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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Rubies v. Aqua Club, Inc.

Judge Read dissents from the majority's interpretation of 'permanent total disability' concerning acquired brain injuries under Workers’ Compensation Law § 11. Read argues for a narrower definition, requiring the inability to perform usual daily living activities, aligning with legislative intent for the 1996 amendment to section 11. This amendment aimed to strictly curtail third-party actions against employers by narrowly defining 'grave injuries.' The dissent stresses that the list of grave injuries is exhaustive, not illustrative, and should not be broadly interpreted. Therefore, the definition of 'permanent total disability' for an acquired brain injury should essentially require a vegetative state to protect employers as intended by the Legislature.

Workers' CompensationGrave InjuryAcquired Brain InjuryPermanent Total DisabilityLegislative IntentStatutory InterpretationEmployer LiabilityThird-Party ActionsDissenting OpinionJudicial Review
References
5
Case No. ADJ10116932
Regular
Jul 15, 2019

KRIS WILSON vs. STATE OF CA CAL FIRE; legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration regarding a catastrophic injury determination. The Board affirmed that the definition of "catastrophic injury" under Labor Code section 4660.1(c)(2)(B) focuses on the nature of the injury, not solely the immediate mechanism or condition after onset. The Board also rejected the argument that it exceeded its authority by outlining factors for assessing catastrophic injuries, stating these factors provide a helpful analytical framework. The defendant's petition did not dispute that the applicant sustained a catastrophic injury, raising questions about their standing as an aggrieved party.

Labor Code section 4660.1(c)(2)(B)catastrophic injuryincreased impairment ratingpsychiatric injurymechanism of injuryfact-driven inquiryen banc decisionPetition for Reconsiderationtrier of factlegislative history
References
14
Case No. ADJ11114962
Regular
Jan 10, 2019

HECTOR HERNANDEZ vs. MARK DATTILLO’S HEATING AND AIR CONDITIONING, CALIFORNIA INSURANCE COMPANY, APPLIED RISK SERVICES

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, affirming the judge's finding that the applicant's accepted head injury included a brain injury. The Board found the defendant's objections regarding notice of the brain injury claim and the timeliness of their response to medical treatment requests were unfounded. Furthermore, the Board determined that the defendant waived its right to dispute the industrial causation of the brain injury by previously authorizing treatment with a neurologist who diagnosed such an injury. The defendant's due process claims were also rejected.

Workers' Compensation Appeals BoardTraumatic Brain InjuryExpedited HearingFindings and AwardPetition for ReconsiderationLabor Code section 4610Utilization ReviewPrimary Treating PhysicianAgreed Medical ExaminationWCJ
References
9
Case No. ADJ9084165
Regular
Oct 19, 2015

BOBBY DUCKWORTH vs. LOS ANGELES RAMS, TRAVELERS, SAN DIEGO CHARGERS, INSURANCE COMPANY OF THE WEST, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration, upholding the finding that the applicant's current claim for cumulative brain injury is not barred by a 1989 compromise and release agreement. The 1989 agreement specifically released claims for orthopedic injuries, and there was no evidence that the applicant knew of or intended to release a brain injury claim at that time. The Board found that the brain injury claim, diagnosed later, involved a distinct injury not contemplated by the earlier settlement. Therefore, the doctrines of res judicata and collateral estoppel did not apply to bar the current claim.

res judicatacollateral estoppelcompromise and releasecumulative injurybrain injurynervous systemorthopedic injurylatent conditiondate of injuryworkers' compensation appeals board
References
13
Case No. MISSING
Regular Panel Decision

Bush v. Mechanicville Warehouse Corp.

This case involves an appeal from the denial of a third-party defendant's (Yankee One Dollar Stores, Inc.) motions for summary judgment against a defendant (Mechanicville Warehouse Corp.). The plaintiff, Bush, was injured at work and sued Mechanicville, who then brought a third-party action against Yankee for indemnification. Yankee argued that plaintiff did not sustain a 'grave injury' under Workers’ Compensation Law § 11 and that there was no written contractual indemnification agreement. The appellate court affirmed the denial of summary judgment regarding the 'grave injury' claim, finding sufficient evidence of permanent total disability due to a traumatic brain injury. However, the court reversed the denial of summary judgment for contractual indemnification, ruling that Workers’ Compensation Law § 11 requires an *express written contract* of indemnification from the employer, which was not present between Yankee and Mechanicville.

Summary JudgmentThird-Party ActionWorkers' Compensation Law § 11Grave InjuryContractual IndemnificationBrain InjuryPermanent Total DisabilityHoldover TenantExpress AgreementAppellate Review
References
18
Case No. ADJ8815528
Regular
Aug 22, 2016

RICARDO SALINAS vs. SOUTHEAST PERSONNEL LEASING, INC.; STATE NATIONAL INSURANCE COMPANY

The applicant sought reconsideration of a decision finding his psychiatric injury, stemming from a fall, was not compensable at an increased impairment rating. The applicant argued the injury was a "violent act" or "catastrophic" under Labor Code § 4660.1, thereby exempting it from limitations on psychiatric impairment increases. The Workers' Compensation Judge recommended denying reconsideration, finding the applicant's fall lacked the element of a violent act and that the resulting orthopedic injury and restrictions did not qualify as catastrophic. The judge concluded that the mere fact of hospitalization did not elevate the injury to catastrophic status.

Petition for ReconsiderationWorkers' Compensation Appeals Boardpsychiatric injuryLabor Code § 3208.3Labor Code § 4660.1catastrophic injuryviolent actpredominant causesix months employmentorthopedic injury
References
1
Case No. ADJ9898989
Regular
Sep 20, 2022

DOUGLAS SCHAAN vs. JERRY THOMPSON & SONS, LIBERTY MUTUAL

The applicant sought reconsideration of a Workers' Compensation Appeals Board decision that awarded 74% permanent disability, excluding psychiatric impairment. The applicant argued for 100% permanent disability and that his injury was catastrophic, entitling him to an increased rating for his psychiatric condition. The Board affirmed the original decision, finding the injury was not catastrophic under Labor Code section 4660.1(c)(2)(B) and that the applicant failed to prove he was permanently totally disabled due to the industrial injury. The applicant's vocational expert's conclusions were deemed unreliable as they improperly considered non-industrial factors and psychiatric issues outside the scope of catastrophic injury.

Permanent DisabilityCatastrophic InjuryLabor Code Section 4660.1(c)(2)(B)Qualified Medical EvaluatorWhole Person ImpairmentActivities of Daily LivingVocational RehabilitationPermanent Total DisabilityFindings and AwardReconsideration
References
7
Case No. ADJ9713798
Regular
Dec 20, 2019

BRIGETTE LEONARD vs. SANTA MONICA-MALIBU UNIFIED SCHOOL DISTRICT

The Appeals Board denied the defendant's petition for reconsideration, upholding the finding that the applicant sustained a catastrophic injury under Labor Code section 4660.1(c)(2)(B). While rejecting the WCJ's reliance on psychiatric injury to deem the physical injury catastrophic, the Board found sufficient independent evidence. Applicant's industrial thyroid cancer, requiring lifelong treatment including thyroidectomy and radioactive iodine, alongside GERD and hypertension, supports the catastrophic designation. This designation allows for an increased impairment rating for her psychiatric disability.

Labor Code section 4660.1(c)(2)(B)catastrophic injurypsychiatric injuryimpairment ratingthyroid cancerWilson v. State of CA Cal FireADLscumulative exposuretotal thyroidectomyradioactive iodine therapy
References
1
Case No. MISSING
Regular Panel Decision

Rubeis v. Aqua Club, Inc.

Aldo Rubeis was injured after falling from a ladder while installing a steel cupola, sustaining a brain injury. He sued Aqua Club, Inc., who then impleaded Rubeis's employer, Venezia Iron Works, Inc., alleging a "grave injury" under Workers' Compensation Law § 11 for common-law indemnification and contribution. The Supreme Court denied Venezia Iron Works' motion to dismiss, and a jury found Rubeis sustained a grave injury. Venezia Iron Works appealed. The Appellate Division reviewed the definition of "grave injury" under Workers' Compensation Law § 11, specifically "permanent total disability" in the context of brain injury cases. The Court concluded that Rubeis's injuries, despite their severity, did not meet the "narrowly defined" standard for grave injury based on prior precedents, which focus on day-to-day functions rather than just employability. Therefore, the Appellate Division reversed the judgment, granted Venezia Iron Works' motion, and dismissed the third-party complaint.

Grave InjuryWorkers' Compensation Law § 11Permanent Total Disability DefinitionBrain Injury SeverityCommon Law IndemnificationContribution ClaimThird-Party Action DismissalAppellate Review StandardsStatutory InterpretationEmployer Liability Exemption
References
9
Case No. ADJ10908652, ADJ10908914
Regular
Sep 16, 2025

ZENAIDA AVILES vs. PIH HEALTH HOSPITAL, ATHENS ADMINISTRATORS

Applicant sought reconsideration of a Joint Findings and Award that denied industrial psyche injury (cumulative) and barred permanent disability from psyche injury (specific injury). Applicant contended that medical evidence supported cumulative psyche injury and that the WCJ erred in denying compensability of psychiatric permanent disability due to catastrophic consequences. The Appeals Board granted the petition for reconsideration, rescinded the prior Findings and Award, and returned the matter to the trial level for further proceedings, citing the need for further development of the medical record regarding intertwined disability and the application of the catastrophic injury exception.

Petition for ReconsiderationJoint Findings and AwardIndustrial InjuryPsycheCumulative PeriodSpecific InjuryPermanent DisabilityLabor Code section 4660.1Substantial Medical EvidenceQualified Medical Evaluator
References
27
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