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

Case No. ADJ8210063
Significant

Grace Nunes, Applicant vs. State of California, DEPT. OF MOTOR VEHICLES, Legally Uninsured; STATE COMPENSATION INSURANCE FUND, Adjusting Agency, Defendants

The Appeals Board denied the applicant's Petition for Reconsideration, affirming its prior en banc decision that vocational evidence cannot substitute for valid medical apportionment from a physician, as mandated by Labor Code section 4663.

Labor Code Section 4663Vocational ApportionmentMedical ApportionmentPermanent DisabilityQualified Medical EvaluatorSubstantial EvidencePetition for ReconsiderationEn Banc DecisionWorkers' Compensation Appeals BoardApportionment Analysis
References
Case No. ADJ7894308; ADJ7661229; ADJ9465603
Regular
Aug 20, 2025

Assadour Assadourian vs. Ari G. Minassian School, State Compensation Insurance Fund, Church Mutual Insurance Company

The Workers' Compensation Appeals Board reviewed the Findings of Fact, Award and Order concerning Assadour Assadourian's industrial injury claims against Ari G. Minassian School and its insurers. The Board affirmed that contract non-renewal constituted an actual event of employment for psychiatric injury claims. However, it rejected the "pass-through" apportionment from cardiac conditions to psychiatric and sleep-related disabilities, deeming the medical opinions legally unsustainable. Consequently, the Board amended the permanent disability award to 78 percent, reserving jurisdiction to the WCJ for attorney's fees adjustments.

Workers' Compensation Appeals BoardReconsiderationFindings of FactAward and OrderIndustrial InjuryCardiovascular SystemPsycheSleep DisorderUrologic SystemSexual Dysfunction
References
Case No. ADJ8210063; ADJ8621818
En Banc
Aug 29, 2023

GRACE NUNES vs. STATE OF CALIFORNIA, DEPT. OF MOTOR VEHICLES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, affirming its prior en banc decision that permanent disability apportionment must be based on a physician's medical evaluation as mandated by Labor Code section 4663, and that vocational evidence cannot substitute an impermissible 'vocational apportionment' in place of a valid medical apportionment.

VOCATIONAL APPORTIONMENTMEDICAL APPORTIONMENTPERMANENT DISABILITYQUALIFIED MEDICAL EVALUATORLABOR CODE SECTION 4663SUBSTANTIAL EVIDENCEAPPEALS BOARD EN BANCFINDINGS OF FACT AND AWARDFINAL ORDERRECONSIDERATION DENIED
References
Case No. ADJ8210063; ADJ8621818
En Banc
Jun 22, 2023

GRACE NUNES vs. STATE OF CALIFORNIA, DEPT. OF MOTOR VEHICLES, STATE COMPENSATION INSURANCE FUND

The Appeals Board rescinded a 100% disability award because the vocational and medical records were incomplete regarding apportionment. The case was returned to the trial level to properly evaluate whether non-industrial factors contributed to the applicant's inability to be retrained for work.

En BancReconsiderationApportionmentVocational ApportionmentMedical ApportionmentPermanent DisabilityVocational ExpertQualified Medical EvaluatorAMA GuidesLabor Code Section 4663
References
Case No. ADJ3207910 (SJO 0257814)
Regular
Jul 20, 2010

BARTON LEWIS vs. COUNTY OF SANTA CLARA, SUBSEQUENT INJURIES BENEFITS TRUST FUND (SIBTF)

This case concerns the Subsequent Injuries Benefits Trust Fund (SIBF) liability for applicant Barton Lewis, who suffered multiple industrial injuries. The SIBF contested the applicant's eligibility, arguing he did not meet the statutory thresholds for benefits. The Board affirmed the Administrative Law Judge's decision, finding the applicant met the 35% permanent disability threshold under Labor Code section 4751 based on the February 5, 2003 injury alone, without apportionment. This decision allows the applicant to receive benefits from the SIBF.

Workers' Compensation Appeals BoardSubsequent Injuries Benefits Trust FundSIBTFdistrict attorney investigatorindustrial injurylow backbrainheartright armcumulative injury
References
Case No. GOL 0089200
Regular
Mar 21, 2008

YOLANDA MARQUEZ vs. COMP USA, AIG, AMERICAN INT'L CLAIMS SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a decision that apportioned 75% of the applicant's disability to non-industrial factors based on the Agreed Medical Examiner's (AME) opinion. The Board found that the AME's apportionment might have been based on the cause of the injury rather than the cause of the disability, which is an incorrect legal standard. Therefore, the Board deferred the issues of permanent disability, apportionment, and attorney's fees and returned the case to the trial level for further development of the record on apportionment.

Workers Compensation Appeals BoardYolanda MarquezCOMP USAAIGAmerican International Claims ServicesFindings and Awardindustrial injurypermanent disabilityapportionmentAgreed Medical Examiner (AME)
References
Case No. ADJ2287904
Regular
Apr 02, 2012

MERRELL LEE CALVILLO vs. SUBSEQUENT INJURIES FUND, COUNTY OF LOS ANGELES PARKS

The Workers' Compensation Appeals Board denied reconsideration of the decision that apportioned applicant's permanent disability. The WCJ properly relied on medical opinions, including Dr. Wood's, to find apportionment based on pre-existing conditions. The applicant's argument that total permanent disability should be awarded without apportionment when unable to compete in the labor market was rejected. The Board found that apportionment is still applicable even when an applicant is deemed totally disabled from the open labor market.

Workers' Compensation Appeals BoardSubsequent Injuries FundApportionmentTotally Permanently DisabledLabor Code Section 4662Causation ApportionmentLabor Code Section 4663Dr. WoodPetition for ReconsiderationMedical Opinion
References
Case No. ADJ9485504
Regular
Apr 22, 2025

MARY ANNE AIKENS vs. CHILD ABUSE PREVENTION, STATE COMPENSATION INSURANCE FUND

Applicant Mary Anne Aikens sought reconsideration of a Findings and Award (F&A) from April 15, 2021, regarding injuries sustained in 2009. The Workers' Compensation Appeals Board rescinded the F&A, finding errors in the WCJ's decision regarding apportionment of permanent disability for both orthopedic and psychological injuries. The Board concluded that the medical reports from AME Dr. Joel Renbaum and AME Dr. James Cole lacked sufficient independent justification for their apportionment findings. Consequently, the case was returned to the trial level for further development of the medical record concerning apportionment.

ApportionmentPermanent DisabilityCervical SpineRight ShoulderRight HipBilateral KneesPsycheAgreed Medical Evaluator (AME)Dr. RenbaumDr. Cole
References
Case No. ADJ8203843
Regular
Aug 15, 2016

GARY KUBECK vs. CALETTI JUNGSTEN CONSTRUCTION, AMERICAN ZURICH INSURANCE COMPANY

In this workers' compensation case, the defendant sought reconsideration of the original finding that the applicant sustained $71\%$ permanent disability, arguing the judge improperly rejected the Agreed Medical Evaluator's (AME) apportionment opinion on psychiatric injury. The Board granted reconsideration, amending the award to include $35\%$ non-industrial apportionment to the applicant's psychiatric disability. This resulted in a revised permanent disability award of $68\%$. The Board found the AME's opinion on apportionment constituted substantial medical evidence and was not unpersuasive.

ApportionmentAgreed Medical Evaluator (AME)Psychiatric InjuryPermanent DisabilityFindings and AwardPetition for ReconsiderationIndustrial InjuryNon-industrial ApportionmentCausationSubstantial Medical Evidence
References
Case No. ADJ1861602 (NOR 0180537) ADJ509009 (NOR 0190111)
Regular
Aug 23, 2010

MARIO VAZQUEZ vs. SOUTHERN CALIFORNIA GAS COMPANY, ALEXIS RISK MANAGEMENT SERVICES, INC.

The defendant sought reconsideration of a Workers' Compensation Appeals Board (WCAB) award of 100% permanent disability and lifetime benefits to the applicant for psychological and physical injuries. The defendant argued for apportionment to non-industrial factors, citing a medical evaluator's opinion that the applicant had pre-existing personality disorders. However, the WCAB denied reconsideration, finding the defendant failed to meet its burden of proof on apportionment, as the medical expert could not medically quantify the non-industrial contribution to the disability. Furthermore, the WCAB upheld the finding that the applicant's two industrial injuries were intertwined, preventing separate apportionment between them.

Petition for ReconsiderationJoint Findings of Fact and AwardIndustrial InjuryPsycheHeadachesSeizuresPermanent DisabilityApportionmentNon-Industrial FactorsSubstantial Evidence
References
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