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

Case No. ADJ4258585 (OXN 0130492) ADJ220258 (OXN 0130487)
Regular
Apr 17, 2018

ENRIQUE HERRERA vs. MAPLE LEAF FOODS, U.S. FIRE INSURANCE COMPANY, ALEA NORTH AMERICAN INSURANCE COMPANY

This notice informs parties that the Workers' Compensation Appeals Board (WCAB) intends to admit its rating instructions and a disability rater's recommended permanent disability rating into evidence. The WCAB previously granted reconsideration for further study. Parties have seven days to object to the rating instructions or the recommended rating, with specific procedures for addressing objections. If no timely objection is filed, the matters will be submitted for decision thirty days after service.

WORKERS' COMPENSATION APPEALS BOARDPermanent Disability RatingDisability Evaluation UnitRating InstructionsRecommended Permanent Disability RatingJoint RatingReconsiderationObjectionRater Cross-ExaminationRebuttal Evidence
References
0
Case No. ADJ1679104 (LBO 0387820)
Regular
Aug 26, 2010

GUADALUPE FREGOSO vs. INTEGRAL DESIGN CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

This case concerns a defendant's petition for reconsideration of a permanent disability rating for an applicant injured on August 1, 2006. The defendant argued the rating was erroneous because the administrative law judge (WCJ) instructed the disability evaluator to rate the treating physician's report without referencing the AMA Guides. The Appeals Board denied the petition, finding that the WCJ's instructions were based on the physician's opinion, which complied with the AMA Guides, and the evaluator's rating followed those instructions. The Board also corrected a clerical error regarding the attorney fee calculation.

WORKERS' COMPENSATION APPEALS BOARDReconsiderationFindings and Awardtemporary disabilitypermanent disabilityapportionmentnon-industrial causesindustrial injurynecklow back
References
1
Case No. ADJ360205 (LBO 0384980)
Regular
Aug 05, 2010

Gurdev Malhotra vs. STATE OF CALIFORNIA, DEPARTMENT OF DEVELOPMENTAL SERVICES FAIRVIEW; Legally Uninsured, CONTRACT SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's advisory opinion concerning permanent disability rating for grip loss. Defendant argued the WCJ erred by allowing rating for grip loss when range of motion was present, and that the QME's reports did not support grip loss rating. The Board rescinded the WCJ's findings, remanding the case for further proceedings to ensure the WCJ follows the established process for issuing rating instructions based on substantial medical evidence, as clarified in *Blackledge v. Bank of America*. The ultimate determination of permanent disability requires a proper QME opinion and subsequent rating instructions from the WCJ.

Workers' Compensation Appeals BoardGurdev MalhotraState of California Department of Developmental ServicesLegally UninsuredContract ServicesPermanent Disability RatingGrip LossAMA GuidesQualified Medical EvaluatorQME
References
1
Case No. MISSING
Regular Panel Decision

People v. Young

An attorney representing an indigent defendant in Monroe County filed an application seeking reimbursement for legal services at a rate of $200 per hour, mirroring the rate charged by the Special Prosecutor, rather than the statutory rates under County Law § 722-b. The attorney argued that the significant disparity in hourly compensation violated the defendant's right to equal protection and that his qualifications justified the requested rate. The New York State Association of Criminal Defense Lawyers supported the application as amicus curiae, while Monroe County opposed it, arguing the request was untimely and lacked extraordinary circumstances. Presiding Judge Donald J. Mark, J., acknowledged the court's authority to grant compensation in excess of statutory limits under extraordinary circumstances but ultimately denied the application. The denial was based on the court's reasoning that an analogous argument was previously rejected, that linking assigned counsel rates to prosecutor rates would render County Law § 722-b ineffective, and that extraordinary circumstances could not be demonstrated prior to the conclusion of the criminal action. The court, however, reserved the right to reconsider an increased hourly fee upon the case's termination if such circumstances are then proven.

Assigned CounselLegal Aid CompensationCounty Law Section 722-bHourly Rate DisputeSpecial Prosecutor FeesIndigent RightsJudicial DiscretionExtraordinary CircumstancesMonroe County LawEqual Protection Challenge
References
16
Case No. ADJ9757215
Regular
Feb 16, 2017

CHRISTOPHER COLLINS vs. SOUTHEAST PERSONNEL LEASING, INC., STATE NATIONAL INSURANCE COMPANY, PACKARD CLAIMS ADMINISTRATION

This case involves a Petition for Removal filed by the applicant, Christopher Collins, challenging Formal Rating Instructions. The Workers' Compensation Appeals Board (WCAB) dismissed the Petition for Removal, clarifying that it is not the proper procedural vehicle for objecting to rating instructions. The WCAB noted that pursuant to Rule 10602, a timely objection must be made directly to the Workers' Compensation Judge. Therefore, the WCAB is remanding the matter to the trial level to have the Petition for Removal treated as a timely objection.

Petition for RemovalFormal Rating InstructionsWorkers' Compensation Appeals BoardWCJObjectionTrial LevelDismissedTimelyRule 10602
References
0
Case No. ADJ3673382 (AHM 0084473) ADJ1727200 (AHM 0085831) ADJ4050086 (AHM 0085856) ADJ2402991 (AHM 0085857) ADJ1361609 (AHM 0085858) ADJ700319 (AHM 0085827) ADJ1199908 (AHM 0085828) ADJ2455910 (AHM 0085829) ADJ1533147 (AHM 0085855)
Regular
Jun 19, 2009

DOUGLAS BOULWARE vs. COUNTY OF LOS ANGLES FIRE DEPARTMENT

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior decision due to acknowledged errors by the WCJ, including a miscalculation of the applicant's life pension, and procedural issues raised by the defendant regarding service of rating instructions. The case involves multiple injury claims to various body parts over a long period, with complex apportionment issues. The matter is returned to the trial level for new formal rating instructions, proper service, opportunity for cross-examination, and a new decision addressing all contentions.

Workers' Compensation Appeals BoardDouglas BoulwareCounty of Los Angeles Fire DepartmentIntercare Insurance Servicesfirefighterindustrial injuryskinhearingshoulderselbows
References
2
Case No. ADJ696907 (VNO 0543817)
Regular
Jul 23, 2010

ROBERT PERCHLAK vs. WAL-MART, AVIZENT BENTONVILLE

The Workers' Compensation Appeals Board (WCAB) reconsidered a decision regarding Robert Perchlak's industrial injury claim against Wal-Mart. The applicant challenged the $44\%$ permanent disability rating, arguing the rating specialist improperly disregarded physician findings. The WCAB clarified that rating specialists are limited to rating based on WCJ instructions and cannot independently assess medical impairments or deviate from AMA Guides criteria. The WCAB amended the decision to defer permanent disability and attorney's fees, returning the case for further proceedings to clarify the physician's impairment findings and ensure proper rating procedures are followed.

Workers' Compensation Appeals BoardRobert PerchlakWal-MartAvizent BentonvilleOpinion and Decision After ReconsiderationPermanent DisabilityApportionmentDr. Arthur LipperAppeals Board Rule 10602Rater Authority
References
1
Case No. ADJ2419784 (LBO 0367096)
Regular
Oct 02, 2012

ANTHONY DE FAZIO vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, SEDGWICK CMS

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to review the apportionment of permanent disability awards for applicant Anthony De Fazio. Applicant sustained three separate industrial injuries in 2002, 2003, and 2004, resulting in distinct permanent disability ratings. Applicant argued that all permanent disability should be awarded as a single lump sum due to intertwined work restrictions, citing *Benson v. Permanente Medical Group*. The WCAB rescinded the prior decision and returned the matter to the trial level. This was done to allow for new rating instructions that would apply the "common restriction" to each injury, with a specific instruction for the workers' compensation judge to consider any overlap in disability.

Workers' Compensation Appeals BoardAnthony De FazioLos Angeles Unified School DistrictSedgwick CMSReconsiderationJoint Findings and AwardPermanent DisabilityApportionmentBenson v. Permanente Medical GroupIndustrial Injuries
References
6
Case No. ADJ4136427 (VNO 0353070)
Regular
Apr 15, 2019

Gloria Novoa vs. AMEJEAN CORPORATION, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, TRISTAR RISK MANAGEMENT, SUPERIOR PACIFIC INSURANCE COMPANY

This case involves CIGA's appeal of a Workers' Compensation Appeals Board decision finding applicant sustained industrial injuries to her head, psychiatric, cervical spine, lumbar spine, and heart, resulting in 98% permanent disability. CIGA argued for greater apportionment of disability based on medical opinions and questioned the rating instructions for headaches and GI injury. The Board granted reconsideration to address a procedural error concerning the GI injury, deferring that issue for further proceedings. Otherwise, the Board affirmed the original findings, finding CIGA's arguments regarding apportionment and rating instructions lacked merit, and specifically rejecting CIGA's attempt to impose apportionment for psychiatric injury based on orthopedic opinions.

Workers' Compensation Appeals BoardCalifornia Insurance Guarantee Association (CIGA)ReconsiderationFindings and AwardWorkers' Compensation Administrative Law Judge (WCJ)Industrial InjuryPost Concussive SyndromePsychiatric InjuryCervical SpineLumbar Spine
References
6
Case No. MISSING
Regular Panel Decision

Claim of Perrin v. Builders Resource, Inc.

The case concerns an appeal from a Workers' Compensation Board decision regarding the reimbursement rate for home health aide services provided to a claimant by their sister. Initially, the carrier denied payment but was later directed to pay. The Workers’ Compensation Law Judge set the reimbursement rate at $12 per hour for services starting in 2011, which the Board affirmed. The claimant appealed, solely challenging this rate. The court dismissed the appeal, ruling that the claimant was not an aggrieved party concerning the reimbursement rate, as the dispute was between the care provider (the sister) and the carrier. The court affirmed that the claimant received the care sought and could not raise issues on behalf of the care provider.

Workers' CompensationHome Health Aide ServicesReimbursement RateAppeal DismissalAggrieved PartyCare ProviderWorkers' Compensation BoardAppellate ProcedureNew York LawCarrier Liability
References
4
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