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

Case No. ADJ7261203
Regular
Oct 11, 2012

ANGELINA KENDRICK McGEE vs. STATE OF CALIFORNIA, DEPARTMENT OF JUSTICE, Legally Uninsured, Administered by STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

The defendant sought reconsideration of a workers' compensation award, challenging the inclusion of a grip strength rating for the applicant's left hand. The Appeals Board granted reconsideration, finding the Agreed Medical Examiner did not adequately justify departing from the AMA Guides' limitations on rating grip strength. Consequently, the applicant's permanent disability rating was reduced from 56% to 51% by excluding the grip strength impairment. The award for permanent disability indemnity and attorney fees was amended accordingly.

Workers' Compensation Appeals BoardAngelina Kendrick McGeeState of California Department of JusticeState Compensation Insurance FundOpinion and Order Granting ReconsiderationFindings and AwardOffice Assistant SupervisorPermanent DisabilityCervical SpineLeft Hand and Wrist
References
1
Case No. ADJ2453188 (LBO 0391424)
Regular
Jul 20, 2009

WILLIAM GILBERT vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award, finding the medical evidence insufficient. The applicant sought a higher permanent disability rating than the $12\%$ awarded, arguing the judge erred in calculating impairment and omitting pain and grip strength adjustments recommended by the Agreed Medical Evaluator. The Board returned the case to the trial level for further development of the medical record, requiring the evaluator to fully explain their findings on impairment, pain, and grip strength, and to consider *Almaraz* principles regarding equitable permanent disability awards.

Workers' Compensation Appeals BoardCumulative InjuryPermanent DisabilityLeft Median Sensory NeuropathyLeft Ulnar Motor NeuropathyAgreed Medical EvaluatorOrthopedistAMA GuidesImpairment RatingGrip Strength
References
9
Case No. ADJ10440533
Regular
Apr 20, 2020

SUMUDU JAYASURIYA vs. SAN FRANCISCO BAY AREA RAPID TRANSIT DISTRICT

The Workers' Compensation Appeals Board (WCAB) rescinded the original Findings and Award due to insufficient substantial evidence. The WCAB found that the chiropractor QME's reports did not adequately explain the basis for combining wrist range of motion impairment with grip strength impairment, particularly in relation to the AMA Guides. The case is returned to the WCJ for further development of the record, likely through an evaluation by an orthopedic hand specialist, to properly assess the applicant's permanent disability.

Workers' Compensation Appeals BoardSan Francisco Bay Area Rapid Transit DistrictSumudu JayasuriyaQualified Medical Examiner (QME)Dennis M. SosineD.C.left upper extremity injurypermanent partial disabilityrange of motiongrip strength
References
6
Case No. ADJ9254420; ADJ9253953
Regular
Mar 05, 2018

LORENA LOPEZ vs. DOLAN FOSTER ENTERPRISES dba TACO BELL, PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE CO.

This case involves two workers' compensation claims for cumulative trauma injuries to an applicant's neck, back, arms, and shoulders sustained while working at Taco Bell. The defendant sought reconsideration, arguing a due process violation due to the WCJ finding cumulative trauma injuries after parties stipulated to specific injuries. The Appeals Board affirmed the WCJ's decision, holding that the WCJ properly amended pleadings to conform to proof based on AME medical reports, and the defendant had ample notice of the potential for cumulative trauma claims, thus not violating due process. The Board also found the AME's use of grip strength for impairment assessment and the lumbar spine impairment category to be consistent with the AMA Guides and supported by substantial evidence.

Cumulative traumaSpecific injuryDue processStipulationAgreed Medical EvaluatorAMA GuidesWhole Person ImpairmentGrip strengthWCJWCAB
References
10
Case No. ADJ834041
Regular
Jan 24, 2011

DAWN DEANS vs. PALMDALE WATER DISTRICT; Permissibly Self-Insured, Administered by ACWA/JPIA

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding 13% permanent disability for the applicant's right elbow and wrist injury. Defendant argued the award was not supported by substantial medical evidence. The Board found the Qualified Medical Evaluator's (PQME) report deficient due to inadequate grip strength testing, misinterpretation of AMA Guides on grip strength differences, and failure to explain why grip loss was the primary rating factor. Consequently, the prior award was rescinded, and the case was returned to the trial level for further medical development and a new decision.

Workers' Compensation Appeals BoardPalmdale Water DistrictPermissibly Self-InsuredACWA/JPIAFindings and AwardPermanent Disability RatingSubstantial Medical EvidenceQualified Medical EvaluatorAMA GuidesGrip Strength
References
11
Case No. ADJ9526635
Regular
Feb 21, 2017

SISSON STEWART vs. CALIFORNIA STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and affirmed the original award, but remanded the case to defer the issue of permanent disability. This decision arose because the treating physician's permanent disability rating, based on grip strength loss, was deemed not substantial medical evidence under AMA Guides. The Appeals Board found that the doctor failed to adequately justify the use of grip strength over range of motion or other objective findings, and further development of the medical record is required. Consequently, the case returns to the trial level for further proceedings on permanent disability.

Workers' Compensation Appeals BoardPermanent DisabilityMedical EvidenceTreating PhysicianQualified Medical EvaluatorAMA GuidesGrip StrengthRange of MotionFindings and AwardPetition for Reconsideration
References
4
Case No. ADJ1728771 (LBO 0316743) ADJ1516565 (LBO 0860347)
Regular
Sep 27, 2012

Kay Rodriguez vs. STATE OF CALIFORNIA, DEPARTMENT OF SOCIAL SERVICES, Legally Uninsured, Administered By STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of the Applicant's claim. The Board adopted the Workers' Compensation Administrative Law Judge's report, which found that the Agreed Medical Evaluator (AME) failed to adequately explain why an alternative impairment rating method (grip loss) was more accurate than the standard method (carpal tunnel syndrome) according to the AMA Guides. This lack of reasoning rendered the AME's opinion unsubstantial evidence for determining the Applicant's impairment. Therefore, the Board upheld the initial finding based on carpal tunnel syndrome, not grip loss.

Kay RodriguezLegally UninsuredState Compensation Insurance FundOrder Denying ReconsiderationAlmaraz-Guzman casesAMA GuidesWhole Person Impairment (WPI)Agreed Medical Evaluator (AME)substantial evidenceActivities of Daily Living (ADLs)
References
15
Case No. ADJ7483972, ADJ7483952
Regular
Nov 08, 2012

ROY HAAS vs. CITY OF SANTA ROSA, REDWOOD EMPIRE MUNICIPAL INSURANCE FUND

This case involves a workers' compensation applicant, Roy Haas, who sustained injuries to his left elbow and bilateral shoulders. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to increase Haas's permanent disability ratings. The WCAB adopted the WCJ's recommendation to rate impairments based on the highest applicable factor, citing that Dr. Suchard's report did not adequately explain combining strength and range of motion impairments for the elbow, and that strength deficits should not be rated where objective anatomic findings like loss of motion are present and prioritized by the AMA Guides. Consequently, Haas's permanent disability for the left elbow was increased to 25%, and for his shoulders to 31%.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardsPermanent Disability RatingAgreed Medical ExaminerAMA GuidesRange of MotionLoss of StrengthOccupational CodeLabor Code Sections
References
2
Case No. ADJ6757080
Regular
Jul 23, 2012

GRACE AOKI vs. CITY OF TORRANCE

This case concerns a library page's permanent disability rating for a right shoulder injury. The agreed medical evaluator combined ratings for loss of motion and weakness/grip strength, exceeding AMA Guides limitations for combining such impairments. The Appeals Board found the physician's report insufficient to rebut AMA Guide standards or explain the combined rating. Consequently, the permanent disability award was reduced from 46% to 20%.

Workers' Compensation Appeals BoardGrace AokiCity of TorrancePermissibly Self-InsuredReconsiderationJoint Findings and AwardPermanent DisabilityAgreed Medical EvaluatorSeymour L. AlbanPetition for Reconsideration
References
1
Case No. ADJ6758053, ADJ7135126
Regular
Sep 15, 2014

MARCO TARACENA vs. NORTHROP GRUMMAN CORPORATION, CHARTIS CLAIMS, INC.

The Workers' Compensation Appeals Board granted reconsideration of a prior award, rescinding the original decision. The Board found that the administrative law judge erred by excluding applicant's loss of grip strength in his right upper extremity from the permanent disability assessment. The case is returned to the trial level for further proceedings and a new decision that includes this factor. The Board affirmed the judge's decisions regarding the left knee impairment and the exclusion of Dr. Majcher's report.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings and AwardAir Frame MechanicCumulative TraumaSpecific InjuryPermanent DisabilityLoss of Grip StrengthAMA GuidesAgreed Medical Evaluator
References
2
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