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PLATTO-SOSINE-SEMINAR GROUP
CASE LAW INTRODUCTION
INTRODUCTION TO CASE LAW
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There are many case laws in workers’ compensation that have resulted from en banc decisions made by a 3-judge panel when a party to a case disagrees with a lower WCAB court decision made by one judge. If there is such a disagreement, the party can then file a petition to the WCAB for reconsideration by a 3-judge panel. If the petition is accepted and the 3-judge panel changes/overturns the lower court decision, then the 3-judge panel decision becomes case law. And case law can only be changed/reversed by the California Supreme Court or by the State legislature. While there are many case laws in the California’s workers’ compensation system, probably the 4 most important ones that QME’s are often confronted with and should be familiar with are the following:
Benson:
This case law requires that if the same body parts and/or systems injured in separate injuries become permanent and stationary/MMI at the same time, the cause of the impairment(s) must be apportioned to each cause of the impariment.
Escobedo:
This case law involves apportionment whether or not the QME’s explanation for apportionment is appropriate for a degree of medical probability or is based upon mere speculation
Hikida:
This case law involves secondary (or compensable) consequences that result from treatment for the claimed and accepted work injury with regard to apportionment
Vigil:
This case law involves whether or not the impairment for 2 or more body parts and/or systems can be added instead of combined..
While it is recommended that QMEs read the actual case law decisions noted above, the documents in this folder are intended to provide the QME with basic, simple and relevant information for each of these case law decisions. The full text of these case laws can be easily found through various internet search engines, such as Google or Yahoo.
*See DOWNLOAD page for additional Case Law Explanation
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