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

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. ADJ8903621, ADJ8469820
Regular
May 22, 2015

ALICIA BRIGHT WALKER vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS, Permissibly Self-Insured

The Workers' Compensation Appeals Board granted reconsideration and rescinded a WCJ's award of attorney's fees. The Board found the WCJ erred in calculating the fee based on a combined disability rating from two separate injuries and on total permanent disability indemnity, rather than the amount accrued before the applicant's death. The matter was returned to the trial level for a proper determination of a reasonable attorney's fee based on accrued indemnity and consideration of the defendant's prior payments. The WCJ also erred by issuing a narrative award instead of findings on ultimate issues with a separate opinion.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAttorney's FeePermanent Disability IndemnitySpecific InjuryCumulative InjuryCombined Values ChartAccrued CompensationDeath of Employee
References
Case No. ADJ7475146
Significant
Jun 23, 2020

Richard Todd, Applicant vs. Subsequent Injuries Benefits Trust Fund

The Appeals Board, in an en banc decision, held that when determining the combined permanent disability for Subsequent Injuries Benefits Trust Fund (SIBTF) liability under Labor Code section 4751, prior and subsequent permanent disabilities are to be added to the extent they do not overlap, rather than combined using the Combined Values Chart (CVC).

SIBTFSubsequent Injuries Benefits Trust Funden bancSection 4751permanent disabilitycombined permanent disabilityprior disabilitysubsequent injuryadditionoverlap
References
Case No. ADJ1436245
Regular
Feb 05, 2015

RAYMUNDO ARGUETA vs. POSTAL ALARM SYSTEMS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed the finding that Huntington Memorial Hospital is a Level 2 trauma facility and thus exempt from the standard Inpatient Hospital Official Medical Fee Schedule. However, the Board rescinded the order for payment of Huntington's full lien amount because the trial judge failed to make specific findings on the reasonable value of services and the basis for penalties and interest. The case is remanded to the trial level for further proceedings to determine these amounts with supporting evidence and findings.

Workers' Compensation Appeals BoardState Compensation Insurance FundHuntington Memorial HospitalLien ClaimantInpatient Hospital Official Medical Fee ScheduleLevel 2 Trauma FacilityLabor Code section 4609Administrative Director RulesReasonable FeeSubstantial Evidence
References
Case No. SAC 286368
Regular
Jan 25, 2008

DALE OLIVER vs. BRIAN WILLIAMS CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

This case involves an applicant seeking approval for disc replacement surgery for a work-related back injury. The defendant argued the surgery is experimental per ACOEM guidelines, thus not covered. The Board denied reconsideration, finding the applicant's physician rebutted the presumption of experimental status. The Board determined the surgery is no longer experimental, citing FDA approval, and is reasonably required for the applicant's specific condition, supported by expert medical opinion.

Workers' Compensation Appeals BoardBrian Williams ConstructionState Compensation Insurance Fundindustrial injuryright anklefootelbowshoulderskneesleft lower extremity
References
Case No. VNO 0453567, VNO 0453569
Regular
Jan 23, 2008

GEORGE FORTNER, JR. vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board rescinded a prior decision that combined permanent disability ratings for two industrial injuries. This action was based on the recent en banc decision in *Benson v. The Permanente Medical Group*, which held that the *Wilkinson* rule for combining disabilities is generally no longer applicable due to new apportionment requirements. The case is returned to the trial level for the judge to revisit permanent disability ratings consistent with the *Benson* decision.

Workers Compensation Appeals BoardGeorge Fortner Jr.County of Los AngelesPermissibly Self-InsuredVNO 0453567VNO 0453569Opinion and Decision After ReconsiderationJoint Findings and AwardIndustrial InjuryLow Back
References
Case No. GRO 0034542 GRO 0034543
Regular
Aug 04, 2008

BRADLEY LORENZ vs. STOWASSER PONTIAC, INTERCARE INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to both applicant and defendant regarding a prior award for two industrial injuries. The Board rescinded the prior award and returned the case to the trial level, pending a decision in *Benson v. Workers' Comp. Appeals Bd.*, which addresses the application of the *Wilkinson* rule regarding combined permanent disability from successive injuries. The case will be further considered at the trial level after the *Benson* decision or other court guidance.

Coming and Going RuleJoint Findings and AwardReconsiderationPetitionsPermanent DisabilityIndustrial InjuriesCar Lot ManagerGross InjurySeparate Permanent DisabilityCombined Permanent Disability
References
Case No. ADJ12660754
Regular
Apr 04, 2025

NANCY ARNOLD vs. SUBEQUENT INJURIES BENEFITS TRUST FUND, et. al.

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of a WCJ's F&A finding the applicant entitled to SIBTF benefits for 100% permanent total disability. SIBTF contended errors regarding findings on prior/subsequent disabilities, psychiatric disability compensability, and the method of combining disabilities. The Appeals Board granted reconsideration, rescinded the F&A, and remanded the case for further proceedings. The trial level must now address the compensability of psyche injury and permanent disability, and the correct application of the Combined Values Chart.

Subsequent Injuries Benefits Trust FundSIBTFpermanent total disabilityprior disabilitysubsequent industrial disabilitypsychiatric disabilitycompensabilityLabor Code section 4660.1Combined Values ChartCVC
References
Case No. ADJ3143756 (SFO 0487728) ADJ317043 (SFO 0488179)
Regular
Nov 22, 2011

MICHAEL MCNAMARA vs. LYNGSO GARDEN MATERIAL, SUBSEQUENT INJURIES TRUST FUND, TRAVELERS SACRAMENTO

This case concerns applicant Michael McNamara's claim for Subsequent Injuries Benefits Fund (SIF) benefits due to three industrial injuries. The Workers' Compensation Appeals Board (Appeals Board) initially awarded SIF benefits based on 100% permanent disability, but SIF sought reconsideration, arguing the Permanent Disability Rating Schedule's Combined Values Chart (CVC) was not properly applied to avoid overlap between disabilities. The Appeals Board found that the WCJ incorrectly combined disabilities from multiple injuries and rescinded the award. The matter was returned to the trial level for further medical record development to properly assess the applicant's overall disability from all three injuries.

Subsequent Injuries FundPermanent DisabilityCombined Values ChartMultiple Disabilities TableApportionmentOverlapPyramidingWhole Person ImpairmentAMA GuidesLabor Code section 4751
References
Case No. ADJ2706793 [SFO 0468588]
Regular
Nov 16, 2009

GUADALUPE RAMIREZ (DECEASED); and KATHRYN YOLKEN (Guardian ad Litem for minor dependents), JUAN JENOVEBO GARCIA (DECEASED); and KATHRYN YOLKEN (Guardian ad Litem for minor dependents), RAFAEL TAPIA, JR., minor; and KATHRYN YOLKEN (Guardian ad Litem), ROLANDO TAPIA (DECEASED); and KATHRYN YOLKEN (Guardian ad Litem for dependent minors) vs. ARGUS NEWSPAPER/ANG NEWSPAPERS; and LIBERTY MUTUAL INSURANCE COMPANY

The WCAB rescinds its July 1, 2008 Findings of Fact and Order, and returns the case to the trial level for review and potential approval of the parties' proposed settlements.

WORKERS' COMPENSATION APPEALS BOARDGuadalupe RamirezJuan Jeno'vebo GarciaRafael Tapia Jr.Rolando TapiaGuardian ad LitemArgus NewspaperLiberty Mutual Insurance CompanyCompromise and ReleaseFindings of Fact and Order
References
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