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

Case No. ADJ1099369
Regular
Jul 01, 2009

SANDRA SMULLEN vs. CITY OF SAN DIEGO, PERMISSIBLY SELF-INSURED

The Workers' Compensation Appeals Board granted reconsideration of a prior award, finding that the applicant's pre-2005 treating physician reports sufficiently indicated permanent disability. Consequently, the Board applied the 1997 permanent disability rating schedule instead of the 2005 schedule. This resulted in an amended award of 56 percent permanent disability based on the stipulated rating under the 1997 schedule. The decision reversed the prior award that had utilized the 2005 schedule and awarded 35 percent permanent disability.

Workers' Compensation Appeals BoardPermanent Disability Rating Schedule2005 Rating Schedule1997 Rating ScheduleLabor Code section 4660(d)Petition for ReconsiderationIndustrial InjuryPolice OfficerBack InjuryTreating Physician
References
6
Case No. ADJ351818 (FRE 0240633) ADJ850154 (FRE 0245677)
Regular
May 10, 2011

FELIX LOPEZ HEREDIA vs. NUNEZ BROTHERS RANCH, ZENITH INSURANCE COMPANY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted Zenith Insurance Company's petition for reconsideration, reversing the original award. The Board found that a prior treating physician's report did not adequately indicate permanent disability, thus the 2005 rating schedule, not the 1997 schedule, should apply to the applicant's 2003 injury. The case was returned to the trial level for rating under the 2005 schedule and to determine attorney's fees. A dissenting opinion argued that the prior physician's report did indicate permanent disability.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityApportionmentRating ScheduleLabor Code section 4660(d)Treating PhysicianMedical-Legal ReportVocational RehabilitationIndustrial Injury
References
3
Case No. ADJ1188182 (SFO 481756)
Regular
Mar 02, 2009

LELEON KIZINE vs. CITY & COUNTY OF SAN FRANCISCO, SEDGWICK CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior decision that rated the applicant's permanent disability using the 1997 Permanent Disability Rating Schedule (1997 PDRS). The defendant argued that the 2005 PDRS should apply, and the WCAB agreed that no exception to its use was properly established. The case is returned to the trial level, and parties are relieved of prior stipulations regarding the rating schedules due to intervening precedent in *Almaraz* and *Ogilvie*. This will allow for further proceedings considering these new legal interpretations.

Permanent Disability Rating Schedule1997 PDRS2005 PDRSAMA GuidesLabor Code Section 4660(d)ReconsiderationFindings of Fact and AwardAgreed Medical ExaminerRobert Steiner M.D.Operative Note
References
9
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. ADJ3416937 (SRO 0141443) ADJ4476347 (SRO 0118020)
Regular
Apr 25, 2011

TIMOTHY ROBINSON vs. COUNTY OF SONOMA, Permissibly Self-Insured

This case concerns apportionment of permanent disability for an injured correctional officer. The applicant sustained an admitted industrial injury to his neck, resulting in a 12% permanent disability after initial apportionment. The WCJ calculated a total permanent disability of 43%, then apportioned 20% to non-industrial factors under Labor Code section 4663. Further apportionment occurred for a prior low back injury under Labor Code section 4664, using a converted rating from the old schedule to the new AMA Guides. The Appeals Board affirmed the WCJ's decision, finding no prohibition against applying both section 4663 and section 4664 apportionment, and deeming the prior injury properly converted and subtracted. A dissenting opinion argued that the older rating schedule's "overlap" concept is incompatible with the current AMA Guides method, and that the defendant failed to prove overlap for the prior injury.

Workers' Compensation Appeals BoardCounty of SonomaTimothy RobinsonCorrectional OfficerIndustrial InjuryNeck InjuryPermanent DisabilityApportionmentLabor Code Section 4663Labor Code Section 4664
References
6
Case No. ADJ2269231 (OXN 0139900)
Regular
Apr 13, 2008

CAROLE KRAL vs. ST. JOHN'S REGIONAL MEDICAL CENTER, Permissibly Self-Insured OCTAGON RISK SERVICES

This case concerns an applicant challenging a WCJ's denial to reopen a prior finding that the 2005 permanent disability rating schedule applied. The Appeals Board affirmed the WCJ's decision, holding that the April 18, 2007 decision on the rating schedule was a "final order" because it addressed a "threshold issue" fundamental to permanent disability benefits. Applicant's failure to timely seek reconsideration of this final order means the rating schedule issue is now conclusively determined. Therefore, the November 25, 2008 Findings, Award and Orders, which incorporated the 2005 schedule, were properly affirmed.

Workers' Compensation Appeals BoardReconsiderationFindings and OrdersPermanent Disability Rating ScheduleThreshold IssueFinal OrderReopeningSupplemental PleadingsOccupational TherapistIndustrial Injury
References
15
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. ADJ1568179 (BAK 0150495)
Regular
Nov 01, 2010

SHARON DEROSSETT vs. KERN HIGH SCHOOL DISTRICT; SELF INSURED SCHOOLS BAKERSFIELD

The Workers' Compensation Appeals Board granted reconsideration of a prior award, finding the administrative law judge erred in applying the 1997 disability rating schedule. The applicant sustained a low back injury in 2004, and the central issue is which permanent disability rating schedule applies given the injury date and subsequent medical reports. The Board found that neither the Labor Code section 4061 notice exception nor a clear "indication of permanent disability" exception under the 2005 schedule was definitively met by the October 27, 2004 report. Therefore, the matter is returned to the trial level for further development of the record to determine the correct schedule and rating.

Workers' Compensation Appeals BoardKern High School DistrictPermanent Disability2005 Schedule1997 ScheduleLabor Code Section 4660(d)Petition for ReconsiderationFindings and AwardQualified Medical EvaluatorTreating Physician
References
8
Case No. LAO 0857719
Regular
Aug 08, 2008

ELISAVED HERNANDEZ vs. ASHWORTH ASSOCIATES, INC., REDWOOD FIRE & CASUALTY INSURANCE COMPANY

This case concerns an applicant seeking reconsideration of a permanent disability rating for a back injury. The applicant argued the revised rating schedule was wrongly applied, claiming the defendant should have provided notice and a prior medical report indicated permanent disability. The Board denied reconsideration, finding that the applicant failed to establish the exceptions required to use the older rating schedule, thus affirming the application of the revised schedule.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and Awardlaborerindustrial injurylow backpermanent disabilityrevised rating scheduleprior rating scheduleLabor Code Section 4061
References
2
Case No. LAO 0842819
Regular
Sep 04, 2007

JUAN M. VILLALOBOS vs. ANCRA INTERNATIONAL, GALLAGHER BASSETT SERVICES, INC.

This case concerns the application of the correct permanent disability rating schedule for an industrial injury occurring before January 1, 2005. The applicant sought to apply the prior rating schedule, arguing specific medical reports indicated permanent disability. However, the Workers' Compensation Appeals Board denied reconsideration, affirming the use of the revised rating schedule. The Board found no qualifying pre-January 1, 2005 medical report indicating the applicant was permanent and stationary, nor was the employer required to issue notice under Labor Code § 4061 until after that date.

WCABReconsiderationSupplemental Findings and AwardIndustrial InjuryLower BackPermanent DisabilityRevised Rating SchedulePrior Rating ScheduleLabor Code Section 4061Labor Code Section 4660(d)
References
4
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