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

Case No. ADJ1177048
Significant
Sep 03, 2009

Wanda Ogilvie, Applicant vs. City and County of San Francisco, Permissibly Self-Insured

This en banc decision clarifies that a permanent disability rating established by the 2005 Schedule is rebuttable, the burden of rebuttal rests with the party disputing the rating, and a rating may be rebutted by challenging one of its components, such as the Diminished Future Earning Capacity (DFEC) adjustment factor.

Permanent DisabilityDiminished Future Earning CapacityDFECSchedulePrima Facie EvidenceRebuttableBurden of ProofRAND DataAMA GuidesOccupational Group
References
54
Case No. GRO 0031810
En Banc
Dec 07, 2006

JOEY M. COSTA vs. HARDY DIAGNOSTIC, STATE COMPENSATION INSURANCE FUND

The Appeals Board, in an en banc decision, holds that the applicant has not met the burden of proving the new Permanent Disability Rating Schedule (PDRS) invalid and affirms that rebuttal evidence to a rating is permissible under the new schedule.

PDRSSB 899Labor Code section 4660en bancrebuttal evidencecosts of rebuttal evidenceRAND Reportfuture earnings capacityempirical dataAMA Guides
References
18
Case No. ADJ425881 (MON 0349358) ADJ1664800 (MON 0330278)
Regular
Feb 23, 2009

Jerry Salmeron vs. COCA COLA ENTERPRISES

This case concerns an applicant's admitted industrial injuries to his low back, psyche, and hernias, and his subsequent permanent disability ratings. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address disputes regarding the proper application of the 2005 Schedule for Rating Permanent Disabilities, particularly concerning diminished future earning capacity (DFEC). The WCAB rescinded the prior awards and remanded the cases to the trial level to allow the judge and parties to apply recent en banc decisions clarifying how the DFEC and AMA Guides portions of the schedule can be rebutted. The decision emphasizes that rebuttal must be consistent with Labor Code section 4660 and specific en banc rulings on evidence and methodology.

WCABSalmeronCoca Cola EnterprisesDecision After ReconsiderationFindings and Awardpermanent disabilityrebutted2005 Schedulediminished future earning capacityDFEC
References
3
Case No. ADJ100201 (GRO 0034542) ADJ2946755 (GRO 0034543)
Regular
Mar 08, 2010

Bradley Lorenz vs. STOWASSER PONTIAC, INTERCARE ROSEVILLE

This case concerns an applicant's claim for workers' compensation benefits due to back injuries. The applicant sought reconsideration of a prior award, arguing the permanent disability rating was too low, as he believed he had successfully rebutted the rating based on the AMA Guides. The Appeals Board affirmed the WCJ's decision, finding that the applicant failed to provide substantial medical evidence to rebut the scheduled rating. The Board clarified that the burden of proof for rebuttal rests with the applicant and that a conclusory statement of "loss of function" is insufficient.

Workers' Compensation Appeals BoardPermanent DisabilityAMA GuidesReconsiderationJoint Findings and AwardIndustrial InjuryRebuttalWhole Person ImpairmentMedical OpinionAgreed Medical Evaluator
References
9
Case No. ADJ2769249 (SAL 0116181)
Regular
Mar 18, 2009

MIGUEL GONZALEZ vs. SCHRIVER PLUMBING, SCIF INSURED SAN JOSE

This case involves an applicant whose nine percent permanent disability rating for a right knee injury is disputed. The applicant argues this rating is disproportionate and unfair, as it prevents him from returning to his former plumbing work and is contradicted by a vocational expert's assessment of a 36-53% loss of future earning capacity. The Appeals Board granted reconsideration, rescinded the original decision, and returned the case for further proceedings. This is to allow the WCJ to consider the applicant's permanent disability in light of two en banc decisions, *Almaraz* and *Ogilvie*, which clarified the rebuttability of the 2005 Permanent Disability Rating Schedule.

WCABReconsiderationPermanent DisabilityRating ScheduleAlmarazOgilvieDFECAMA GuidesVocational ExpertEarning Capacity
References
3
Case No. ADJ3385753 (SFO 0495153)
Regular
Mar 17, 2009

LORETTA L. ENNON vs. WALGREENS, permissibly self-insured

This case involves an admitted industrial injury to the applicant's back and hip. The primary dispute concerns the applicant's permanent disability rating, which the trial judge set at 41% based on a vocational expert's opinion on diminished future earning capacity (DFEC). The defendant appealed, arguing the rating was excessive and the expert's opinion improperly applied. The Appeals Board rescinded the original award, remanding the case to the trial level to apply recent en banc decisions regarding the rebuttal of the DFEC and AMA Guides portions of the permanent disability rating schedule. This remand allows for further proceedings to ensure correct application of these established legal standards.

Workers Compensation Appeals BoardReconsiderationPermanent DisabilityDiminished Future Earning CapacityDFEC2005 ScheduleAMA GuidesVocational ExpertJeffrey MalmuthAgreed Medical Evaluator
References
4
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. ADJ102175 (MON 0317302)
Regular
Mar 22, 2011

TERRY LYNN ROSS vs. BERNARD & SONS, INC., STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the Appeals Board affirmed a finding of 100% permanent disability for Terry Lynn Ross, a truck driver injured in 2004. The defendant contested the total disability finding, arguing the wrong rating schedule was applied and medical evidence didn't support the rating. The Board found the 2005 rating schedule was applicable and that medical opinions from multiple physicians, particularly Dr. Salick's, established the applicant's inability to compete in the open labor market, thus supporting the total disability award. The Board also reaffirmed that permanent total disability can be established under Labor Code Section 4662 based on factual inability to work, even if the scheduled rating is less than 100%.

Permanent disability rating scheduleWhole Person ImpairmentAgreed Medical ExaminerQualified Medical EvaluationPain Related ImpairmentFuture earning capacityOpen labor marketVocational rehabilitationLabor Code Section 4662AMA Guides
References
7
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