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

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. STK 178713
Regular
Sep 17, 2007

FRED VAN DYKEN vs. FRAGOMEN, DEL RAY, BERNSEN & LOWERY, ATLANTIC MUTUAL FIRE INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and amended a prior decision. While affirming the apportionment of permanent disability and the credit for overpaid indemnity, the Board found the employer unreasonably delayed vocational rehabilitation benefits. The applicant is now entitled to retroactive vocational rehabilitation maintenance allowance at the temporary disability rate for the period of that delay.

Vocational RehabilitationApportionmentQualified Medical ExaminerPermanent DisabilityTemporary DisabilityEMG/NCV StudiesRehabilitation UnitDelay of BenefitsThird Party CreditVocational Rehabilitation Maintenance Allowance
References
8
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. NO. 03-05-00031-CV
Regular Panel Decision
Dec 08, 2005

Texas Department of Assistive and Rehabilitative Services, Successor in Interest to the Former Texas Rehabilitation Commission v. Richard Howard

Richard Howard, a unit manager at the Texas Department of Assistive and Rehabilitative Services, reported alleged illegal practices to the State Auditor’s Office (SAO). Howard claimed his superiors retaliated against him by rating him below standard on performance appraisals and denying promotions and merit pay increases. He sued under the Whistleblower Act, and a jury awarded him damages, costs, and attorney's fees. The Department appealed, challenging the sufficiency of evidence regarding Howard's good faith report, appropriate authority, causation, and damages. The Court of Appeals affirmed the trial court's judgment, finding sufficient evidence to support the jury's verdict that Howard made a good faith report to an appropriate authority and that his report caused the adverse actions.

Whistleblower ActRetaliationPublic EmployeeState Auditor’s OfficePerformance AppraisalMerit PayPromotion DenialDamagesCausationGood Faith Report
References
20
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. 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. OAK 0284985
Regular
Oct 10, 2007

RICHARD DENNY vs. PINKERTON, ACE USA/ESIS

The Workers' Compensation Appeals Board denied reconsideration of a decision that found Richard Denny's employer, Pinkerton, liable for Vocational Rehabilitation Maintenance Allowance (VRMA) at the medical temporary disability rate outside the vocational rehabilitation cap. This liability arose from Pinkerton's violation of Labor Code §4642 and related regulations by failing to timely refer the applicant for vocational rehabilitation services after determining him to be a Qualified Injured Worker. The Board affirmed that this VRMA award is not considered a penalty and rejected Pinkerton's claim for restitution.

Workers' Compensation Appeals BoardPinkertonACE USA/ESISPetition for ReconsiderationVRMAMedical TD RateVocational Rehabilitation CapLabor Code §4642Cal.CodeRegs.tit. 8
References
4
Case No. ADJ1463911 (AHM 0090590)
Regular
Oct 06, 2008

SUZETTE LADAY vs. COUNTY OF LA/DEPT. OF CHILDREN AND FAMILY SERVICES, Permissibly Self-Insured, administered by ACCLAMATION INSURANCE MANAGEMENT SERVICES

The Workers' Compensation Appeals Board dismissed the defendant's Petition for Reconsideration because it was filed late, two days after the statutory deadline. The Board noted clerical errors in the original award regarding vocational rehabilitation benefit dates and rates, which it corrected despite the dismissal of the reconsideration petition. The corrected award specifies vocational rehabilitation benefits from November 20, 2002, to November 2, 2007, with specific weekly rates for different periods within that timeframe.

LadayCounty of LA/Dept. of Children and Family ServicesAcclamation Insurance Management ServicesPetition for ReconsiderationUntimely FilingClerical ErrorVocational Rehabilitation BenefitsLabor Code SectionsCode of Civil ProcedureBoard Rule 10390
References
6
Case No. ADJ1908213
Regular
Mar 11, 2009

ROBERT WARD vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, PSI AND ADJUSTED BY SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the WCJ's decision that applicant was entitled to retroactive vocational rehabilitation maintenance allowance (VRMA) but not at the delay rate. The Board found the delay in VRMA reinstatement was caused by the applicant's pursuit of a settlement rather than the employer's actions. The issue of a Labor Code section 5814 penalty was deferred by the WCJ and therefore not addressed in this order.

Vocational Rehabilitation Maintenance AllowanceVRMA delay rateLabor Code section 5814 penaltyretroactive VRMAPetition for Reconsiderationindustrial injurypermanent disabilityvocational rehabilitation benefitssettlement negotiationsRehabilitation Unit
References
0
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