant is not entitled to temporary total disability indemnity from May 12, 2012, to September 19, 2012, and no attorney's fees can be awarded from this period.

Workers' Compensation Appeals BoardPatrick DespresPacific Titan Inc.Seabright Insurance Companyindustrial injuryleft kneepaintertemporary total disabilityaverage weekly earningsindemnity rate
References
Case No. ADJ6807374, ADJ6807475
Regular
Apr 25, 2011

CIIRISTINE OSTRANDER vs. COUNTY OF LOS ANGELES/SHERIFF'S DEPARTMENT

This case involves an employer's failure to provide an injured employee with timely notice of modified or alternative work following a determination of permanent and stationary status. While the employee eventually returned to her regular duties, the employer did not formally offer such positions within the 60-day window mandated by Labor Code section 4658(d)(2). Consequently, the employer is not entitled to a 15% decrease in permanent disability payments. However, the Appeals Board found that awarding the employee a 15% increase would elevate form over substance, given the employee's early return to regular work. Therefore, the Board rescinded the original award of a 15% increase and modified the decision to state there is no 15% adjustment under Labor Code section 4658(d).

Workers' Compensation Appeals BoardChristine OstranderCounty of Los Angeles/Sheriff's Departmentindustrial injuryrespiratory systemasthmainternal diseasepermanent disabilitypermanent and stationary (P&S) dateLabor Code section 4658(d)
References
Case No. ADJ8442625
Regular
Jul 25, 2016

PATRICIA TILLMAN vs. STATE OF CALIFORNIA, CORRECTIONS & REHABILITATION PAROLE, STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board rescinded an award of increased permanent disability benefits for applicant Patricia Tillman. The Board found that while the employer did not offer modified work within 60 days of the P&S date, the applicant had returned to her regular duties, and the employer had complied with the statute's intent. The Board also amended the applicant's permanent and stationary date to March 17, 2014, based on a psychological AME's report. Finally, the Board noted that the applicant was not entitled to a discount on benefits as she had not been offered modified work and had lost time from work.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityLabor Code Section 4658(d)Permanent and Stationary DateAgreed Medical ExaminerMedical Improvement (MMI)ApportionmentParole AgentIndustrial Injury
References
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