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Workers' Compensation Appeals Board - Significant panel decisions
En Banc decisions | Significant panel decisions | Cases pending on appellate grants | Disclaimer
To view decisions, click on the PDF name of the decision (to the right of the date) and you will access the PDF file which contains the decision. Use of the California Compensation Cases citation is used for the community's information and convenience only with a recognition that the text and/or summary of the decisions may also appear in other publications.
2007 significant panel decisions
Kimberly Stokes | July 9, 2007 | 2007-SPD-2 ( pdf)2007-SPD-2 (  MS Word) |
| Case No. SBR 0311485 72 Cal. Comp. Cases 996
| ||
| The Board panel concluded that if an ambulatory surgery center is claiming to have provided medical treatment to applicant as a "clinic," it is required to have a fictitious-name permit and license from the Medical Board. However, if it is claiming to have provided services only as an "outpatient setting," it is not required to have a license or fictitious-name permit from the Medical Board if it is properly accredited by an agency recognized by the Medical Board. | ||
Nelly Romero
| June 14, 2007 | 2007-SPD-1
( pdf) 2007-SPD-1 ( MS Word) |
| Case No. OAK 0328271 72 Cal. Comp. Cases 824 | ||
| The Board held that for purposes of Labor Code §§4062.1(e) and 4062.2(e), an employee has "received" a comprehensive medical-legal evaluation when the employee attends and participates in the medical evaluator's examination. In this case, because the applicant had not attended and participated in (i.e., not "received") an examination by a panel QME scheduled while the applicant was not represented by an attorney, the applicant was entitled to request a new QME panel when the applicant became represented by an attorney. The workers' compensation judge's order for a new QME panel was therefore affirmed. This opinion involved interpretation of additions to Labor Code §§4062.1 and 4062.2 by SB 899. | ||
2006 significant panel decisions
|
Caryl Erickson vs. Southern California Permanente Medical Group/Kaiser Permanente, Permissibly Self-Insured | December 28, 2006 | 2006-SPD-5
( pdf) 2006-SPD-5 ( MS Word) |
| Case Nos. POM 246580, POM 2465824 71 Cal. Comp. Cases 103 | ||
| The Board panel granted reconsideration and amended the WCJ’s decision to defer the issue of the calculation of the amount of the permanent disability indemnity due to applicant after apportionment, pending issuance of the Supreme Court’s decision(s) in Brodie v. Workers’ Comp. Appeals Bd., review granted November 15, 2006, S146979 (2006 Cal. LEXIS 13527), in Welcher v. Workers’ Comp. Appeals Bd., review granted November 15, 2006, S147030 (2006 Cal. LEXIS 13523), or in any other case in which the Supreme Court issues an opinion that resolves this issue. This deferral approach was a continuation of the approach previously being employed by the Appeals Board in light of the ongoing conflict and uncertainty in the appellate case law on this issue where multiple injuries and/or apportionment of permanent disability under new Labor Code sections 4663 and 4664 are involved. | ||
|
Catherine Robbins vs. Sharp Healthcare; American Manufacturers Mutual Insurance Company; and Broadspire Services, Inc., Adjusting Agency | September 26, 2006 | 2006-SPD-4
( pdf) 2006-SPD-4 ( MS Word) |
| Case No. SDO 0335934 71 Cal. Comp. Cases 1291 | ||
| The Board panel concluded that bias or the appearance of bias solely against an attorney or law firm, as opposed to the party that the attorney or law firm represents, may be a valid ground for a petition for disqualification of a WCJ. In granting the defendant’s petition for disqualification, it was determined that although there was no present actual bias by the judge toward the petitioning law firm, there was the appearance of bias sufficient to warrant disqualification. | ||
|
Kathy Ward vs. City of Desert Hot Springs; permissibly self-insured and administered by Hezelrigg Risk, Management Services | September 25, 2006 | 2006-SPD-3
( pdf) 2006-SPD-3 ( MS Word) |
| Case No. RIV 0069499 71 Cal. Comp. Cases 1313 | ||
| The Board panel held that for claimed industrial injuries
occurring on or after January 1, 2005, in which the employee is represented by
an attorney: (1) pursuant to section 4060(c), medical disputes regarding the compensability
of the alleged industrial injury must be resolved solely by the procedure provided
in section 4062.2; and (2) an evaluation regarding compensability may not be obtained
pursuant to section 4064(d) – and, if obtained, it is not admissible. | ||
| J
Deanna Brasher vs. Nationwide Studio Fund; and State Compensation Insurance Fund | September 5, 2006 | 2006-SPD-2
( pdf) 2006-SPD-2 ( MS Word) |
| Case No. OAK 0296709 71 Cal. Comp. Cases 1282 | ||
| The Board panel held that, in response to a treating physician's recommendation for spinal surgery, an employer has the following options: 1) authorize the surgery, 2) object to the surgery, pursuant to section 4062(b), by filing a DWC Form 233 within 10 days of receipt of the doctor's recommendation, 3) submit the recommendation to utilization review, or 4) pursue both options 2 and 3, either simultaneously or by filing an objection after a utilization review denial, meeting the timelines for each process. If the employer denies the surgery pursuant to its utilization review, the employee must object within 10 days of receipt by the employee of the employer's denial. The dispute will then be resolved under the second opinion procedures in section 4062(b). | ||
| In the Matter of John H. Hoffman Jr. | May 17, 2006 | 2006-SPD-1
( pdf) 2006-SPD-1 ( MS Word) |
| Case No. Misc. 250 71 Cal. Comp. Cases 609 | ||
| The Board, in affirming
the WCJ’s finding that Mr. Hoffman had violated the provisions of WCAB Rule 10779,
concluded that (1) both Rule 10779 and the State Bar Act preclude any non-reinstated
former attorney who has been disbarred or suspended by the Supreme Court (for
reasons other than nonpayment of State Bar fees), who has been placed on involuntary
inactive status by the State Bar, or who has resigned with disciplinary proceedings
pending against him or her from appearing as a representative of any party before
the WCAB (at least if they have not received permission under Rule 10779); (2)
this preclusion against appearing as a representative of any “party” extends to
appearing on the behalf of any litigant, including but not limited to lien claimants;
and (3) this preclusion against “appearing as a representative” in WCAB proceedings
extends to any activity that would constitute the practice of law. | ||
2005 significant panel decisions
| Wilma Diggle | October 7, 2005 | 2005-SPD-3
( pdf) 2005-SPD-3 ( MS Word) |
| (WCAB No. BAK 0138299) | ||
| 70 Cal. Comp. Cases 1480 | ||
| It
was noted that en banc decisions of the Appeals Board are binding precedent on
all Appeals Board panels and WCJs pursuant to WCAB Rule 10341. The Board concluded
that this principle remains true where a petition for writ of review has been
filed or even where a writ of review has been granted, either in the actual case
in which the en banc decision issued or in a different case in which the en banc
decision is directly implicated, unless and until either (1) the appellate court
issues an opinion that explicitly or implicitly overrules the en banc decision
or (2) the appellate court stays or suspends the operation of the en banc decision
prior to the Court’s issuance of an opinion. | ||
|
Paul Hestehauge vs. Wayne Charkins; Laurie Charkins; California State Automobile Association Inter-Insurance Bureau; and Tri-Star Risk Management (adjusting agent), | September 23, 2005 |
<2005-SPD-2 (pdf text 236KB) 2004-SPD-2 (MS Word 275KB) |
| (WCAB No. SFO 452026) | ||
| 70 Cal.Comp.Cases 1294 | ||
|
NOTE: The Board held that applicant was not an “employee” of defendant
homeowners under Labor Code sections 3351(d) and 3352(h) because, in the 90 days
prior to his injury, he had not both worked at least 52 hours for them and earned
at least $100 from them. Nevertheless, the Board also concluded applicant was
an “employee” of defendant homeowners under Labor Code section 3715(b):
(1) because it applies to all residential employees listed therein, including
those employed by insured employers; (2) because it is the Legislature’s
express intent that the three types of residential employees listed therein are
covered under the Workers’ Compensation Act if they would have been covered
by the law in effect prior to January 1, 1977; and (3) because the pre-1977 law
covered residential employees if either the work being performed was contemplated
to last more than 10 days or the total labor cost was at least $100.00, and here
applicant’s work met the latter requirement. | ||
| Jose Reyes vs. Hart Plastering | February 10, 2005 |
<2005-SPD-1 (pdf text 70KB) 2004-SPD-1 (MS Word 31KB) |
| (WCAB No. POM 0261129) | ||
| 70 Cal.Comp.Cases 223 | ||
|
NOTE: The Board held that the amendments to sections 4663 and 4664, which concern
apportionment of permanent disability, have not affected the statutes governing
the determination of whether an injury arises out of and occurs in the course
of employment, i.e., sections 3600 and 3208.3, or the case law interpreting those
statutes. | ||
2004 significant panel decisions
| Kenneth Grom vs. Shasta Wood | December 8, 2004 |
<2004-SPD-4 (pdf text 90KB) 2004-SPD-4 (MS Word 40KB) |
| (WCAB No. RDG 0091839) | ||
| 69 Cal.Comp.Cases 1567 | ||
|
NOTE: The Board held that an applicant is entitled to such medical treatment as
is reasonably required to "relieve" from the effects of an industrial
injury, even if such treatment will not "cure" that injury. Thus, the
phrases "cure and relieve" and "cure or relieve" are interchangeable. | ||
|
Teresa Godinez vs. Buffets, Inc., permissibly self-insured and Specialty Risk Services, adjusting agent, | October 4, 2004 |
<2004-SPD-3 (pdf text 90KB) 2004-SPD-3 (MS Word 40KB) |
| (WCAB No. SJO 0225696) | ||
| 69 Cal.Comp.Cases 1311 | ||
|
NOTE: The Board held that the timelines of an appeal from any determination or
recommendation of the Administrative Director's vocational rehabilitation unit
with reference to an injury occurring before January 1, 2004, is controlled by
former Labor Code section 4645(d), and that defendant's appeal in this case was
timely filed (i.e., filing of appeal with the Board within 20 days of service
of the decision/recommendation, plus any additional time pursuant to WCAB Rule
10507). | ||
| Thomas
Messinese vs. Automatic Heating and State Compensation Insurance Fund | May 21, 2004 |
<2004-SPD-2 (pdf text 183KB) 2004-SPD-2 (MS Word 68KB) |
| (WCAB No. RIV 055831) | ||
| 69 Cal.Comp.Cases 480 | ||
|
NOTE: The Board concluded in essence that local child support agencies may issue
valid and enforceable earning assignment orders without a signature by a judicial
officer, that those assignment orders may include both future support obligations
and arrearages, and that the local agencies are not required to obtain prior WCAB
approval of these assignment orders. | ||
| John
Lett vs. L.A.C.M.T.A; The Travelers' Insurance Company | March 5, 2004 |
<2004-SPD-1 (pdf text 149KB) 2004-SPD-1 (MS Word 21KB) |
| (WCAB No. VNO 0378504, VNO 0378505, VNO 0382578, VNO 0402513, VNO 0462718) | ||
| 69 Cal.Comp.Cases 250 - Writ denied at 69 Cal.Comp.Cases 636 | ||
|
NOTE: The board held that applicant's signature on a deposition is not a condition
precedent to the allowance of a deposition fee under Labor Code section 5710(b)(4).." | ||
2003 significant panel decisions
| Noe Vega vs. Taco Bell; California Indemnity Insurance Company | June 9, 2003 |
2003-SPD-3 (pdf text 145KB) 2003-SPD-3 (MS Word 42 KB) |
| (WCAB No. VNO 458318) | ||
| 68 Cal.Comp.Cases 921 | ||
|
NOTE: The board held "that an expedited hearing shall be set on a defendant's
Declaration of Readiness to Proceed to Expedited Hearing under Section 5502(b)
where the issue of a defendant's right to medical control within the scope of
Section 4600.3, and concomitantly, an applicant's entitlement to medical treatment,
is presented for decision." | ||
| Donna Yee Sanchez Natalie
Piatt | April 29 , 2003 | *2003SPD-3
(pdf text 233 KB) *2003SPD-3 (MS Word 79 KB) |
| (WCAB No. OAK 271713 & SAC 304854) | ||
| 68 Cal.Comp. Cases 637 | ||
| In summary fashion, the Board (1) opined
that for pre and post window period injury cases, applications must be filed before
hearings may be conducted, orders issued, or the Board's judicial process invoked
to compel discovery; (2) recognized that non-compelled pre-application investigation
is permissible; (3) outlined remedies for pre-application abuse of discovery procedures;
and (4) outlined conditions requiring the filing of an application under Labor
Code section sections 4061(m) and 4063. | ||
| Shahin
Motallebi, vs. Astro Business Solutions, ICS.; Canon USA; Yasuda Fire & Marine Insurance. | March 18 , 2003 | *2003SPD-2
(pdf text 136 KB) *2003SPD-2 (MS Word 46 KB) |
| (WCAB No. VNO368013; VNO368014,
VNO368015; VNO368016, VNO368017; VNO368018 | ||
| 68 Cal.Comp. Cases 445 | ||
| The case sets forth the specific conditions
under which it was found that the Board had no jurisdiction to determine an applicant's
liability for repayment of UCD benefits to EDD. | ||
| Alfred Lee (Deceased) | February 18 , 2003 | *2003SPD-1
(pdf text 153 KB) *2003SPD-1 (MS Word 46 KB) |
| (WCAB No. LAO 781284) | ||
| 68 Cal.Comp. Cases 213 | ||
| The Board concluded that an applicant may
not elect against CIGA when there are other viable carriers having liability during
the alleged cumulative exposure period. | ||
2002 significant panel decisions
|
Les Hall, | September 12, 2002 | *2002SPD-2
(pdf text 234 KB) *2002SPD-2 (MS Word 36 KB) |
| (WCAB No. SAC 309589) | ||
| 67 Cal.Comp. Cases 1147 | ||
| The case deals with whether and under what
circumstances Legion Insurance Company, now in rehabilitation, can be excused
from an obligation to make lump-sum payments and can receive a stay on future
hearings if a settlement is not reached in denied or disputed cases. | ||
| Manuel Manzano vs. Flavurence
Corporation; Fremont Compensation Insurance | July 10, 2002 | *2002SPD-1
(pdf text 206 KB) *2002SPD-1 (MS Word 34 KB) |
| (WCAB No. LAO
778749 - Manzano) (WCAB No AHM 075204 -Singh ) | ||
| 67 Cal.Comp. Cases 914 | ||
| The cases deal with the issue of at what
point in case proceedings may CIGA be appropriately dismissed. | ||
2000 significant panel decisions
| Isidoro
A. Lucena Diablo Auto Body: Liberty: Mutual Insurance; Sun Valley Ford; Great States Insurance | December 20, 2000 | *2000SPD-1 |
| (WCAB No. WCK 037874) | ||
| 65 Cal. Comp. Cases 1425 | ||
1998 significant panel decisions
| Jeffrey Mabe
vs. Mike's Trucking California Indemnity Indurance Company, | October 28, 1998 | *1998-SPD-8 |
| (WCAB No. VEN 105613) | ||
| 63
Cal. Comp. Cases 1394 | ||
| Daniel
Kaiser vs. California Electric California Casualty Indemnity Exchange, | October 26, 1998 | *1998-SPD-7 |
| (WCAB No. WCK 0039701) | ||
| 63
Cal. Comp. Cases 1391 | ||
| Louis
Jones vs. Target Stores Constitution State Services, | October 26, 1998 | *1998-SPD-6 |
| (WCAB No. PAS 0040032) | ||
| 63
Cal. Comp. Cases 1385 | ||
| George
Wilson vs. Centinela Hospital Medical Center | September 4, 1998 | *1998-SPD-5 |
| (WCAB No. LAO 726063, LAO 726064, LAO 727783) | ||
| 63 Cal. Comp. Cases 1048 NOTE: Order Correcting for Clerical Error | ||
| George
Wilson vs. Centinela Hospital Medical Center | August 31, 1998 | *1998-SPD-4 |
| (WCAB Nos. LAO 726063, LAO 726064, LAO 727783) | ||
| 63 Cal. Comp. Cases 1048 | ||
| Stockman vs.
State of California, Department of Corrections | July 24, 1998 | *1998-SPD-3 |
| (WCAB No. BAK 123730, BAK 123079, BAK 123080) | ||
| 63 Cal. Comp. Cases 1042 | ||
| Larch (Fleming) vs. Contra Costa County | July 10, 1998 | *1998-SPD-2 |
| (WCAB No. WCK 21372) | ||
| 63
Cal. Comp. Cases 831 Writ of review denied 8/12/99 -- 64 CCC 1098 Supreme Court denied review 10/20/99 NOTE: Petition for Writ of Review filed August 21, 1998. | ||
| Czarnecki
vs. Golden Eagle Insurance Company | May 26, 1998 | *1998-SPD-1 |
| (WCAB No. SDO 0217617, SDO 0217759) | ||
| 63 Cal. Comp. Cases 742 | ||
1997 significant panel decisions
| Becerra
v. Eastside Reservoir Project/Advanco Constructors | July 17, 1997 | *1997-SPD-1 |
| (WCAB No. AHM 51304) | ||
| 62 Cal.Comp.Cases 937 | ||
| Green-Rhoads v. Gran Teasley | July 17, 1997 | *1997-SPD-2 |
| (WCAB No. RDG 0060772) | ||
| 62 Cal.Comp.Cases 943 | ||
| Gubbins
v. Metropolitan Insurance Companies | July 17, 1997 | *1997-SPD-3 |
| (WCAB No. SAL 227062) | ||
| 62 Cal.Comp.Cases 946 | ||
| Cedeno
v. American National Insurance Company | July 21, 1997 | *1997-SPD-4 |
| (WCAB No. LAO 729720) | ||
| 62 Cal.Comp.Cases 939 | ||
September 2007
