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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
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
Case No. ADJ758842 (VNO 0559214)
Regular
Dec 17, 2010

JOHN PATCHETT vs. CITY OF LOS ANGELES

The Appeals Board denied the applicant's petition for removal, affirming the WCJ's decision to vacate the submission. This action was based on the DEU evaluator's testimony, which revealed deficiencies in the AMEs' reports concerning the AMA Guides. The Board found the applicant waived any objection to this testimony by failing to object at trial, and that the evaluator's expert opinion was permissible per *Blackledge v. Bank of America*. Defendant's objection, though not styled as a motion to strike, sufficiently raised the issues leading to the vacation of the rating.

Petition for RemovalOrder Vacating SubmissionDEU evaluatorAMA Guidesagreed medical evaluators (AMEs)rating instructionssubstantial evidenceobjective factors of disabilitywhole person impairmentformal rating
References
Case No. ADJ4669912 (VNO 0530425) ADJ1143446 (VNO 0553298)
Regular
Nov 29, 2010

CLAUDIA ARIZMENDI vs. CLEUGH'S FROZEN FOODS, PACIFIC COMEPNSATION INSURANCE COMPANY

This case concerns a lien claimant's petition for reconsideration regarding the allowable reimbursement rate for medical treatment. The Workers' Compensation Appeals Board (WCAB) granted reconsideration due to a discrepancy between the administrative law judge's (WCJ) original award and the testimony of the defendant's expert witness. The WCJ's award was based on an incorrect calculation of the expert's testimony, which the WCAB corrected to reflect the expert's stated daily allowable rate. Consequently, the WCAB amended the Findings and Award to reimburse the lien claimant at the higher rate of $86.72 per day.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings and AwardAdministrative Law JudgeExpert WitnessReimbursement RateAcupuncture Procedure CodePhysical Therapy CodeBill Review Expert
References
Case No. ADJ11368246
Regular
Mar 03, 2020

Marta Ubillus vs. One Stop Employment Services, LLC/Vensure Employer Services, Security National Insurance Company, State National Insurance Company

The Workers' Compensation Appeals Board (WCAB) denied the lien claimant's petition for reconsideration regarding the valuation of interpreter services. The WCAB adopted the Administrative Law Judge's (ALJ) report, which found that while the defendant did not present rebuttal evidence, the ALJ had substantial evidence to make a determination. The ALJ determined a market rate of $114.97 per hour but noted the lien claimant failed to provide sufficient evidence of the duration of services on most dates, preventing application of the market rate. Consequently, the statutory rate was applied for those services.

WCABPetition for ReconsiderationDeniedLien ClaimantInterpreter ServicesMarket RateStatutory RateWCJ ReportSubstantial EvidenceFindings and Award
References
Case No. ADJ10187704, ADJ10924724
Regular
May 17, 2018

STEVEN CASE vs. GOLDEN GATE BRIDGE HIGHWAY AND TRANSPORTATION DISTRICT

The Workers' Compensation Appeals Board granted reconsideration to increase applicant's permanent disability rating for bilateral shoulder injury from 9% to 38%. The Board found the Agreed Medical Evaluator's (AME) alternative rating, based on strength loss, was substantial medical evidence and properly considered within the AMA Guides. The WCJ erred in applying an overly restrictive interpretation of "complex or extraordinary" cases for deviating from strict AMA Guides ratings. The AME's use of strength loss data from the AMA Guides, even for an age outside the specified range, was permissible under the *Almaraz-Guzman* line of cases when justified by clinical judgment.

Workers' Compensation Appeals BoardJoint Findings and AwardPetition for ReconsiderationAgreed Medical Evaluator (AME)permanent disability ratingbilateral shouldersorthopedic AMEAMA GuidesAlmaraz-Guzmanstrength loss index
References
Case No. ADJ1058308 (VNO 0482296)
Regular
May 28, 2013

DONNA DeRUSSY vs. ANTELOPE VALLEY HEALTH CARE SYSTEM, TRAVELERS INSURANCE, SAFETY NATIONAL, FRONTIER INSURANCE

This case involves a workers' compensation appeal where the defendants seek reconsideration of a prior award. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, rescinded the prior award, and remanded the case for further proceedings. The primary grounds for this decision were that the defendants were denied due process by not being given an opportunity to cross-examine the rating rater and that the award relied on outdated medical reports. The WCAB also suggested obtaining current medical evaluations due to the time elapsed since the original reports.

Workers' Compensation Appeals BoardReconsiderationJoint Findings and AwardAttorney FeesPermanent Disability RatingApportionmentIndustrial InjuryLumbar SpineTreating PhysiciansMedical Reports
References
Case No. SDO 0321444 SDO 0321446
Regular
Jun 28, 2007

MARY BLOEMSMA vs. SAN DIEGO UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied reconsideration, upholding the use of the revised permanent disability rating schedule for applicant's pre-January 1, 2005 injury. The Board found that the treating physician's reports did not explicitly state the applicant was "permanent and stationary" with a ratable disability, a prerequisite for applying the older rating schedule under Labor Code § 4660(d). Therefore, the revised schedule was correctly applied, resulting in a 22% permanent disability rating.

Workers' Compensation Appeals BoardPermanent Disability Rating ScheduleRevised Rating SchedulePrior Rating ScheduleLabor Code Section 4660(d)Permanent and Stationary StatusTreating Physician's ReportComprehensive Medical-Legal ReportIndustrial InjuryHerniated Disc
References
Case No. ADJ2531503 (AHM 0111102), ADJ3636599 (AHM 0111103), ADJ4058229 (AHM 0123911)
Regular
Dec 23, 2010

JIM POTTS vs. CITY OF IRVINE POLICE DEPARTMENT

The Workers' Compensation Appeals Board granted reconsideration to correct the permanent disability rate and defer the attorney's fee calculation for the life pension. The Board affirmed the 86% permanent disability finding, rejecting the defendant's argument that the applicant's post-injury work history should have altered the medical opinions, as the defendant had the opportunity to address this. The Board also clarified that the 1997 Permanent Disability Rating Schedule was correctly applied and deferred the issue of temporary disability overpayment to the trial level.

Cumulative traumaSpineLeft shoulderRight wristBilateral kneesLeft ankleCardiovascular systemHypertensionPermanent disabilityLife pension
References
Case No. MON 0307421
Regular
Jun 20, 2008

Frank E. Snedecor vs. L.A. COMMUNITY COLLEGE DISTRICT

This case involves a dispute over which permanent disability rating schedule applies to an admitted 2003 neck injury. The defendant argued the 1997 schedule was incorrectly used by the WCJ. The Appeals Board granted reconsideration, finding no pre-2005 medical report indicated the existence of permanent disability, and remanded the case for rating under the 2005 schedule.

Workers' Compensation Appeals BoardFrank E. SnedecorL.A. Community College DistrictPermanent Disability Rating1997 Rating Schedule2005 Rating ScheduleLabor Code section 4660(b)ReconsiderationFindings and AwardMedical-Legal Report
References
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