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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. ADJ2531503 (AHM 0111102), ADJ3636599 (AHM 0111103), ADJ4058229 (AHM 0123911)
Regular
Dec 23, 2010

JIM POTTS vs. CITY OF IRVINE POLICE DEPARTMENT

The Workers' Compensation Appeals Board granted reconsideration to correct the permanent disability rate and defer the attorney's fee calculation for the life pension. The Board affirmed the 86% permanent disability finding, rejecting the defendant's argument that the applicant's post-injury work history should have altered the medical opinions, as the defendant had the opportunity to address this. The Board also clarified that the 1997 Permanent Disability Rating Schedule was correctly applied and deferred the issue of temporary disability overpayment to the trial level.

Cumulative traumaSpineLeft shoulderRight wristBilateral kneesLeft ankleCardiovascular systemHypertensionPermanent disabilityLife pension
References
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
Case No. ADJ10187704, ADJ10924724
Regular
May 17, 2018

STEVEN CASE vs. GOLDEN GATE BRIDGE HIGHWAY AND TRANSPORTATION DISTRICT

The Workers' Compensation Appeals Board granted reconsideration to increase applicant's permanent disability rating for bilateral shoulder injury from 9% to 38%. The Board found the Agreed Medical Evaluator's (AME) alternative rating, based on strength loss, was substantial medical evidence and properly considered within the AMA Guides. The WCJ erred in applying an overly restrictive interpretation of "complex or extraordinary" cases for deviating from strict AMA Guides ratings. The AME's use of strength loss data from the AMA Guides, even for an age outside the specified range, was permissible under the *Almaraz-Guzman* line of cases when justified by clinical judgment.

Workers' Compensation Appeals BoardJoint Findings and AwardPetition for ReconsiderationAgreed Medical Evaluator (AME)permanent disability ratingbilateral shouldersorthopedic AMEAMA GuidesAlmaraz-Guzmanstrength loss index
References
Case No. ADJ758842 (VNO 0559214)
Regular
Dec 17, 2010

JOHN PATCHETT vs. CITY OF LOS ANGELES

The Appeals Board denied the applicant's petition for removal, affirming the WCJ's decision to vacate the submission. This action was based on the DEU evaluator's testimony, which revealed deficiencies in the AMEs' reports concerning the AMA Guides. The Board found the applicant waived any objection to this testimony by failing to object at trial, and that the evaluator's expert opinion was permissible per *Blackledge v. Bank of America*. Defendant's objection, though not styled as a motion to strike, sufficiently raised the issues leading to the vacation of the rating.

Petition for RemovalOrder Vacating SubmissionDEU evaluatorAMA Guidesagreed medical evaluators (AMEs)rating instructionssubstantial evidenceobjective factors of disabilitywhole person impairmentformal rating
References
Case No. ADJ8824230
Regular
Apr 03, 2017

Braulina Rodriguez vs. ANAHEIM HEALTH CARE CENTER, AIG administered by CORVEL

The Appeals Board granted reconsideration, amending the original award regarding permanent disability indemnity. The primary issue deferred for further development is whether a 15% rate increase under Labor Code section 4658(d)(2) applies, contingent on employer size and failure to offer suitable work. The original findings of a 34% permanent disability and 159 weeks of indemnity remain, but the payment rate is now to be determined. The Board adopted the WCJ's report, which highlighted the need for record development on employer employee count relevant to the rate increase.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award & OrdersAdministrative Law JudgeCervical spineLumbar spineLeft anklePsycheTemporary disabilityPermanent disability
References
Case No. ADJ11368246
Regular
Mar 03, 2020

Marta Ubillus vs. One Stop Employment Services, LLC/Vensure Employer Services, Security National Insurance Company, State National Insurance Company

The Workers' Compensation Appeals Board (WCAB) denied the lien claimant's petition for reconsideration regarding the valuation of interpreter services. The WCAB adopted the Administrative Law Judge's (ALJ) report, which found that while the defendant did not present rebuttal evidence, the ALJ had substantial evidence to make a determination. The ALJ determined a market rate of $114.97 per hour but noted the lien claimant failed to provide sufficient evidence of the duration of services on most dates, preventing application of the market rate. Consequently, the statutory rate was applied for those services.

WCABPetition for ReconsiderationDeniedLien ClaimantInterpreter ServicesMarket RateStatutory RateWCJ ReportSubstantial EvidenceFindings and Award
References
Case No. ADJ8530656, ADJ8553993
Regular
May 03, 2019

Feliciano Hernandez vs. Fresh Express, Inc., Federal Insurance Company, Sedgwick Claims Management Services

The Workers' Compensation Appeals Board granted reconsideration of a prior award, amending the applicant's permanent disability rating. The Board disagreed with the initial finding of 67% permanent disability, determining that the psychiatric impairment rating should be increased based on the Agreed Medical Examiner's opinion. This adjustment, utilizing an analogical rating method and considering the applicant's GAF score of 50, increased the total permanent disability to 73% and will include a life pension. The Board upheld the rejection of the vocational expert's total disability finding due to improper consideration of the applicant's age.

Agreed Medical ExaminerAlmaraz/GuzmanGAF scorepermanent disability ratingvocational expertsubstantial medical evidencerebuttal of scheduled ratingindustrial injuryspecific injurycumulative trauma injury
References
Case No. ADJ2977853 (SRO 0128753)
Regular
Jul 21, 2010

JORGE ALVAREZ vs. PEREZ FARMS & ASSOCIATES, STATE COMPENSATION INSURANCE FUND

In this case, the applicant sought reconsideration of a prior award, arguing the permanent disability rating was too low and the attorney's fee calculation was incorrect. The Board granted reconsideration, adopting the judge's recommendation to increase the attorney's fee significantly. While the applicant's permanent disability rating remained at 86 percent, the judge acknowledged error in how attorney fees were factored, particularly concerning a life pension. The amended award reflects an increased attorney fee, with a portion to be commuted from the applicant's future life pension payments.

Workers' Compensation Appeals BoardPermanent DisabilityApportionmentAttorney FeesLife PensionCost of Living AdjustmentsSchedule for Rating Permanent DisabilitiesGAF ratingLabor Code section 4660(d)Industrial Injury
References
Case No. SDO 0321444 SDO 0321446
Regular
Jun 28, 2007

MARY BLOEMSMA vs. SAN DIEGO UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied reconsideration, upholding the use of the revised permanent disability rating schedule for applicant's pre-January 1, 2005 injury. The Board found that the treating physician's reports did not explicitly state the applicant was "permanent and stationary" with a ratable disability, a prerequisite for applying the older rating schedule under Labor Code § 4660(d). Therefore, the revised schedule was correctly applied, resulting in a 22% permanent disability rating.

Workers' Compensation Appeals BoardPermanent Disability Rating ScheduleRevised Rating SchedulePrior Rating ScheduleLabor Code Section 4660(d)Permanent and Stationary StatusTreating Physician's ReportComprehensive Medical-Legal ReportIndustrial InjuryHerniated Disc
References
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