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

Case No. GOL 96757
Regular
Jun 10, 2008

SA YANG LO vs. CUSTOM SENSORS & TECHNOLOGIES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a prior award, upholding the application of the 2005 Permanent Disability Rating Schedule. The Board found that exceptions allowing for the 1997 Schedule did not apply, as the applicant's temporary disability indemnity extended beyond January 1, 2005, and no qualifying pre-2005 reports indicated permanent disability. Furthermore, the Board found the applicant's vocational expert's opinion regarding diminished future earning capacity unpersuasive, thus affirming the initial 9% permanent disability rating.

Workers' Compensation Appeals BoardSA Yang LoCustom Sensors & TechnologiesInc.State Compensation Insurance FundGOL 96757Opinion and Order Denying ReconsiderationFindings and AwardWorkers' Compensation Administrative Law JudgeWCJ
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. ADJ924878 (LAO 0883182)
Regular
Nov 12, 2019

ROSARIO VALDEZ vs. ATLANTIC EXPRESS OF L.A. INC., Administered By LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, amending a prior award. The Board affirmed the finding of industrial injury to the applicant's bilateral ankles and knees and the award of further medical treatment, including surgery. However, the Board modified the award of temporary disability benefits to comply with the 104-week limitation under Labor Code section 4656(c)(1), starting from the date temporary disability payments commence.

Petition for ReconsiderationFindings and Awardbus driverbilateral anklesbilateral kneestemporary disabilityEmployment Development DepartmentEDD lienfurther medical treatmentleft knee surgery
References
Case No. ADJ3566472 (SFO 04633189)
Regular
Apr 05, 2010

MAURICE EDWARDS vs. CALIFORNIA PACIFIC MEDICAL CENTER

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant argued the judge erred by combining work restrictions for the left knee and subjective pain for the right knee. The Board found the rating justified, noting the Agreed Medical Examiner stated the applicant was more disabled due to right knee pain. The Board concluded the rater's testimony supported the combined rating without improper addition of disability percentages.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryLeft KneeRight KneePsycheApportioned Permanent Partial DisabilityBilateral Knee DisabilityWork Restrictions
References
Case No. ADJ9387309
Regular
Oct 20, 2020

ENEDINA GONZALEZ vs. VEOLIA TRANSPORTATION, INC., OLD REPUBLIC INSURANCE, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a prior decision that denied the applicant's claim for bilateral knee injury. The Board found that the medical evidence regarding the applicant's knee injury was not substantial and required further development. Specifically, the Board deferred the issue of injury AOE/COE to the bilateral knees and returned the matter to the WCJ for further proceedings. This action allows for the re-evaluation of the knee injury claim, considering potential contributions from post-injury weight gain.

Workers Compensation Appeals BoardVeolia TransportationAgreed Medical ExaminerQualified Medical ExaminerPetition for ReconsiderationFindings Award and OrderArising Out of and Occurring in the Course of EmploymentBilateral KneesCumulative InjurySpecific Injury
References
Case No. ADJ987312 (OAK 0273831) ADJ1314100 (OAK 0273829) ADJ2663048 (OAK 0273830) ADJ10521891
Regular
Nov 07, 2016

LORETTA LITTLE vs. OAKLAND UNIFIED SCHOOL DISTRICT, HAZELRIGG CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration and affirmed findings of industrial injury for bilateral plantar fasciitis, lumbar spine, knees, right ankle, and bilateral carpal tunnel. The Board rescinded findings in one case that was not properly set for trial. Three cases were returned to the trial level for specific determinations on temporary disability indemnity and a petition to terminate benefits. The Board also upheld the denial of a penalty claim, the deferral of self-procured medical treatment reimbursement, the permanent and stationary date, and the applicant's occupational group number.

Petition for ReconsiderationPetition for RemovalFindings Award and OrdersIndustrial InjuryBilateral Plantar FasciitisLumbar Spine InjuryBilateral Knee InjuryRight Ankle InjuryCarpal Tunnel SyndromeOccupational Group Number
References
Case No. ADJ10443669
Regular
Oct 04, 2017

Donna Carter vs. Rose International Group, OneBeacon Insurance Group

The Appeals Board affirmed the Workers' Compensation Judge's finding that Donna Carter sustained an industrial injury to her right knee and left wrist on May 18, 2016. Despite inconsistencies in the applicant's testimony regarding a slip and fall incident, her account was corroborated by a witness who found her on the floor. Medical records from the day of the incident also supported the applicant's claim, establishing a clear mechanism of injury. The Board found that the common sense nature of a slip and fall does not require expert medical opinion to establish industrial causation for the incident itself.

ADJ10443669Rose International GroupOneBeacon Insurance GroupDonna CarterWorkers' Compensation Appeals BoardOpinion and Decision After Reconsiderationslip and fallindustrial injuryright kneeleft wrist
References
Case No. ADJ10829802
Regular
Apr 26, 2019

Antonio Corona vs. Custom Pipe & Coupling Company, Inc., The Hartford, Insurance Company of the West

The Workers' Compensation Appeals Board granted reconsideration to clarify findings regarding applicant Antonio Corona's industrial injury. The Board substituted new findings, confirming injury to his thoracic spine, lumbar spine, left shoulder, bilateral wrists, bilateral hands, and left knee, and held the claim was not barred by the post-termination defense. The Board awarded temporary total disability from April 25, 2017, through June 8, 2017, and permanent disability at 18%, returning the matter to the trial level to resolve issues of average weekly wage, additional temporary disability periods, and an EDD lien. The Board adopted the WCJ's report, particularly regarding the credibility of the applicant's treating physician and the absence of substantial evidence to support the defense's arguments.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardMachine OperatorThoracic Spine InjuryLumbar Spine InjuryLeft Shoulder InjuryBilateral Wrists InjuryBilateral Hands InjuryLeft Knee Injury
References
Case No. ADJ5787878
Regular
Sep 26, 2011

RUBY ALLEN vs. UC SAN FRANCISCO

This case concerns a worker's compensation claim for bilateral knee injuries. The Appeals Board granted reconsideration to correct a clerical error in the applicant's average weekly earnings and, crucially, to re-evaluate the permanent disability apportionment. The Board found the administrative law judge erred in applying an outdated "but for" standard for apportionment and correctly applied the causation-based standard from Labor Code section 4663. Consequently, the applicant's permanent disability was reduced from 45% to 24% after apportionment, and the attorney's fee was adjusted accordingly.

Workers' Compensation Appeals BoardReconsiderationApportionmentPermanent DisabilityAgreed Medical EvaluatorCausationAverage Weekly EarningsLabor Code Section 4663SB 899Dr. Lipton
References
Case No. ADJ3590098 (AGO 0012985) ADJ1209123 (AGO 0012984) ADJ3901810 (AGO 0012983)
Regular
Apr 07, 2009

GERALDINE UMBENHAUER vs. J.C. PENNEY, LIBERTY MUTUAL INSURANCE COMPANY

This case involves Geraldine Umbenhauer's claims for industrial injuries sustained while working for J.C. Penney. The administrative law judge (WCJ) found three injuries to the back, knees, and hands, but denied claims for psychological, internal, and fibromyalgia conditions. The WCJ awarded 53% permanent disability, apportioning 50% to non-industrial causes, and a ten-year period of temporary disability. The Appeals Board granted reconsideration due to a lack of support in the record for the WCJ's 50% apportionment of bilateral knee disability, ordering the matter returned for a new determination on apportionment and further proceedings regarding temporary disability indemnity.

WORKERS' COMPENSATION APPEALS BOARDGERALDINE UMBENHAUERJ.C. PENNEYLIBERTY MUTUAL INSURANCE COMPANYADJ3590098ADJ1209123ADJ3901810OPINION AND ORDERSGRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATION
References
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