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

Case No. ADJ3055486 (SJO 0260286)
Regular
Nov 17, 2008

MARK BRIDGES vs. CITY OF SUNNYVALE, permissibly Self-insured, GREGORY BRAGG and ASSOCIATES, TPA

The Appeals Board granted reconsideration for both the applicant and defendant due to procedural due process issues, specifically the WCJ's reliance on an unserved rater's letter to determine permanent disability. The Board rescinded the prior award and returned the case for further proceedings, including potential cross-examination of the rater and reconsideration of apportionment. The Board expressed no final opinion on the permanent disability rating or apportionment at this stage.

Workers' Compensation Appeals BoardPolice OfficerIndustrial InjuryPermanent Disability2005 Permanent Disability Rating ScheduleRange-of-Motion (ROM) methodDiagnostic-Related Estimate (DRE) methodAgreed Medical Evaluator (AME)ApportionmentDisability Evaluation Specialist (DES)
References
0
Case No. ADJ2951251 (LBO 0388783) ADJ405202 (LBO 0388784)
Regular
Aug 16, 2010

MARIANA CONTRERAS, MARIANA CONTRERAS MADRIGAL vs. 99 CENTS STORES, Permissibly Self-Insured, Administered By SOUTHERN CALIFORNIA RISK MANAGEMENT ASSOCIATES

The Workers' Compensation Appeals Board granted reconsideration because the defendant was denied due process. The defendant timely filed a petition to cross-examine the disability rater and submit rebuttal evidence electronically. However, the administrative law judge was unaware of this filing and issued a decision without allowing the defendant the opportunity to cross-examine the rater. Consequently, the Board rescinded the prior award and returned the case for further proceedings.

Workers' Compensation Appeals BoardPermissibly Self-InsuredSouthern California Risk Management AssociatesFindings and AwardPermanent DisabilityDisability Evaluation SpecialistReconsiderationElectronic Adjudication Management SystemDue ProcessAgreed Medical Examiner
References
5
Case No. VNO 514162, VNO 514164, VNO 514165, VNO 542022
Regular
Mar 17, 2008

MIA DOEVE vs. COUNTY OF LOS ANGELES

This case involves an applicant who sustained multiple admitted industrial injuries while employed as a deputy sheriff. The Workers' Compensation Appeals Board granted reconsideration because the WCJ's finding of 0% permanent disability was not adequately supported by the evidence, particularly the DEU rater's conclusions. The Board rescinded the prior award and returned the case for further proceedings, including cross-examination of the DEU rater and reconsideration of which permanent disability rating schedule applies.

Workers' Compensation Appeals BoardDeputy SheriffIndustrial InjuriesPermanent DisabilityAgreed Medical Evaluator1997 Schedule2005 ScheduleLabor Code Section 4061Wilkinson doctrineDisability Evaluation Unit
References
3
Case No. ADJ887948 (SRO 0103492) ADJ4222536 (SRO 0103500) ADJ3891200 (SRO 0103496)
Regular
Oct 04, 2010

RICHARD CARROLL vs. CONSOLIDATED FREIGHTWAYS, INC., Permissibly Self-Insured, Reinsured By RELIANCE, In Liquidation, Adjusted By CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Workers' Compensation Appeals Board granted reconsideration and rescinded prior awards due to a due process violation. The applicant was denied the opportunity to cross-examine the Disability Evaluation Unit rater when the WCJ simultaneously issued decisions and the recommended rating. This prevented applicant's right to object or seek rebuttal evidence before submission for decision. The case is returned to the trial level for further proceedings, including potential rater cross-examination, and a new decision.

Workers' Compensation Appeals BoardReconsiderationFindings Award and OrdersJoint Findings and AwardWCJDisability Evaluation UnitRating InstructionsDue ProcessCross-examinationRater
References
3
Case No. ADJ1880658
Regular
Feb 09, 2011

CLAIRE COATS vs. STATE COMPENSATION INSURANCE FUND

The applicant sought reconsideration of a WCJ's decision that denied her motion to strike a permanent disability rating and denied her request for cross-examination of the rater. The Appeals Board granted reconsideration, finding that the applicant was improperly denied her due process right to cross-examine the rater. The Board rescinded the WCJ's decision and returned the case to the trial level for a new WCJ to conduct further proceedings and issue a new decision, allowing consideration of the applicant's other contentions. This procedural error regarding the cross-examination right necessitated the remand.

Workers' Compensation Appeals BoardClaire CoatsState Compensation Insurance FundFindings and Award and OrderSenior Claims AdjusterIndustrial InjuryPermanent DisabilityMotion to StrikeCross-examinationRater
References
1
Case No. ADJ6674613
Regular
Mar 16, 2011

Donald Kusar vs. CITY OF LOS ANGELES

The Appeals Board granted reconsideration to address issues with the applicant's permanent disability rating after an admitted left elbow injury. The WCJ had found no permanent disability but vacated submission in companion cases involving other injuries for clarification from the Agreed Medical Examiner (AME). The applicant argued the WCJ erred by striking ratings and vacating submission in consolidated cases and that the DEU rater improperly substituted her own judgment for the AME's findings. The Board rescinded the Findings and Award, returning the matter to the trial level to rate all three consolidated cases together, and to reconsider the permanent disability rating in light of the *Blackledge* decision regarding the rater's role.

Agreed Medical ExaminerAppeals BoardConsolidated casesDEU raterDisability evaluationEn banc decisionFindings and AwardImpairment ratingMedical evidencePermanent disability
References
1
Case No. ADJ892742 (SJO 0240973) MF ADJ6718849
Regular
Jul 21, 2000

SALLY MACKIN vs. SANTA CLARA COUNTY FAIRGROUNDS

Here's a summary of the case for a lawyer in four sentences: The applicant sought reconsideration of a WCJ's decision finding industrial injuries to her shoulders, neck, and wrists, resulting in 43% and 9% permanent disability respectively, and awarded future medical treatment but denied claims for hypertension and psychological injury. Applicant contended the WCJ erred in permanent disability ratings, the application of the PDRS, and the DEU rater's methodology. The Board denied reconsideration, adopting the WCJ's report which found the 1997 PDRS was not applicable to the cumulative injury and that the DEU rater acted within her expertise. A dissenting commissioner argued the 1997 PDRS should apply to the cumulative injury and that the record needed further development regarding permanent disability.

Workers' Compensation Appeals BoardSally MackinSanta Clara County FairgroundsADJ892742ADJ6718849Findings Awards and Orderspermanent disabilitycumulative injuryhypertension injuryfuture medical treatment
References
12
Case No. ADJ2056731
Regular
Nov 30, 2009

FRED SMITH vs. RALPHS GROCERY COMPANY, SEDGWICK CLAIMS MANAGEMENT

The WCAB grants reconsideration, rescinding the prior decision and returning the matter for further proceedings due to the applicant's counsel's failure to use the correct form to request cross-examination of the rater.

WCABPetition for ReconsiderationFindings Award and OrderPermanent DisabilityApportionmentTemporary Total DisabilityVocational Rehabilitation Maintenance AllowanceAttorney FeesLabor Code Section 5814.5Declaration of Readiness to Proceed
References
1
Case No. ADJ2266211 (GOL 0101534)
Regular
Dec 28, 2009

Miles Wallace vs. BELLAGIO & BACK DOOR BOARD SHOP, CNA CLAIMPLUS for VALLEY FORGE (PORTLAND)

Reconsideration granted; case returned to trial level to re-rate applicant's permanent disability and address other issues due to inadequate explanation of the basis of the original decision and lack of cross-examination of the DEU rater.

Permanent Disability RatingOccupational Group NumberFactors of DisabilityWork RestrictionsDEU RaterCross-examinationMedical ReportingWorkers' Compensation Appeals BoardFindings and AwardReconsideration
References
1
Case No. ADJ1735018
Significant
Jun 03, 2010

CYNTHIA BLACKLEDGE vs. BANK OF AMERICA, ACE AMERICAN INSURANCE COMPANY

This en banc decision clarifies the distinct roles of the evaluating physician, the workers’ compensation administrative law judge (WCJ), and the disability rater in determining whole person impairment (WPI) under the AMA Guides, and remands the specific case for reassessment of the permanent disability.

AMA GuidesWhole Person ImpairmentPhysician's RoleWCJ's RoleRater's RoleFormal RatingPermanent DisabilitySubstantial EvidenceDRE Lumbar Category IIPatellofemoral Pain Syndrome
References
33
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