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

Case No. ADJ2434971 (OAK 0238163)
Regular
Dec 02, 2010

ANA RODRIGUEZ vs. SHERATON PALACE HOTEL, TOKIO MARINE

The Workers' Compensation Appeals Board denied reconsideration of a finding that the applicant, Ana Rodriguez, did not sustain new and further permanent disability subsequent to a 1997 stipulated award. The judge found her testimony regarding increased orthopedic and psychiatric symptoms to be not credible. Medical evidence from Dr. Edington indicated no orthopedic increase in disability since the award, and the psychiatric disability became permanent and stationary concurrently with the orthopedic condition. Therefore, the judge concluded there was no "new and further" disability as defined by Labor Code Section 5410.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedCredibility FindingGarza v. Workers' Comp. Appeals Bd.Stipulated AwardPetition to ReopenNew and Further DisabilityOrthopedic DisabilityPsychiatric Disability
References
Case No. ADJ7485185, ADJ9885267
Regular
Sep 18, 2017

LAURA ORTIZ vs. FARMERS INSURANCE GROUP, MID CENTURY INSURANCE

This Workers' Compensation Appeals Board decision denies a petition for reconsideration, affirming the applicant's timely invocation of jurisdiction to seek additional benefits. The Board adopted the WCJ's reasoning that the applicant's filings of an Application for Adjudication of Claim and an Amended Application, along with documented medical evidence of worsening condition, satisfied the requirements for reopening and seeking further compensation. These actions put the defendants on notice of the applicant's intent to pursue increased benefits, even without a formal petition to reopen.

Petition for ReconsiderationLabor Code section 5410Application for Adjudication of ClaimRiel v. State of CaliforniaBeaida v. Workers' Comp. Appeals Bd.stipulated awardpro perfuture medical treatmentincreased symptomsworsening condition
References
Case No. ADJ9064752
Regular
May 12, 2016

SANTOS MARTINEZ vs. TROON GOLF, INC., dba MARIN COUNTRY CLUB, UNITED STATES FIRE INSURANCE COMPANY

This case concerns a dispute over temporary disability indemnity rate calculations following an admitted industrial back, lower extremity, and wrist injury. The employer challenged the administrative law judge's (WCJ) finding of an average weekly earning capacity of \$648.00, arguing insufficient evidence of increased earning potential. The Workers' Compensation Appeals Board affirmed the WCJ's decision, holding that earning capacity is a dynamic assessment considering overall capability, not just actual earnings at the time of injury. The Board cited the applicant's acceptance of a full-time position at a higher wage rate as strong evidence supporting the determined earning capacity.

Earning capacityLabor Code section 4453(c)(4)Average weekly earning capacityTemporary disability indemnityPetition for ReconsiderationFindings and AwardGoytiaMontanaKyllonenGrossmont Hospital
References
Case No. ADJ7166686
Regular
Jul 24, 2012

RICHARD ANDERSON vs. JAGUAR/LANDROVER OF VENTURA, COMPWEST INSURANCE COMPANY

This case involves an applicant who suffered a stroke and subsequent 100% permanent disability following surgery for an industrial shoulder injury. The defendant sought reconsideration, arguing for apportionment to pre-existing conditions and challenging the attorney's fee calculation. The Appeals Board affirmed the 100% permanent disability finding, finding no basis for apportionment as the applicant's pre-existing conditions did not cause the disability itself. However, the Board modified the attorney's fee award, requiring commutation using a specific method and a 3% cost of living adjustment, finding the previously assumed 4.6% to be speculative.

Workers Compensation Appeals BoardRichard AndersonJaguar/Landrover of VenturaCompwest Insurance CompanyADJ7166686ReconsiderationFindings and AwardIndustrial InjuryBrain InjuryNeurological System
References
Case No. ADJ555322, ADJ1127657, ADJ3643619, ADJ3733400, ADJ615070
Regular
Jan 23, 2023

RICHARD CORTEZ vs. PARAMOUNT PICTURES, MURPHY AND BEANE

The Workers' Compensation Appeals Board denied Paramount Pictures' petition for reconsideration. The Board upheld the WCJ's finding that the applicant was entitled to a retroactive increase in temporary disability payments based on Labor Code Section 4661.5. The defendant failed to provide evidence to support their proposed method of calculating the earnings rate or to establish prejudice for the applicant's delay in claiming the increase. Therefore, the original award granting the increased benefits remains in effect.

Workers' Compensation Appeals BoardPetition for Reconsideration DeniedTemporary Disability (TTD) RateLabor Code Section 4661.5Labor Code Section 4453Average Weekly EarningsUnion ContractMotion Picture Health and WelfareRetroactive IncreaseCollective Bargaining Agreement
References
Case No. ADJ8067157
Regular
Nov 30, 2012

MARISOL PERALTA vs. FROZEN YOGURT OF VALLEY VILLAGE, INC., STAR INSURANCE CO.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to further develop the record regarding applicant Marisol Peralta's alleged industrial injury. The WCAB rescinded the prior decision finding an injury, citing that the medical opinions were not substantial evidence as they lacked definitive causation findings and weren't based on complete medical histories. Crucially, neither physician reviewed applicant's full medical records, and one deferred causation due to pregnancy while the other awaited X-ray results. The case is returned to the trial level for further proceedings and a new decision by the WCJ.

Workers' Compensation Appeals BoardMarisol PeraltaFrozen Yogurt of Valley VillageInc.Star Insurance Co.Illinois Midwest Insurance AgencyLLCADJ8067157Opinion and Order Granting ReconsiderationDecision After Reconsideration
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. ADJ 4200496 (GRO 0030688)
Regular
Jan 19, 2010

FRANCISCO MARTINEZ-REYES vs. SOLAMAR FARMS, INC., STATE COMPENSATION INSURANCE FUND

This case concerns the proper method for calculating permanent disability award commutations for a farm laborer with 100% disability sustained on February 10, 2004. The applicant appeals the administrative law judge's decision favoring the Uniformed Reduction (UR) method, arguing the Uniformed Increasing Reduction (UIR) method better accounts for state average weekly wage (SAWW) increases mandated by Labor Code section 4659. The Appeals Board granted reconsideration, rescinded the prior decision, and remanded the case for a new decision. The Board found the UIR method better serves the goal of consistent periodic payments, and the SAWW increase commencement date was not moot.

Workers' Compensation Appeals BoardUniformed Reduction (UR)Uniformed Increasing Reduction (UIR)State Average Weekly Wage (SAWW)Permanent Disability AwardCommutationLabor Code Section 4659Life PensionTotal Permanent DisabilityCost of Living Adjustment (COLA)
References
Case No. ADJ3066350 (RIV 0081274)
Regular
Jun 07, 2011

RICHARD KAUTZER vs. KENNY STRICKLAND, INC./ HEMET OIL CO.; STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Richard Kautzer's petition for reconsideration in this case. The Board adopted the WCJ's report and reasoning for the denial. Additionally, the Board noted that the applicant's attorney failed to comply with WCAB Rule 10778 regarding notification to the applicant of adverse interests and rights to independent counsel when requesting a fee increase. This procedural deficiency could have been grounds for dismissing the fee increase request.

Workers' Compensation Appeals BoardKenny StricklandHemet Oil Co.State Compensation Insurance FundADJ3066350RIV 0081274Order Denying ReconsiderationWCAB Rule 10778increased feeadverse interest
References
Case No. ADJ4646082 (OAK 0341803)
Regular
Jul 22, 2016

WILLIAM MATEO vs. B&C TRANSIT CONSULTANTS, INC.

The Workers' Compensation Appeals Board granted reconsideration to increase the applicant's award by 10% under Labor Code section 4554 due to the employer's willful failure to secure workers' compensation insurance. The Board found that the employer failed to meet its burden of proving its uninsured status was not willful, despite stipulations of uninsured status. The applicant's attorney's fees were also increased to include 15% of the penalty award.

Labor Code section 4554Willful failure to secure compensationPrima facie evidence of willfulnessIncreased compensationUninsured employers fundPetition for reconsiderationFindings of Fact and AwardDecision after reconsiderationTemporary disability indemnityPermanent disability indemnity
References
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