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

Case No. ADJ1220987 (SJO 0262634)
Regular
Nov 17, 2010

RICHARD GILLISPIE vs. PLASTECH, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) appealed an award of benefits to an applicant with a pre-existing disability, arguing a subsequent industrial back injury did not cause pathology in the opposite leg as required by statute. The Appeals Board affirmed the award, finding that Labor Code section 4751 only requires the subsequent injury to "affect" the opposite member, not necessarily cause direct pathology. Evidence showed the applicant's low back injury caused verified radiculopathy and impaired leg function, meeting the statutory requirement. The Board found SIBTF's legal arguments unpersuasive and the WCJ's findings supported by substantial evidence.

Subsequent Injuries Benefits Trust FundLabor Code section 4751industrial injurylow backradiculopathypermanent disabilityopposite and corresponding memberpathologyAMA GuidesDRE category III
References
Case No. ADJ2329367 (OAK 0323054)
Regular
May 06, 2013

JOSEPH VALTIERRA vs. TCB INDUSTRIAL, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and rescinded the WCJ's award due to inadequate medical evidence regarding the applicant's left shoulder injury. Both the applicant's and defendant's medical evaluators provided opinions that were found to be speculative, incomplete, and not based on a full understanding of the underlying pathology. The Board determined that substantial evidence was lacking on the apportionment of disability and the precise nature of the left shoulder condition. The case is returned to the trial level for further development of the medical record.

Compensable consequenceApportionmentSubstantial evidenceMedical opinionReasonable medical probabilityUnderlying pathologyLeft shoulder injuryRight shoulder injuryMillwrightCumulative trauma
References
Case No. ADJ10387978
Regular
Aug 13, 2019

MELE LATU vs. HEWLETT PACKARD ENTERPRISE SERVICES, SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case involves a denied petition for reconsideration regarding Subsequent Injuries Benefits Trust Fund (SIBTF) benefits. The applicant settled her industrial injury claim for $937,166, then sought SIBTF benefits. The Board denied the petition because the applicant failed to prove a pre-existing "labor disabling" condition, which is a requirement for SIBTF eligibility even after statutory changes. Medical evidence indicated the applicant was asymptomatic and functional prior to her industrial injury, and any apportionment was to asymptomatic pathology, not a labor-disabling condition.

Subsequent Injuries Benefits Trust FundSIBTFLabor Code section 4751labor disablingpermanent partial disabilityapportionmentSenate Bill 899SB 899asymptomatic pathologyEscobedo v. Marshalls
References
Case No. SJO 243795
Regular
Sep 17, 2007

BAIRO SISIC vs. VASONA MANAGEMENT, INC., UNITED STATES FIRE INSURANCE COMPANY

The Appeals Board granted reconsideration because the administrative law judge (WCJ) incorrectly applied the 1997 Permanent Disability Rating Schedule. The WCJ's reasoning for using the older schedule, based on pre-existing pathology and unadmitted medical reports, was flawed. The case is remanded for a new decision on which rating schedule applies, considering Labor Code § 4660(d) and whether specific reports or prior temporary disability payments trigger the 1997 schedule.

Workers' Compensation Appeals BoardVasona ManagementInc.United States Fire Insurance CompanyCrum & Forsterpermanent disability rating1997 Schedule2005 Schedulepre-existing pathologydegenerative disc disease
References
Case No. ADJ8423386
Regular
Nov 14, 2016

CARLOS FIGUEROA vs. PERFORMANCE AUTO CARE, AMTRUST NORTH AMERICA

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's decision that apportioned 50% of the applicant's left knee disability to non-industrial factors. The Board found that the agreed medical evaluator's opinion on apportionment lacked sufficient detail and clarity to constitute substantial evidence. Consequently, the Board deferred the issues of permanent disability and apportionment, remanding the case for further development of the record. This will involve obtaining clarification from the medical evaluator regarding how prior injuries and pathology specifically contributed to the applicant's current impairment and the success of his knee replacement surgery.

Workers' Compensation Appeals BoardPetition for ReconsiderationApportionmentAgreed Medical EvaluatorOrthopedistSubstantial Medical EvidenceAMA GuidesWhole Person ImpairmentTotal Knee ReplacementPre-existing Pathology
References
Case No. ADJ9519541
Regular
Jul 26, 2019

Sonia Young-Mitchell vs. SECURITAS SECURITY SERVICES

This case involves an applicant seeking permanent total disability benefits after an admitted industrial injury to her back, lower extremities, right ankle, and left knee. The applicant argues the Workers' Compensation Judge (WCJ) erred by apportioning 10% of her left knee disability to a pre-existing asymptomatic condition. The Appeals Board granted reconsideration, finding that the Agreed Medical Examiner (AME) impermissibly apportioned to the cause of the injury rather than pre-existing pathology. Consequently, the Board amended the award to find the applicant 100% permanently totally disabled, returning the matter for a new award.

Workers Compensation Appeals BoardSonia Young-MitchellSecuritas Security ServicesSedgwick Claims Management Servicespermanent total disabilityapportionmentleft knee injurycompensable consequencevocational evidenceAgreed Medical Examiner
References
Case No. ADJ8083715
Regular
Sep 15, 2025

KAREN WHISNANT vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board granted reconsideration to address whether apportionment applies when calculating the subsequent permanent disability threshold for SIBTF benefits. Applicant Karen Whisnant's eligibility for SIBTF benefits hinged on this interpretation, with the WCJ initially finding her eligible based on a 42% disability without apportionment. The Board affirmed the WCJ's April 5, 2022 Findings of Fact but clarified that apportionment is not considered when determining the 5% or 35% SIBTF eligibility threshold, citing precedents like Bookout v. Workers' Comp. Appeals Bd. Consequently, the Board's decision ensures that the applicant's subsequent injury rating of 42% (unapportioned) qualifies her for benefits.

Subsequent Injuries Benefits Trust FundSIBTFpermanent disabilityapportionmentLabor Code section 4751eligibility thresholdWCJreconsiderationFindings of FactBookout
References
Case No. ADJ4151507 (SFO 0487197)
Regular
Feb 02, 2020

Tracy Sullivan vs. Café Amsterdam, State Compensation Insurance Fund

The Appeals Board granted reconsideration and amended the previous award, finding the applicant's burn injury did not qualify for the "severe burns" exception to the temporary disability indemnity limit under Labor Code section 4656(c)(3)(D). Consequently, temporary disability indemnity is limited to 104 weeks from the commencement of payments on August 10, 2004. The Board affirmed the WCJ's finding that the applicant's psychiatric injury was compensable, meeting the "sudden and extraordinary" employment condition exception. Clerical errors in the original findings were also corrected.

ADJ4151507SFO 0487197Tracy SullivanCafé AmsterdamState Compensation Insurance FundPetition for ReconsiderationFindings Award and OrderWCJindustrial injurycervical spine
References
Case No. ADJ3339526
Regular
Oct 14, 2008

Jeffrey Zajdel vs. CALIPATRIA STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to address the issue of apportionment of the applicant's permanent disability due to a heart and brain injury. The Board rescinded the prior decision that apportioned 50% of the disability to non-industrial factors, finding the medical opinion supporting apportionment speculative and not based on established legal principles. Consequently, the Board issued a new award for 100% permanent disability without apportionment and reinstated the applicant's attorney's fees based on this higher award.

WORKERS' COMPENSATION APPEALS BOARDJEFFREY ZAJDELCALIPATRIA STATE PRISONSTATE COMPENSATION INSURANCE FUNDADJ3339526VNO 0491968OPINION AND ORDER GRANTING RECONSIDERATIONSUPPLEMENTAL FINDINGS AND AWARDINDUSTRIAL INJURYHEART INJURY
References
Case No. LBO 359136
Regular
Dec 17, 2007

JOAQUIN GRANADOS vs. JKB CORPORATION, STATE COMPENSATION INSURANCE FUND

This case involves a dispute over whether the 1997 or 2005 disability rating schedule applies to applicant Joaquin Granados's left knee and back injury, and the appropriateness of apportionment. The Appeals Board granted reconsideration, rescinded the previous award, and returned the matter for new rating instructions. This decision was based on the finding that no medical report established applicant reached permanent and stationary status prior to January 1, 2005, thus mandating the application of the 2005 Schedule. Furthermore, the Board found Dr. Nottage's apportionment report to be substantial evidence, unlike Dr. Schwartz's, and ordered further proceedings based on Dr. Nottage's findings.

Workers' Compensation Appeals BoardJoaquin GranadosJKB CorporationState Compensation Insurance FundAmended Findings and AwardConstruction WorkerIndustrial InjuryLeft KneeBackPermanent Disability
References
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