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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ3870460 (ANA 410080)
Regular
Nov 15, 2010

LEONARD ROBINSON vs. NEW YORK KNICKERBOCKERS, MURPHY & BEANE

The Board granted reconsideration to address the proper workers' compensation permanent disability rating schedule. The defendant argued the WCJ erred in applying the 1997 Schedule, contending the 2005 Schedule or, alternatively, the 1978 Schedule should apply. The WCJ's reliance on Labor Code § 4061 exceptions was found to be flawed, as the statute was not in effect during the applicant's period of temporary disability. The case was returned to the trial level for a determination on the correct schedule, considering the effective dates of relevant statutes and the existence of any pre-2005 medical reports indicating permanent disability.

Workers' Compensation Appeals BoardLeonard RobinsonNew York KnickerbockersPermissibly Self-InsuredMurphy & BeaneReconsiderationAmended Findings and AwardWCJCumulative InjuryIndustrial Injury
References
Case No. ADJ2904305 (GOL 0095697) ADJ1827151 (GOL 0095698)
Regular
Aug 02, 2010

GUADALUPE CARRILLO vs. SAN ANTONIO VILLAGE HOA, STATE FARM INSURANCE COMPANIES

The Workers' Compensation Appeals Board denied a lien claimant's petition for reconsideration regarding a disallowed lien balance of $9,349.46. The claimant, a doctor, failed to obtain required written authorization for work hardening services billed under CPT Code 97545. Despite a claim of verbal authorization and a general request for multiple modalities, the Board found the lack of specific written authorization for the disputed services to be determinative. Therefore, the administrative law judge's disallowance of the lien balance was upheld.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationCompromise and ReleaseWork hardeningWork conditioningCPT Code 97545Prior authorizationVerbal authorizationWritten authorization
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. RDG 120102
Regular
Jul 30, 2007

Dominic Watkins vs. Outback Steakhouse, State Compensation Insurance Fund

This case concerns the application of the correct permanent disability rating schedule for an industrial injury occurring between 2003 and 2004. The applicant argued that the pre-2005 schedule should apply due to treating physician reports from November 2004 indicating permanent disability. The Workers' Compensation Appeals Board reversed the initial decision, agreeing that the doctor's reports, which noted a "chronic problem" and imposed significant work restrictions, sufficiently "indicated the existence of permanent disability" to trigger the older 1997 Schedule.

Rating Schedule2005 Schedule1997 SchedulePermanent DisabilityTreating PhysicianMedical-Legal ReportLabor Code Section 4660(d)Prospective ApplicationCumulative InjuryIndustrial Injury
References
Case No. SAC 308714, SAC 341852
Regular
Oct 01, 2007

WAYNE LEWIS vs. BEUTLER HEATING AND AIR, ARCH INSURANCE, ST. JOHN'S RETIREMENT VILLAGE, STATE COMPENSATION INSURANCE FUND

This case concerns the applicability of either the 1997 or 2005 Schedule for Rating Permanent Disabilities. The applicant argued a December 2004 treating physician's report indicated permanent disability, thus requiring application of the older 1997 Schedule. The Board denied reconsideration, holding that the physician's report did not state the applicant was permanent and stationary, a necessary condition under Labor Code section 4660(d) and *Vera v. Workers' Comp. Appeals Bd.* for the 1997 Schedule to apply. Therefore, the 2005 Schedule was correctly applied.

Permanent disability schedule1997 schedule2005 schedulepermanent and stationaryP\&SLabor Code section 4660(d)treating physician's reportratable disabilityVera v. Workers' Comp. Appeals Bd.August 18
References
Case No. FRE 0222374
Regular
Sep 20, 2007

JAMES ZERNIAL vs. PEPSI BOTTLING COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to address a dispute over which permanent disability rating schedule applied to the applicant's 2003 injury. The defendant argued the WCJ erred by using the old 1997 Schedule instead of the new 2005 Schedule. The Board rescinded the prior award and returned the case for a new decision after the WCJ reevaluates the schedule's applicability in light of a recent Court of Appeal ruling.

Permanent Disability Rating Schedule1997 Schedule2005 ScheduleLabor Code § 4660(d)Vera v. Workers' Comp. Appeals Bd.Industrial InjuryReconsiderationFindings and AwardRescindedReturned to Trial Level
References
Case No. ADJ3291959 (VNO 0487238)
Regular
Feb 27, 2009

JOHNNY HERRERA vs. PEPSI BOTTLING GROUP, OLD REPUBLIC INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, finding the 1997 Permanent Disability Rating Schedule applied. This decision reversed the trial judge's ruling that the 2005 Schedule was appropriate. The Board determined that the employer's obligation to provide notice under Labor Code section 4061 prior to January 1, 2005, triggered the application of the earlier schedule. Therefore, the case was returned for further proceedings and a new decision based on the 1997 Schedule.

Permanent disability rating scheduleLabor Code section 4061 notice1997 Schedule2005 Scheduletemporary disability indemnitycessation of benefitsnotice exceptionPendergrass v. Duggan PlumbingPTPQME
References
Case No. ADJ160544 (LBO 0359144), ADJ4209690 (LBO 0372848), ADJ4666278 (LBO 0389220)
Regular
Mar 09, 2009

THELMA MORALES vs. CEDARS SINAI HEALTH SYSTEM

This case concerns whether the 1997 or 2005 Permanent Disability Rating Schedule applies. The defendant argued the WCJ erred by using the 1997 Schedule. The Board found that Dr. Lane's 2004 report did not indicate permanent disability as required to trigger the older schedule. Additionally, the final temporary disability payment occurred after January 1, 2005, meaning the Labor Code § 4061 notice exception did not apply. Consequently, the Board granted reconsideration, rescinded the previous findings, and remanded the cases for rating under the 2005 Schedule.

Permanent Disability Rating Schedule1997 Schedule2005 ScheduleLabor Code § 4660(d)Medical-Legal ReportTreating PhysicianPermanent and Stationary StatusCubital Tunnel SyndromeTemporary Disability IndemnityLabor Code § 4061 Notice
References
Case No. ADJ3870460 (ANA 0410080)
Regular
Apr 11, 2011

LEONARD ROBINSON vs. NEW YORK KNICKERBOCKERS, MURPHY & BEANE

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award because the Administrative Law Judge (WCJ) failed to follow previous instructions. The core issue is determining which permanent disability rating schedule applies to an injury sustained between 1982 and 1985. The WCJ incorrectly applied the 2005 Schedule and failed to allow parties a hearing on the applicability of the 1978 Schedule, which the applicant argues is appropriate. The Board remanded the case for further proceedings, including development of the record and a hearing, to address the proper schedule and explain the reasoning for any resulting disability rating.

Workers' Compensation Appeals BoardLeonard RobinsonNew York KnickerbockersReconsiderationFindings and AwardPermanent Disability Rating ScheduleLabor Code Section 4660(d)Labor Code Section 4061Labor Code Section 4067.51978 Schedule
References
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