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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. SFO 0500209
Regular
Jul 01, 2008

LAVENDER GALVAO vs. KINKO'S, ZURICH AMERICAN INSURANCE COMPANY

The Appeals Board granted reconsideration, amending the prior award to allow the employer a credit against Vocational Rehabilitation Maintenance Allowance (VRMA) for wages earned by the applicant from subsequent employment. While the applicant was found to be a Qualified Injured Worker (QIW) entitled to vocational rehabilitation services and VRMA, the Board distinguished this case from *Gamble v. Workers' Comp. Appeals Bd.*, finding that the applicant's subsequent employment replaced her injured position rather than being concurrent. Therefore, allowing the credit prevents the applicant from receiving a windfall and is consistent with the wage-loss basis of temporary disability indemnity.

Qualified Injured WorkerVocational Rehabilitation ServicesVocational Rehabilitation Maintenance AllowanceVRMATemporary Disability RateCredit for Wages EarnedWage Loss BasisRehabilitation UnitFindings Order AwardPetition for Reconsideration
References
Case No. AHM 0091706 AHM 0102322
Regular
Aug 22, 2007

MATTHEW MCCORD vs. COUNTY OF SANTA BARBARA, RISK MANAGEMENT

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and reversed the prior award of vocational rehabilitation maintenance allowance (VRMA) for applicant Matthew McCord. The Board found that McCord's liability for vocational rehabilitation services ended on October 17, 2003, the scheduled termination date of his rehabilitation plan. McCord's failure to complete the plan, despite receiving one, and his subsequent return to work as a court bailiff, rendered him ineligible for VRMA after that date.

Workers' Compensation Appeals BoardVocational RehabilitationCollateral EstoppelRes JudicataNotice of Potential Eligibility (NOPE)Vocational Rehabilitation Maintenance Allowance (VRMA)Qualified Injured Worker (QIW)Rehabilitation PlanMedical RestrictionsRetirement Board
References
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
Case No. AHM 0116452 AHM 0116457 AHM 0116470
Regular
Jul 21, 2008

BRUCE SERVISS vs. RALPH'S GROCERY, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration and amended the award to clarify that the applicant is not entitled to duplicative temporary disability and vocational rehabilitation maintenance allowance payments for the same period. The Board found the defendant breached its duty to provide timely vocational rehabilitation notices after the applicant's January 16, 2004 permanent and stationary date. Consequently, the defendant remains liable for vocational rehabilitation maintenance allowance from that date, adjusted for prior payments.

Workers' Compensation Appeals BoardReconsiderationVocational RehabilitationMaintenance AllowanceTemporary DisabilityIndustrial InjuryMeat CutterRalph's GrocerySedgwick Claims Management ServicesPermanent and Stationary
References
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
Case No. FRE 0191108
Regular
Oct 01, 2007

RICK L. REITZ vs. COUNTY OF FRESNO, CLAIMS MANAGEMENT, INC.

This case involves a worker's compensation claim where the applicant, a Corrections Officer, sustained industrial injuries to his low back and legs, leading to significant permanent disability. Despite completing a prior vocational rehabilitation plan, the applicant was approved for a second plan and awarded vocational rehabilitation maintenance allowance (VRMA) for a period when benefits were initially denied. The defendant appealed, arguing the second plan was unwarranted and the VRMA award inequitable, but the Board denied reconsideration, upholding the award based on existing case law, though expressing concern over delays.

Second vocational rehabilitation planVocational rehabilitation maintenance allowanceVRMACounty Service Disability RetirementRehabilitation Unit determinationProbation TechnicianMedical feasibilityIndustrial injuryLow backLegs
References
Case No. ADJ4604540 (VNO 0382502)
Regular
Apr 25, 2011

DOREEN JONES vs. DAVID & BARBARA SALKIN, ITT SPECIALTY RISK SERVICES

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award. The WCJ had awarded vocational rehabilitation services and maintenance allowance at a delayed rate, plus penalties and interest, based on a final Rehabilitation Unit determination. However, the Board found that the WCJ exceeded the scope of the issues presented at the hearing, denying the defendant due process. Therefore, the case was returned to the trial level for clarification and proper adjudication of all outstanding issues.

Workers' Compensation Appeals BoardVocational Rehabilitation UnitVocational Rehabilitation Maintenance AllowanceVRMAJoint Findings and AwardWorkers' Compensation JudgeWCJRehabilitation UnitDue ProcessJurisdiction
References
Case No. ADJ2255750 (LAO 0803099)
Regular
Sep 14, 2009

RAQUEL ZUNIGA vs. RADIO SHACK, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and awarded attorney's fees for services in obtaining vocational rehabilitation benefits. The Board found that the applicant's attorney was entitled to a fee calculated as 15% of the *new money* awarded in the Rehabilitation Unit's Determination and Order, not the total VRMA amount. Because the defendant failed to withhold any funds for attorney fees despite knowing the applicant was represented, the defendant was ordered to pay the awarded attorney's fee.

Workers' Compensation Appeals BoardRaquel ZunigaRadio ShackLiberty Mutual Insurance CompanyADJ2255750Attorney FeesVocational RehabilitationQualified Rehabilitation RepresentativeDetermination and OrderRehabilitation Unit
References
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