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

Case No. ADJ510402 (OAK 0303526)
Regular
May 22, 2009

Sharon Levitt vs. COUNTY OF ALAMEDA, SEDGWICK 2065 OAKLAND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior award, and returned the case for a new permanent disability rating. The Board determined that Dr. Warbritton's pre-2005 "check the box" letter did not constitute substantial medical evidence indicating the existence of permanent disability. Therefore, the 2005 Permanent Disability Rating Schedule must be applied to the applicant's injury, rendering other issues raised by the defendant moot.

Workers Compensation Appeals BoardPermanent Disability Rating ScheduleApportionmentOccupational GroupAgreed Medical ExaminerLight Duty WorkMedical-Legal ReportTreating PhysicianLabor Code Section 4660(d)Comprehensive Medical-Legal Report
References
Case No. SJO 0262198
Regular
Aug 17, 2007

ANTHONY LAYTON vs. CITY OF SANTA CLARA

The Workers' Compensation Appeals Board granted reconsideration and reversed its prior decision, holding that the 1997 permanent disability rating schedule, not the 2005 schedule, applies to this case. This decision was based on two exceptions to the 2005 schedule's applicability: the treating physician indicated permanent disability before January 1, 2005, and the employer provided proper notice of rights before the 2005 schedule became effective. Consequently, the applicant's permanent disability is rated at 37% under the 1997 schedule, totaling $38,950.00.

Workers' Compensation Appeals BoardReconsideration2005 Schedule1997 ScheduleLabor Code Section 4660(d)ExceptionsTreating Physician ReportSection 4061 NoticePermanent Disability RatingPolice Officer
References
Case No. ADJ12427109
Regular
Apr 04, 2023

RICHARD ADAMS vs. MR. PLASTICS, INC., EMPLOYERS ASSURANCE COMPANY

This case involves a defendant's petition for reconsideration of a workers' compensation award finding an industrial injury to the applicant's right hand. The applicant claimed a fracture occurred while operating a machine, though medical records initially focused on a non-industrial injury from a ladder. Crucially, a Qualified Medical Examiner (QME) opined the fracture was consistent with the applicant's described work mechanism. The Board denied reconsideration, adopting the WCJ's reasoning which prioritized the QME's opinion and medical records documenting the fracture prior to termination, over the defendant's arguments regarding proof of injury and temporary disability.

Petition for ReconsiderationIndustrial InjuryTemporary DisabilityMachine OperatorRight Hand InjuryScaphoid FractureAOE/COEContemporaneous Medical RecordsQualified Medical Examiner (QME)Dr. Roland
References
Case No. ADJ14015513
Regular
Feb 15, 2023

BRADEN NANEZ vs. 3 STONEDEGGS, INC., TECHNOLOGY INSURANCE COMPANY, AMTRUST NORTH AMERICA

The Appeals Board rescinded the initial Findings and Order, finding the applicant's petition for reconsideration was timely due to defective service. The Board applied the commercial traveler rule, determining the applicant's injury arose out of and in the course of employment. The claim is not barred by the going and coming rule or intoxication, and the applicant sustained a fractured right femur. Issues of traumatic brain injury and bruised lung are deferred for further proceedings.

Workers' Compensation Appeals BoardReconsiderationOpinion and DecisionFindings and OrderApplicantEmployerAdjustedAdjudication NumberRedding District OfficeInjury Arising Out of and In the Course of Employment (AOE/COE)
References
Case No. ADJ6814665
Regular
Oct 29, 2010

JULIO GARCIA vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's (WCJ) findings. The WCJ determined the applicant sustained admitted industrial injury to his left knee and non-admitted industrial injury to his right second toe, resulting in 25% permanent disability. The WCJ found the right second toe injury industrial based on hospital records indicating a fracture, despite the Agreed Medical Evaluator's (AME) opinion that it was not industrial. The defendant also challenged the attorney's fee, but the Board found they lacked standing.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeFindings Award and OrdersIndustrial InjuryPermanent DisabilityAgreed Medical EvaluatorOrthopedistCausationRancho Los Amigos Hospital Records
References
Case No. SRO 0126020
Regular
Nov 05, 2007

Nicholas Wilson vs. PRESTIGE ACURA, ST. PAUL TRAVELERS INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to award an additional attorney's fee of $12,631.00, to be commuted from the applicant's life pension, finding the WCJ's initial award of $16,739.40 was unreasonable. The Board found that *O'Keefe v. Workers' Comp. Appeals Bd.* does not prohibit fees from a life pension and that the applicant's attorney's significant efforts, responsibility, and results warranted a higher fee. The Board also clarified that proper notification to the applicant regarding the fee increase was given.

Workers Compensation Appeals BoardPetition for ReconsiderationAttorney's FeeLife PensionPermanent DisabilityGuardian ad LitemCognitive LossSkull FractureSeizure SyndromeVertigo
References
Case No. SDO 0340101
Regular
Sep 10, 2007

RITA CORDOVA vs. SAN DIEGO UNIFIED PORT DISTRICT, AMERICAN HOME ASSURANCE COMPANY

This case concerns the application of the 2005 permanent disability rating schedule (PDRS) over the older 1997 PDRS for an applicant injured in 2004. The applicant argued that exceptions in Labor Code section 4660(d) should trigger the 1997 schedule, primarily based on a physician's report predating the schedule change. The Workers' Compensation Appeals Board affirmed the original award, finding that recent appellate decisions clarified that the older schedule only applies if a report indicating permanent disability exists prior to January 1, 2005, and the employer was not required to provide notice under Labor Code section 4061 before that date. Therefore, the 2005 PDRS was correctly applied.

Workers' Compensation Appeals BoardReconsiderationPermanent Disability Rating ScheduleLabor Code section 4660(d)Labor Code section 4061Medical-legal reportTreating physician's reportPermanent and stationary statusTemporary disability indemnityIndustrial injury
References
Case No. ADJ1930275 (LAO 0856552)
Regular
Aug 19, 2019

Juan Ledesma vs. Nelson Martinez, Amador Estrada, Sara Montenegro

This case concerns Applicant Juan Ledesma's workers' compensation claim for injuries sustained on December 4, 2004, while working as a drywall installer. The initial decision denied benefits, finding intoxication barred recovery under Labor Code section 3600(a)(4). The Appeals Board granted reconsideration, rescinding the prior order and finding that Applicant did sustain injury to multiple body parts. The Board determined the defendants failed to prove Applicant's intoxication was a substantial or proximate cause of his injury, therefore section 3600(a)(4) did not bar recovery, deferring other issues.

Labor Code section 3600(a)(4)Petition for ReconsiderationFindings and Orderintoxication defenseproximate causesubstantial factoraffirmative defensepre-ponderance of the evidencesubstantial evidenceAOE/COE
References
Case No. STK 0196520
Regular
Jul 17, 2008

GARY L. WIKA vs. ROEBERS, INC., STATE COMPENSATION INSURANCE FUND

The applicant sustained an industrial injury to his left heel in March 2004. The defendant sought reconsideration of the WCJ's award of 74% permanent disability, arguing the wrong rating schedule was applied. The Board granted reconsideration to extend the defendant's time for calculating a life pension commutation. The Board affirmed the original award, finding the prior rating schedule applicable due to evidence of permanent disability from a treating physician before January 1, 2005.

Workers' Compensation Appeals BoardPermanent Disability Rating ScheduleSB 899AMA GuidesLabor Code 4660(d)Treating Physician ReportPermanent and Stationary StatusComminuted Calcaneous FractureBoehler AngleTalocalcaneal Joint Fracture
References
Case No. ANA 0388502
Regular
Aug 15, 2007

MICHAEL BELTRAN vs. REESE CONCRETE, CLARENDON NAT'L. INSURANCE COMPANY, AMERICAN ALL RISK LOSS ADMINISTRATORS

The Appeals Board granted reconsideration, overturning the WCJ's decision to apply the old permanent disability rating schedule. The Board found that the presence of multiple fractures alone did not constitute a report indicating permanent disability under Labor Code section 4660(d), thus the new 2005 Schedule must apply. The case is returned to the trial level for a new rating and decision regarding permanent disability and attorney's fees.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent Disability1997 Schedule2005 ScheduleQualified Medical EvaluatorTreating PhysicianLabor Code section 4660(d)Pendergrass II
References
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