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California Supreme Court Upholds Workers' Compensation Apportionment Rule, but Allows for Important Exception

The California Supreme Court recently ruled on the appeal in the Benson case. The Court's ruling deals with the issue of apportionment, which is how permanent disability benefits are divided between different causes. Permanent disability is paid only for the portion of the disability that is industrially related. Now, each industrial injury may also have to be rated separately. The Benson case reflects a further change in the apportionment laws under the 2004 Workers' Compensation "Reform" (Senate Bill 899).

The Court's ruling is significant because it supports the requirement that each injury suffered by a worker be treated separately in terms of a disability award. Prior to the 2004 "overhaul" of the Workers' Compensation system (in the form of SB 899), if an employee had two injuries to the same body part that were permanent and stable at the same time, the injuries were combined into one disability award. Combining injuries leads to an increased disability rating percentage and, hence, a much more substantial monetary award.

However, the good news from this decision is that the Court left intact a most important exception to the rule that in some cases will still allow an injured worker to get an appropriate permanent disability monetary recovery.

The medical record in the Benson case did not take into consideration the possible exception to the rule. As a result, the decision for Ms. Benson was not favorable. In the Benson case, the employer succeeded in proving that Ms. Benson's 62 percent permanent disability rating should be divided into two separate 31 percent ratings, which resulted in greatly reduced permanent disability monies paid to her.

"We were hoping that the California Supreme Court would overturn the Benson decision and bring some equity back into the workers' compensation system," says attorney Richard Felton, a partner in the law firm of Gordon, Edelstein, Krepack, Grant, Felton & Goldstein, LLP. "Why should a worker who suffers two back injuries with the same employer receive less benefits than another worker with the same disability from one injury?

"That being said, there may be exceptions to this ruling in certain cases. We will examine thoroughly every opportunity to obtain the full range of benefits for injured workers. The key will be questioning the doctor(s) about the rule, and whether the facts of a given case will allow for the exception to apply, resulting in a better permanent disability recovery for the injured worker.

"Now more than ever, it is crucial to have the best attorneys possible on your side who understand how to apply the rule and its exception to secure an appropriate permanent disability award."

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