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

Case No. SRO 0132302 SRO 0137260 SRO 0137261
Regular
Apr 25, 2008

ROMAN BELTRAN vs. PIEDMONT LUMBER & MILL COMPANY, STATE COMPENSATION INSURANCE FUND

This case concerns the application of Labor Code section 4658(d) to an injury occurring on May 10, 2004, after Senate Bill 899's enactment. The Appeals Board affirmed the WCJ's finding that because the employer did not offer a return-to-work plan for at least 12 months, the permanent disability indemnity payable from 60 days after the P&S date must be increased by 15%. This ruling clarifies that SB 899's provisions apply prospectively from its enactment date to injuries not specifically excluded by the legislation.

Labor Code section 4658(d)SB 899permanent disability awardpermanent and stationary datereturn to workjob offerweekly conversion schedulemedical-legal reporttreating physician's reporttemporary disability indemnity
References
11
Case No. MISSING
Regular Panel Decision

Emspak v. Conroy

The defendants moved for a further bill of particulars regarding item 30 and requested the entire bill be verified by a union officer. The plaintiff's attorney acknowledged the omission for item 30 was an oversight and agreed to provide it. He argued his self-verification was proper under subdivision 3 of rule 99 of the Rules of Civil Practice, citing the plaintiff's absence from the county, and claimed defendants waived objection by not returning the bill within 24 hours. The court clarified that Rules 10 and 11 do not apply to verification. While an attorney can verify a bill of particulars under rule 117, the court ruled that merely stating the party is out of county is insufficient; the attorney must also detail the basis of their knowledge, especially given a prior order requiring an oath for inability to furnish particulars. The motion for a further bill was granted.

Bill of particularsVerificationAttorney verificationRules of Civil PracticeWaiverMotionCourt procedurePleadingSufficiency of verification
References
3
Case No. LAO 0795696
Regular
Jul 09, 2007

DULCE MONTES vs. NATIONWIDE PAGING, INC., PREFERRED EMPLOYERS INSURANCE COMPANY

The applicant sought reconsideration of a decision mandating transfer into the defendant's Medical Provider Network (MPN) for treatment. The Workers' Compensation Appeals Board denied reconsideration, affirming that MPNs, as established by SB 899, allow for transfer of care regardless of prior treatment relationships or awards. The Board found no evidence applicant met exceptions to MPN transfer rules and rejected arguments based on pre-SB 899 law or MPN rule unconstitutionality.

MPNMedical Provider NetworkPrimary Treating PhysicianReconsiderationFindings of FactLabor Code Section 4616Appeals Board Rule 9767.9Transfer of CareSB 899Babbitt v. Ow Jing
References
7
Case No. MON 0261251 MON 0315082
Regular
Mar 17, 2008

RICHARD HICKS vs. BRAND & HILL PRODUCTIONS, LEGION INSURANCE, CALIFORNIA INSURANCE GURANTEE ASSOCIATION

The Workers' Compensation Appeals Board granted reconsideration and rescinded the previous award because the Administrative Law Judge's decision on permanent disability was based on a medical report predating SB 899, which failed to address apportionment as required by current law. The court found inconsistencies in the apportionment of disability, particularly regarding pre-existing conditions and subsequent cumulative trauma. The case was returned to the trial level for further development of the record on apportionment to comply with post-SB 899 legal standards.

CIGALegion InsuranceSB 899apportionmentDr. Charles SadlerDr. Thomas SheryLabor Code section 4663cumulative traumapermanent disabilitymedical treatment
References
7
Case No. ADJ4146224 (SBR 0296668) ADJ1272169 (SBR 0296667)
Regular
Oct 28, 2013

KATHLEEN ZAMANJAHROMI vs. KAISER FOUNDATION HOSPITAL

This case involves Kathleen Zamanjahromi seeking increased permanent disability benefits for an industrial injury. The Workers' Compensation Appeals Board (WCAB) denied Kaiser Foundation Hospital's petition for reconsideration. The WCAB affirmed the finding of good cause to reopen a prior stipulated award for new and further disability, resulting in a 96% permanent disability rating. The defendant's argument that SB 899's apportionment provisions applied to the original award was rejected. The WCAB clarified that SB 899's apportionment applies to new and further disability but cannot retroactively alter prior findings.

Petition for ReconsiderationNew and Further DisabilityLabor Code Section 5410Senate Bill 899ApportionmentStipulated AwardReopeningFinal OrderWorkers' Compensation Appeals BoardAgreed Medical Examiner
References
7
Case No. ADJ1438639 (GRO 0024593) ADJ3262777 (GRO 0025366)
Regular
Sep 20, 2011

Dennis Timmons vs. CALIFORNIA MENS COLONY, STATE COMP. INS. FUND, SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case concerns applicant Dennis Timmons' petition for reconsideration of a denial of Subsequent Injuries Benefits Trust Fund (SIBTF) benefits. The Appeals Board reversed a prior award, finding applicant failed to prove a pre-existing permanent partial disability from a 1991 cervical fusion surgery prior to his 2000 industrial injury. Applicant argued the fusion itself constituted a previous impairment and that SB 899's apportionment changes should apply, but the Board affirmed its decision. The Board reiterated that contemporaneous medical evidence is required for SIBTF eligibility, and that SB 899 did not alter SIBTF's established requirements.

Subsequent Injuries Benefits Trust FundSIBTFpermanent disabilitypre-existing disabilitycervical fusionApril 132000 industrial injurySB 899apportionment to causationLabor Code section 4751
References
2
Case No. FRE 231905
Regular
Aug 06, 2007

DONALD VAN NESS vs. CLOVIS UNIFIED SCHOOL DISTRICT, PSI, Administered By TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board rescinded a prior award, returning the case to the administrative law judge for recalculation of permanent disability indemnity and attorney fees. This decision was based on the California Supreme Court's ruling in *Brodie v. Workers' Comp. Appeals Bd.*, which clarified that the "subtracting percentages from percentages" method remains the proper approach for permanent disability apportionment post-Senate Bill 899. The Board directed the judge to apply *Brodie* and conduct further proceedings as needed.

Workers' Compensation Appeals BoardDonald Van NessClovis Unified School DistrictTristar Risk ManagementOpinion and Decision After ReconsiderationLabor Code section 4664apportionmentpermanent disabilityFindings and AwardErickson v. Kaiser Permanente
References
4
Case No. ADJ1457992 (AHM 0084718)
Regular
Dec 26, 2014

DARLENE HELLER vs. COWELL BAKER'S STRIPPING SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, SEDGWICK CMS, FREMONT INSURANCE COMPANY

This case concerns a dispute over the correct procedure for obtaining medical reevaluations for a worker's injury with a date prior to January 1, 2005. The Appeals Board denied the applicant's petition for reconsideration, reversing an earlier decision that had directed the parties to use the panel QME process. The Board clarified that for pre-2005 injuries, the pre-Senate Bill 899 AME/QME procedures apply, not the current section 4062.2 QME process. One Commissioner dissented, arguing the prior award should be reinstated.

Workers' Compensation Appeals BoardPetition for ReconsiderationOpinion and Order DenyingFindings and AwardLabor Code section 4062.2panel qualified medical examinationQMEdisputed body partsadmitted liabilitydate of injury
References
3
Case No. ADJ6974763
Regular
Nov 04, 2011

TradeY PRUITT vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

This case involves an inmate firefighter claiming industrial injury to her knees from a fall while on duty. The original award found temporary and permanent disability, but the defendant sought reconsideration. The appeals board granted reconsideration, rescinded the award, and returned the matter for further proceedings. This was due to the medical expert's report on apportionment not adhering to the current legal standards for causation as established by Senate Bill 899. The board emphasized that new apportionment requires physicians to determine the percentage of disability caused by the industrial injury versus other factors, which the prior report failed to do.

Labor Code Section 4658(d)Inmate FirefighterOccupational Code 492Occupational Group 460Permanent Disability IndemnityReconsiderationApportionmentCausationSenate Bill 899AMA Guides
References
16
Case No. MISSING
Regular Panel Decision

Hojnowski v. Buffalo Bills, Inc.

David Hojnowski, a former equipment manager for the Buffalo Bills, sued his former employer alleging age discrimination under the Age Discrimination in Employment Act, New York State Human Rights Law, and violations of the Employee Retirement Income Security Act. The Buffalo Bills moved to dismiss the claims and compel arbitration, citing an arbitration clause in Hojnowski's employment contract. Hojnowski contended that the arbitration agreement was unenforceable due to the absence of arbitration rules and unconscionability. The court determined that the arbitration rules were sufficiently incorporated into the agreement and that the contract was not unconscionable. Consequently, the court granted the Bills' motion, compelling Hojnowski to arbitration and dismissing his complaint.

Arbitration AgreementEmployment LawAge DiscriminationERISANew York State Human Rights LawMotion to DismissContract EnforceabilityUnconscionability DefenseFederal Arbitration ActNFL Commissioner
References
25
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