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

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. 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. 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. 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
Case No. OAK 313422
Regular
Mar 11, 2008

JOHN SILVA vs. BMD PLUMBING, INC., STATE FARM

The Appeals Board granted reconsideration to clarify the applicability of the 2005 Permanent Disability Rating Schedule. The Board affirmed its prior decision rescinding the original award and remanding for new findings using the 2005 schedule, concluding that no report pre-dating 2005 indicated the existence of permanent disability. This ruling aligns with recent appellate court decisions holding that specific P&S statements are not required if a report indicates permanent disability.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilityPDRSVera v. Workers' Comp. Appeals Bd.Genlyte Group v. Workers' Comp. Appeals Bd.Zenith Insurance Co. v. Workers' Comp. Appeals Bd.Labor Code Section 4660(d)Medical-Legal Report
References
6
Case No. ADJ2653629 (LAO 0826099)
Regular
Dec 02, 2011

, Applicant, vs. HERITAGE PRINTING AND FINISHING CORP.; CHARTIS,

This case concerns the application of the 1997 or 2005 permanent disability rating schedule for a 2003 injury. The applicant's psychiatric permanent disability was found to exist as of November 1, 2004, based on a comprehensive medical-legal report. The Appeals Board affirmed the WCJ's decision to use the 1997 schedule, as the pre-2005 report triggered an exception under Labor Code section 4660(d). The defendant's arguments regarding the report's qualifications and separate rating for body parts were rejected.

Permanent disability rating scheduleLabor Code section 4660(d)1997 rating schedule2005 rating scheduleComprehensive medical-legal reportTreating physician reportAldi v. CarrMcClellanIngersollThompson & Horn
References
4
Case No. ADJ4099888 (WCK 0066521)
Regular
Nov 16, 2011

SALLY MERDIAN vs. AIG CLAIMS SERVICES, CHARTIS INSURANCE

This case concerns the proper permanent disability rating schedule to apply for an injury sustained in 2002. The Workers' Compensation Appeals Board (WCAB) found that the primary treating physician's December 20, 2004 report, when considered with the entire record, provided substantial evidence of permanent disability prior to January 1, 2005. Therefore, the WCAB rescinded the trial judge's decision and returned the case to the trial level to rate the permanent disability using the 1997 Schedule, not the 2005 Schedule. The WCAB clarified that the magnitude of the injury or disability is immaterial to determining if a pre-2005 report "indicates" permanent disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent DisabilityRating SchedulePrimary Treating PhysicianMedical-Legal ReportLabor Code Section 4660(d)Industrial InjuryNeck Injury
References
9
Case No. SJO 0251644
En Banc
Jan 24, 2007

Joseph Baglione vs. Hertz Car Sales, AIG

The Board holds that for a pre-2005 injury, the former Permanent Disability Rating Schedule (PDRS) applies if a comprehensive medical-legal report was issued before January 1, 2005, regardless of whether the report itself indicated the existence of permanent disability.

SB 899PDRSLabor Code section 4660(d)en banccomprehensive medical-legal reporttreating physician reportformer PDRSnew PDRSlast antecedent rulestatutory construction
References
19
Case No. SJO 0251644
En Banc
Apr 06, 2007

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

The Appeals Board holds that for the 1997 Schedule for Rating Permanent Disabilities to apply to a pre-2005 injury, a comprehensive medical-legal report or treating physician's report issued before 2005 must explicitly indicate the existence of permanent disability.

Workers' Compensation Appeals BoardJoseph BaglioneHertz Car SalesAIGCambridge Integrated ServicesOpinion and Order Granting ReconsiderationDecision After ReconsiderationEn Banc1997 Schedule2005 Schedule
References
27
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