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

Case No. ADJ229693 (MON 0362437)
Regular
Mar 28, 2011

JUAN PALMA vs. NORMAN'S NURSERY WHOLESALE GROWERS

A lien claimant, former attorney for the applicant, filed a motion to disqualify the Workers' Compensation Judge, alleging bias. The Workers' Compensation Appeals Board (WCAB) construed this motion as a petition for disqualification. The petition was denied because it was not properly verified under oath as required by WCAB Rule 10844. Furthermore, the petition lacked the necessary supporting affidavit or declaration under penalty of perjury required by WCAB Rule 10452.

Petition for disqualificationWCAB Rule 10844Verified pleadingsAffidavitDeclaration under penalty of perjuryWorkers' Compensation Administrative Law JudgeBiasMotion to disqualifyLabor Code section 5311WCJ Blais
References
Case No. ADJ7549203
Regular
Feb 22, 2018

RONALD WILSON vs. AEROTEK COMMERCIAL STAFFING; As Administered By ESIS CHATSWORTH

The Workers' Compensation Appeals Board (WCAB) granted the defendant's Petition for Removal. The WCAB rescinded the previous order that denied the defendant's motion to set a trial date. The case is now returned to the workers' compensation administrative law judge for further proceedings. This means the previous denial of the trial setting motion is nullified.

Petition for RemovalDecision After RemovalWorkers' Compensation Appeals BoardWCJrescind ordermotion to set trial datereturn to trial leveladministrative law judgedefendant's motiondenial of motion
References
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
Case No. ADJ10440533
Regular
Apr 20, 2020

SUMUDU JAYASURIYA vs. SAN FRANCISCO BAY AREA RAPID TRANSIT DISTRICT

The Workers' Compensation Appeals Board (WCAB) rescinded the original Findings and Award due to insufficient substantial evidence. The WCAB found that the chiropractor QME's reports did not adequately explain the basis for combining wrist range of motion impairment with grip strength impairment, particularly in relation to the AMA Guides. The case is returned to the WCJ for further development of the record, likely through an evaluation by an orthopedic hand specialist, to properly assess the applicant's permanent disability.

Workers' Compensation Appeals BoardSan Francisco Bay Area Rapid Transit DistrictSumudu JayasuriyaQualified Medical Examiner (QME)Dennis M. SosineD.C.left upper extremity injurypermanent partial disabilityrange of motiongrip strength
References
Case No. ADJ9526635
Regular
Feb 21, 2017

SISSON STEWART vs. CALIFORNIA STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and affirmed the original award, but remanded the case to defer the issue of permanent disability. This decision arose because the treating physician's permanent disability rating, based on grip strength loss, was deemed not substantial medical evidence under AMA Guides. The Appeals Board found that the doctor failed to adequately justify the use of grip strength over range of motion or other objective findings, and further development of the medical record is required. Consequently, the case returns to the trial level for further proceedings on permanent disability.

Workers' Compensation Appeals BoardPermanent DisabilityMedical EvidenceTreating PhysicianQualified Medical EvaluatorAMA GuidesGrip StrengthRange of MotionFindings and AwardPetition for Reconsideration
References
Case No. ADJ1475903
Regular
Jun 10, 2011

JEFFREY SMITH vs. COAST MACHINERY MOVERS, STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the defendant sought reconsideration of an award finding the applicant sustained an industrial injury and $87\%$ permanent disability. The defendant argued the administrative law judge erred by relying on the primary treating physician's opinions and using a Diagnosis Related Estimates method instead of Range of Motion. The Appeals Board denied reconsideration, agreeing that the physician's reports constituted substantial medical evidence and the judge did not err in their application. Although the Board found the judge incorrectly stated the defendant waived its objection to the evidence, the core findings were upheld.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and AwardSteam and PipefitterIndustrial InjuryPermanent DisabilityPrimary Treating PhysicianSubstantial Medical EvidenceDiagnosis Related EstimatesRange of Motion
References
Case No. ADJ6957361
Regular
Jan 12, 2012

ROBERTO BARAJAS vs. FRESNO UNIFIED SCHOOL DISTRICT

This case concerns a petition for reconsideration by Fresno Unified School District regarding a workers' compensation award for Roberto Barajas. The District challenged the permanent disability rating, arguing the Agreed Medical Examiner improperly included grip strength loss alongside range of motion limitations, contrary to AMA Guides guidelines. Additionally, the District contested a 10% penalty for delayed permanent disability advances and sought a reduction in benefits based on an offer of regular work. The Workers' Compensation Appeals Board denied reconsideration, affirming the WCJ's findings on the permanent disability rating by finding the AME appropriately applied *Almaraz/Guzman II* principles for calculating impairment. The Board also upheld the penalty for delayed advances and rejected the District's claim regarding work offer reductions.

Workers' Compensation Appeals BoardFresno Unified School DistrictRoberto BarajasFindings of Fact and Awardpermanent disabilityright wrist injuryright hand injuryright finger injurygroundskeeper/gardenerLabor Code section 4650
References
Case No. ADJ9499569
Regular
Sep 11, 2018

CHRIS HENDERSON vs. CDCR - CORCORAN STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration, increasing the applicant's permanent disability rating from 16% to 26%. This revision was based on incorporating the agreed medical evaluator's findings of a 14% upper extremity impairment due to decreased shoulder range of motion, which the original rating had omitted. The Board also noted the WCJ's rating instructions did not comply with established precedent regarding listing all impairments. The decision otherwise affirmed the WCJ's findings.

Workers' Compensation Appeals BoardCDCR - Corcoran State PrisonState Compensation Insurance FundPetition for ReconsiderationPermanent Disability RatingAgreed Medical EvaluatorOrthopedistEugene HarrisM.D.Temporary Disability Indemnity
References
Case No. ADJ10243412
Regular
Jun 10, 2019

DEBRA LUX vs. COUNTY OF SANTA BARBARA

This case involves an injured firefighter seeking workers' compensation for a right knee injury. The defendant sought reconsideration of a finding of 17% permanent disability, arguing the administrative law judge erred by combining range of motion and diagnosis-based impairments, and by not apportioning the diagnosis-based impairment. The Appeals Board denied reconsideration, finding the medical evaluator adequately explained the departure from standard AMA Guides methodology for rating the combined impairments. The Board also affirmed no apportionment of the diagnosis-based impairment as no substantial evidence showed non-industrial factors contributed to the need for surgery.

Workers' Compensation Appeals BoardApplicantDefendantPermissibly Self-InsuredAdministered by CORVELFirefighterIndustrial InjuryRight KneePermanent DisabilityWhole Person Impairment
References
Case No. ADJ9344211
Regular
Dec 01, 2017

Patricia Preston vs. Los Angeles Unified School District, SEDGWICK CLAIMS MANAGEMENT SERVICES

The applicant sought reconsideration of a workers' compensation award, challenging the permanent disability rating primarily based on the chosen medical evaluation method. The applicant argued the Range-of-Motion (ROM) method, favored by her treating physician, should have been used instead of the Diagnosis-Related Estimates (DRE) method employed by a Qualified Medical Evaluator (QME). Additionally, she contended that her vocational expert's opinion supported a finding of total permanent disability. The Board denied reconsideration, affirming the administrative law judge's decision, finding the QME's DRE rating supported by substantial evidence and the applicant's vocational evidence insufficient to prove total disability. A dissenting opinion argued that findings of multi-level spinal involvement supported the use of the ROM method for a potentially higher rating and questioned the QME's justification for choosing DRE.

Workers' Compensation Appeals BoardPatricia PrestonLos Angeles Unified School DistrictSedgwick Claims Management ServicesADJ9344211Permanent Disability RatingRange-of-Motion MethodDiagnosis-Related Estimates MethodApportionmentDr. Fenton
References
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