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Case Law Database

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

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 The Appeals Board granted reconsideration, rescinded the prior award, and returned the case for further proceedings.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
4
Case No. ADJ11297621
Regular
Apr 30, 2019

MICHAEL NEUFELD vs. COUNTY OF SAN BERNARDINO FIRE DEPARTMENT

This case concerns a firefighter injured on January 1, 2018, who was awarded temporary disability benefits. The defendant sought reconsideration, arguing benefits should terminate based on a QME's report, not solely the primary treating physician's determination of permanent and stationary status. The Appeals Board granted reconsideration to clarify the termination conditions for temporary disability benefits. The Board affirmed the WCJ's award but amended the findings to allow termination of benefits upon a properly supported QME determination of permanent and stationary status, as well as by the PTP.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardTemporary Disability IndemnityLabor Code Section 4850Primary Treating PhysicianPermanent and Stationary StatusQualified Medical EvaluatorAdministrative Law JudgeAverage Weekly Wage
References
0
Case No. ADJ9930849
Regular
Feb 22, 2017

JEDEDIAH KELTNER vs. CALIFORNIA GUEST SERVICES, INC.; CHUBB GROUP OF INSURANCE COMPANIES

The Workers' Compensation Appeals Board denied reconsideration of a decision finding applicant Jedediah Keltner was adequately compensated for temporary disability. The Board affirmed the administrative law judge's reliance on the Agreed Medical Examiner's opinion that applicant reached permanent and stationary status after lumbar surgery was denied by Utilization Review. Applicant argued the AME's opinion was insufficient without considering the UR denial and sought further development of the record, but the Board found the AME's opinion on permanent and stationary status to be substantial medical evidence in the absence of ongoing treatment likely to improve his condition. The dissenting opinion argued for granting reconsideration to clarify whether applicant was truly temporarily disabled, given the AME's conflicting statements and the nuances of his reporting.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactTemporary Disability IndemnityPermanent and Stationary StatusAgreed Medical Examiner (AME)Utilization Review (UR)Lumbar SurgeryTreating PhysicianSubstantial Medical Evidence
References
2
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
4
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
3
Case No. ADJ1498865 (WCK 0071162) ADJ3989369 (WCK 0071163) ADJ2618113 (WCK 0071164)
Regular
Jul 09, 2010

MICHELLE LIVENGOOD vs. MT. DIABLO STATE PARK (CALIFORNIA DEPARTMENT OF PARKS AND RECREATION) and AIG

This case concerns Michelle Livengood's multiple industrial injuries. The Court of Appeal found contradictory findings regarding her permanent and stationary status, remanding the case for clarification. The Appeals Board has now granted reconsideration, affirmed the original findings but deferred the issue of temporary disability. The matter is returned to the trial level for further proceedings to clarify if the neurological consultation was diagnostic, which would necessitate a finding of not permanent and stationary.

Workers' Compensation Appeals BoardRemittiturPermanent and StationaryTemporary DisabilityNeurological ConsultationDiscogramQualified Medical EvaluatorPetition for ReconsiderationWrit of ReviewSubstantial Evidence
References
3
Case No. ADJ1180912 (ANA 0395704)
Regular
Oct 08, 2012

ERLINDA NORMAN vs. LOS ANGELES COUNTY HEALTH DEPARTMENT

This case concerns a worker's compensation appeal where the applicant challenged the employer's credit for temporary disability payments made after her permanent and stationary date. The Appeals Board granted reconsideration, finding the employer was only entitled to a credit for temporary disability indemnity paid after the Agreed Medical Evaluator's report dated January 6, 2009. This decision recognized the applicant received benefits in good faith prior to notice of her permanent and stationary status and cautioned employers to ensure timely issuance of medical reports.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilityTemporary DisabilityCreditAgreed Medical EvaluatorTreating PhysicianLabor CodeEquitable Principles
References
6
Case No. ADJ9668616
Regular
Oct 05, 2015

FREDRICK KEPLINGER vs. CITY OF UKIAH

The WCAB affirmed the finding of industrial psyche injury for a police officer, holding the employer's arguments regarding insufficient medical evidence unpersuasive as the QME considered applicant's stressors. The Board rescinded the prior award, ruling the applicant was entitled to leave of absence without loss of salary (Labor Code section 4850) until January 15, 2015, when he consented to retirement, due to the employer's premature disability retirement application and the applicant not being permanent and stationary. This decision was based on Government Code section 21164, which prohibits involuntary retirement before the termination of section 4850 benefits or attainment of permanent and stationary status. The applicant was awarded accrued section 4850 benefits totaling $54,135.51 and future medical treatment.

PSYCHE INJURYLABOR CODE SECTION 4850PERMANENT AND STATIONARY STATUSGOVERNMENT CODE SECTION 21164INDUSTRIAL DISABILITY RETIREMENTGOOD FAITH PERSONNEL ACTIONSSUBSTANTIAL EVIDENCEPANEL QUALIFIED MEDICAL EVALUATORTEMPORARY DISABILITYLEAVE OF ABSENCE WITHOUT LOSS OF SALARY
References
2
Case No. RDG 0119917
Regular
Feb 04, 2008

WILLIAM ROBERTS vs. BURGER KING, ZENITH INSURANCE COMPANY

This case affirmed a finding of 100% permanent disability for an industrial injury to an assistant manager's left knee, shoulder, hip, and leg. The Appeals Board ruled that a physician's report indicating the existence of permanent disability before reaching the "permanent and stationary" status qualified for using the older 1997 permanent disability rating schedule. The Board found substantial evidence supported the 100% rating, deferring to the WCJ's credibility assessment.

Workers' Compensation Appeals BoardPermanent Disability Rating ScheduleReconsiderationIndustrial InjuryAssistant ManagerLeft KneeLeft ShoulderLeft HipLeft LegPermanent Disability
References
14
Case No. ADJ1346707
Regular
Dec 17, 2008

James Clay vs. PINNACLE CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of a prior award to an applicant for $100\%$ permanent disability due to a shoulder and neck injury. While acknowledging the medical record appears to support the finding of total permanent disability, the Board rescinded the award to clarify the commencement date of permanent disability payments, which was eight months after the applicant reached a permanent and stationary status. The matter was returned to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardPermanent DisabilityFindings and AwardReconsiderationLabor Code Section 4061.5AMA GuidesOld Permanent Disability Rating SchedulePermanent and Stationary StatusCommutationIndustrial Injury
References
0
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