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Case Law Database

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. ADJ1471935 (LAO 0872244)
Regular
Mar 26, 2014

JESUS RIOS vs. BRYAN JONES dba THE K GROUP, TOKIO MARINE, UNISURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to determine the admissibility of evidence obtained after the Mandatory Settlement Conference (MSC). The applicant sought to introduce supplemental medical reports from previously seen physicians and reports from new medical and vocational experts, arguing his condition worsened and the existing record was inadequate. The WCAB held that supplemental reports from the applicant's original physicians were admissible under Labor Code section 5502(d)(3) due to a changed condition, but reports from newly disclosed physicians and vocational experts were not. The majority affirmed the WCJ's decision to exclude the latter evidence, finding the applicant failed to demonstrate good cause or due diligence in obtaining it prior to the MSC.

Mandatory Settlement Conferencediscovery closurereopen recordsupplemental medical reportsvocational expertdue diligencegood causepermanent and stationaryAMA Guidesloss of earnings capacity
References
7
Case No. ADJ7682218
Regular
Aug 05, 2015

RICHARD ROSSI vs. BINKS MANUFACTURING COMPANY, TIG INSURANCE COMPANY, ZENITH [RIVER STONE GROUP], HARTFORD INSURANCE, ACE INSURANCE COMPANY, COMMERCE AND INDUSTRY INSURANCE, AIG DOMESTIC CLAIMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, INTERCARE INSURANCE SERVICES, AMERICAN MOTORISTS INSURANCE COMPANY, AMERICAN MANUFACTURERS MUTUAL INSURANCE COMPANY, LUMBERMEN'S MUTUAL CASUALTY, ILLINOIS TOOL WORKS, FINISHING BRANDS, ZURICH AMERICAN INSURANCE COMPANY, BROADSPIRE

The Appeals Board granted reconsideration to address applicant's contentions regarding the admissibility of vocational expert reports and his disability level. The Board reversed the exclusion of applicant's vocational expert reports, finding they should have been admitted into evidence despite CIGA's claims of insufficient notice. Issues regarding applicant's permanent disability exceeding 79%, entitlement to additional attorney's fees, and CIGA's liability for the vocational expert's costs were deferred. The case was returned to the trial level for further proceedings and decisions on these deferred issues.

CIGAvocational expertpermanent disabilityindustrial injurycancerlatency perioddue processsubstantial evidenceadmissibilityreconsideration
References
10
Case No. ADJ6788617
Regular
Mar 02, 2020

JOSE MURILLO vs. ROYAL PAPER BOX COMPANY, LIBERTY MUTUAL INSURANCE COMPANY

In this workers' compensation case, the defendant appealed the finding of permanent total disability for applicant Jose Murillo, arguing the vocational evidence was unsubstantial and improperly considered non-industrial factors. The Board affirmed the Administrative Law Judge's (WCJ) decision, finding the vocational expert's report constituted substantial evidence. The report concluded Murillo's multiple industrial impairments rendered him unable to participate in vocational rehabilitation or compete in the labor market. The Board specifically found the defendant's apportionment arguments unpersuasive.

WCABPetition for ReconsiderationPermanent Total DisabilityVocational ExpertDiminished Future Earning CapacityAgreed Medical ExaminerApportionmentContra Costa County v. DahlVocational RehabilitationResidual Functional Capacity
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. 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. Dkt. No. 1
Regular Panel Decision
Mar 29, 2012

Hamilton v. Colvin

Plaintiff William Hamilton applied for Social Security disability benefits, which were denied by the Commissioner. Hamilton sought judicial review of this decision in federal court. Magistrate Judge Bianchini issued a Report and Recommendation, suggesting the court reverse the Commissioner's decision and remand the case for further proceedings due to errors in evaluating severe impairments, credibility, and the use of Medical-Vocational Guidelines. Senior District Judge Scullin accepted the Magistrate Judge's recommendations, granting Plaintiff's motion for judgment on the pleadings, denying the Defendant's, and reversing the Commissioner's denial of benefits. The case was remanded for reconsideration of Plaintiff's carpal tunnel syndrome, other alleged severe impairments, and the credibility determination.

Disability benefitsSocial Security ActJudicial reviewAdministrative Law JudgeReport and RecommendationCarpal Tunnel SyndromeResidual Functional CapacityCredibility determinationVocational expertRemand
References
41
Case No. ADJ2007189 (LAO 0857899)
Regular
Nov 01, 2019

Monica Bernasani vs. International Filing Company, U.S. Fire Insurance Company, Crum & Forster

This case involves Monica Bernasani's workers' compensation claim against International Filing Company for cumulative trauma injury. The Administrative Law Judge (ALJ) found Bernasani permanently totally disabled due to industrial injuries to her back, neck, shoulders, wrists, knees, psyche, headaches, weight gain, hypertension, and gastrointestinal system, awarding lifetime benefits. The defendant appealed, arguing the Agreed Medical Examiner's (AME) opinion was insufficient to support total disability and that a vocational report by Enrique Vega was improperly admitted. The Appeals Board denied the defendant's petition, affirming the ALJ's decision and finding the vocational report admissible due to the defendant's waiver of objection. The Board found substantial medical and vocational evidence supported the finding of permanent total disability.

Workers' Compensation Appeals BoardMonica BernasaniInternational Filing CompanyU.S. Fire Insurance CompanyPetition for ReconsiderationFindings Award and OrderAdministrative Law JudgeWCJIndustrial Cumulative Trauma InjuryPermanently Totally Disabled
References
7
Case No. MISSING
Regular Panel Decision

Ficken v. Vocational Education & Extension Board of Suffolk

The petitioner sought review of her employment termination as a secretary by the Vocational Education and Extension Board of the County of Suffolk (VEEB) and requested reinstatement with back pay. She argued that she was discharged without the procedural protections afforded to civil servants under Civil Service Law § 75. VEEB contended that the petitioner was not covered by these protections. The Supreme Court ruled in favor of the petitioner, directing her reinstatement and back pay. The appellate court affirmed this decision, holding that the petitioner's position, though designated 'unclassified' by Suffolk County, did not fit any category under Civil Service Law § 35, thus classifying it as 'classified' and entitling her to § 75 protections. The court emphasized that the petitioner could not be denied these rights until a proper classification was established.

Civil Service LawEmployment TerminationReinstatementBack PayUnclassified ServiceClassified ServiceCivil Servant RightsDue ProcessArticle 78 ProceedingSuffolk County
References
5
Case No. MISSING
Regular Panel Decision
Jan 27, 1965

Rivera v. Hellman

This case involves a motion to confirm a Special Referee's report concerning the amounts and priorities of various liens. The Special Referee conducted a hearing and reported on claims from an attorney for the plaintiff ($793.50), Roosevelt Hospital ($846.53), and the Millinery Health Fund ($641.00, later adjusted to $528). The report established the amounts of each lien and recommended priorities, placing the attorney's lien first, followed by the hospital lien (except for a $12 outpatient service), and then the compensation lien. The court concurred with the Special Referee's report and recommendations, granting the motion to confirm.

Lien PriorityAttorney's LienHospital LienDisability BenefitsWorkmen's Compensation LawSpecial Referee ReportMotion GrantedNew York Supreme CourtLien LawMotion Practice
References
2
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