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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. 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. ADJ10079944
Regular
Feb 26, 2019

Robert Fndkyan vs. Opus One Labs, Employers Compensation Insurance Company

This case concerns an applicant's entitlement to a Supplemental Job Displacement Voucher (SJDV). The original decision denied the SJDV due to the absence of a specific Physician's Return-to-Work form. However, the Appeals Board granted reconsideration, finding that the employer was sufficiently informed of the applicant's permanent disability status and work restrictions through a Qualified Medical Evaluator's report. Therefore, the Board determined that the applicant substantially complied with the requirements and is entitled to the SJDV, prioritizing substance over strict adherence to a particular form.

Supplemental Job Displacement VoucherPhysician's Return-To-Work and Voucher formQualified Medical Evaluation ReportLabor Code section 4658.7(b)permanent and stationary statuspermanent partial disabilityvocational statuswork capacitysubstantial complianceform over substance
References
Case No. ADJ8128282
Regular
Jan 23, 2014

ANGELA EGBIKUADJE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings. The defendant, California Department of Corrections and Rehabilitation, argued that the applicant's psychiatric injury claim was preempted by the ADA and not proven under Labor Code section 3208.3. The Board found the original decision lacked proper analysis regarding predominant industrial causation and the good faith personnel action defense. Therefore, the case was remanded for further development of the record, including expert medical opinion on these issues.

Workers' Compensation Appeals BoardAngela EgbikuadjeCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8128282Van Nuys District OfficeReconsiderationFindings and AwardIndustrial cumulative trauma injury
References
Case No. ADJ2073428 (VNO 0465400) ADJ1610465 (VNO 0540972) ADJ3247765 (VNO 00384869)
Regular
Apr 04, 2011

JAY ZAVERI vs. STATE COMPENSATION INSURANCE FUND; Legally Uninsured

The applicant sought reconsideration of a workers' compensation award, arguing for a 100% permanent disability rating and challenging the permanent disability start date used for attorney fee commutation. The Appeals Board denied the petition, finding insufficient evidence to establish total permanent disability, as the applicant was currently employed and medical opinions did not definitively support such a rating. The Board also ruled that the applicant waived arguments regarding the rating of specific injuries by failing to properly object, and that even if considered, separate ratings for back, knee, and plantar fasciitis conditions would not result in a higher award due to fibromyalgia being the primary cause and rating higher. Finally, the Board clarified that the July 2, 2000 date was only relevant to the attorney fee commutation calculation and not to the determination of permanent disability indemnity payments.

WCABPetition for ReconsiderationJoint Findings and AwardWorkers' Compensation Judge (WCJ)Industrial InjuryBack InjuryHip InjuryBilateral Knee InjuryBilateral Foot InjuryBilateral Plantar Fasciitis
References
Case No. ADJ9890148
Regular
Feb 02, 2017

Timothy Bedford vs. CITY OF LOS ANGELES

This Workers' Compensation Appeals Board case denies reconsideration of a permanent disability rating. The Board affirmed the use of Figure 15-19 of the AMA Guides, finding it permissible to use any chapter or method within the Guides that most accurately reflects impairment. The Agreed Medical Evaluator's opinion was deemed substantial, as he explained how Figure 15-19 was used to derive a more accurate rating based on the applicant's specific spinal condition. The decision also distinguished the current case from prior panel decisions regarding the application of the AMA Guides and work limitations.

AMA Guidespermanent disability ratingrebuttable presumptionwhole person impairmentAlmaraz/Guzman IIclinical judgmentagreed medical evaluator (AME)Figure 15-19functional losssurgical-grade disc herniations
References
Case No. ADJ6925034
Regular
May 12, 2011

FRANCIS LARA vs. BIMBO BAKERIES USA, ACE AMERICAN INSURANCE COMPANY

The defendant, Bimbo Bakeries USA, sought reconsideration of an award increasing permanent disability payments by 15%, arguing they were entitled to a 15% decrease. This was based on their claim of offering the injured employee, Francis Lara, regular work. However, the Workers' Compensation Appeals Board denied the petition because the defendant's offer of work was fatally flawed, being incomplete, unsigned, and not clearly tied to the employee's specific work restrictions at the time. The Board also noted the offer was made before the employee was declared permanent and stationary, further undermining its validity under Labor Code section 4658(d)(3)(A).

Labor Code section 4658(d)(2)Labor Code section 4658(d)(3)(A)Permanent and Stationary (P&S) reportPetition for ReconsiderationFindings and Awardindustrial injuryright lower extremitypermanent disabilitymodified workalternative work
References
Case No. ADJ9123534
Regular
Jul 18, 2015

PHILLIP WARD vs. CITY OF FORT BRAGG, REDWOOD EMPIRE MUNICIPAL INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and amended an award, finding the defendant liable for a 15% increase in permanent disability benefits. This increase is due to the defendant's failure to offer the applicant qualified work within 60 days of his permanent and stationary status, as required by Labor Code section 4658(d)(2). While the applicant had retired, the Board found this did not excuse the employer from making a compliant work offer. The amended order clarifies the increase applies only to payments made 60 days after the Qualified Medical Evaluator's permanent and stationary report.

Labor Code section 4658(d)(2)permanent disability increaseoffer of workmodified workalternative workregular workpermanent and stationary60-day periodretirementCalPERS
References
Case No. ADJ6410496
Regular
Dec 21, 2009

JAKE BOATMAN vs. TOWN OF WINDSOR, PSI, by REMIF

The Appeals Board affirmed the WCJ’s decision disallowing a 15% reduction in permanent disability indemnity under Labor Code section 4658(d)(3)(A) because the applicant returned to work quickly and the employer's offer to return to work was made after the 60 day time requirement and was not made in accordance with the statute.

Workers Compensation Appeals BoardPermanent Disability IndemnityLabor Code Section 4658(d)(3)(A)ReconsiderationStipulations with Request for AwardJob OfferRetroactive PeriodWhole Person ImpairmentPermanent and StationaryReturn to Work
References
Case No. ADJ2792613 (LBO 0348698)
Regular
Dec 27, 2017

BETTY GREEN vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case concerns Betty Green's petition for reconsideration of a workers' compensation award for psyche, back, and elbow injuries. The applicant seeks $100\%$ permanent disability, while the defendant argues for apportionment due to prior injuries. The Appeals Board granted reconsideration to address discrepancies in the medical evaluator's assessment of work function impairments, specifically regarding stress tolerance and supervisory responsibilities. Consequently, the Board deferred the issue of permanent disability and attorney's fees for further proceedings at the trial level, while affirming other aspects of the initial award.

ReconsiderationPetition for ReconsiderationAgreed Medical EvaluatorPermanent DisabilityPsycheOrthopedic InjuriesWork Function ImpairmentsStressVocational ReportApportionment
References
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