Permanent total disability — one rating point, and $1,460 a week

Route one — the conclusive presumptions

Conclusively presumed means no rating exercise and no argument. No AMA Guides analysis, no occupational variant, no age adjustment, no vocational expert.

LABOR CODE § 4662(a)

“(1) Loss of both eyes or the sight thereof. (2) Loss of both hands or the use thereof. (3) An injury resulting in a practically total paralysis. (4) An injury to the brain resulting in permanent mental incapacity.”

And two phrases do more work than people notice: “or the use thereof” reaches functional loss without amputation, and “practically total paralysis” is deliberately not “complete paralysis.”

Brain injury Catastrophic injuries

Route two — 100% “in accordance with the fact”

§ 4662(b): “In all other cases, permanent total disabilityPTD Permanent Total Disability. 100%. Paid at the temporary disability rate for life. shall be determined in accordance with the fact.” This is the vocational route, and it descends from LeBoeufLeBoeuf The line of authority permitting a 100% finding where a worker cannot compete in the open labor market. v. WCAB (1983): a worker who cannot compete in the open labor market is totally disabled regardless of what the rating stringRating string The row of numbers encoding your entire permanent disability calculation. Checkable arithmetic. produces.

The scheduled rating is rebuttable. Under Ogilvie v. WCAB (2011) the schedule can be rebutted with vocational evidence — and under Contra Costa County v. WCAB (Dahl) (2015) that rebuttal is narrow: it requires showing the worker is not amenable to rehabilitation.

The four-step burden

This part changed in 2024. Following the Nunes en banc decisions, WCAB panel decisions in 2024 — including Havanis v. Caltrans, Fiore v. Los Angeles Community College District, and Cano v. Ecology Control Industries — set out what an applicant must establish to rebut a scheduled rating and prove permanent total disability.

Step 4 is where these cases are lost. A worker can satisfy steps 1 through 3 completely — genuinely unable to work, genuinely unemployable — and still fail, because the physician apportioned 30% of the restrictions to degenerative disease. And the vocational expert cannot fix it. Under Nunes (WCAB en banc, June 22, 2023), only reporting physicians determine apportionmentApportionment Dividing permanent disability between industrial and non-industrial causes. It is to disability, not to findings on an image., and “vocational apportionment” is not a valid legal theory. A vocational expert evaluates employability using the restrictions the physician provides. They cannot contest those restrictions and cannot perform apportionment.

How to attack an apportionment opinion

Which means the medical apportionment opinion has to be addressed at the medical level, before the vocational expert is even retained.

Building the case in the right order

• Get the medical restrictions stated specifically — Not “light duty.” Pounds, hours, positions, frequencies, and what happens on a bad day.
• Address apportionment at the medical level first — Under EscobedoEscobedo The en banc decision requiring an apportionment opinion to explain how and why. A percentage without reasoning is not substantial evidence., an opinion that assigns a percentage without explaining how and why is not substantial evidenceSubstantial evidence The standard a medical opinion must meet to support a finding.. This is step 4, and it has to be won with the physician.
• Then retain the vocational expert — Working from the physician’s restrictions.
• Build the evidence the expert needs — The complete work history, education, transferable skills, English proficiency, age, the actual local labor market, and any failed return-to-work attempts. A documented failed attempt to return to work is among the most persuasive evidence available.
• Do it before the mandatory settlement conferenceMSC Mandatory Settlement Conference. Where most cases end — and where discovery closes. — Discovery closes there.

What 100% actually pays

§ 4659(b): the indemnity based on average weekly earnings is paid during the remainder of life. Plus annual cost-of-living increases, tied to the state average weekly wage. Under Baker v. WCAB (2011) 52 Cal.4th 434, those increases commence on the January 1 following the date the worker first becomes entitled to and actually begins receiving the payments — not retroactively.

Over a long life the compounding is substantial, and it runs on the higher base. And medical treatment for the injury continues for life — unless it is settled away.