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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Claim of Keselman v. New York City Transit Authority

Claimant, injured in 1986, initially established a right shoulder injury. The Workers’ Compensation Board affirmed this but denied a causally related neck injury in 1996. After another application in 1998 alleging a worsened neck condition, the Workers’ Compensation Law Judge found a causally related neck injury and permanent partial disability, awarding benefits from February 5, 1998, which the Board affirmed. Separately, the Board also ruled the employer was entitled to credit schedule payments against disability payments made after February 5, 1998. The court affirmed both decisions, finding substantial evidence supported the deterioration of the neck injury post-1996 and that schedule awards are independent of actual disability periods, thus allowing the employer's credit.

Workers' CompensationPermanent Partial DisabilitySchedule AwardDisability PaymentsNeck InjuryRight Shoulder InjuryCausally Related InjuryReopening CaseMedical EvidenceMRI
References
7
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
0
Case No. ANA 0388502
Regular
Aug 15, 2007

MICHAEL BELTRAN vs. REESE CONCRETE, CLARENDON NAT'L. INSURANCE COMPANY, AMERICAN ALL RISK LOSS ADMINISTRATORS

The Appeals Board granted reconsideration, overturning the WCJ's decision to apply the old permanent disability rating schedule. The Board found that the presence of multiple fractures alone did not constitute a report indicating permanent disability under Labor Code section 4660(d), thus the new 2005 Schedule must apply. The case is returned to the trial level for a new rating and decision regarding permanent disability and attorney's fees.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent Disability1997 Schedule2005 ScheduleQualified Medical EvaluatorTreating PhysicianLabor Code section 4660(d)Pendergrass II
References
8
Case No. ADJ 8560911
Regular
May 02, 2016

TIM MCDONALD vs. SAN FRANCISCO 49ERS, TIG SPECIALTY COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, rescinding the original award of 73% permanent disability and attorney fees. The Board determined that the 2005 Permanent Disability Rating Schedule, not an older schedule, should be used for rating the applicant's cumulative trauma injury claim filed in 2012. The case is returned to the trial level for a new determination of permanent disability using the 2005 schedule, affirming findings on injury and medical treatment.

Workers' Compensation Appeals BoardSan Francisco 49ersTIG Specialty Companyindustrial injuryprofessional athletefootball playerstrong safetycumulative traumapermanent disabilityapportionment
References
8
Case No. ADJ2770463 (SAC 0336537)
Regular
Sep 16, 2009

JOHN FARMER vs. MADE IN JAPAN, EVEREST NATIONAL INSURANCE COMPANY, AMERICAN COMMERCIAL CLAIMS ADMINISTRATORS

The applicant sought reconsideration of a permanent disability rating of 8%, arguing the incorrect rating schedule was applied. The WCAB granted reconsideration, finding that a treating physician's report dated December 1, 2004, may indicate the existence of permanent disability prior to January 1, 2005. Consequently, the WCAB rescinded the prior decision and returned the case to the trial level for further proceedings and a new decision under the correct legal interpretation. This action allows the WCJ to re-evaluate whether the 1997 Permanent Disability Rating Schedule should apply.

WCABPetition for ReconsiderationFindings and AwardIndustrial InjuryLumbar SpinePermanent Disability2005 Permanent Disability Rating Schedule1997 Permanent Disability Rating ScheduleTreating PhysicianPermanent Work Restrictions
References
3
Case No. ADJ8376717
Regular
Apr 12, 2019

SOOHYUN KIM vs. VALENTINO, Permissibly Self-Insured, Administered By GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board (WCAB) affirmed the finding of industrial injury for Complex Regional Pain Syndrome (CRPS) but rescinded the finding of chronic pain. The WCAB also rescinded the finding of permanent and total disability, finding the medical evidence supported a scheduled disability rating between 64-81%. The vocational expert's opinion was deemed insufficient to rebut the scheduled rating or establish permanent total disability. The case was returned to the trial level for further proceedings and a new permanent disability finding based on the medical reports.

Complex Regional Pain SyndromeCRPSIndustrial InjuryPermanent and Total DisabilityReconsiderationVocational ExpertMedical EvidencePermanent Disability RatingAMA GuidesLabor Code
References
14
Case No. ADJ1357359 (ANA 0384919) ADJ2070955 (ANA 0381261) ADJ2274268 (ANA 0381264) ADJ1962006 (ANA 0381265)
Regular
Oct 04, 2011

JOSE RIVERA vs. CENTRAL FREIGHT LINES, ARROWWOOD INDEMNITY COMPANY

This case concerns the proper rating schedule for Jose Rivera's multiple industrial injuries. The Workers' Compensation Appeals Board granted reconsideration, finding that the administrative law judge erred by applying the 1997 rating schedule to all injuries. Specifically, the Board determined that the 2005 rating schedule should apply to the lumbar spine injury, as the medical report cited did not indicate permanent disability. However, a report from November 2004 did indicate permanent disability for the left lower extremity injury, thus allowing the use of the 1997 schedule for that specific injury. The Board rescinded the prior award and remanded the case for further proceedings and a new decision.

Workers' Compensation Appeals BoardJose RiveraCentral Freight LinesArrowwood IndemnityJoint Findings and AwardPermanent DisabilityLumbar SpinePsycheLeft WristLeft Foot
References
2
Case No. SDO 0323941
Regular
Aug 20, 2007

CAPRICE SMITH vs. KINDERCARE LEARNING CENTER, SPECIALTY RISK SERVICES, AIG

This case concerns whether the old or new workers' compensation permanent disability rating schedule applies to an injury predating the 2005 schedule changes. The Board affirmed the WCJ's prior determination that the 1997 schedule applies due to a final, unchallenged finding on the matter. However, the Board granted reconsideration to amend the award, deferring the issue of permanent disability and attorney's fees for further proceedings at the trial level due to the WCJ's insufficient explanation of the disability rating and apportionment.

Workers' Compensation Appeals BoardKindercare Learning CenterSpecialty Risk ServicesAIGCaprice SmithSDO 0323941Petition for ReconsiderationAmended Findings and AwardPreschool TeacherIndustrial Injury
References
7
Case No. ADJ448774
Regular
Nov 14, 2008

LUIS CERVANTES vs. IRVINE MARRIOTT, MARRIOTT CLAIMS SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a decision that awarded 16% permanent disability based on the 2005 rating schedule and applied a 20% apportionment to the applicant's shoulder injury. The applicant argued for the applicability of the 1997 rating schedule and challenged the substantiality of the defense Qualified Medical Evaluator's opinions on permanent disability and apportionment. The Board rescinded the original award and returned the case for further proceedings and a new decision by the WCJ, who will determine the applicable rating schedule and issue a simplified award.

Petition for ReconsiderationFindings and AwardPermanent DisabilityApportionmentRating ScheduleQualified Medical EvaluatorSubstantial EvidenceIndustrial InjuryWaiterBack Injury
References
0
Case No. ADJ3509199 (SAL 0115084) ADJ3504739 (SAL 0115085)
Regular
Apr 08, 2009

JOSEFINA FUNES vs. CON AGRA FOODS, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves applicant Josefina Funes, who sustained industrial injuries to her carpal tunnels and shoulder. The WCJ previously awarded 33% permanent disability, finding the scheduled rating of 5% disproportionate. The defendants petitioned for reconsideration, arguing the WCJ erred in rebutting the 2005 Permanent Disability Rating Schedule. The Appeals Board, referencing its en banc decisions in *Almaraz* and *Ogilvie*, amended the WCJ's decision. The issues of permanent disability and attorney's fees are deferred and returned to the trial level for further proceedings and decision consistent with the new guidance.

Workers' Compensation Appeals BoardCon Agra FoodsSedgwick Claims Management ServicesAmended Findings and AwardToast Mill OperatorCumulative TraumaCarpal TunnelShoulder InjuryPermanent Disability2005 Permanent Disability Rating Schedule
References
2
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