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

Case No. ADJ6879193
Regular
Feb 10, 2012

KATHERINE LAU vs. CUPERTINO UNION SCHOOL DISTRICT, KEENAN and ASSOCIATES

The Workers' Compensation Appeals Board granted reconsideration to review the application of the 1997 vs. 2005 Permanent Disability Rating Schedules. The Board reversed the WCJ's finding, determining there was insufficient pre-2005 medical evidence of permanent disability to apply the 1997 schedule. Consequently, the Board applied the 2005 schedule, reducing the applicant's permanent disability rating from 29% to 12%. One Commissioner dissented, arguing the record supported the use of the 1997 schedule based on pre-2005 indications of permanent disability.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent Disability Rating1997 Schedule2005 ScheduleLabor Code Section 4660(d)Comprehensive Medical-Legal ReportTreating Physician ReportIndustrial Injury
References
4
Case No. SJO 0251644
Significant
Apr 06, 2007

Joseph Baglione vs. Hertz Car Sales, AIG, Cambridge Integrated Services

The Workers' Compensation Appeals Board, in an en banc decision, reconsiders and reverses its prior ruling, holding that for pre-2005 injury claims, the 1997 Schedule for Rating Permanent Disabilities applies only if a pre-2005 comprehensive medical-legal report or a treating physician's report explicitly indicates the existence of permanent disability. The Board affirmed the original judge's decision to apply the 2005 Schedule in this case.

Workers Compensation Appeals BoardJoseph BaglioneHertz Car SalesAIGCambridge Integrated ServicesSJO 0251644Opinion and Order Granting ReconsiderationEn Banc1997 Schedule2005 Schedule
References
27
Case No. ADJ1232911
Regular
Jun 22, 2009

ADALBERTO OCHOA vs. SLATON & SON ROOFING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the original finding of industrial injury, temporary disability, need for further treatment, and 37% permanent disability for applicant Adalberto Ochoa. The defendant argued the WCJ erred by applying the 1997 permanent disability rating schedule, claiming no pre-2005 medical reports indicated permanent disability. However, the Board adopted the WCJ's report, denying reconsideration and affirming the original award. A dissenting opinion argued the 2005 rating schedule should apply as no pre-2005 medical reports indicated permanent disability, and the WCJ's interpretation of temporary disability advances was improper.

WCABADALBERTO OCHOASLATON & SON ROOFINGSTATE COMPENSATION INSURANCE FUNDFindings and Awardrooferlumbar spinetemporary disabilitypermanent disabilityLabor Code section 4909
References
5
Case No. ADJ3470129 (SAC 0343138)
Regular
Jun 19, 2009

Refugio Hidalgo vs. Falcon Roofing

This case concerns applicant Refugio Hidalgo's appeal of a workers' compensation award for injuries sustained in 2004. The primary dispute involves whether to apply the 2005 or 1997 Permanent Disability Rating Schedule, with applicant arguing exceptions exist due to pre-2005 medical reports indicating disability and employer notice failures. The Board granted reconsideration to address the applicant's diminished future earning capacity (DFEC) claim and agreed to use a corrected occupational group number. However, a dissenting commissioner argued that the pre-2005 medical reports on file met the criteria to use the 1997 schedule, disagreeing with the majority's deferral of this issue.

Refugio HidalgoFalcon RoofingADJ3470129SAC 0343138Workers' Compensation Appeals BoardAmended Findings and AwardTMJspinal injurychin injuryupper extremity injury
References
5
Case No. ADJ1457992 (AHM 0084718)
Regular
Dec 26, 2014

DARLENE HELLER vs. COWELL BAKER'S STRIPPING SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, SEDGWICK CMS, FREMONT INSURANCE COMPANY

This case concerns a dispute over the correct procedure for obtaining medical reevaluations for a worker's injury with a date prior to January 1, 2005. The Appeals Board denied the applicant's petition for reconsideration, reversing an earlier decision that had directed the parties to use the panel QME process. The Board clarified that for pre-2005 injuries, the pre-Senate Bill 899 AME/QME procedures apply, not the current section 4062.2 QME process. One Commissioner dissented, arguing the prior award should be reinstated.

Workers' Compensation Appeals BoardPetition for ReconsiderationOpinion and Order DenyingFindings and AwardLabor Code section 4062.2panel qualified medical examinationQMEdisputed body partsadmitted liabilitydate of injury
References
3
Case No. ADJ3692050
Regular
Mar 11, 2011

STEVEN HAULENBECK vs. CITY OF ANAHEIM

This case concerns an applicant seeking reconsideration of a denial for lumbar spinal decompression therapy. The Appeals Board previously reversed a WCJ's award of this treatment, finding the applicant failed to follow proper utilization review (UR) and dispute resolution procedures. Although the applicant argued that the prior decision incorrectly applied a statute not applicable to pre-2005 injuries, the Board denied reconsideration. The Board determined that even under the applicable pre-2005 law, the applicant failed to timely object to the UR denial and initiate the required dispute resolution process. Therefore, the requested medical treatment was not authorized.

Workers' Compensation Appeals BoardPetition for ReconsiderationLumbar spinal decompression therapyIndustrial injuryKnee injuryPolice officerPermanent disabilityCompensable consequenceUtilization reviewLabor Code section 4062.2
References
3
Case No. GRO 0031310
Regular
May 02, 2008

RONALD CHRISTENSEN vs. CALIFORNIA POLYTECHNIC SAN LUIS OBISPO; Permissibly Self-Insured c/o SEDGWICK CMS

This case concerns an applicant injured before January 1, 2005, who sought reconsideration of a finding of no permanent disability. The Appeals Board denied reconsideration, holding that the 2005 permanent disability rating schedule applies unless specific exceptions under Labor Code section 4660(d) are met. Since no pre-2005 report indicated permanent disability, the WCJ correctly applied the 2005 schedule.

Permanent disability rating scheduleLabor Code section 4660AD Rule 9805prospective applicationexceptionsAldi v. CarrMcClellanIngersollThompson & HornCostco Wholesale Corp. v. Workers' Comp. Appeals Bd. (Chavez)
References
2
Case No. MISSING
Regular Panel Decision

Stolarski v. Family Services of Westchester, Inc.

Plaintiff Arlene Stolarski appealed a judgment from the Supreme Court, Westchester County, which dismissed her cause of action to recover damages for conscious pain and suffering in a wrongful death action. The decedent, after an apparent suicide attempt and subsequent consultations with Family Services of Westchester, Inc., died by suicide shortly after. Plaintiff alleged negligence by Family Services in treating the decedent's depression, causing conscious pain and suffering between October 19, 2005, and October 28, 2005. The Supreme Court initially granted the defendant's motion to dismiss, reasoning that such damages couldn't be recovered in a wrongful death action and that the depression was pre-existing. The Appellate Division reversed, holding that a cause of action for personal injuries, including conscious pain and suffering due to professional malpractice, survives the decedent's death and may be recovered by her estate, and that pre-existing conditions do not preclude proving exacerbation by alleged negligent treatment.

Wrongful DeathConscious Pain and SufferingProfessional MalpracticeNegligenceSuicideMental Health TreatmentSurvival StatuteAppellate ReviewMotion to DismissPre-existing Condition
References
14
Case No. STK 181253
Regular
Sep 21, 2007

VIRGINIA NENITA CORTEZ vs. VILLA MARCHE, INC., UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board granted reconsideration to apply the 2005 Schedule for Permanent Disability Ratings instead of the 1997 Schedule. The Board found that no exceptions applied to require the older schedule, as no pre-2005 comprehensive medical-legal reports or treating physician reports indicated permanent disability, and the last temporary disability payment occurred after January 1, 2005. Therefore, the case was returned for a new decision under the 2005 Schedule.

Uninsured Employers Benefits Trust FundLabor Code section 4660(d)1997 Schedule2005 SchedulePermanent and StationaryComprehensive Medical-Legal ReportTreating Physician ReportTemporary Disability IndemnitySection 4061 NoticeAldi v. Carr
References
6
Case No. ANA 0385112
Regular
Feb 15, 2008

LIANA SAENZ vs. ORANGE COUNTY DEPARTMENT OF EDUCATION, Permissibly Self-Insured, Adjusted By SOUTHERN CALIFORNIA RISK MANAGEMENT ASSOCIATES, INC.

This case involves a dispute over which workers' compensation permanent disability rating schedule to apply. The applicant sustained injury before January 1, 2005, but the defense QME report determining her permanent and stationary status was dated November 2004 but not signed until February 2005. The Appeals Board granted reconsideration to apply the 1997 Schedule, finding that the date of the physician's evaluation, not the signing date of the report, should control when an exception to the 2005 Schedule is invoked for pre-2005 injuries.

Workers' Compensation Appeals BoardCumulative trauma injuryPermanent disability rating2005 Schedule1997 ScheduleLabor Code section 4660(d)Qualified Medical EvaluatorComprehensive medical-legal reportPermanent and stationary statusDate of evaluation
References
3
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