Updated Daily

Case Law Database

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

Case No. ADJ7369877, ADJ7369872

Regular

Jan 20, 2016

SAMUEL DEBONE vs. CEMEX, INC., AMERICAN HOME ASSURANCE COMPANY, INC., GALLAGHER BASSETT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to correct errors in a previous permanent disability rating. The WCJ incorrectly applied the Agreed Medical Examiner's (AME) WPI ratings, conflating cervical and lumbar spine impairments and miscalculating lower extremity to WPI conversions for the hips. The case is returned to the trial level for a new rating based on correct WPI values and to clarify the basis for any departure from AMA Guides ratings. The apportionment of disability was found to be correct.

Workers' Compensation Appeals BoardPetition for ReconsiderationPermanent DisabilityApportionmentAgreed Medical Examiner (AME)Cumulative TraumaCervical SpineLumbar SpineHipsDRE Method

References

Case No. ADJ8330411

Regular

Jul 07, 2017

LARRY SINGLETARY vs. PARAMOUNT PICTURES

The Workers' Compensation Appeals Board (WCAB) denied Paramount Pictures' petition for reconsideration, upholding the Administrative Law Judge's (ALJ) decision. Paramount argued the ALJ erred by applying a 50% WPI for the applicant's right lower extremity, instead of 30%, based on conflicting reports from an agreed medical examiner. The ALJ found the evidence insufficient to prove the applicant could walk more than a "block" without a walker, which was the key factor in the different WPI ratings. The WCAB gave great weight to the ALJ's credibility determinations and found no substantial evidence to overturn them.

Petition for ReconsiderationDeniedWCJCredibility determinationsGarza v. Workmen's Comp. Appeals Bd.Permanent disabilityWPIRight lower extremityOrthopedic AMESpecific date of injury

References

Case No. ADJ7560161

Regular

Feb 16, 2017

Julie Cagle vs. Bank of America, ACE AMERICAN INSURANCE COMPANY

This case involves Julie Cagle's workers' compensation claim against Bank of America for admitted industrial injuries to her psyche and abdomen. The Appeals Board reconsidered a prior award, increasing the applicant's permanent disability rating. The key dispute centered on the proper rating for internal injuries under the AMA Guides, with the applicant arguing for a higher WPI rating based on a Class 3 classification. The Board ultimately determined the applicant's internal system impairment warranted a 25% WPI, leading to a total of 49% permanent disability. The award was also clarified to allow the defendant credit for permanent disability advances already paid.

Workers' Compensation Appeals BoardJulie CagleBank of AmericaAce American Insurance CompanyCorvelPetition for ReconsiderationFindings of Fact and AwardInternal Systems InjuryPsyche InjuryPermanent Disability

References

Case No. ADJ6820873

Regular

Oct 29, 2010

Thomas Wong vs. CITY OF LOS ANGELES/LAPD, TRISTAR 29106 GLENDALE

Here's a summary of the case in four sentences for a lawyer: The Workers' Compensation Appeals Board denied the City of Los Angeles' petition for reconsideration of an award for an injured police officer. The defendant contended the WCJ erred in adopting the PQME's whole person impairment (WPI) ratings for hypertension and cardiomyopathy, and in finding the defendant failed to rebut the diminished future earning capacity (DFEC) component. The Board affirmed the WCJ's reliance on Dr. Carlish's WPI ratings, finding them supported by the AMA Guides and substantial evidence. Furthermore, the Board found the defendant failed to meet its burden of proof to rebut the scheduled DFEC rating, as their arguments lacked sufficient evidentiary support.

Workers' Compensation Appeals BoardIndustrial InjuryHypertensionHypertensive Heart DiseaseCardiomyopathyWhole Person Impairment (WPI)AMA GuidesDisability Evaluation SpecialistDiminished Future Earning Capacity (DFEC)Ogilvie v. City and County of San Francisco

References

Case No. ADJ1078163, ADJ3341185

Significant

Sep 03, 2009

Applicant vs. Workers' Compensation Appeals Board

The court holds that a permanent disability rating under the 2005 Schedule is rebuttable, but any rebuttal evidence concerning Whole Person Impairment (WPI) must be founded within the four corners of the AMA Guides.

AMA GuidesPermanent Disability RatingRebuttablePrima Facie EvidenceWhole Person ImpairmentScheduleLabor Code Section 4660SB 899En Banc DecisionWorkers' Compensation Appeals Board

References

Case No. ADJ1078163, ADJ3341185

En Banc

Sep 03, 2009

MARIO ALMARAZ, JOYCE GUZMAN vs. ENVIRONMENTAL RECOVERY SERVICES, STATE COMPENSATION INSURANCE FUND, MILPITAS UNIFIED SCHOOL DISTRICT, KEENAN & ASSOCIATES

This en banc decision clarifies that a permanent disability rating established by the Schedule is rebuttable, but any evidence to rebut the Whole Person Impairment (WPI) component must be based within the four corners of the AMA Guides.

AlmarazGuzmanWorkers' Compensation Appeals Boarden bancprecedentAMA Guides2005 Schedulepermanent disabilityrebuttableprima facie evidence

References

Case No. ADJ1735018

En Banc

Jun 03, 2010

CYNTHIA BLACKLEDGE vs. BANK OF AMERICA, ACE AMERICAN INSURANCE COMPANY

An en banc decision clarifying the respective roles of the evaluating physician, the workers’ compensation administrative law judge (WCJ), and the disability rater in determining whole person impairment (WPI). The Appeals Board amended the WCJ's decision and remanded the matter for further proceedings.

AMA GuidesWhole Person ImpairmentPhysician's RoleWCJ's RoleRater's RoleFormal Rating InstructionsSubstantial Medical EvidenceDisability Evaluation UnitNon-Formal RatingsEx Parte Communication

References

Case No. ADJ1735018

Significant

Jun 03, 2010

CYNTHIA BLACKLEDGE vs. BANK OF AMERICA, ACE AMERICAN INSURANCE COMPANY

This en banc decision clarifies the distinct roles of the evaluating physician, the workers’ compensation administrative law judge (WCJ), and the disability rater in determining whole person impairment (WPI) under the AMA Guides, and remands the specific case for reassessment of the permanent disability.

AMA GuidesWhole Person ImpairmentPhysician's RoleWCJ's RoleRater's RoleFormal RatingPermanent DisabilitySubstantial EvidenceDRE Lumbar Category IIPatellofemoral Pain Syndrome

References

Case No. ADJ6760596

Regular

May 23, 2018

SAMUEL ESPINOZA vs. EXCEL STAFFING SERVICES, ACE AMERICAN INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to amend a prior decision regarding applicant Samuel Espinoza's work injury. The Board increased Espinoza's lumbar spine Whole Person Impairment (WPI) from 29% to 45%, based on the agreed medical examiner's alternative rating which was deemed more accurate. Consequently, Espinoza's permanent disability rating was increased from 43% to 57%. The Board also deferred the issue of mileage reimbursement.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardWhole Person Impairmentlumbar spineagreed medical examinerAMA Guidespermanent disabilitysexual dysfunctionurological issues

References

Case No. ADJ8007922

Regular

Aug 13, 2013

CHRISTOPHER RUBIO vs. GENERAL ATOMICS, ZENITH INSURANCE COMPANY

This case involves a dispute over the permanent disability rating for an applicant's left shoulder injury. The Workers' Compensation Appeals Board (WCAB) granted reconsideration of the original award. The WCAB found the treating physician's medical evidence regarding the applicant's whole person impairment (WPI) to be inconsistent and confusing. Therefore, the WCAB rescinded the original decision and returned the matter to the trial level for further development of the record, including potentially a re-examination by the physician.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilityWhole Person ImpairmentTreating PhysicianDeposition TestimonyAMA GuidesShoulder InstabilityBankart Lesion

References

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Updated Daily

Case Law Database

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

Case No. ADJ7369877, ADJ7369872

Regular

Jan 20, 2016

SAMUEL DEBONE vs. CEMEX, INC., AMERICAN HOME ASSURANCE COMPANY, INC., GALLAGHER BASSETT SERVICES

Workers' Compensation Appeals BoardPetition for ReconsiderationPermanent DisabilityApportionmentAgreed Medical Examiner (AME)Cumulative TraumaCervical SpineLumbar SpineHipsDRE Method

References

Case No. ADJ8330411

Regular

Jul 07, 2017

LARRY SINGLETARY vs. PARAMOUNT PICTURES

Petition for ReconsiderationDeniedWCJCredibility determinationsGarza v. Workmen's Comp. Appeals Bd.Permanent disabilityWPIRight lower extremityOrthopedic AMESpecific date of injury

References

Case No. ADJ7560161

Regular

Feb 16, 2017

Julie Cagle vs. Bank of America, ACE AMERICAN INSURANCE COMPANY

References

Case No. ADJ6820873

Regular

Oct 29, 2010

Thomas Wong vs. CITY OF LOS ANGELES/LAPD, TRISTAR 29106 GLENDALE

References

Case No. ADJ1078163, ADJ3341185

Significant

Sep 03, 2009

Applicant vs. Workers' Compensation Appeals Board

AMA GuidesPermanent Disability RatingRebuttablePrima Facie EvidenceWhole Person ImpairmentScheduleLabor Code Section 4660SB 899En Banc DecisionWorkers' Compensation Appeals Board

References

Case No. ADJ1078163, ADJ3341185

En Banc

Sep 03, 2009

MARIO ALMARAZ, JOYCE GUZMAN vs. ENVIRONMENTAL RECOVERY SERVICES, STATE COMPENSATION INSURANCE FUND, MILPITAS UNIFIED SCHOOL DISTRICT, KEENAN & ASSOCIATES

AlmarazGuzmanWorkers' Compensation Appeals Boarden bancprecedentAMA Guides2005 Schedulepermanent disabilityrebuttableprima facie evidence

References

Case No. ADJ1735018

En Banc

Jun 03, 2010

CYNTHIA BLACKLEDGE vs. BANK OF AMERICA, ACE AMERICAN INSURANCE COMPANY

AMA GuidesWhole Person ImpairmentPhysician's RoleWCJ's RoleRater's RoleFormal Rating InstructionsSubstantial Medical EvidenceDisability Evaluation UnitNon-Formal RatingsEx Parte Communication

References

Case No. ADJ1735018

Significant

Jun 03, 2010

CYNTHIA BLACKLEDGE vs. BANK OF AMERICA, ACE AMERICAN INSURANCE COMPANY

AMA GuidesWhole Person ImpairmentPhysician's RoleWCJ's RoleRater's RoleFormal RatingPermanent DisabilitySubstantial EvidenceDRE Lumbar Category IIPatellofemoral Pain Syndrome

References

Case No. ADJ6760596

Regular

May 23, 2018

SAMUEL ESPINOZA vs. EXCEL STAFFING SERVICES, ACE AMERICAN INSURANCE

References

Case No. ADJ8007922

Regular

Aug 13, 2013

CHRISTOPHER RUBIO vs. GENERAL ATOMICS, ZENITH INSURANCE COMPANY

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilityWhole Person ImpairmentTreating PhysicianDeposition TestimonyAMA GuidesShoulder InstabilityBankart Lesion

References

Showing 1-10 of 17 results

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