April 21, 2025 | Sacramento, CA — MedLegalNews.com — Worker Loses Appeal on AWW: A California worker’s challenge to the calculation of their average weekly wage (AWW), the termination of workers’ compensation benefits, and a request to change treating physicians has been rejected by the Workers Compensation Appeals Board (WCAB).
WCAB Supports Employer’s Wage Calculation
The worker argued that the AWW was too low, which resulted in reduced temporary disability payments. However, the WCAB found that the employer had applied the correct formula under Labor Code § 4453(c).
The board reviewed the worker’s earnings during the 52 weeks before the injury. It determined that the wage data accurately reflected the worker’s typical income. The WCAB also noted that seasonal or variable hours alone don’t invalidate a calculation unless it clearly misrepresents actual earning capacity.
Medical Evidence Supports Termination of Benefits
Worker Loses Appeal on AWW: The worker also disputed the termination of temporary disability payments. They claimed that a treating physician’s opinion showed ongoing impairment. But the WCAB sided with the employer, citing a panel qualified medical evaluator (PQME) who concluded the worker was permanent and stationary.
The WCAB emphasized that the PQME’s findings were well-supported and more persuasive. It found the treating physician’s report lacked enough detail to challenge the panel’s conclusion.
Board Rejects Request for New Treating Physician
The worker tried to switch their treating doctor but failed to follow the required procedures. Under California Code of Regulations § 9785, injured workers may request a physician change through the Medical Provider Network (MPN). However, they must notify the claims administrator and meet specific conditions.
The WCAB found no evidence that the worker had trouble accessing care or that the treatment was inadequate. Because of that, the board denied the request.
What This Case Means
This decision highlights several key points in California workers’ compensation law:
- Employers must use standard methods to calculate wages, but those calculations hold up when backed by records.
- Benefit termination is valid when supported by strong medical evidence.
- Requests to change doctors must follow the MPN process and include proper documentation.
Employers should keep clear records of earnings and medical evaluations. Injured workers should seek legal advice early when challenging wage calculations or medical treatment decisions.while, should consult experienced workers’ compensation attorneys when disputing AWW or seeking medical provider changes.
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FAQS: California Workers Compensation Appeal
What is a California workers compensation appeal?
A California workers compensation appeal occurs when an injured worker challenges a decision by the claims administrator or employer, such as wage calculation, benefit termination, or medical treatment disputes, before the WCAB.
How is the average weekly wage calculated in a California workers compensation appeal?
The WCAB reviews earnings for the 52 weeks prior to injury. Seasonal or variable hours are included unless they misrepresent actual earning capacity, ensuring an accurate calculation of temporary disability benefits.
Can a worker request a new treating doctor during a California workers compensation appeal?
Yes, but only through the Medical Provider Network (MPN) process. Injured workers must notify the claims administrator and meet regulatory requirements under California Code of Regulations § 9785.
What should injured workers do if their California workers compensation appeal is denied?
Workers should consult experienced workers’ compensation attorneys to understand next steps, review medical evidence, and determine if further legal or procedural options are available.