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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. ADJ8072993
Regular
Nov 26, 2012

VIRGINIA PALACIOS vs. MAXIMUM REALTY, AMERICAN CLAIMS

The Workers' Compensation Appeals Board denied reconsideration of the applicant's earning capacity determination. The Administrative Law Judge (WCJ) found the applicant's earning capacity based on actual wages, including rent-free housing as compensation, not solely on an hourly minimum wage calculation. The WCJ emphasized that earning capacity considers various factors like age, skill, and employment opportunities, not just hours worked at minimum wage. The Board noted that minimum wage issues should be addressed in a different forum and that such adjudication could potentially lead to reopening this case within statutory timeframes.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedEarning CapacityMinimum WageApartment ManagerActual EarningsLegal Minimum WageStatutory Time FramesAdjudication
References
Case No. ADJ9064752
Regular
May 12, 2016

SANTOS MARTINEZ vs. TROON GOLF, INC., dba MARIN COUNTRY CLUB, UNITED STATES FIRE INSURANCE COMPANY

This case concerns a dispute over temporary disability indemnity rate calculations following an admitted industrial back, lower extremity, and wrist injury. The employer challenged the administrative law judge's (WCJ) finding of an average weekly earning capacity of \$648.00, arguing insufficient evidence of increased earning potential. The Workers' Compensation Appeals Board affirmed the WCJ's decision, holding that earning capacity is a dynamic assessment considering overall capability, not just actual earnings at the time of injury. The Board cited the applicant's acceptance of a full-time position at a higher wage rate as strong evidence supporting the determined earning capacity.

Earning capacityLabor Code section 4453(c)(4)Average weekly earning capacityTemporary disability indemnityPetition for ReconsiderationFindings and AwardGoytiaMontanaKyllonenGrossmont Hospital
References
Case No. ADJ14244909
Regular
Apr 25, 2025

YONGQUAN HU vs. AMERICAN ALLIANCE LOGISTICS, INC., LIANG YE, UNINSURED EMPLOYERS BENEFITS TRUST FUND

Applicant Yongquan Hu and defendant Uninsured Employers Benefits Trust Fund (UEBTF) both petitioned for reconsideration of an Amended Findings and Award. The WCJ's initial decision found an industrial injury resulting in permanent total disability and calculated average weekly earnings based on multiple employers. Applicant disputed the wage calculation method, while UEBTF identified an inadvertently omitted week of wages. The Appeals Board granted both petitions, adopting the WCJ's report and amending the decision to reflect corrected average weekly earnings of $1,462.15, leading to a temporary and permanent total disability rate of $974.77 per week.

Workers' Compensation Appeals BoardYongquan HuAmerican Alliance LogisticsInc.Uninsured Employers Benefits Trust FundAdjudication NumberVan Nuys District OfficeOpinion and OrderGranting Petitions for ReconsiderationDecision After Reconsideration
References
Case No. ADJ13385386
Regular
Nov 17, 2020

ABRAHAM BERNAL vs. NIAGARA BOTTLING, LLC, SAFETY NATIONAL CASUALTY COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to amend the original decision regarding applicant Abraham Bernal's average weekly wage. The WCAB found the prior calculation of $\$1,383.39$ per week was erroneous as it diluted the applicant's earning capacity by using a lower hourly wage than his rate at the time of injury. The Board recalculated the average weekly wage based on actual hours worked, including overtime and holiday pay, at the applicant's established $\$27.00$ per hour rate. This resulted in an amended average weekly wage of $\$1,414.26$, increasing the temporary disability indemnity rate to $\$942.84$ per week.

ADJ13385386NIAGARA BOTTLING LLCSAFETY NATIONAL CASUALTY COMPANYVan Nuys District OfficePETITION FOR RECONSIDERATIONAVERAGE WEEKLY WAGESTEMPORARY DISABILITY INDEMNITYLABOR CODE § 4453(c)EARNING CAPACITYREGULAR WAGE
References
Case No. ADJ2110739 (MON 0313927)
Regular
Oct 01, 2010

Rosalind Eskridge (Vallery) vs. TARGET STORES, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

This case returns to the trial level for a comprehensive re-analysis of applicant's permanent disability rating, specifically focusing on the Diminished Future Earning Capacity (DFEC) adjustment factor. The Board rescinded the prior award because the judge's decision did not fully adhere to the *Ogilvie* en banc decisions, which mandate a specific four-step analysis for rebutting the DFEC. The judge must now conduct a complete *Ogilvie* analysis, potentially developing the record further, to determine if the applicant's demonstrated earning loss and other relevant factors, including *Montana* factors, justify an individualized DFEC adjustment over the scheduled rating. The applicant bears the burden of proving that her evidence substantially overcomes the prima facie validity of the scheduled DFEC.

Workers' Compensation Appeals BoardDiminished Future Earning CapacityDFECPermanent Disability Rating Schedule2005 PDRSOgilvie analysisAgreed Medical ExaminerDisability Evaluation UnitDEUAgreed Medical Examiner
References
Case No. ADJ12393038
Regular
Mar 07, 2023

CRISTIAN AVILA GARCIA (Deceased) SINTIA YANETH GARCIA (Guardia Ad Litem) vs. BAYVIEW ENVIRONMENTAL SERVICES INCORPORATED, GREAT DIVIDE INSURANCE COMPANY, BERKELEY ENTERTAINMENT

In this workers' compensation case, the applicant's average weekly wage (AWW) was determined based on his higher earnings during the four weeks prior to his death on a special project. The defendant sought reconsideration, arguing the AWW should have been based on his entire tenure, but the Appeals Board affirmed the original award. The Board held that AWW is calculated based on earnings "at the time of injury" to reflect earning capacity, not necessarily the entire earnings history. Therefore, the calculation using the prevailing wage during the Santa Monica project was upheld.

Workers' Compensation Appeals BoardCristan Avila GarciaSintia Yaneth GarciaBayview Environmental Services IncorporatedGreat Divide Insurance CompanyBerkeley EntertainmentAdjudication NumberFindings and AwardAverage Weekly WageTemporary Disability Indemnity
References
Case No. ADJ2360182 (MON 0334561) ADJ493129 (MON 0334562) ADJ3850358 (MON 0334563)
Regular
Oct 18, 2010

YOLANDA M. PIDECH vs. METROPOLITAN STATE HOSPITAL, STATE COMPENSATION INSURANCE FUND

The Appeals Board rescinded the prior award and returned the case for further proceedings because the WCJ did not adequately consider the applicant's post-injury earning capacity as required by *Ogilvie I* and *Ogilvie II*. The WCJ failed to adequately explain the calculation of the applicant's earnings loss and did not provide substantial medical evidence supporting her inability to work. The Board requires further development of the record, particularly medical opinions on work capacity, before a complete *Ogilvie* analysis can be performed. This includes assessing whether the earning loss is industrially caused and weighing the adjusted DFEC factor against the scheduled factor.

Ogilvie analysisDFEC rebuttalpost-injury earning capacitypermanent disability ratingAgreed Medical Evaluatorsubstantial medical evidencevocational rehabilitationloss of earning capacityindustrial injurytemporary disability
References
Case No. ADJ8032573
Regular
Dec 11, 2012

MELVIN JONES vs. RGW CONSTRUCTION CO., OLD REPUBLIC GENERAL INSURANCE CORPORATION

This case concerns a dispute over the calculation of an injured construction laborer's average weekly earnings (AWW) for temporary total disability (TTD) benefits. The applicant sought TTD based on an AWW of $1,085.60, while the defendant proposed an AWW of $805.58. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, finding the applicant's earnings were irregular. The WCAB ultimately amended the original award, reducing the TTD rate to $537.05 per week based on an AWW of $805.58, applying Labor Code section 4453(c)(4) to reflect the applicant's actual earning capacity rather than a hypothetical full-time wage.

Labor Code section 4453(c)(4)average weekly earningsearning capacitytemporary disability indemnitycumulative traumaconstruction laborerbilateral kneesbilateral shouldersReconsiderationOpinion and Decision
References
Case No. ADJ9108040
Regular
Oct 30, 2018

STEPHEN McKEOWEN vs. CAST AND CREW ENTERTAINMENT, ZURICH NORTH AMERICA

This case involves a dispute over an applicant's entitlement to temporary disability benefits in a workers' compensation claim. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, finding the administrative law judge (ALJ) erred in barring temporary disability benefits without a proper determination of the "date of injury" as defined by Labor Code Section 5412. The WCAB clarified that disability requires an impairment of earning capacity and ordered the matter returned to the trial level for a de novo analysis of the applicant's temporary disability entitlement based on this standard. The defendants' request to overturn findings on certain body parts was not addressed, with permission to raise that issue on remand.

WCABPetition for ReconsiderationTemporary DisabilityLabor Code Section 4656(c)(2)Date of InjuryCumulative InjuryLabor Code Section 5412Impairment of Earnings CapacityCompensable DisabilityWage Loss
References
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