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

Case No. ADJ8240882; ADJ8240881; ADJ8615401
Regular
Apr 21, 2025

ROBERT S. HAPPENY vs. STATE OF CALIFORNIA, CALIFORNIA INSTITUTE FOR WOMEN

Applicant Robert S. Happeny sustained industrial injuries during his employment as a correctional officer, leading to a finding of permanent and total disability by the WCJ due to his inability for vocational retraining. The WCJ also issued an unapportioned award, concluding that apportionment to nonindustrial factors was not proven. Defendant challenged this decision via a petition for reconsideration, disputing the method of combining disabilities and the reliability of vocational reports. The Appeals Board granted reconsideration, affirming the WCJ's determination of permanent and total disability based on vocational infeasibility and the lack of established apportionment, ultimately rescinding the original decision and substituting new findings of fact.

ADJ8240882ADJ8240881ADJ8615401correctional officerindustrial injuryheartpsycheright wristrespiratory systemlumbar spine
References
Case No. ADJ8210063; ADJ8621818
En Banc
Jun 22, 2023

GRACE NUNES vs. STATE OF CALIFORNIA, DEPT. OF MOTOR VEHICLES, STATE COMPENSATION INSURANCE FUND

The Appeals Board rescinded a 100% disability award because the vocational and medical records were incomplete regarding apportionment. The case was returned to the trial level to properly evaluate whether non-industrial factors contributed to the applicant's inability to be retrained for work.

En BancReconsiderationApportionmentVocational ApportionmentMedical ApportionmentPermanent DisabilityVocational ExpertQualified Medical EvaluatorAMA GuidesLabor Code Section 4663
References
Case No. ADJ8210063
Significant

Grace Nunes, Applicant vs. State of California, DEPT. OF MOTOR VEHICLES, Legally Uninsured; STATE COMPENSATION INSURANCE FUND, Adjusting Agency, Defendants

The Appeals Board denied the applicant's Petition for Reconsideration, affirming its prior en banc decision that vocational evidence cannot substitute for valid medical apportionment from a physician, as mandated by Labor Code section 4663.

Labor Code Section 4663Vocational ApportionmentMedical ApportionmentPermanent DisabilityQualified Medical EvaluatorSubstantial EvidencePetition for ReconsiderationEn Banc DecisionWorkers' Compensation Appeals BoardApportionment Analysis
References
Case No. ADJ7894308; ADJ7661229; ADJ9465603
Regular
Aug 20, 2025

Assadour Assadourian vs. Ari G. Minassian School, State Compensation Insurance Fund, Church Mutual Insurance Company

The Workers' Compensation Appeals Board reviewed the Findings of Fact, Award and Order concerning Assadour Assadourian's industrial injury claims against Ari G. Minassian School and its insurers. The Board affirmed that contract non-renewal constituted an actual event of employment for psychiatric injury claims. However, it rejected the "pass-through" apportionment from cardiac conditions to psychiatric and sleep-related disabilities, deeming the medical opinions legally unsustainable. Consequently, the Board amended the permanent disability award to 78 percent, reserving jurisdiction to the WCJ for attorney's fees adjustments.

Workers' Compensation Appeals BoardReconsiderationFindings of FactAward and OrderIndustrial InjuryCardiovascular SystemPsycheSleep DisorderUrologic SystemSexual Dysfunction
References
Case No. ADJ3339526
Regular
Oct 14, 2008

Jeffrey Zajdel vs. CALIPATRIA STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to address the issue of apportionment of the applicant's permanent disability due to a heart and brain injury. The Board rescinded the prior decision that apportioned 50% of the disability to non-industrial factors, finding the medical opinion supporting apportionment speculative and not based on established legal principles. Consequently, the Board issued a new award for 100% permanent disability without apportionment and reinstated the applicant's attorney's fees based on this higher award.

WORKERS' COMPENSATION APPEALS BOARDJEFFREY ZAJDELCALIPATRIA STATE PRISONSTATE COMPENSATION INSURANCE FUNDADJ3339526VNO 0491968OPINION AND ORDER GRANTING RECONSIDERATIONSUPPLEMENTAL FINDINGS AND AWARDINDUSTRIAL INJURYHEART INJURY
References
Case No. ADJ11207109; ADJ11207111
Regular
May 29, 2025

Darren Hailey vs. Continental Labor, National Union Fire Insurance Company

Applicant Darren Hailey sought reconsideration of two Findings and Awards from October 19, 2021, in cases ADJ11207109 and ADJ11207111, where a WCJ found industrial injuries but apportioned 50 percent of permanent disability to nonindustrial factors based on a Qualified Medical Evaluator's (QME) opinion. Hailey contended that the QME's apportionment opinion was not substantial medical evidence. The Workers' Compensation Appeals Board, in a majority decision, affirmed the WCJ's findings, concluding that the QME adequately explained the basis of his apportionment, attributing 50 percent of the impairment to nonindustrial obesity due to its role in inhibiting recovery and causing accelerated wear and tear on joints. However, Commissioner Katherine A. Zalewski dissented, agreeing that the QME identified the factors of permanent disability but arguing that he failed to adequately explain how he arrived at the 50 percent apportionment figure, deeming the analysis incomplete.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityApportionmentQualified Medical Evaluator (QME)Industrial InjuryNonindustrial FactorsCausationSubstantial Medical EvidenceObesity
References
Case No. ADJ6526755; ADJ6526979 ADJ6671938; ADJ6672994
Regular
Jul 13, 2015

Diane Nye vs. WALGREENS COMPANY

In this workers' compensation case, the Workers' Compensation Appeals Board denied Walgreens' petition for reconsideration of four findings and awards issued to applicant Diane Nye. Walgreens challenged the awards, claiming a May 14, 2004 psychiatric injury was nonindustrial, the combined permanent disability exceeded 100%, further apportionment was needed for obesity, smoking, and a subsequent nonindustrial injury, and Nye's occupation was misclassified. The Board found substantial evidence supported the WCJ's findings, including industrial psychiatric injury and appropriate apportionment based on AME opinions. The Board also affirmed the dual occupation classification and resulting permanent disability rating, as Nye's stock clerk duties were an integral part of her employment.

Petition for ReconsiderationIndustrial InjuryPsycheHypertensionGastric SystemPermanent DisabilityAgreed Medical EvaluatorApportionmentObesitySmoking
References
Case No. ADJ8210063; ADJ8621818
En Banc
Aug 29, 2023

GRACE NUNES vs. STATE OF CALIFORNIA, DEPT. OF MOTOR VEHICLES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, affirming its prior en banc decision that permanent disability apportionment must be based on a physician's medical evaluation as mandated by Labor Code section 4663, and that vocational evidence cannot substitute an impermissible 'vocational apportionment' in place of a valid medical apportionment.

VOCATIONAL APPORTIONMENTMEDICAL APPORTIONMENTPERMANENT DISABILITYQUALIFIED MEDICAL EVALUATORLABOR CODE SECTION 4663SUBSTANTIAL EVIDENCEAPPEALS BOARD EN BANCFINDINGS OF FACT AND AWARDFINAL ORDERRECONSIDERATION DENIED
References
Case No. ADJ 4121660 ADJ 4115607
Regular
Sep 05, 2008

Kevin Dickinsen vs. ARAI DESIGN, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and amended the WCJ’s decision to reflect apportionment of 25% to nonindustrial factors, affirming the rest of the decision. Apportionment was based on Dr. Miles' opinion and compliance with legal standards.

Workers Compensation Appeals BoardFindings and AwardReconsiderationPermanent DisabilityApportionmentIndustrial InjuryCumulative TraumaState Compensation Insurance FundAgreed Medical ExaminerAMA Guides
References
Case No. ADJ11065177
Regular
Apr 09, 2019

FRANK ROMANO vs. PROVIDENCE HEALTH AND SERVICES, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration, rescinding a prior award that found 4% permanent disability. The Board found the orthopedist's apportionment of lumbar spine impairment to nonindustrial daily activities to be unsubstantiated. Specifically, the doctor could not identify specific nonindustrial activities causing impairment or link them to the found impairment. Therefore, the Board awarded an unapportioned 7% permanent disability for the applicant's industrial lumbar spine injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationPermanent DisabilityApportionmentSubstantial Medical EvidenceMedical OpinionLumbar Spine DRE Category IIWhole Person ImpairmentAMA GuidesMuscle Spasm
References
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