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Case Law Database

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

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. ADJ1030139 (STK 0203781)
Regular
Nov 19, 2014

GERALD REESE vs. MICRODENTAL LABORATORIES, AMERICAN HOME ASSURANCE, AIG CLAIMS SERVICES

The Appeals Board granted reconsideration to review the permanent disability rating for applicant Gerald Reese, who sustained an industrial injury in 2006. The primary issue was whether to include a deconditioning impairment, rated by a PQME using analogy, into the permanent disability award. The Board affirmed the WCJ's decision but amended it to defer the issue of permanent disability for further proceedings. This deferral is to allow the WCJ to issue rating instructions based on the established legal framework for incorporating AMA Guides impairments, even those addressed by analogy.

PQMEdeconditioningAMA Guideswhole person impairmentanalogyLabor Code section 4660Almaraz/Guzman IIMilpitas Unified School Dist.City of Sacramento v. Workers' Comp. Appeals Bd.rating instructions
References
3
Case No. ADJ8550681
Regular
May 14, 2015

NANCY TOM vs. PARAMOUNT PICTURES

Applicant Nancy Tom sought reconsideration of a workers' compensation award, arguing her 9% permanent disability rating was too low. She contended for further medical evaluation regarding worsening symptoms and a claimed 40% grip loss in her right hand, plus additional impairment ratings for her thumb and knee. The Board denied reconsideration, adopting the WCJ's reasoning that Dr. Angerman's conclusory deposition testimony regarding increased impairment lacked substantial medical evidence and conflicted with AMA Guides to the Evaluation of Permanent Impairment. The Board found that Applicant failed to meet her burden of proof for a higher disability rating.

Workers' Compensation Appeals BoardParamount PicturesPermissibly Self-InsuredPetition for ReconsiderationFindings of Fact and AwardExecutive AssistantIndustrial InjuryPermanent DisabilityAgreed Medical EvaluatorOrthopedist
References
4
Case No. ADJ696907 (VNO 0543817)
Regular
Jul 23, 2010

ROBERT PERCHLAK vs. WAL-MART, AVIZENT BENTONVILLE

The Workers' Compensation Appeals Board (WCAB) reconsidered a decision regarding Robert Perchlak's industrial injury claim against Wal-Mart. The applicant challenged the $44\%$ permanent disability rating, arguing the rating specialist improperly disregarded physician findings. The WCAB clarified that rating specialists are limited to rating based on WCJ instructions and cannot independently assess medical impairments or deviate from AMA Guides criteria. The WCAB amended the decision to defer permanent disability and attorney's fees, returning the case for further proceedings to clarify the physician's impairment findings and ensure proper rating procedures are followed.

Workers' Compensation Appeals BoardRobert PerchlakWal-MartAvizent BentonvilleOpinion and Decision After ReconsiderationPermanent DisabilityApportionmentDr. Arthur LipperAppeals Board Rule 10602Rater Authority
References
1
Case No. ADJ480092 (SFO 0498380) ADJ2934310 (SFO 0498381)
Regular
Apr 26, 2009

TONI MORGAN vs. REDWOOD CREDIT UNION, ZENITH INSURANCE COMPANY, UNITED STATES FIRE INSURANCE CO.

This case concerns an applicant's petition for reconsideration of a workers' compensation judge's finding that the 2005 Permanent Disability Rating Schedule (PDRS) should apply to two cumulative trauma injuries. The applicant argued for the 1997 PDRS, asserting a defendant's termination of temporary disability payments triggered a Labor Code notice requirement. Alternatively, the applicant contended the $15\%$ permanent disability rating was too low, citing *Almaraz/Guzman* regarding disparities between AMA Guides impairment ratings and actual employability. The Appeals Board granted reconsideration, agreeing the medical record needed further development under *Almaraz/Guzman*, and deferred the permanent disability issue for trial level review. A dissenting opinion argued the applicant waived the AMA Guides impairment issue by not raising it earlier.

WCABRedwood Credit UnionZenith Insurance CompanyUnited States Fire Insurance Co.cumulative traumapermanent disability rating schedule2005 PDRS1997 PDRSLabor Code section 4061Labor Code section 4660
References
11
Case No. ADJ10091553
Regular
May 06, 2019

DWIGHT STILLWELL vs. WYLATTI RESOURCE MANAGEMENT, INC., STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the applicant challenged the administrative law judge's (WCJ) permanent disability rating of $76\%$. The applicant argued that the WCJ improperly combined medical impairments when an agreed medical evaluator suggested adding them for a higher rating of $88\%$. The WCJ acknowledged misinterpreting the medical evidence in their report, admitting that the agreed medical evaluator did indicate adding impairments was more appropriate. Consequently, the Workers' Compensation Appeals Board granted reconsideration to allow the WCJ to re-evaluate the permanent disability rating based on the correct understanding of the medical evidence.

Agreed Medical EvaluatorAMA GuidesPermanent Disability RatingPetition for ReconsiderationWorkers' Compensation Appeals BoardFindings and AwardCVCSchedule for Rating Permanent DisabilitiesOrthopedistIndustrial Injury
References
0
Case No. ADJ9777475
Regular
Feb 14, 2017

MOSES CASTILLO vs. CITY OF LOS ANGELES

The WCAB granted reconsideration regarding a prior award of $73\%$ permanent disability for an applicant's industrial injuries. The Board found the WCJ erred by including a $2\%$ rating for sleep apnea, as Labor Code section 4660.1(c)(1) prohibits increases for sleep dysfunction arising from a compensable physical injury. Furthermore, the Board remanded for clarification on the $10\%$ right hand and wrist impairment rating, as the agreed medical evaluator may have improperly combined impairment components under the AMA Guides. Jurisdiction was deferred for a re-rating of permanent disability after these issues are resolved.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent DisabilityLabor Code section 4660.1(c)(1)AMA GuidesAgreed Medical EvaluatorCarpal Tunnel SyndromeCumulative InjuryDate of Injury
References
12
Case No. ADJ9311285
Regular
Jan 12, 2018

Herbert Schmitz vs. Westlands Water District, Liberty Mutual Insurance Company/Wausau

The Workers' Compensation Appeals Board (WCAB) reconsidered a decision awarding 74% permanent disability. The defendant argued the Qualified Medical Evaluator (QME), Dr. Deshmukh, improperly used the hernia chapter of the AMA Guides for impairment rating, violating *Almaraz-Guzman* principles. The WCAB agreed that Dr. Deshmukh's rating lacked sufficient explanation for deviating from standard orthopedic evaluations. Consequently, the WCAB rescinded the permanent disability and attorney's fees findings, returning the case for further proceedings, potentially including a supplemental report or deposition from Dr. Deshmukh, to properly address impairment rating.

Workers Compensation Appeals BoardPermanent DisabilityQualified Medical EvaluatorWhole Person ImpairmentAMA GuidesAlmaraz-GuzmanIndustrial InjuryMedical TreatmentLabor CodeFindings and Award
References
6
Case No. ADJ7483972, ADJ7483952
Regular
Nov 08, 2012

ROY HAAS vs. CITY OF SANTA ROSA, REDWOOD EMPIRE MUNICIPAL INSURANCE FUND

This case involves a workers' compensation applicant, Roy Haas, who sustained injuries to his left elbow and bilateral shoulders. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to increase Haas's permanent disability ratings. The WCAB adopted the WCJ's recommendation to rate impairments based on the highest applicable factor, citing that Dr. Suchard's report did not adequately explain combining strength and range of motion impairments for the elbow, and that strength deficits should not be rated where objective anatomic findings like loss of motion are present and prioritized by the AMA Guides. Consequently, Haas's permanent disability for the left elbow was increased to 25%, and for his shoulders to 31%.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardsPermanent Disability RatingAgreed Medical ExaminerAMA GuidesRange of MotionLoss of StrengthOccupational CodeLabor Code Sections
References
2
Case No. MISSING
Regular Panel Decision

Claim of Milner v. Country Developers, Inc.

The Special Disability Fund appealed decisions by the Workmen’s Compensation Board which imposed liability on the Fund for a claimant's injuries. The Board found that the employer, Country Developers, continued to employ the claimant, a carpenter, with knowledge of his pre-existing permanent physical impairment, triggering liability under subdivision 8 of section 15 of the Workmen’s Compensation Law. The claimant suffered a fracture of the nose and a hip dislocation in 1964, having a history of three ruptured disc surgeries and other conditions. The appeal centered on whether the employer had sufficient knowledge of the claimant’s permanent condition. Testimony from the employer’s foreman, Mr. Pahlck, indicated awareness of the claimant's back issues, including wearing a back brace and being favored by co-workers. The court affirmed the Board’s decision, reiterating that employer knowledge is a question of fact for the Board, and its findings, if supported by substantial evidence, will not be disturbed.

Workers' Compensation LawSpecial Disability FundEmployer LiabilityPre-existing Permanent ImpairmentEmployer KnowledgeSubstantial EvidencePermanent Partial DisabilityFracture of NoseHip DislocationRuptured Discs
References
3
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