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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. 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. ADJ9123534
Regular
Jul 18, 2015

PHILLIP WARD vs. CITY OF FORT BRAGG, REDWOOD EMPIRE MUNICIPAL INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and amended an award, finding the defendant liable for a 15% increase in permanent disability benefits. This increase is due to the defendant's failure to offer the applicant qualified work within 60 days of his permanent and stationary status, as required by Labor Code section 4658(d)(2). While the applicant had retired, the Board found this did not excuse the employer from making a compliant work offer. The amended order clarifies the increase applies only to payments made 60 days after the Qualified Medical Evaluator's permanent and stationary report.

Labor Code section 4658(d)(2)permanent disability increaseoffer of workmodified workalternative workregular workpermanent and stationary60-day periodretirementCalPERS
References
Case No. ADJ4192266 (VNO 0544329)
Regular
Mar 07, 2011

JOHN HENRY vs. CITY OF SANTA MONICA, Permissibly Self-Insured

This case involves a police officer's workers' compensation claim for multiple injuries. The applicant was awarded 85% permanent disability and an additional 15% increase due to the employer's failure to offer suitable work within 60 days of the applicant reaching permanent and stationary status. The defendant sought reconsideration, arguing it had offered work and that the applicant's post-injury earnings rebutted the diminished future earning capacity (DFEC) presumption. The Appeals Board granted reconsideration, rescinded the prior award, and returned the case for further proceedings. The Board found the employer's work offer was invalid because the applicant had not reached permanent and stationary status for all his injuries at the time of the offer. Furthermore, the defendant failed to adequately rebut the DFEC presumption by not presenting comprehensive evidence regarding earning capacity beyond just post-injury earnings.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilitySection 4658(d)Diminished Future Earning CapacityDFECQualified Medical EvaluatorQMEAgreed Medical Examiner
References
Case No. ADJ8869367
Regular
Nov 07, 2013

LUIS CENDEJAS vs. AMERICAN LABOR POOL, INC., OLD REPUBLIC GENERAL INSURANCE CORPORATION, GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant argued that they made a valid offer of modified work, relieving them of temporary disability obligations. However, the Board affirmed the judge's finding that the work offers were not sufficiently clear, lacked specificity regarding physical appropriateness, and failed to convey the exact terms to the applicant. Consequently, the employer did not meet their burden of proving a valid offer of modified work was made.

Petition for ReconsiderationModified Work OfferTemporary DisabilityPhysical AppropriatenessDoctor's RestrictionsVocational RehabilitationSupplemental Job Displacement VoucherOffer ValidityCommunication of OfferEmployer's Burden of Proof
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. ADJ10887310
Regular
Jan 30, 2023

OSCAR MARTINEZ vs. SECURITA AMERICA, INC., GALLAGHER BASSETT, EVEREST NATIONAL INSURANCE

The applicant, Oscar Martinez, was injured on May 3, 2017, resulting in a 3% permanent disability. He returned to his regular job duties with his employer, Securita America, Inc., but was laid off approximately five months later due to his employer's contract ending. While Martinez subsequently worked for a new employer at the same location and performing similar duties, the Board found that this did not satisfy the requirement of returning to the "same job for the same employer" for at least 12 months. Therefore, the Appeals Board amended the prior finding, ruling that Martinez is entitled to a Supplemental Job Displacement Benefit (SJDB) voucher.

Supplemental Job Displacement BenefitSJDB voucherpermanent partial disabilityemployer's dutyregular work offermodified work offeralternative work offer12-month durationRule 10133.31(c)substantial evidence
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. ADJ6410496
Regular
Dec 21, 2009

JAKE BOATMAN vs. TOWN OF WINDSOR, PSI, by REMIF

The Appeals Board affirmed the WCJ’s decision disallowing a 15% reduction in permanent disability indemnity under Labor Code section 4658(d)(3)(A) because the applicant returned to work quickly and the employer's offer to return to work was made after the 60 day time requirement and was not made in accordance with the statute.

Workers Compensation Appeals BoardPermanent Disability IndemnityLabor Code Section 4658(d)(3)(A)ReconsiderationStipulations with Request for AwardJob OfferRetroactive PeriodWhole Person ImpairmentPermanent and StationaryReturn to Work
References
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