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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. FRE 0065599
Regular
Mar 04, 2008

JOHN ALLEN vs. KENT MAGNELL CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied John Allen's petition for reconsideration, affirming the WCJ's decision to terminate his vocational rehabilitation services due to a consistent failure to cooperate. The Board found that Allen's persistent insistence on a specific, unachievable vocational goal, coupled with his refusal to undergo necessary medical evaluations and provide requested records, led to the impasse. Consequently, his request for retroactive benefits and vocational rehabilitation was denied.

Workers' Compensation Appeals BoardVocational RehabilitationPetition for ReconsiderationFindings and OrderRehabilitation UnitSuitable Gainful EmploymentVocational Rehabilitation Maintenance AllowanceAverage Weekly EarningsTemporary Disability IndemnityCompromise and Release
References
1
Case No. ADJ7399938 ADJ7068967
Regular
Jun 23, 2015

OLENA GARCIA vs. RESIDENCE INN, NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PENNSYLVANIA

The Appeals Board granted reconsideration, rescinded the prior award, and returned the case for further development of the record. The initial award found permanent total disability based on a vocational expert's opinion, but the Board found this opinion lacked substantial medical evidence. Specifically, the medical expert's supplemental report was not based on a current evaluation, and the vocational expert's conclusions, relying on that report, were therefore also flawed. The matter is remanded to allow for a current medical evaluation and reassessment of vocational rehabilitation and diminished earning capacity.

Workers' Compensation Appeals BoardPermanent Total DisabilityJoint Findings and AwardVocational ExpertSubstantial EvidenceScheduled RatingFunctional Capacity EvaluationAgreed Medical ExaminerApportionmentModified Work
References
0
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. 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. ADJ1909369 (LAO 0760509)
Regular
Mar 24, 2010

SANTOS MORALES vs. ASSOCIATED ROOFERS, INC., CENTRE INSURANCE COMPANY, RISK ENTERPRISE 600 BREA

The Workers' Compensation Appeals Board granted reconsideration of a prior award concerning applicant Santos Morales' industrial injuries. The Board found the applicant's petition timely and that the Workers' Compensation Judge (WCJ) miscalculated the life pension. The case is returned to the trial level for further proceedings and a new decision, as the WCJ must revisit permanent disability, apportionment, and the costs of the vocational rehabilitation expert in light of controlling legal precedent. The WCJ should re-evaluate the vocational rehabilitation expert's costs based on the Appeals Board's en banc decisions in *Costa I* and *II*.

Workers' Compensation Appeals BoardIndustrial InjuryPsycheCervical SpineShoulder InjuryPermanent Partial DisabilityDisability IndemnityLife PensionVocational Rehabilitation ExpertReconsideration
References
5
Case No. 13-08-00351-CV
Regular Panel Decision
Aug 31, 2009

Mitch Burkhart and Christine Burkhart v. Sedgwick Claim Management Services, Inc. and Concentra Integrated Services, and rgv/nueces Rehabilitation D/B/A Innovative Physical and Occupational Therapy

Mitch Burkhart sustained a foot and ankle injury while training for his employer, Verizon Communications. Verizon's workers' compensation claims were administered by Sedgwick Claim Management Services, Inc., who, along with Concentra Integrated Services, arranged a Functional Capacity Evaluation (FCE) for Burkhart with RGV/Nueces Rehabilitation d/b/a Innovative Physical and Occupational Therapy. The Burkharts alleged that the FCE aggravated Mitch's injury, causing permanent damage. They sued Sedgwick, Concentra, and Innovative, claiming negligence, civil conspiracy, assault, fraud, and breach of the duty of good faith and fair dealing. The trial court dismissed the case against Innovative for an inadequate expert report and granted summary judgment to Sedgwick and Concentra, citing the exclusive remedy provision of the Texas Workers' Compensation Act. The appellate court affirmed the trial court's judgment, concluding that Mitch's aggravation injury was an 'extension injury' covered by the exclusive remedy provision of the TWCA.

Workers' CompensationFunctional Capacity EvaluationExclusive RemedyAggravation InjurySummary JudgmentMedical Expert ReportHealth Care LiabilityCivil ConspiracyBreach of Duty of Good Faith and Fair DealingTexas Court of Appeals
References
23
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. 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. ADJ8838103
Regular
Dec 11, 2020

STEVE BOSROCK vs. BEN R. WADSWORTH, INC., DBA VALLEY GLASS COMPANY, SECURITY NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award. The Board found the medical evaluator, Dr. Rosenberg, should have the opportunity to review subsequent vocational evidence. This vocational evidence impacted the determination of the applicant's ability to return to the open labor market and benefit from vocational rehabilitation. The case is returned to the trial level for further medical record development and a new final decision.

Permanent DisabilityApportionmentVocational ExpertMedical ApportionmentQualified Medical Evaluator (QME)AMA GuidesWhole Person Impairment (WPI)Functional Capacity EvaluationVocational RehabilitationCompensable Consequence Injuries
References
3
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