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

Case No. AHM 0116452 AHM 0116457 AHM 0116470
Regular
Jul 21, 2008

BRUCE SERVISS vs. RALPH'S GROCERY, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration and amended the award to clarify that the applicant is not entitled to duplicative temporary disability and vocational rehabilitation maintenance allowance payments for the same period. The Board found the defendant breached its duty to provide timely vocational rehabilitation notices after the applicant's January 16, 2004 permanent and stationary date. Consequently, the defendant remains liable for vocational rehabilitation maintenance allowance from that date, adjusted for prior payments.

Workers' Compensation Appeals BoardReconsiderationVocational RehabilitationMaintenance AllowanceTemporary DisabilityIndustrial InjuryMeat CutterRalph's GrocerySedgwick Claims Management ServicesPermanent and Stationary
References
6
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
9
Case No. ADJ2862114
Regular
Oct 30, 2008

PATRICIA TRUJILLO vs. EARTHLINK, INC., CHUBB INSURANCE SERVICES

The Workers' Compensation Appeals Board affirmed a prior ruling that the defendant, Earthlink, Inc., owes vocational rehabilitation benefits to the applicant, Patricia Trujillo. The court found that the defendant failed to provide legally required notices when the applicant deferred vocational rehabilitation services. This failure meant the deferral was invalid, making the defendant liable for vocational rehabilitation maintenance allowance (VRMA) from the date of the notice breach.

Vocational rehabilitationAD Rule 9813(a)(4)VRMAdeferral of servicesnotice requirementsclaims administratorinterrupted servicesreinstatement of servicesstatute of limitationsemployer's duty
References
6
Case No. OAK 0284985
Regular
Oct 10, 2007

RICHARD DENNY vs. PINKERTON, ACE USA/ESIS

The Workers' Compensation Appeals Board denied reconsideration of a decision that found Richard Denny's employer, Pinkerton, liable for Vocational Rehabilitation Maintenance Allowance (VRMA) at the medical temporary disability rate outside the vocational rehabilitation cap. This liability arose from Pinkerton's violation of Labor Code §4642 and related regulations by failing to timely refer the applicant for vocational rehabilitation services after determining him to be a Qualified Injured Worker. The Board affirmed that this VRMA award is not considered a penalty and rejected Pinkerton's claim for restitution.

Workers' Compensation Appeals BoardPinkertonACE USA/ESISPetition for ReconsiderationVRMAMedical TD RateVocational Rehabilitation CapLabor Code §4642Cal.CodeRegs.tit. 8
References
4
Case No. AHM 0099560 AHM 0099539 AHM 0099552 AHM 0099611 AHM 0099625 AHM 0099626 AHM 0102769
Regular
Oct 16, 2007

CHERILYNN H. CAIRNS vs. CON AGRA GROCERY PRODUCTS, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to amend a prior award, establishing that the applicant is entitled to Vocational Rehabilitation Maintenance Allowance (VRMA) at the temporary disability rate. This VRMA is payable from November 16, 2006, onward, a date determined by the applicant's unequivocal demand for vocational rehabilitation services. The Board clarified that prior stipulations did not obligate payment from an earlier date, as VRMA is contingent upon an employee's willingness to participate in rehabilitation.

Workers' Compensation Appeals BoardPetition for ReconsiderationVocational Rehabilitation Maintenance Allowance (VRMA)Temporary Total Disability (TTD) rateFindings Award and OrderRehabilitation Unit (RU)Stipulation and OrderGastric Bypass SurgeryPermanent and Stationary ReportLabor Code section 139.5(c)
References
3
Case No. AHM 0091706 AHM 0102322
Regular
Aug 22, 2007

MATTHEW MCCORD vs. COUNTY OF SANTA BARBARA, RISK MANAGEMENT

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and reversed the prior award of vocational rehabilitation maintenance allowance (VRMA) for applicant Matthew McCord. The Board found that McCord's liability for vocational rehabilitation services ended on October 17, 2003, the scheduled termination date of his rehabilitation plan. McCord's failure to complete the plan, despite receiving one, and his subsequent return to work as a court bailiff, rendered him ineligible for VRMA after that date.

Workers' Compensation Appeals BoardVocational RehabilitationCollateral EstoppelRes JudicataNotice of Potential Eligibility (NOPE)Vocational Rehabilitation Maintenance Allowance (VRMA)Qualified Injured Worker (QIW)Rehabilitation PlanMedical RestrictionsRetirement Board
References
1
Case No. ADJ3947517
Regular
Sep 30, 2009

RUDY GONZALES vs. CELITE CORPORATION, NATIONAL UNION FIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) denied the applicant's petition for reconsideration, upholding the prior ruling that his claim for retroactive vocational rehabilitation maintenance allowance (VRMA) was terminated by the repeal of Labor Code section 139.5 on January 1, 2009. The WCAB granted the defendant's petition, vacating the Rehabilitation Unit's order awarding VRMA because the applicant's right to benefits had not vested in a final order before the effective date of the repeal. The Board clarified that a determination of Qualified Injured Worker status does not constitute a final award of VRMA, and jurisdiction over such claims cannot be conferred by waiver. Therefore, the applicant is not entitled to any further vocational rehabilitation benefits.

Labor Code section 139.5vocational rehabilitationVRMAQIWvested rightinchoate rightfinal orderrepealjurisdictionreconsideration
References
1
Case No. STK 178713
Regular
Sep 17, 2007

FRED VAN DYKEN vs. FRAGOMEN, DEL RAY, BERNSEN & LOWERY, ATLANTIC MUTUAL FIRE INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and amended a prior decision. While affirming the apportionment of permanent disability and the credit for overpaid indemnity, the Board found the employer unreasonably delayed vocational rehabilitation benefits. The applicant is now entitled to retroactive vocational rehabilitation maintenance allowance at the temporary disability rate for the period of that delay.

Vocational RehabilitationApportionmentQualified Medical ExaminerPermanent DisabilityTemporary DisabilityEMG/NCV StudiesRehabilitation UnitDelay of BenefitsThird Party CreditVocational Rehabilitation Maintenance Allowance
References
8
Case No. ANA 0339254ANA 0339253
Regular
Aug 04, 2008

CONSTANCE VOIGT vs. BOEING COMPANY, INSURANCE COMPANY of the STATE of PENNSYLVANIA, AIG CLAIMS SERVICES, A.A.S.I., ARGONAUT INSURANCE

The Appeals Board granted reconsideration, amending the award to grant retroactive vocational rehabilitation maintenance allowance (VRMA) at the applicant's temporary disability rate, finding that repealed vocational rehabilitation statutes still apply to pre-2004 injuries. However, the Board affirmed the exclusion of the period the applicant was temporarily disabled due to non-industrial causes. The applicant's contention that the defendant's appeal was untimely was also denied.

WCABConstance VoigtBoeing CompanyVRMAGodinez v. BuffetsInc.Rehabilitation Unittemporary disabilitydelay rateLabor Code 139.5
References
18
Case No. MON 0288316, MON 314548
Regular
Mar 13, 2008

VICKIE WARD vs. DEPARTMENT OF JUSTICE, STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board denied the Department of Justice's petition for reconsideration, affirming the administrative law judge's award of retroactive vocational rehabilitation maintenance allowance (VRMA). The Board found that the defendant failed to provide a timely notice of vocational rehabilitation eligibility after the applicant's physician declared her a qualified injured worker. This failure triggered the applicant's entitlement to VRMA from the date of that medical determination, despite prior notices and deferrals.

Workers' Compensation Appeals BoardVocational Rehabilitation Maintenance AllowanceVRMAQualified Injured WorkerQIWNotice of Potential EligibilityNOPEDeferral NoticeLabor Code Section 4636Labor Code Section 4637
References
2
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