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

Case No. ADJ11197264
Regular
Apr 13, 2023

CECILIA MENDOZA vs. BERRYESSA CONTRACTING, INCORPORATED, STATE COMPENSATION INSURANCE FUND

The Appeals Board affirmed a prior decision awarding 25% permanent disability for industrial injuries to the applicant's left shoulder, neck, left lower arm, and upper back. The applicant contended the judge erred by not developing the medical-legal record regarding her vocational expert and by not awarding a higher disability rating based on vocational expert opinions. The Board found the applicant's vocational expert's opinions unreliable due to misunderstandings of her physical restrictions and other inaccuracies. Therefore, the applicant failed to rebut the scheduled permanent disability rating of 25%.

Workers' Compensation Appeals BoardReconsiderationVocational ExpertPermanent Disability RatingAMA GuidesLabor Code Section 4660.1Scheduled Permanent Disability RatingWhole Person ImpairmentVocational RehabilitationSubstantial Evidence
References
4
Case No. ADJ358084 (OAK 0320488)
Regular
Dec 19, 2008

Samuel Arledge vs. RGW Construction, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration of a prior award finding the applicant sustained 39% permanent disability. The applicant argued for 100% disability based on a vocational expert's opinion and Labor Code section 4662. The Board found the WCJ erred by not fully considering the vocational expert's opinion, specifically regarding the applicant's employability and earning capacity post-injury. The case is remanded to the trial level for further proceedings to re-evaluate the vocational expert's findings and determine the applicant's total disability status.

Workers' Compensation Appeals BoardCumulative Trauma InjuryPermanent DisabilityVocational ExpertLabor Code Section 4662Qualified Medical EvaluatorImpairment RatingWPIFunctional Capacity EvaluationTransferable Skills
References
0
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The Appeals Board granted reconsideration, rescinded the prior award, and returned the case for further development of the record.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. ADJ2186466
Regular
Jun 26, 2017

AMADO URIAS vs. VALLEY COUNTY WATER DISTRICT

This case involves Amado Urias's petition for reconsideration of a Supplemental Findings and Award that determined his permanent disability at 54% after apportionment. Urias argued that his vocational expert's opinion on diminished earning capacity should have been prioritized over the medical opinions regarding his physical and psychiatric limitations. The Workers' Compensation Appeals Board denied the petition, affirming the administrative law judge's decision. The Board found that the issue of psychiatric apportionment was previously adjudicated and that the vocational expert's opinion was not substantial evidence due to its reliance on subjective complaints over objective medical findings.

Workers' Compensation Appeals BoardSupplemental Findings and AwardPermanent DisabilityApportionmentVocational ExpertDr. Albert SimpkinsDr. StewartDr. WixenDr. AhmedCumulative Injury
References
1
Case No. ADJ2262922 (SRO 0041418)
Regular
Jul 07, 2011

DEBBIE LEVINE vs. STARBUCKS, INC., GALLAGHER BASSETT SERVICES, INC.

The applicant sought reconsideration of a permanent disability rating of 42%, arguing the vocational expert's assessment of diminished future earning capacity (DFEC) was rebutted and that Labor Code section 4662 should apply for total disability. The Appeals Board denied the petition, finding that the applicant failed to present substantial evidence to rebut the DFEC, as she never sought employment and her vocational expert's opinion was largely attributed to economic factors. Furthermore, the Board found no basis for applying Labor Code section 4662, as the applicant's alleged permanent total disability was not supported by persuasive medical or vocational evidence. The applicant's unsupported claim of zero earning capacity was contradicted by medical opinions.

Diminished Future Earning Capacity2005 PDRSOgilvie IOgilvie IIrebuttalLabor Code section 4662permanent total disabilityvocational expertsubstantial evidenceAME
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. ADJ6692520
Regular
Jul 20, 2010

CRYSTAL VOS vs. STEVEN CHANG, DDS, ZENITH INSURANCE COMPANY

This case affirms a WCJ's decision finding the applicant sustained a 12% permanent disability. The applicant sought reconsideration, arguing the WCJ erred by limiting rebuttal evidence to "wage loss" rather than "loss of long-term earning capacity" and denying costs for a vocational expert. The Appeals Board, relying on precedent from *Ogilvie v. City and County of San Francisco*, held that the vocational expert's opinion was not substantial evidence to rebut the permanent disability rating. Therefore, the WCJ's denial of the vocational expert's costs was also affirmed.

Workers' Compensation Appeals BoardSupplemental Findings and Awardindustrial injurypermanent disabilityvocational expertwage lossloss of long-term earning capacitydiminished future earning capacity (DFEC)2005 Permanent Disability Rating ScheduleOgilvie v. City and County of San Francisco
References
4
Case No. ADJ8731516
Regular
Oct 17, 2018

JOSE NIEVES vs. CITY OF HAYWARD

This case involves Jose Nieves' claim for workers' compensation benefits following an industrial injury. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to review a prior decision awarding 47% permanent disability and specific vocational expert costs. Applicant argued for total permanent disability and higher expert fees, while the defendant claimed apportionment for pre-existing conditions. The WCAB affirmed the prior decision regarding permanent disability but rescinded the vocational expert fee, remanding for a new determination of reasonable costs. A dissenting opinion argued the WCJ misunderstood vocational and medical evidence regarding the applicant's limitations and earning capacity.

Workers' Compensation Appeals BoardReconsiderationIndustrial InjuryCumulative PeriodVocational ExpertPermanent DisabilityApportionmentLabor Code Section 4664Agreed Medical EvaluatorWhole Person Impairment
References
15
Case No. ADJ2653468 (LBO 0389795), ADJ7229862, ADJ9578758, ADJ10137164
Regular
Apr 28, 2017

MUKESH SINGH vs. STATE OF CALIFORNIA

The Workers' Compensation Appeals Board (WCAB) reconsidered a decision awarding high permanent disability ratings to Mukesh Singh based on a vocational expert's opinion that he couldn't compete in the labor market. The WCAB found the expert's opinion insufficient because it failed to adequately address the impact of non-industrial factors and the applicant's ability to participate in vocational rehabilitation. Consequently, the WCAB amended the decision to use scheduled permanent disability ratings for each of the applicant's three injuries, allowing for apportionment among them. This adjustment corrects an improper use of the Combined Values Chart for combining distinct injuries and aligns the award with existing legal precedent on rebutting scheduled ratings.

Workers' Compensation Appeals BoardLegally UninsuredJoint Findings and AwardPetition for ReconsiderationPermanent DisabilityScheduled RatingsApportionmentVocational ExpertSubstantial EvidenceLeBoeuf Rule
References
6
Case No. ADJ8700541
Regular
Oct 17, 2019

ZAHRA STEPHENS vs. COX ENTERPRISES, INC.

The Appeals Board granted reconsideration to review the WCJ's finding of permanent and total disability based on the opinions of a psychologist, Dr. Windman, and a vocational expert, Mr. Wilkinson. The Board found that Dr. Windman's opinion lacked substantial evidence due to inconsistencies, inadequate record review, and conflicts with other medical opinions. Consequently, Mr. Wilkinson's vocational opinion, which relied heavily on Dr. Windman's findings, was also deemed not substantial evidence. The case is remanded to the trial level for further proceedings and a new determination of permanent disability.

Workers' Compensation Appeals BoardReconsiderationPermanent Total DisabilityMedical OpinionVocational ExpertSubstantial EvidencePQMENeurologistPsychologistOrthopedist
References
10
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