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Case Law Database

Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. MISSING
Regular Panel Decision

Marshall v. Atlantic Container Line, GIE

The Secretary of Labor alleged that Atlantic Container Line (ACL) violated the Age Discrimination in Employment Act (ADEA) by involuntarily retiring employees at age 62, while ACL contended these retirements were exempt under ADEA § 4(f)(2). The court had previously denied summary judgment, noting factual questions regarding whether a 1974 amendment to ACL's pension plan constituted a subterfuge to evade the ADEA and if ACL relied in good faith on administrative regulations. Upon review of stipulated facts, the court found no evidence of subterfuge in ACL's plan amendment, which aimed to create promotional opportunities and harmonize retirement ages. Furthermore, ACL successfully established a good faith defense under the Portal-to-Portal Act, having relied on official administrative regulations despite conflicting advice from a Department of Labor representative. Consequently, the defendants' motion for summary judgment was granted.

Age DiscriminationEmployment ActPension PlanSubterfugeGood Faith DefenseSummary JudgmentMandatory RetirementEmployer LiabilityStatutory InterpretationDepartment of Labor
References
8
Case No. MISSING
Regular Panel Decision

Zapico v. Bucyrus-Erie Co.

This case addresses post-trial motions concerning the liability of Atlantic Container Lines (ACL), a stevedore, to Bucyrus-Erie Co., a truck-crane manufacturer and third-party plaintiff. The central issue is whether ACL enjoys immunity from contribution or indemnity claims under 33 U.S.C. § 905, following a jury finding that both Bucyrus-Erie's negligent manufacturing and ACL's incompetent employee (Antonio Fuet) equally contributed to the injury of Adolfo Millan and death of Joseph Zapico, ACL's employees. ACL argued it was immune as a compensation-paying stevedore and lacked an indemnity agreement. The court found that Bucyrus-Erie's claim was not 'on account of' the employee injury, but rather for partial indemnification based on ACL's implied warranty of workmanlike performance or a quasi-contractual theory. The court concluded that extending third-party benefits or apportioning damages based on fault would not violate statutory immunity and would be equitable, especially given manufacturers' lack of control over stevedoring functions and increasing strict liability. Therefore, ACL's motion for judgment in its favor was denied, Bucyrus-Erie Co.'s motion to amend its pleadings was granted, and Celia Zapico's motion to strike the jury's finding of contributory negligence was denied.

Stevedore LiabilityMaritime IndemnityLongshoremen's ActThird-Party ClaimsProduct Manufacturer NegligenceEmployee IncompetenceContribution LawWarranty of Workmanlike PerformanceFederal Civil ProcedurePost-Trial Litigation
References
14
Case No. MISSING
Regular Panel Decision

Claim of Jacob v. New York City Transit Authority

Claimant sustained work-related injuries in January 2000 and later sought workers’ compensation benefits alleging recurrence. An issue arose regarding the veracity of the medical history provided to the employer’s independent medical examiners, specifically concerning undisclosed prior similar injuries. A workers’ compensation law judge and subsequently the Workers’ Compensation Board found that the claimant violated Workers’ Compensation Law § 114-a, leading to disqualification from wage replacement benefits. However, the Board authorized medical treatment for the January 2000 injuries. On cross appeals, the Board’s determination was affirmed, finding substantial evidence supported the violation and the appropriateness of the penalties imposed.

Workers' Compensation Law Section 114-aMedical MisrepresentationWage Replacement Benefits DisqualificationMedical Treatment AuthorizationPrior Injuries DisclosureSubstantial Evidence ReviewIndependent Medical ExaminationWorkers' Compensation Board DecisionAppellate ReviewAffirmed Decision
References
4
Case No. MISSING
Regular Panel Decision
Jul 27, 2001

Claim of Losurdo v. Asbestos Free, Inc.

The case involves a claimant appealing a Workers’ Compensation Board decision. The Board ruled that the claimant violated Workers’ Compensation Law § 114-a by failing to disclose prior left and right knee injuries to physicians and under oath, leading to disqualification from future wage replacement benefits. Although a Workers’ Compensation Law Judge initially found no fraud, the Board reversed this determination on administrative appeal, concluding the claimant knowingly made false statements. The Appellate Division affirmed the Board's decision, finding it supported by substantial evidence, emphasizing the Board's authority as the sole arbiter of witness credibility. The court rejected the claimant's explanations of forgetting the prior incidents as not credible.

Workers' Compensation FraudMisrepresentation of Medical HistoryFalse Statements Under OathWage Replacement Benefits DisqualificationWorkers' Compensation Law Section 114-aAppellate Review of Board DecisionWitness CredibilitySubstantial EvidencePrior Knee InjuriesAdministrative Appeal
References
11
Case No. ADJ1384238 (SAC 0366460)
Regular
Oct 09, 2017

ROSA VIRGEN vs. MACY'S WEST, MACY'S CORPORATE SERVICES-RISK MANAGEMENT DEPARTMENT

The Workers' Compensation Appeals Board denied Macy's West's petition for removal, upholding the WCJ's decision not to grant a replacement Qualified Medical Evaluator (QME). The Board found that a late supplemental report alone does not mandate a replacement QME under LC 4062.5 or AD Rule 31.5(a)(12). Granting a replacement QME for untimely supplemental reporting is discretionary and requires a showing of good cause, which Macy's failed to demonstrate. The Appeals Board retains exclusive jurisdiction over the validity of replacement panels.

Workers' Compensation Appeals BoardPetition for RemovalQualified Medical EvaluationPQMEReplacement PanelMedical DirectorTimelinessSupplemental ReportGood CausePrejudice
References
4
Case No. ADJ15951486, ADJ15951487
Regular
Aug 25, 2025

JEFF CRAIL vs. AMTRUST NORTH AMERICA, HARTFORD FIRE INSURANCE COMPANY

The defendant, Amtrust North America and Hartford Fire Insurance Company, filed a Petition for Reconsideration of a Joint Findings of Fact and Orders (F&O) issued on May 20, 2025. The F&O had ordered the replacement of Panel Qualified Medical Examiner (PQME) Dr. Wiseman due to his failure to properly serve his report. The defendant argued that the court improperly interpreted Administrative Director Rule 31.5(a)(12) and that a Declaration of Readiness (DOR) does not constitute both an objection and a request for a replacement panel. The Appeals Board denied the Petition for Reconsideration, affirming the WCJ's decision to replace Dr. Wiseman. The Board's decision cited its en banc ruling in Vazquez v. Inocensio Renteria, reinforcing that a QME's failure to timely issue and serve a report, and engaging in ex parte communication by serving only one party, grants a party the right to seek replacement. The Board also emphasized the informal nature of pleadings in workers' compensation proceedings, as established in Perez v. Chicago Dogs, when addressing the applicant's DOR.

PQMEPetition for ReconsiderationJoint Findings of Fact and OrdersAdministrative Director RuleDeclaration of ReadinessIrreparable HarmMandatory Settlement ConferenceOncology PanelQualified Medical ExaminerProof of Service
References
14
Case No. ADJ6794293
Regular
Jul 29, 2011

SHARON HIRONYMOUS vs. CENTRAL ANESTHESIA SERVICE, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration of an order allowing a replacement QME panel. The Board granted removal, rescinded the order, and ruled the applicant was not entitled to a replacement QME. This decision was based on the applicant's failure to object to the QME's conduct during the examination itself, instead waiting until after reviewing the QME's report. Allowing a replacement panel under these circumstances was deemed prejudicial to the defendant.

QMEreplacement panelPetition for ReconsiderationPetition for Removalindustrial injurycarpal tunnel syndromeAdministrative Law JudgeQualified Medical Evaluator Complaint FormTitle 8 California Code of Regulationsinterlocutory procedural order
References
16
Case No. ADJ11802539
Regular
Dec 03, 2019

LA TONYA RIDER vs. PRIDE INDUSTRIES, NORTH RIVER INSURANCE

The Appeals Board granted removal and rescinded the WCJ's order denying a replacement QME panel. Defendant sought a replacement due to the current QME's unavailability for deposition. The Board found the original order lacked an evidentiary basis, necessitating a return to the trial level. Further proceedings will establish an evidentiary record to adjudicate the QME replacement issue, considering relevant Administrative Director Rules.

Petition for RemovalQualified Medical Evaluator paneldeposition unavailabilityevidentiary recordsubstantial evidenceAdministrative Director Rule 31.5(a)Administrative Director Rule 35.5(f)trial levelrescinded orderReturn to trial
References
4
Case No. ADJ9186134
Regular
Oct 01, 2019

KARLA SARABIA vs. COUNTY OF SAN BERNARDINO

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration because the order to replace a Qualified Medical Evaluator (QME) was not a final order. The Board also denied the applicant's petition for removal, adopting the judge's report which found no basis for removal. The applicant sought to challenge the replacement of a QME, alleging prejudice and irreparable harm. The Board found no substantive right or liability determined by the QME replacement order.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalQualified Medical EvaluatorPQMEReplacement PQMEFindings and OrderVocational NurseIndustrial InjuryNeck Injury
References
4
Case No. ADJ6754074
Regular
Dec 14, 2010

BARBARA JACOME vs. DURHAM SCHOOL SERVICES, OLD REPUBLIC, SEDGWICK CMS

This case involves an applicant's petition for removal challenging a WCJ's order granting the defendant's request for a replacement Qualified Medical Evaluator (QME). The applicant argued the defendant's objection to the QME's report timeliness was conditional and not properly served, thereby waiving their right to a replacement. The Appeals Board granted removal, finding the defendant's objection, made after receiving the report, was insufficient and void. Therefore, the defendant was not entitled to a replacement panel, and the QME's report was deemed admissible.

Petition for RemovalQualified Medical EvaluatorReplacement PanelTimeliness ObjectionConditional ObjectionLabor Code SectionsCalifornia Code of RegulationsMedical DirectorAdministrative DirectorComprehensive Medical-Legal Evaluation
References
0
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