ADJ4006497 — California WCAB decision

What was disputed, and how it came out

Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.

Temporary disabilityApplicant prevailedcervical spine · thoracic spine · lumbar spine · shoulders · psyche · shiftwork sleep disorder · dental injury

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

Applicant was temporarily partially disabled from August 25, 2006, through November 12, 2008, supported by medical evidence and stipulations on employment and earnings.

Favours Applicant prevailed

This fact established applicant's entitlement to temporary partial disability indemnity.

From the decision · page 5Here, QME Dr. Field stated that as of his March 5, 2007 examination of applicant, she had not reached permanent and stationary/maximum medical improvement (P&S/MMI) status. (Joint Exh. 1, p. 10.) AME Dr. Hoy subsequently determined that applicant "was at a point of" being P&S/MMI as of December 2, 2008. (Court Exh. Y, p. 23.) AME Dr. Angerman, stated that he believed applicant's condition had remained P&S/MMI "for rating purposes since she was seen by the prior Agreed Medical Examiner, Dr. Sew Hoy." (Court Exh. Z2, p. 10.)

There was no evidence supporting defendant's claim of prompt investigation and no unreasonable delay in benefits.

Favours Applicant prevailed

The rules the panel named

Authorities as the decision cited them, with how this panel applied each one.

Signature Fruit Co. v. Workers' Comp. Appeals Bd. (Ochoa) (2006) 142 Cal.App.4th 790

A temporary disability is an impairment reasonably expected to be cured or improved with proper medical treatment.

Used to define temporary disability in this case.

From the decision · page 4"A temporary disability is an impairment reasonably expected to be cured or improved with proper medical treatment." (Signature Fruit Co. v. Workers' Comp. Appeals Bd. (Ochoa) (2006) 142 Cal.App.4th 790, 795 [71 Cal.Comp.Cases 1044].) "The essential purpose of temporary disability indemnity is to help replace the wages the employee would have earned, but for the injury, during his or her period(s) of temporary disability." (Ibid, at 801 (quoting from Jimenez v. San Joaquin Valley Labor (2002) 67 Cal.Comp.Cases 74, 78 (Appeals Board en banc).) A determination regarding whether an applicant is permanent and stationary or temporarily disabled typically requires medical evidence. (Huston v. Workers' Comp. Appeals Bd. (1979) 95 Cal.App.3d 856, 867 [44 Cal.Comp.Cases 798]; Bstandig v. Workers' Comp. Appeals Bd. (1977) 68 Cal.App.3d 988 [42 Cal.Comp.Cases 114].) An employer's obligation to pay temporary disability indemnity to an injured worker ceases when (1) the employee returns to work, (2) the

Huston v. Workers' Comp. Appeals Bd. (1979) 95 Cal.App.3d 856

An employer's obligation to pay temporary disability indemnity ceases when the employee returns to work, is medically able to return to work, or the condition becomes permanent and stationary.

Applied to determine when temporary disability ends.

From the decision · page 4"A temporary disability is an impairment reasonably expected to be cured or improved with proper medical treatment." (Signature Fruit Co. v. Workers' Comp. Appeals Bd. (Ochoa) (2006) 142 Cal.App.4th 790, 795 [71 Cal.Comp.Cases 1044].) "The essential purpose of temporary disability indemnity is to help replace the wages the employee would have earned, but for the injury, during his or her period(s) of temporary disability." (Ibid, at 801 (quoting from Jimenez v. San Joaquin Valley Labor (2002) 67 Cal.Comp.Cases 74, 78 (Appeals Board en banc).) A determination regarding whether an applicant is permanent and stationary or temporarily disabled typically requires medical evidence. (Huston v. Workers' Comp. Appeals Bd. (1979) 95 Cal.App.3d 856, 867 [44 Cal.Comp.Cases 798]; Bstandig v. Workers' Comp. Appeals Bd. (1977) 68 Cal.App.3d 988 [42 Cal.Comp.Cases 114].) An employer's obligation to pay temporary disability indemnity to an injured worker ceases when (1) the employee returns to work, (2) the

Labor Code section 4656(c)(1)

Aggregate disability payments for a single injury causing temporary disability shall not extend for more than 104 compensable weeks within two years from commencement of temporary disability payment.

Applied to limit the duration of temporary disability benefits awarded.

From the decision · page 5Pursuant to Labor Code section 4656 (c) (1):

ADJ4006497 · April 16, 2021

What was disputed, and how it came out

The facts that decided it

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What the panel did with the medical opinions

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