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Case Law Database

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

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 The Board rescinded the prior award and remanded the case for further proceedings and a new decision.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
Case No. MISSING
Regular Panel Decision

Local 363, International Brotherhood of Electrical Workers v. New York State Department of Labor

This case addresses a challenge to respondent's determination concerning prevailing wage schedules for telecommunication workers in New York. The respondent had merged voice and data telecommunications work into a single "telecommunication worker" category and adopted a multi-tiered step rate wage schedule, asserting progression was based solely on longevity. Petitioners, including Local 363 of the IBEW, argued that this schedule was flawed as progression through step rates was contingent on skill mastery and training, effectively making lower-tier workers trainees. The court, citing Labor Law § 220 (3), found evidence supporting the petitioners' claim that advancement required acquired skills, not just time. Consequently, the court reversed the lower court's judgment, annulled the respondent's determination, and granted the petition, concluding that adopting the full step rate schedule was arbitrary and capricious.

Wage disputeTelecommunication workersPrevailing wage lawLabor Law § 220Step rate wage scheduleApprenticeship programSkill-based progressionLongevity-based payJudicial reviewArticle 78 proceeding
References
5
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. LAO 0857719
Regular
Aug 08, 2008

ELISAVED HERNANDEZ vs. ASHWORTH ASSOCIATES, INC., REDWOOD FIRE & CASUALTY INSURANCE COMPANY

This case concerns an applicant seeking reconsideration of a permanent disability rating for a back injury. The applicant argued the revised rating schedule was wrongly applied, claiming the defendant should have provided notice and a prior medical report indicated permanent disability. The Board denied reconsideration, finding that the applicant failed to establish the exceptions required to use the older rating schedule, thus affirming the application of the revised schedule.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and Awardlaborerindustrial injurylow backpermanent disabilityrevised rating scheduleprior rating scheduleLabor Code Section 4061
References
2
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
2
Case No. ADJ448774
Regular
Nov 14, 2008

LUIS CERVANTES vs. IRVINE MARRIOTT, MARRIOTT CLAIMS SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a decision that awarded 16% permanent disability based on the 2005 rating schedule and applied a 20% apportionment to the applicant's shoulder injury. The applicant argued for the applicability of the 1997 rating schedule and challenged the substantiality of the defense Qualified Medical Evaluator's opinions on permanent disability and apportionment. The Board rescinded the original award and returned the case for further proceedings and a new decision by the WCJ, who will determine the applicable rating schedule and issue a simplified award.

Petition for ReconsiderationFindings and AwardPermanent DisabilityApportionmentRating ScheduleQualified Medical EvaluatorSubstantial EvidenceIndustrial InjuryWaiterBack Injury
References
0
Case No. MON 0318706
Regular
Jul 11, 2008

EDGAR BENITEZ vs. IRISH COMMUNICATIONS, AIG CLAIMS SERVICES, INC.

This case concerns the appropriate permanent disability rating schedule. The applicant argues the 1997 schedule applies due to his physician indicating permanent disability before January 1, 2005, an exception to the 2005 schedule's use. The Board granted reconsideration, agreeing that the physician's report finding the applicant eligible for vocational rehabilitation constituted an indication of permanent disability, thus triggering the 1997 schedule. The matter is returned to the trial level for rating under the 1997 schedule and subsequent issuance of a decision.

Permanent Disability Rating ScheduleLabor Code Section 4660(d)Primary Treating PhysicianVocational RehabilitationComprehensive Medical-Legal ReportPermanent and Stationary StatusGenlyte Group v. ZavalaZenith v. CuginiVera v. Workers' Comp. Appeals Bd.Agreed Medical Evaluator
References
3
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