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

Case No. ADJ8415183
Regular
Apr 27, 2015

TIM HAGER vs. COUNTY OF SANTA CLARA CENTRAL FIRE DISTRICT

The Workers' Compensation Appeals Board granted reconsideration to correct a technical rating error in the applicant's permanent disability award. The Board affirmed the original finding that the applicant, a firefighter, sustained industrial injuries to his bilateral upper extremities and heart. However, the permanent disability rating was adjusted from 71% to 70% due to the correction of a specific rating modifier. The Board also found that the orthopedic Agreed Medical Evaluator's use of grip loss to rate the applicant's upper extremity impairment was supported by substantial evidence.

WCABPetition for ReconsiderationFindings and AwardPermanent DisabilityFirefighterBilateral Upper ExtremitiesHeart HypertensionAgreed Medical Evaluator (AME)Orthopedic AMEInternal Medicine AME
References
5
Case No. ADJ7713711
Regular
Mar 11, 2016

JULIANA MASTERS vs. STATE OF CALIFORNIA, DEPARTMENT OF MOTOR VEHICLES

The Appeals Board denied reconsideration of the WCJ's decision, upholding the finding that applicant's sleep impairment, though present, was subsumed by the physical upper extremity impairments and thus not separately ratable. The Board found the Agreed Medical Examiner's opinion on sleep disorder impairment was not substantial evidence as it was predicated on pain already accounted for in the physical injury ratings per the AMA Guides. Therefore, the applicant's permanent disability rating remained at 69%. A dissenting opinion argued the Agreed Medical Examiner's opinion should be followed, as it addressed distinct impairments beyond pain and was supported by relevant case law.

Workers' Compensation Appeals BoardAmended Findings of Fact and AwardsIndustrial InjuryUpper ExtremitiesPsycheBook BinderSleep ImpairmentAMA GuidesPermanent DisabilityAgreed Medical Examiner
References
9
Case No. ADJ7311200
Regular
Aug 03, 2017

SEAN HARRIS vs. COAST CRANE COMPANY, EMPLOYERS INSURANCE OF WAUSAU, THUNDER MACHINE WORKS, AIX INSURANCE COMPANY, AEROTEK, ALLEGIS GROUP INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

This case concerns a petition for reconsideration by defendant Wausau regarding an arbitrator's findings that applicant sustained industrial injury to his pulmonary system and upper extremities during a cumulative period. Wausau argued the claim was time-barred and that liability for upper extremity injury was improper. The Board denied Wausau's petition, finding Wausau failed to meet its burden of proof on the statute of limitations defense. The Board also determined that applicant properly amended his claim for upper extremities and that apportionment of liability based on days worked was appropriate.

Workers' Compensation Appeals BoardCoast Crane CompanyEmployers Insurance of WausauThunder Machine WorksAIX Insurance CompanyAerotekAllegis Group Insurance Companycumulative injurypulmonary systemupper extremities
References
10
Case No. ADJ602790 (STK 0179563)
Regular
Jul 17, 2012

TRACEE MAWYER vs. GALLO GLASS COMPANY

This case involves Tracee Mawyer's workers' compensation claim against Gallo Glass Company for cumulative trauma injuries. The Appeals Board granted reconsideration, reversing the trial judge's denial of injury to applicant's bilateral upper extremities, specifically carpal tunnel syndrome. The Board found Dr. Clayman's reports sufficiently supported an industrial injury to the upper extremities and awarded additional temporary disability for the period following carpal tunnel surgery. The case was returned for a new permanent disability rating for the upper extremity injuries.

Cumulative traumabilateral upper extremitiescarpal tunnel release surgerytemporary disabilitypermanent disability ratingreconsiderationDr. Claymanneck injuryshoulder injuryspine injury
References
0
Case No. ADJ8835660
Regular
Jan 19, 2018

JOE CASILLAS vs. GRAYD A PRECISION METAL FABRICATORS; STATE COMPENSATION INSURANCE FUND

This case concerns a petition for reconsideration by the defendant regarding a permanent total disability award for Joe Casillas. The defendant argued against the total disability finding, questioned injury to the left upper extremity, and contested the basis for vocational rehabilitation findings. The Board granted reconsideration to amend the findings, rescinding the finding of injury to the left upper extremity due to the applicant unilaterally withdrawing that issue. However, the Board affirmed the permanent total disability finding based on substantial medical and vocational evidence, including the applicant's significant limitations in daily living and unsuitability for vocational rehabilitation, despite the absence of left upper extremity injury.

Permanent total disabilityvocational rehabilitationindustrial injurybilateral upper extremitiescervical spinepsychefabricatorState Compensation Insurance Fundpetition for reconsiderationadministrative law judge
References
3
Case No. ADJ10065069
Regular
May 16, 2018

MARCIA FARRAR vs. STATE OF CALIFORNIA, UNEMPLOYMENT INSURANCE APPEALS BOARD, legally uninsured, administered by STATE COMPENSATION INSURANCE FUND

This case concerns defendant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) finding of injury arising out of and occurring in the course of employment (AOE/COE) to the applicant's right upper extremity. Defendant argued that no evidence supported injury to other alleged body parts and that the WCJ should have made findings on those parts instead of deferring the issue. The WCAB denied reconsideration, affirming the WCJ's decision to limit the trial to the threshold issue of right upper extremity injury AOE/COE. The WCAB found Dr. Amster's opinion constituted substantial evidence for the right upper extremity injury and that the WCJ acted within their authority by deferring other issues.

Workers' Compensation Appeals BoardAOE/COEQualified Medical ExaminerReconsiderationCumulative TraumaRepetitive Strain InjuryPreexisting ConditionAggravationContributing CauseMandatory Settlement Conference
References
7
Case No. ADJ9499569
Regular
Sep 11, 2018

CHRIS HENDERSON vs. CDCR - CORCORAN STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration, increasing the applicant's permanent disability rating from 16% to 26%. This revision was based on incorporating the agreed medical evaluator's findings of a 14% upper extremity impairment due to decreased shoulder range of motion, which the original rating had omitted. The Board also noted the WCJ's rating instructions did not comply with established precedent regarding listing all impairments. The decision otherwise affirmed the WCJ's findings.

Workers' Compensation Appeals BoardCDCR - Corcoran State PrisonState Compensation Insurance FundPetition for ReconsiderationPermanent Disability RatingAgreed Medical EvaluatorOrthopedistEugene HarrisM.D.Temporary Disability Indemnity
References
2
Case No. SBR 0325667
Regular
Apr 29, 2008

JAMES PERRINE vs. THE TIRE GUYS, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant who sustained an industrial injury to his right elbow and upper extremity, resulting in work restrictions despite a 0% whole person impairment rating under AMA guidelines. The Workers' Compensation Appeals Board affirmed the WCJ's decision that the applicant is a Qualified Injured Worker (QIW) entitled to vocational rehabilitation services. The Board found that the applicant's work restrictions constitute an impairment of earning capacity and a competitive handicap, thus qualifying him for benefits under former Labor Code section 4635(a).

Workers Compensation Appeals BoardFindings and AwardCompromise and Releasevocational rehabilitationqualified injured worker (QIW)VRMApermanent disabilityAMA GuidelinesLabor Code 139.5Labor Code 4635
References
8
Case No. ADJ1904323 (GRO 0034275) ADJ3208896 (GRO 0034276) ADJ649343 (GRO 0034277)
Regular
Nov 01, 2010

SARAH SHIPP vs. GOTTSCHALKS, SPECIALTY RISK SERVICES

The Appeals Board granted reconsideration, rescinding the prior award due to the Workers' Compensation Judge's (WCJ) improper reliance on an Agreed Medical Evaluator's (AME) hernia analogy to rate upper extremity impairment. This analogy violated *Almaraz II* by not adhering to the AMA Guides and potentially incorporating pre-2005 rating schedules. The rater also used an incorrect impairment number and occupational adjustment. The case is remanded for further proceedings and a new decision by the WCJ, ensuring the rating is not based on the flawed hernia analogy.

Workers' Compensation Appeals BoardSarah ShippGottschalksSpecialty Risk ServicesJoint Findings and Awardindustrial injuryright shoulderleft shoulderright elbowthumb
References
4
Case No. ADJ966838 (SJO 0266465)
Regular
Jun 18, 2012

LOLA ROBINSON vs. SHELTER NETWORK, SUBSEQUENT INJURIES FUND of the STATE OF CALIFORNIA

The Workers' Compensation Appeals Board affirmed a prior award for applicant Lola Robinson against the Subsequent Injuries Benefits Trust Fund (SIBTF). The award compensated her for a combined permanent disability of 78%, stemming from a subsequent industrial injury to her upper extremity and pre-existing conditions of hepatitis C and a hysterectomy. The Board found that medical evidence established pre-existing whole person impairments from these conditions, meeting the "labor disabling" threshold for SIBTF benefits. The Board held that the physician's ratings under the AMA Guides constituted prima facie evidence of pre-existing impairment, which the SIBTF failed to rebut.

Subsequent Injuries FundSIBTFHepatitis CHysterectomyPermanent Partial DisabilityLabor DisablingAMA GuidesWhole Person ImpairmentWCJReconsideration
References
7
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