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Case Law Database

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

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
0
Case No. ADJ2651355 (LAO 0795117)
Regular
Jul 27, 2009

LAI L. LUI vs. S & W MANUFACTURING, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, For LEGION INSURANCE COMPANY, In Liquidation

The Appeals Board granted reconsideration of the WCJ's $69\%$ permanent disability rating and the defendant's challenge to attorney's fees. After obtaining a recommended rating from the DEU based on agreed medical evaluator reports, the Board affirmed the WCJ's decision but increased the permanent disability rating to $72\%$. The Board also determined that $15\%$ of awarded temporary and permanent disability indemnity is a reasonable attorney's fee, with final amounts and distribution to be determined at the trial level. Jurisdiction was returned to the trial level for further proceedings and awards consistent with this decision.

Workers' Compensation Appeals BoardPermanent Disability RatingAgreed Medical EvaluatorDisability Evaluation UnitMultiple Disabilities TableLife PensionAttorney's FeesTemporary Disability IndemnityLitigation ExpensesSelf-Procured Medical Expenses
References
0
Case No. MISSING
Regular Panel Decision

Linger v. Anchor Motor Freight, Inc.

Claimant sustained permanent partial disabilities from two 1977 accidents and one 1980 accident, leading to separate awards from different employers and their respective insurance carriers. Initially, the claimant received concurrent benefits exceeding the statutory maximum rate. Upon discovering these concurrent payments, a joint hearing was held. An Administrative Law Judge apportioned the award, which was subsequently affirmed by the Workers' Compensation Board, stating that concurrent awards exceeding the statutory maximum for a permanent partial disability were impermissible. The claimant appealed this decision, arguing for a per-accident application of the statutory maximum. However, the appellate court affirmed the Board's decision, asserting that the Workers' Compensation Law establishes an overall maximum rate for permanent partial disability regardless of the number of accidents or employments.

Permanent Partial DisabilityConcurrent AwardsStatutory MaximumApportionmentMultiple AccidentsWage LossJudicial PrecedentAdministrative Law JudgeWorkers' Compensation BoardInsurance Carriers
References
2
Case No. ADJ7936482
Regular
Apr 20, 2020

EXTELA MONTIEL vs. MICRO SOLUTIONS, ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board granted reconsideration to further study factual and legal issues concerning an applicant's permanent disability award. Key disputes involve the correct permanent disability indemnity rate, with the defendant arguing for a lower weekly rate based on the injury date, and the validity of the $60\%$ permanent disability finding due to conflicting medical opinions. The Board found deficiencies in the medical evidence regarding psychiatric permanent disability and issues with the apportionment of that disability. Consequently, the Board deferred resolution of temporary disability, the EDD lien, permanent disability, apportionment, and the permanent disability rate pending further record development.

Petition for ReconsiderationFindings and AwardSupervising assemblerAdmitted industrial injuryNon-admitted injuryCervical spinePsychePermanent disabilityLabor Code section 4658(d)GAF
References
10
Case No. ADJ203727 (SRO 0140512)
Regular
Jan 29, 2013

CONRADO HERNANDEZ vs. JOHNNY FRANKLIN MUFFLER, BERKSHIRE HATHAWAY/REDWOOD FIRE AND CASUALTY COMPANY

In this workers' compensation case, the applicant sustained an industrial injury resulting in multiple impairments. Initially awarded 60% permanent disability, the applicant sought reconsideration, arguing the rating omitted the thoracic spine and advocating for total disability based on vocational expert testimony. The WCJ amended the rating to 63% after including the thoracic spine, finding no substantial evidence for total disability. The Appeals Board adopted the WCJ's recommendation, affirming the amended 63% permanent disability award and adjusting the attorney's fee.

Petition for ReconsiderationDecision After Reconsiderationindustrial injurycognitive impairmentpsycheconsciousness disorderpermanent disabilityapportionmentvocational expertamended rating
References
0
Case No. ADJ9298442
Regular
May 16, 2016

JOSEPH TREVINO vs. UNITED PARCEL SERVICE, LIBERTY MUTUAL INSURANCE COMPANY

This case involves an appeal by United Parcel Service (UPS) regarding a workers' compensation award to Joseph Trevino for a back injury. UPS challenged the temporary disability period, the weekly rate, liability for an EDD lien, and the percentage of permanent disability apportionment. The Appeals Board granted reconsideration to amend the temporary disability award period and rate as recommended by the WCJ. The Board otherwise affirmed the original decision, including the allowance of the EDD lien and the $31 \%$ permanent disability finding without section 4664 apportionment.

WCABPetition for ReconsiderationFindings and AwardTemporary DisabilityPermanent DisabilityLabor Code Section 4664ApportionmentEDD LienAverage Weekly EarningsCredit for Payments
References
3
Case No. ADJ4481004
Regular
Mar 04, 2010

Ararat Sarkisian vs. VAHAN ENGIBARIAN DBA VAHAN'S ROYAL TOURS, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The applicant sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision regarding his permanent disability rating following an industrial injury. The applicant argued his $98\%$ permanent disability rating was too low, specifically contesting the WCJ's characterization of his headaches. The WCAB granted reconsideration and amended the award to reflect a $99\%$ permanent disability rating. The Board affirmed the WCJ's reasoning, declining to award total permanent disability despite the high rating and rejecting a supplemental medical report.

WCABUninsured Employers Benefits Trust Fundpermanent disability ratingcervical spinelumbar spineribsright wristright ankleheadright tibia
References
0
Case No. ADJ2073428 (VNO 0465400) ADJ1610465 (VNO 0540972) ADJ3247765 (VNO 00384869)
Regular
Apr 04, 2011

JAY ZAVERI vs. STATE COMPENSATION INSURANCE FUND; Legally Uninsured

The applicant sought reconsideration of a workers' compensation award, arguing for a 100% permanent disability rating and challenging the permanent disability start date used for attorney fee commutation. The Appeals Board denied the petition, finding insufficient evidence to establish total permanent disability, as the applicant was currently employed and medical opinions did not definitively support such a rating. The Board also ruled that the applicant waived arguments regarding the rating of specific injuries by failing to properly object, and that even if considered, separate ratings for back, knee, and plantar fasciitis conditions would not result in a higher award due to fibromyalgia being the primary cause and rating higher. Finally, the Board clarified that the July 2, 2000 date was only relevant to the attorney fee commutation calculation and not to the determination of permanent disability indemnity payments.

WCABPetition for ReconsiderationJoint Findings and AwardWorkers' Compensation Judge (WCJ)Industrial InjuryBack InjuryHip InjuryBilateral Knee InjuryBilateral Foot InjuryBilateral Plantar Fasciitis
References
7
Case No. MISSING
Regular Panel Decision

Martin v. E.I. DuPont De Nemours & Co.

Plaintiff Barbara E. Martin filed an action under the Employees’ Retirement Income and Security Act (ERISA), alleging wrongful denial of total and permanent disability benefits by her former employer, E.I. DuPont de Nemours and Company. The case was referred to Magistrate Judge Leslie G. Foschio, who recommended granting DuPont's motion for summary judgment. Plaintiff filed objections to the Report and Recommendation. District Judge Arcara, upon a de novo review, adopted the proposed findings. The court determined that DuPont's denial of benefits was not arbitrary and capricious, as Martin failed to provide sufficient medical evidence to demonstrate a total and permanent disability as defined by the Plan, particularly regarding her condition immediately prior to termination. Consequently, DuPont's motion for summary judgment was granted, and the case was dismissed.

ERISADisability BenefitsSummary JudgmentArbitrary and Capricious StandardDe Novo ReviewTotal and Permanent DisabilityMedical EvidenceRotator Cuff InjuryImpingement SyndromeChronic Tendinitis
References
17
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
2
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