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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. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. RDG 0095368; RDG 0095369; RDG 0095573; RDG 0126270
Regular
Sep 25, 2007

HENRY PHILLIPE vs. GOTTSCHALKS, LIBERTY MUTUAL INSURANCE

The Appeals Board granted reconsideration to allow reimbursement for the applicant's vocational expert fees, reversing the WCJ's decision. The Board found it reasonable for the applicant to hire his own vocational expert to rebut the defendant's expert, especially given the passage of time since the original vocational feasibility report. Consequently, the defendant was ordered to reimburse the applicant's attorney for the $1,075.00 vocational expert cost.

Workers' Compensation Appeals BoardReconsiderationExpert Witness FeesVocational ExpertLabor Code Section 5811Qualified Rehabilitation Representative (QRR)LeBoeuf argumentAgreed Medical Examination (AME)Permanent DisabilityIndustrial Injury
References
Case No. FRE 0065599
Regular
Mar 04, 2008

JOHN ALLEN vs. KENT MAGNELL CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied John Allen's petition for reconsideration, affirming the WCJ's decision to terminate his vocational rehabilitation services due to a consistent failure to cooperate. The Board found that Allen's persistent insistence on a specific, unachievable vocational goal, coupled with his refusal to undergo necessary medical evaluations and provide requested records, led to the impasse. Consequently, his request for retroactive benefits and vocational rehabilitation was denied.

Workers' Compensation Appeals BoardVocational RehabilitationPetition for ReconsiderationFindings and OrderRehabilitation UnitSuitable Gainful EmploymentVocational Rehabilitation Maintenance AllowanceAverage Weekly EarningsTemporary Disability IndemnityCompromise and Release
References
Case No. ADJ8772254
Regular
Jul 20, 2017

Lorenzo Hernandez vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION, NORTH KERN STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Lorenzo Hernandez's petition for reconsideration, upholding the original award of 24% permanent disability for a right shoulder injury. The applicant argued that a vocational expert's report should have rebutted the scheduled disability rating, but the Board found this report insufficient. Relying on *Ogilvie* and *Dahl*, the Board determined that an applicant's amenability to vocational rehabilitation precludes using vocational expert testimony to challenge a scheduled rating based on lost earning capacity. Therefore, the vocational expert's opinion was deemed not substantial evidence to overcome the QME's scheduled rating.

Workers' Compensation Appeals BoardPermanent DisabilityVocational ExpertQualified Medical EvaluatorScheduled RatingReconsiderationLabor Code §4660.1AMA Guides 5th EditionAmenability to Vocational RehabilitationDiminished Future Earning Capacity
References
Case No. ADJ10256108, ADJ10255968, ADJ10256212, ADJ10256223, ADJ10489875
Regular
Sep 23, 2022

JOSEPH RYAN vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Appeals Board affirmed the finding of permanent and total disability for the applicant, Joseph Ryan, stemming from industrial injuries sustained while employed as a correctional captain. However, the Board remanded the matter for further proceedings to specifically address apportionment of the permanent disability under Labor Code section 4663, considering the Agreed Medical Evaluator's opinion on pre-existing spinal disease. The Board found that the applicant's specific and cumulative trauma injuries to his spine resulted in intertwined disabilities, justifying a combined award, but that Dr. Hasday's apportionment findings require further development and determination at the trial level.

Workers' Compensation Appeals BoardJoseph RyanCalifornia Department of CorrectionsLegally UninsuredState Compensation Insurance FundADJ10256108ADJ10255968ADJ10256212ADJ10256223ADJ10489875
References
Case No. SFO 0500209
Regular
Jul 01, 2008

LAVENDER GALVAO vs. KINKO'S, ZURICH AMERICAN INSURANCE COMPANY

The Appeals Board granted reconsideration, amending the prior award to allow the employer a credit against Vocational Rehabilitation Maintenance Allowance (VRMA) for wages earned by the applicant from subsequent employment. While the applicant was found to be a Qualified Injured Worker (QIW) entitled to vocational rehabilitation services and VRMA, the Board distinguished this case from *Gamble v. Workers' Comp. Appeals Bd.*, finding that the applicant's subsequent employment replaced her injured position rather than being concurrent. Therefore, allowing the credit prevents the applicant from receiving a windfall and is consistent with the wage-loss basis of temporary disability indemnity.

Qualified Injured WorkerVocational Rehabilitation ServicesVocational Rehabilitation Maintenance AllowanceVRMATemporary Disability RateCredit for Wages EarnedWage Loss BasisRehabilitation UnitFindings Order AwardPetition for Reconsideration
References
Case No. ADJ2255750 (LAO 0803099)
Regular
Sep 14, 2009

RAQUEL ZUNIGA vs. RADIO SHACK, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and awarded attorney's fees for services in obtaining vocational rehabilitation benefits. The Board found that the applicant's attorney was entitled to a fee calculated as 15% of the *new money* awarded in the Rehabilitation Unit's Determination and Order, not the total VRMA amount. Because the defendant failed to withhold any funds for attorney fees despite knowing the applicant was represented, the defendant was ordered to pay the awarded attorney's fee.

Workers' Compensation Appeals BoardRaquel ZunigaRadio ShackLiberty Mutual Insurance CompanyADJ2255750Attorney FeesVocational RehabilitationQualified Rehabilitation RepresentativeDetermination and OrderRehabilitation Unit
References
Case No. ADJ869605
Regular
Nov 19, 2012

MILES GRAY vs. AT&T, permissibly self-insured, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves an applicant who sustained a severe right lower extremity injury, leading to multiple surgeries, significant leg length discrepancy, and fused ankle/foot, requiring constant mobility aids. The Agreed Medical Evaluator (AME) provided opinions on impairment, and vocational experts testified regarding the applicant's ability to return to work. The Workers' Compensation Appeals Board denied reconsideration of the prior award, finding substantial evidence supporting the applicant's unsuitability for rehabilitation. Defendant's supplemental reply did not alter this decision.

Agreed Medical EvaluatorVocational ExpertPetition for ReconsiderationDeniedRight Lower Extremity InjuryMultiple FracturesLeg Length DiscrepancyShoe LiftAnkle FusionGait Derangement
References
Case No. ADJ7817116
Regular
Dec 17, 2019

KAREN SWANSON vs. FRESNO UNIFIED SCHOOL DISTRICT

In this workers' compensation case, the Board affirmed the trial judge's finding of permanent total disability for applicant Karen Swanson due to a February 17, 2004 industrial injury. The defendant school district sought reconsideration, contesting the total disability finding and arguing for apportionment. Crucially, both the applicant's and the defendant's vocational experts independently concluded that the applicant was unemployable and not amenable to vocational rehabilitation due to her injury. The Board found substantial evidence supported the total disability award, exceeding the scheduled rating based on the unanimous vocational expert opinions.

Permanent total disabilityAgreed Medical ExaminerOrthopedicsApportionmentVocational expertsLabor market preclusionVocational rehabilitationDiminished future earning capacityScheduled ratingIndustrial injury
References
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