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Case Law Database

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

Case No. MISSING
Regular Panel Decision
Dec 21, 1995

In re Jordan Rehabilitation Service, Inc.

Jordan Rehabilitation Service, Inc., providing medical and vocational rehabilitative services, appealed a decision by the Unemployment Insurance Appeal Board. The Board assessed additional unemployment insurance contributions, finding that specialists hired by Jordan were employees, not independent contractors, between 1989 and 1991. The court reviewed whether there was substantial evidence to support the Board's conclusion of an employer-employee relationship. Key factors included Jordan's control over recruitment, screening, compensation, billing, and contractual restrictions on specialists. Ultimately, the court affirmed the Board's decision, determining that Jordan exercised sufficient overall control to establish an employer-employee relationship and thus was liable for the contributions.

Unemployment InsuranceEmployer-Employee RelationshipIndependent ContractorRehabilitation ServicesLabor LawSubstantial EvidenceControl TestJudicial ReviewAdministrative Law JudgeDepartment of Labor
References
8
Case No. ADJ2860436
Regular
Dec 02, 2011

HAROLD DAVID WATSON vs. VANCE INTERNATIONAL, NATIONAL FIRE CO. OF PITTSBURGH PENNSYLVANIA

The applicant seeks reconsideration of a prior decision finding the employer's appeal of a vocational rehabilitation benefits determination was timely filed. The Appeals Board upheld its prior finding, determining that the employer filed its appeal on December 11, 2008, which was before the January 1, 2009 repeal of the vocational rehabilitation statute. Because the appeal was timely and the right to benefits was not vested prior to the repeal, the applicant is not entitled to vocational rehabilitation benefits.

Rehabilitation UnitVocational rehabilitation benefitsLabor Code section 139.5Appeal PetitionDeclaration of Readiness to ProceedPersonal serviceService by mailDocument Cover SheetWCAB District OfficeProof of service
References
50
Case No. ADJ721289 (POM 0278079) ADJ820025 (LBO 0312141) ADJ1988208 (POM 0278080) ADJ6759922
Regular
Sep 06, 2012

GEORGE VELASQUEZ vs. RALPHS, Permissibly Self-Insured

The Court of Appeal ruled that Ralphs' initial appeal of vocational rehabilitation benefits was timely despite lacking a Declaration of Readiness. However, the applicant's vocational rehabilitation award was not final before Labor Code section 139.5 was repealed on January 1, 2009. Consequently, the applicant's right to these benefits expired, and the Appeals Board lost jurisdiction. The Appeals Board rescinded the prior award and ordered that the applicant take nothing for vocational rehabilitation benefits.

RemittiturRehabilitation UnitDeclaration of Readiness to Proceed (DOR)vocational rehabilitation benefitsLabor Code section 139.5finality of awardjurisdictionappeal timelinessannulmentreconsideration
References
3
Case No. ADJ2065496 (LAO 0777249)
Regular
Mar 06, 2013

MIGUEL RODRIGUEZ vs. RALPHS GROCERY COMPANY/FOOD 4 LESS, Permissibly Self-Insured, Administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a defendant's effective appeal of a vocational rehabilitation award, despite the absence of a Declaration of Readiness to Proceed. The Court of Appeal directed the Board to vacate the original vocational rehabilitation allowance and annul a prior Board decision that had invalidated the defendant's appeal. Consequently, the Board rescinded its prior finding and ordered that the applicant take nothing for vocational rehabilitation benefits, as the award was not final before the repeal of the relevant Labor Code section.

Workers' Compensation Appeals BoardRemittiturVocational RehabilitationDeclaration of Readiness to ProceedRehabilitation UnitLabor Code Section 139.5Findings of FactRescindedVacatedAward
References
5
Case No. ADJ8772254
Regular
Jul 20, 2017

Lorenzo Hernandez vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION, NORTH KERN STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Lorenzo Hernandez's petition for reconsideration, upholding the original award of 24% permanent disability for a right shoulder injury. The applicant argued that a vocational expert's report should have rebutted the scheduled disability rating, but the Board found this report insufficient. Relying on *Ogilvie* and *Dahl*, the Board determined that an applicant's amenability to vocational rehabilitation precludes using vocational expert testimony to challenge a scheduled rating based on lost earning capacity. Therefore, the vocational expert's opinion was deemed not substantial evidence to overcome the QME's scheduled rating.

Workers' Compensation Appeals BoardPermanent DisabilityVocational ExpertQualified Medical EvaluatorScheduled RatingReconsiderationLabor Code §4660.1AMA Guides 5th EditionAmenability to Vocational RehabilitationDiminished Future Earning Capacity
References
3
Case No. MISSING
Regular Panel Decision

Claim of Drummond v. Desmond

This appeal consolidates three cases where the disability insurance carrier, First Rehabilitation Life Insurance Company of America, sought reimbursement for disability benefits paid to claimants Headley Drummond, Stephanie Scire, and Sandra Lewis from their workers’ compensation waiver agreements. The Workers' Compensation Board denied the carrier's request for a lien against these settlements, arguing that the proceeds were not 'awards of workers’ compensation benefits' and that the carrier lacked standing to object. The Board subsequently approved the waiver agreements. The Appellate Division dismissed the carrier’s appeals from the Board’s letters, ruling that the letters were not appealable Board decisions. Furthermore, the Court held that approved waiver agreements are explicitly not subject to administrative or appellate review under Workers’ Compensation Law § 32 (c).

Workers' Compensation BenefitsDisability InsuranceReimbursement ClaimsWaiver Agreement ValidityLien EnforcementAppellate Court JurisdictionAdministrative AppealsStanding in Legal DisputesStatutory Interpretation (Workers' Compensation Law)Board Decisions
References
2
Case No. ADJ2723383
Regular
Oct 13, 2010

DIDIER ROSA vs. XCELSIS CORPORATION, STATE COMPENSATION INSURANCE FUND

This case concerns an employee seeking vocational rehabilitation services and retroactive benefits after a neck injury. The insurer, SCIF, failed to appeal a Rehabilitation Unit determination that authorized these services and benefits at the "delay rate." Although SCIF argued jurisdiction and statutory repeal issues, the Board affirmed the Unit's determination, finding SCIF waived its defenses by not appealing. However, the Board limited the award of vocational rehabilitation services, finding the right to them was inchoate and expired with legislative changes.

Rehabilitation Unitvocational rehabilitation servicesretroactive benefitsdelay rateghost statutesvested rightsinchoaterepealed statutesLabor Code section 139.5final judgment
References
4
Case No. ADJ9025732
Regular
Apr 07, 2023

ALBERT MATA vs. STATE OF CALIFORNIA - DEPARTMENT OF CORRECTIONS & REHABILITATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding of 100% permanent total disability for the applicant, Albert Mata. The defendant argued that the applicant's vocational counselor's reports and medical reports did not constitute substantial evidence for total disability. However, the Board affirmed the Administrative Law Judge's decision, finding the vocational expert's opinions were substantial evidence, not based on speculation, and correctly applied California's 2005 Permanent Disability Rating Schedule for psychiatric impairments. Therefore, the Board concluded the applicant was precluded from vocational rehabilitation and participating in the labor force.

Permanent total disabilityPsychiatric injuryVocational Rehabilitation CounselorAmerican Medical Association GuidesGlobal Assessment of FunctioningPermanent Disability Rating ScheduleSubstantial evidencePetition for ReconsiderationAdministrative Law JudgeAgreed Medical Examiner
References
7
Case No. ADJ600916 (SDO 0348725)
Regular
Apr 06, 2020

DAVID GWIN vs. TOYOTA LIFT, INC., ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board rescinded the prior award and remanded the case for further development of the record. The applicant appealed a $66\%$ permanent disability rating, arguing his diminished future earning capacity was greater due to an inability to benefit from vocational rehabilitation. The Board found that the original record was insufficient to determine if the applicant's medication side effects impacted his ability to work in the open labor market or engage in vocational rehabilitation. Further medical and vocational evaluations are required to address these issues before a final determination can be made on the disability rating.

Permanent Disability RatingDiminished Future Earning CapacityVocational RehabilitationReconsiderationMedical EvaluatorsOpen Labor MarketCrush InjuryOsteomyelitisChronic PainMajor Depressive Disorder
References
2
Case No. ADJ2862114
Regular
Oct 30, 2008

PATRICIA TRUJILLO vs. EARTHLINK, INC., CHUBB INSURANCE SERVICES

The Workers' Compensation Appeals Board affirmed a prior ruling that the defendant, Earthlink, Inc., owes vocational rehabilitation benefits to the applicant, Patricia Trujillo. The court found that the defendant failed to provide legally required notices when the applicant deferred vocational rehabilitation services. This failure meant the deferral was invalid, making the defendant liable for vocational rehabilitation maintenance allowance (VRMA) from the date of the notice breach.

Vocational rehabilitationAD Rule 9813(a)(4)VRMAdeferral of servicesnotice requirementsclaims administratorinterrupted servicesreinstatement of servicesstatute of limitationsemployer's duty
References
6
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