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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. 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. 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. ADJ360205 (LBO 0384980)
Regular
Aug 05, 2010

Gurdev Malhotra vs. STATE OF CALIFORNIA, DEPARTMENT OF DEVELOPMENTAL SERVICES FAIRVIEW; Legally Uninsured, CONTRACT SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's advisory opinion concerning permanent disability rating for grip loss. Defendant argued the WCJ erred by allowing rating for grip loss when range of motion was present, and that the QME's reports did not support grip loss rating. The Board rescinded the WCJ's findings, remanding the case for further proceedings to ensure the WCJ follows the established process for issuing rating instructions based on substantial medical evidence, as clarified in *Blackledge v. Bank of America*. The ultimate determination of permanent disability requires a proper QME opinion and subsequent rating instructions from the WCJ.

Workers' Compensation Appeals BoardGurdev MalhotraState of California Department of Developmental ServicesLegally UninsuredContract ServicesPermanent Disability RatingGrip LossAMA GuidesQualified Medical EvaluatorQME
References
Case No. GOL 96757
Regular
Jun 10, 2008

SA YANG LO vs. CUSTOM SENSORS & TECHNOLOGIES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a prior award, upholding the application of the 2005 Permanent Disability Rating Schedule. The Board found that exceptions allowing for the 1997 Schedule did not apply, as the applicant's temporary disability indemnity extended beyond January 1, 2005, and no qualifying pre-2005 reports indicated permanent disability. Furthermore, the Board found the applicant's vocational expert's opinion regarding diminished future earning capacity unpersuasive, thus affirming the initial 9% permanent disability rating.

Workers' Compensation Appeals BoardSA Yang LoCustom Sensors & TechnologiesInc.State Compensation Insurance FundGOL 96757Opinion and Order Denying ReconsiderationFindings and AwardWorkers' Compensation Administrative Law JudgeWCJ
References
Case No. ANA 0402832
Regular
Jul 02, 2008

JOANN RAEKER vs. TSUCHIYAMA KAINO SUN-CARTER, ST. PAUL TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and affirmed a prior award, except for the permanent disability rating. The Board found that due process required further proceedings at the trial level regarding the permanent disability rating because the defendant was not properly served with the formal rating instructions. The case is remanded to the WCJ for a new decision on permanent disability.

Tsusohiya Kaino Sun-CarterSt. Paul Travelers Insurance CompanyFindings and AwardIndustrial InjuryTemporary Total DisabilityPermanent Disability RatingPenaltyAttorney FeeReconsiderationWCJ
References
Case No. ADJ1679104 (LBO 0387820)
Regular
Aug 26, 2010

GUADALUPE FREGOSO vs. INTEGRAL DESIGN CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

This case concerns a defendant's petition for reconsideration of a permanent disability rating for an applicant injured on August 1, 2006. The defendant argued the rating was erroneous because the administrative law judge (WCJ) instructed the disability evaluator to rate the treating physician's report without referencing the AMA Guides. The Appeals Board denied the petition, finding that the WCJ's instructions were based on the physician's opinion, which complied with the AMA Guides, and the evaluator's rating followed those instructions. The Board also corrected a clerical error regarding the attorney fee calculation.

WORKERS' COMPENSATION APPEALS BOARDReconsiderationFindings and Awardtemporary disabilitypermanent disabilityapportionmentnon-industrial causesindustrial injurynecklow back
References
Case No. ADJ2070973 (SAL 0092454)
Regular
Jun 12, 2015

CHARLENE MEEKS-CLOSE vs. RIVER RANCH FRESH FOODS, SEDGWICK CMS

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration due to untimely service on the applicant's counsel of record. The defendant failed to properly serve the petition, which is a procedural defect that deprives the applicant of due process rights. While one commissioner concurred with the dismissal on procedural grounds, she dissented regarding the merits, arguing the petition should have been granted to develop the record on the permanent disability rating. The majority opinion noted that even if properly served, the petition would have been denied on its merits.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderPermanent DisabilityLife PensionHousekeeping ExpensesMileage ExpensesUnreasonable DelayPenaltyAgreed Medical Evaluator
References
Case No. ADJ6662275
Regular
Jun 13, 2011

DARRIN BEAN vs. CITY OF CHULA VISTA

This case involves an applicant seeking workers' compensation for a skin cancer injury. The applicant contests the testimony of an independent medical expert, Dr. Brigham, who offered an opinion on his impairment rating that differed from the agreed medical evaluator's (AME). The Appeals Board granted the applicant's Petition for Removal, ruling that Dr. Brigham's testimony was inadmissible as he was neither an AME nor a treating physician and his testimony was not in rebuttal to formal rating instructions. Consequently, Dr. Brigham's testimony was stricken, the prior order was rescinded, and the case was returned to the trial level for further proceedings based solely on admissible medical evidence.

Petition for RemovalAgreed Medical EvaluatorAMA GuidesWhole Person ImpairmentPermanent Disability RatingClass 1 ImpairmentClass 2 ImpairmentClass 3 ImpairmentMedical Evidence AdmissibilityRebuttal Testimony
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
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