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

Case No. ADJ8134312
Regular
Sep 15, 2016

ERNIE GALLEGOS vs. GROTH BROTHERS CHEVROLET, AUTO DEALERS COMPENSATION OF CALIFORNIA, CORVEL

The applicant sustained a right knee injury, leading to a total knee replacement. The original award granted permanent disability without apportionment, which the defendant appealed. The Appeals Board granted reconsideration, finding that apportionment to pre-existing knee conditions was legally permissible even after total knee replacement. The case is remanded for a new award based on the Qualified Medical Evaluator's 50% apportionment to pre-existing pathology. A dissenting opinion argues the medical evidence lacked sufficient reasoning to support apportionment.

WORKERS' COMPENSATION APPEALS BOARDERNE GALLEGOSGROTH BROTHERS CHEVROLETAUTO DEALERS COMPENSATION OF CALIFORNIACORVELADJ8134312PETITION FOR RECONSIDERATIONFINDINGS AND AWARDPERMANENT DISABILITYAPPORTIONMENT
References
Case No. OAK 0334678, OAK 0334680
Regular
Jul 21, 2008

KENNY AUBREY vs. COLOR TECH CORPORATION

This case involves an applicant who sustained industrial injuries to both knees, resulting in concurrent temporary total disability. The Workers' Compensation Appeals Board (WCAB) affirmed a prior award of temporary disability indemnity, applying the 104-week/two-year limitation under Labor Code section 4656(c)(1). This application was justified by the AME's finding that both injuries contributed to the applicant's concurrent temporary disability, aligning with precedent established in *Foster v. Workers' Comp. Appeals Bd.*.

Workers' Compensation Appeals BoardColor Tech Corporationindustrial injuriesboth kneesarthroscopic surgeriesleft kneeright kneejoint replacementtemporarily totally disabledaggregate disability payments
References
Case No. ADJ6948621 ADJ7946738
Regular
Apr 22, 2013

STEFANO MUSETTI vs. GOLDEN GATE DISPOSAL & RECYCLING dba RECOLOGY, permissibly self-insured, administered by CORVEL CORP.

In this workers' compensation case, the employer sought reconsideration of an award ordering a total knee replacement. The applicant's treating physician recommended the surgery, but the employer argued the award was premature as a panel qualified medical evaluator's report was pending and the treating physician's report lacked proper authorization markings. The Appeals Board denied reconsideration, finding the employer had sufficient time to obtain the PQME report and that the treating physician's report constituted substantial medical evidence supporting the surgery. The Board also noted that the employer failed to initiate utilization review despite being aware of the treatment request.

Workers' Compensation Appeals Boardindustrial injuryright kneegarbage collectortotal knee replacementsupplemental reportpanel qualified medical evaluator (PQME)treating physiciansubstantial medical evidencePetition for Reconsideration
References
Case No. ADJ3727929
Regular
Jul 17, 2013

JOE GAGNE vs. FRU CON CONSTRUCTION, ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration. The Board adopted the WCJ's report, which found that the applicant was only temporarily disabled from June 1, 2007, to July 23, 2007, and was not entitled to further travel expense reimbursement. The WCJ determined that while one physician's opinion could constitute substantial evidence, that opinion lacked sufficient clarity and consistency to support the applicant's broader claims of temporary disability and cumulative trauma to the left knee and back. The Board affirmed that a single physician's considered opinion can be substantial evidence, even if inconsistent with other medical opinions.

Petition for ReconsiderationDeniedSubstantial EvidencePlace v. Workmen's Comp. Appeals Bd.Fru Con ConstructionZurich North AmericaADJ3727929SAC 0315536ApplicantTemporarily Disabled
References
Case No. SRO 0135735
Regular
Nov 06, 2007

ROBERT ANUSEWICZ vs. JOINT INDUSTRY BOARD OF PLUMBING, dba KONOCTI HARBOR INN AND RESORT, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's entitlement to temporary disability indemnity beyond the standard 104-week limit. The Appeals Board rescinded the prior award, ruling that the applicant's hip and knee replacement surgeries did not constitute "amputations" as defined by Labor Code section 4656(c)(2)(C). Therefore, the applicant is limited to 104 weeks of temporary disability indemnity from the commencement of payments, precluding indemnity beyond January 31, 2007.

Workers' Compensation Appeals BoardRobert AnusewiczJoint Industry Board of PlumbingKonocti Harbor Inn and ResortState Compensation Insurance FundSRO 0135735Opinion and Decision After Reconsiderationtemporary disability indemnityindustrial injuryleft knee
References
Case No. LAO 0850067
Regular
Sep 24, 2007

JULIE RAMIREZ vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, PAROLE COMMUNITY SERVICES, Legally Uninsured, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and reversed a prior WCJ finding, ruling that total knee replacement surgery does not constitute an "amputation" for the purpose of extending temporary disability indemnity beyond the 104-week statutory limit. The Board clarified that "amputation" under Labor Code section 4656(c)(2)(C) applies only to the severance or removal of external limbs or appendages, not internal body parts. Therefore, the applicant's claim for additional temporary disability indemnity was denied.

Labor Code section 4656(c)(2)(C)Amputation exceptionTemporary disability indemnity104-week capReconsiderationRemovalInterim Findings and AwardKnee replacement surgeryBilateral kneesIndustrial injury
References
Case No. ADJ8240882; ADJ8240881; ADJ8615401
Regular
Apr 21, 2025

ROBERT S. HAPPENY vs. STATE OF CALIFORNIA, CALIFORNIA INSTITUTE FOR WOMEN

Applicant Robert S. Happeny sustained industrial injuries during his employment as a correctional officer, leading to a finding of permanent and total disability by the WCJ due to his inability for vocational retraining. The WCJ also issued an unapportioned award, concluding that apportionment to nonindustrial factors was not proven. Defendant challenged this decision via a petition for reconsideration, disputing the method of combining disabilities and the reliability of vocational reports. The Appeals Board granted reconsideration, affirming the WCJ's determination of permanent and total disability based on vocational infeasibility and the lack of established apportionment, ultimately rescinding the original decision and substituting new findings of fact.

ADJ8240882ADJ8240881ADJ8615401correctional officerindustrial injuryheartpsycheright wristrespiratory systemlumbar spine
References
Case No. ADJ4016735 (BAK 0147536)
Regular
Jun 11, 2012

COLLEEN PARHAM vs. KERN RADIOLOGY MEDICAL GROUP, LEGION INSURANCE GROUP

This case involves an applicant seeking bilateral knee replacement surgery due to an admitted industrial back injury. The applicant argues the surgery is necessary to enable further treatment for her back, specifically a spinal cord stimulator. The defendants contested this, claiming the knee condition was independent and unrelated to the industrial injury. The Appeals Board granted reconsideration, finding the knee surgery reasonably required to relieve the industrial back injury, citing *Bolton* and *Rowan*, even if the knee condition itself was not industrial. The Board rescinded prior findings, awarding the knee surgery and deferring issues of permanent disability and temporary disability.

Workers' Compensation Appeals BoardReconsiderationFindings of FactBilateral Knee ReplacementIndustrial InjuryBack InjurySpinal Cord StimulatorTemporary Total DisabilityPermanent and StationaryQualified Medical Evaluator
References
Case No. SAC 296205
Regular
Jun 11, 2008

EDWARD A. CASEY vs. CITY OF FULLERTON

This case involved a firefighter/paramedic seeking increased permanent disability for knee injuries. The Appeals Board denied reconsideration, upholding the administrative law judge's decision. The judge's decision was based on the agreed medical examiner's opinion, which apportioned 30% of the permanent disability to non-industrial factors, including a prior knee injury and the natural progression of arthritis.

ApportionmentAgreed Medical Evaluator (AME)Permanent DisabilityCausationLabor Code Section 4663Labor Code Section 4664Firefighter/ParamedicKnee InjuryTotal Knee ReplacementOsteoarthritis
References
Case No. ADJ14244909
Regular
Apr 25, 2025

YONGQUAN HU vs. AMERICAN ALLIANCE LOGISTICS, INC., LIANG YE, UNINSURED EMPLOYERS BENEFITS TRUST FUND

Applicant Yongquan Hu and defendant Uninsured Employers Benefits Trust Fund (UEBTF) both petitioned for reconsideration of an Amended Findings and Award. The WCJ's initial decision found an industrial injury resulting in permanent total disability and calculated average weekly earnings based on multiple employers. Applicant disputed the wage calculation method, while UEBTF identified an inadvertently omitted week of wages. The Appeals Board granted both petitions, adopting the WCJ's report and amending the decision to reflect corrected average weekly earnings of $1,462.15, leading to a temporary and permanent total disability rate of $974.77 per week.

Workers' Compensation Appeals BoardYongquan HuAmerican Alliance LogisticsInc.Uninsured Employers Benefits Trust FundAdjudication NumberVan Nuys District OfficeOpinion and OrderGranting Petitions for ReconsiderationDecision After Reconsideration
References
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