Vera v. Workers' Compensation Appeals Board

65 Cal. Rptr. 3d 151, 154 Cal. App. 4th 996, 2007 Cal. App. LEXIS 1437, 1 Cal. WCC 713
CourtCalifornia Court of Appeal
DecidedAugust 2, 2007
DocketD049629
StatusPublished
Cited by12 cases

This text of 65 Cal. Rptr. 3d 151 (Vera v. Workers' Compensation Appeals Board) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Vera v. Workers' Compensation Appeals Board, 65 Cal. Rptr. 3d 151, 154 Cal. App. 4th 996, 2007 Cal. App. LEXIS 1437, 1 Cal. WCC 713 (Cal. Ct. App. 2007).

Opinion

Opinion

IRION, J.

Daniel Vera petitioned for review of a decision by the Workers’ Compensation Appeals Board (WCAB) denying his petition for reconsideration of a decision awarding him permanent disability benefits in the amount of $18,823.75. The WCAB’s decision was premised on the application of the schedule for rating permanent disabilities that went into effect on January 1, 2005 (Cal. Code Regs., tit. 8, § 9805), which Vera argues does not apply to his case.

We granted review, and we now conclude that the WCAB properly denied the petition for reconsideration because the schedule for rating permanent disabilities that went into effect on January 1, 2005, applies to Vera’s case. Accordingly, we affirm the decision of the WCAB.

I

FACTUAL AND PROCEDURAL BACKGROUND

On March 14, 2003, while employed as a laborer by Sapper Construction, Vera sustained injury to his neck, back and right shoulder.

At the time of the injury, Sapper Construction’s workers’ compensation insurance carrier was State Compensation Insurance Fund (SCIF). SCIF paid temporary disability benefits to Vera from March 17, 2003, to February 1, 2005, and permanent disability benefits from February 2, 2005, to September *1000 27, 2005, but disputed the amount of permanent disability benefits that were payable and sought a credit for any amount that it had overpaid.

On April 19, 2004, while Vera was being treated for his injuries, but before he reached the status of permanent and stationary, the Legislature passed a comprehensive reform of the workers’ compensation laws. (Stats. 2004, ch. 34, § 30.) Among other things, the Legislature required a change in the schedule by which permanent disability is rated. 1 Under the amended law, by January 1, 2005, the Administrative Director of the Division of Workers’ Compensation was to revise the schedule for rating permanent disabilities, using, among other things, “the descriptions and measurements of physical impairments and the corresponding percentages of impairments published in the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment (5th Edition).” (Lab. Code, § 4660, subds. (b)(1), (e).) 2 The schedule was revised and became effective on January 1, 2005 (the new schedule). 3 (Cal. Code Regs., tit. 8, § 9805.)

In many cases, the revision to the schedule for rating permanent disabilities impacts the amount that a worker will be compensated for a permanent disability. In this case, the parties stipulated that the old rating schedule is more favorable to Vera than the new rating schedule, with the new schedule resulting in a permanent disability rating of 26 percent, and the old schedule resulting in a permanent disability rating of 59 percent. 4

In its reform of the workers’ compensation laws, the Legislature included a provision describing which injured workers would be covered by the new schedule. (§ 4660, subd. (d).) Section 4660, subdivision (d) states that the new schedule shall apply to all claims, except certain claims that arose before January 1, 2005. “The schedule shall promote consistency, uniformity, and objectivity. The schedule and any amendment thereto or revision thereof shall apply prospectively and shall apply to and govern only those permanent disabilities that result from compensable injuries received or occurring on and after the effective date of the adoption of the schedule, amendment or revision, as the fact may be. For compensable claims arising before January 1, 2005, the schedule as revised . . . shall apply to the determination of *1001 permanent disabilities when there has been either no comprehensive medical-legal report or no report by a treating physician indicating the existence of permanent disability, or when the employer is not required to provide the notice required by Section 4061 to the injured worker.” (§ 4660, subd. (d), italics added.)

In an apparent attempt to have Vera’s permanent disability rated under the more favorable old schedule, just seven days after the Legislature enacted the revisions to the workers’ compensation laws Vera’s treating physician issued a “Supplemental Primary Treating Physician’s Report,” dated April 26, 2004, indicating that Vera had a permanent disability (the April 2004 report). The April 2004 report stated; “Mr. Vera’s condition is not permanent and stationary at this time, and pursuant to Labor Code Section 4658[, subdivision ](d)(4) it is my opinion that Mr. Vera does currently have the existence of permanent disability. Based on this patient’s condition and the treatment that [he has] undergone, on a preliminary basis it is this examiner’s opinion that [his] permanent partial disability would be consistent with; [ft] Lumbar Spine; No heavy lifting, repetitive bending and stooping, [ft] Right Shoulder: No heavy lifting, no repetitive over shoulder work activity and no pushing/pulling of heavy weighted objects, [ft] At the time that I examine Mr. Vera for permanent and stationary status, I will subsequently render a Primary Treating Physician’s Permanent and Stationary Report in the near future.” 5 (Italics added.)

The administrative proceedings focused on whether the new schedule or the old schedule governed Vera’s claim for permanent disability.

The workers’ compensation administrative law judge ruled that the old schedule applied, finding that the injury caused permanent disability of 59 percent.

SCIF petitioned for reconsideration. A divided WCAB panel determined that the new schedule applied. The panel majority ruled that the April 2004 report “is not substantial evidence as to the existence of permanent disability in light of the report itself, subsequent reports, and subsequent treatment, and, therefore, is insufficient to bring this case under the old schedule.” 6 It pointed out that the April 2004 report stated (1) that the conclusion was “ ‘on a *1002 preliminary basis’ ” and (2) that Vera “ ‘does currently have the existence of permanent disability.’ ” (Italics added.) It also noted that in a June 2004 report, the treating physician stated that Vera “ ‘remains TTD [i.e., temporarily totally disabled],’ ” and that Vera underwent surgery for his shoulder in August 2004. It stated that “[a] disability cannot be both permanent and temporary at the same time,” and that “[a] medical opinion that is internally inconsistent is not substantial evidence, and therefore, cannot be relied upon to support a decision.” The panel majority concluded, “[H]aving permanent disability ‘on a preliminary basis’, is not the same as ‘the existence of permanent disability’, . . . under section 4660[, subdivision ](d) . . . .”

One panel member dissented. The dissent conceded that the April 2004 report did not constitute substantial evidence of a permanent disability, but stated, “. . .

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Bluebook (online)
65 Cal. Rptr. 3d 151, 154 Cal. App. 4th 996, 2007 Cal. App. LEXIS 1437, 1 Cal. WCC 713, Counsel Stack Legal Research, https://law.counselstack.com/opinion/vera-v-workers-compensation-appeals-board-calctapp-2007.