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

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ7555409
Regular
Mar 04, 2014

JESUS ESCANUELA vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the defendant's Petition for Reconsideration and dismissed the applicant's untimely petition. The WCAB found that the Agreed Medical Examiner's (AME) opinion regarding psychiatric permanent disability was not supported by substantial evidence, as it did not properly address causation under the current PDRS. Consequently, the case is remanded to the trial level for further development of the record concerning psychiatric permanent disability. The WCAB deferred the issue of permanent disability and attorney's fees pending this further development.

Workers' Compensation Appeals BoardJesus EscanuelaCalifornia Department of Correctionslegally uninsuredState Compensation Insurance FundADJ7555409Fresno District OfficeOpinion and OrderPetition for ReconsiderationFindings and Award
References
Case No. ADJ823138 (OXN 0142604)
Regular
Oct 25, 2010

CHERYL PEET vs. COUNTY OF VENTURA, Permissibly SelfInsured, Administered By CORVEL CORPORATION

The Workers' Compensation Appeals Board is reconsidering a prior decision that found a deputy probation officer sustained industrial injuries resulting in 78% permanent disability. The defendant sought reconsideration, arguing the Qualified Medical Examiner's (QME) opinion, which formed the basis of the award, was ambiguous and unsubstantiated. The Board agrees that the QME's assessment of 60% whole person impairment is not adequately supported by the record, particularly in light of the applicant's own testimony regarding her daily activities. Therefore, the case is returned to the trial level for further evidence development and a new decision, with consideration for cost of living adjustments if a life pension is awarded.

Workers Compensation Appeals BoardCheryl PeetCounty of VenturaCORVEL CORPORATIONADJ823138OXN 0142604Opinion and Decision After Reconsiderationdeputy probation officerindustrial injuryright upper extremity
References
Case No. ADJ4397000
Regular
Jun 10, 2011

MARIA MERCEDES FELIX vs. SEA DWELLING CREATURES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration, upholding the finding that applicant Maria Mercedes Felix has 0% whole person impairment for her back injury and requires no further medical treatment. This decision was based on the opinion of a qualified medical evaluator (PQME) whose findings were consistent with a prior medical report. The PQME's report concluded that various diagnostic tests were normal and revealed no significant clinical findings, structural alterations, or neurological impairment. Crucially, the Appeals Board clarified that a 3% pain add-on for whole person impairment is legally permissible only to increase an already established impairment rating, which was not the case here as the initial rating was zero.

Workers' Compensation Appeals BoardReconsideration deniedExpert medical evidencePanel Qualified Medical Evaluator (PQME)American Medical Association Guides (AMA Guides)Permanent ImpairmentWhole Person Impairment (WPI)DRE Lumbar Category IMedical treatmentPain add-on
References
Case No. ADJ9183350
Regular
Nov 02, 2016

MEGAN PRELL vs. CEDAR FAIR, L.P. dba as KNOTT'S BERRY FARM, ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, finding that the original permanent disability rating of 2% was insufficient. The Board adopted the Panel Qualified Medical Evaluator's (PQME) finding of 15% Whole Person Impairment (WPI), applying the *Almaraz-Guzman* doctrine. This doctrine allows physicians to use clinical judgment, drawing upon the entire AMA Guides, to more accurately reflect an injured employee's impairment. The applicant's continued symptoms, post-surgery, and MRI findings supported the PQME's higher impairment rating.

WCABPERMANENT DISABILITYWHOLE PERSON IMPAIRMENTWPIAMA GUIDESALMARAZ-GUZMANPQMEORTHOPEDIC SURGERYLEFT SHOULDER INJURYINDUSTRIAL INJURY
References
Case No. ADJ9500046
Regular
Jun 26, 2025

NADINA WARE vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of an Amended Findings and Award, where the WCJ found applicant Nadina Ware's combined injuries resulted in permanent total disability and eligibility for SIBTF benefits. SIBTF contended the findings lacked specific detail on eligibility requirements, insufficient contemporaneous evidence of prior disability, and that medical and vocational reports were not substantial evidence. The Appeals Board rescinded the decision, finding the Amended Findings and Award lacked specific findings and explanation for the conclusion of permanent total disability, and that the medical examiners did not adequately assign Whole Person Impairment (WPI) for all pre-existing conditions. The matter was returned to the trial level for further proceedings.

Subsequent Injuries Benefits Trust FundSIBTFPermanent Total DisabilityPre-existing DisabilitiesApportionmentWhole Person ImpairmentWPIAMA GuidesSubstantial Medical EvidenceVocational Consultant
References
Case No. ADJ8558787
Regular
Apr 11, 2017

Mario Diaz vs. The Gainey Vineyard, Crump & Forster, United States Fire Insurance

This case involves Mario Diaz's workers' compensation claim for a lumbar spine injury. The Appeals Board granted reconsideration to amend the award, finding the agreed medical examiner's apportionment to pre-existing spondylolisthesis was not sufficiently justified. The Board also corrected the permanent disability rating calculation, utilizing the examiner's 34% whole person impairment instead of the initial 45% regional impairment, ultimately awarding 48% permanent disability without apportionment.

WCABapportionmentpermanent disabilityspondylolisthesisdegenerative disc diseaseAgreed Medical ExaminerAMEEscobedoAlmaraz-GuzmanWhole Person Impairment
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. 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. 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
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