ADJ6840627 — California WCAB decision

What the panel ordered

Petition for Reconsideration granted; final decision after reconsideration deferred pending further review of merits and record.

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This docket was decided more than once. Shown here is the latest released decision; we also hold December 3, 2024, April 5, 2024.

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.

LiensRemanded

The Appeals Board found that EDD's lien recovery is not barred by payment for nonindustrial injury and deferred final decision for further review.

From the decision · page 6Lastly, as to defendant's argument that EDD may not recover on its lien because it paid benefits for a nonindustrial injury, we note that if our inquiry as to whether QME Dr. Schneider's reporting constitutes substantial medical evidence as to the period of temporary disability, EDD would be entitled to recover its lien irrespective of whether or not EDD paid benefits for a nonindustrial injury. (See Labor Code § 4904.) Hence, we will order that a final decision after reconsideration is deferred pending further review of the merits of this issue.

The facts that decided it

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

Dr. Schneider reported traumatic brain injury with cognitive impairment and psychiatric sequela resulting in 55% permanent disability rating for brain and psyche injury.

Favours Applicant prevailed

This medical opinion formed the basis for the WCJ's permanent disability rating and was central to the Appeals Board's review.

From the decision · page 4Here, our preliminary review reveals that Dr. Schneider reported that applicant sustained a traumatic brain injury which resulted in cognitive brain impairment and psychiatric sequela which diminished her ability to perform activities of daily living and excluded her from participating in the labor market. Applicant's traumatic brain injury and consequent injury to the psyche received a permanent disability rating of 55%. The WCJ combined this permanent disability rating with the

Favours Defendant prevailed

This wage calculation discrepancy affected the temporary disability indemnity rate determination and was a key issue for reconsideration.

The record lacks substantial medical evidence supporting temporary disability beyond the 104 weeks statutory limit.

Favours Defendant prevailed

This fact challenges the WCJ's finding on the temporary disability period and supports deferral for further review.

From the decision · page 6Our preliminary review does not reveal argument from defendant or a record from the WCJ regarding the legal basis for finding a temporary disability period in excess of the 104 weeks statutory limit allowed after commencement of temporary disability payments. (See Lab. Code, § 4656(c)(1).) We also note that if the 104-week limit of Labor Code section 4656(c)(1) restricts the period for which applicant is entitled to temporary disability indemnity, then the WCJ's finding that the appropriate date for commencement of permanent disability payments was April 24, 2017, would be in error. Hence, we will order that a final decision after reconsideration is deferred pending further review of the merits of this issue.

ADJ6840627 · March 17, 2025

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

What the panel did with the medical opinions

The rules the panel named

What proof carried it

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