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

Case No. ADJ4431752 (ANA 0387918) ADJ771024 (ANA 0387917)
Regular
May 14, 2009

CYNTHIA WILSON vs. ALBERTSONS, INC., permissibly self-insured, administered by SPECIALTY RISK SERVICES

This case involves an applicant seeking reconsideration of a prior finding of no ratable permanent disability for a left knee injury. The applicant argues the Agreed Medical Evaluator's report may not adequately capture her disability under the new *Almaraz/Guzman* precedent, which allows consideration of factors beyond the AMA Guides. The Appeals Board granted reconsideration, rescinded the prior award, and returned the case for further medical record development. This is to allow the Agreed Medical Evaluator to specifically address whether the AMA Guides adequately describe the applicant's disability and, if not, to outline other relevant factors.

WCABAlbertson's Inc.Specialty Risk ServicesADJ4431752ADJ771024Opinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of Fact Award and OrderRatable Permanent DisabilityAlmaraz/Guzman
References
4
Case No. ADJ3416937 (SRO 0141443) ADJ4476347 (SRO 0118020)
Regular
Apr 25, 2011

TIMOTHY ROBINSON vs. COUNTY OF SONOMA, Permissibly Self-Insured

This case concerns apportionment of permanent disability for an injured correctional officer. The applicant sustained an admitted industrial injury to his neck, resulting in a 12% permanent disability after initial apportionment. The WCJ calculated a total permanent disability of 43%, then apportioned 20% to non-industrial factors under Labor Code section 4663. Further apportionment occurred for a prior low back injury under Labor Code section 4664, using a converted rating from the old schedule to the new AMA Guides. The Appeals Board affirmed the WCJ's decision, finding no prohibition against applying both section 4663 and section 4664 apportionment, and deeming the prior injury properly converted and subtracted. A dissenting opinion argued that the older rating schedule's "overlap" concept is incompatible with the current AMA Guides method, and that the defendant failed to prove overlap for the prior injury.

Workers' Compensation Appeals BoardCounty of SonomaTimothy RobinsonCorrectional OfficerIndustrial InjuryNeck InjuryPermanent DisabilityApportionmentLabor Code Section 4663Labor Code Section 4664
References
6
Case No. 2021 NY Slip Op 02579 [193 AD3d 1305]
Regular Panel Decision
Apr 29, 2021

Matter of New York Off. for People with Dev.al Disabilities (Civil Serv. Empls. Assn., Inc., Local 1000, AFSCME, AFL-CIO)

The New York Office for People with Developmental Disabilities (petitioner) sought to vacate an arbitration award that reinstated employee Chad Dominie, who was found to have sexually harassed a coworker. The arbitrator had ordered Dominie's reinstatement despite sustaining multiple charges of sexual harassment, citing mitigating factors. Supreme Court granted the petition, vacating the award and remitting for a new penalty before a different arbitrator. The Appellate Division affirmed this decision, holding that the arbitrator's unconditional reinstatement of Dominie violated the strong public policy against sexual harassment in the workplace. The court emphasized the egregious and escalating nature of Dominie's conduct, concluding that the award failed to protect other employees and conflicted with the employer's obligation to eliminate sexual harassment.

Sexual HarassmentWorkplace SafetyArbitration ReviewPublic Policy ViolationEmployee MisconductDisciplinary ProceedingsReinstatement OrderAppellate Court DecisionCollective BargainingEmployer Responsibility
References
9
Case No. ADJ8762477
Regular
Nov 07, 2014

JAVIER RAMIREZ vs. SPACE LOK, INC.; REPUBLIC UNDERWRITERS INSURANCE, administered by SEDGWICK

The Workers' Compensation Appeals Board granted reconsideration, reversing the original finding of 36% permanent disability. The Board found the WCJ erred by not giving sufficient weight to the PQME's opinion, which suggested a higher impairment rating for the applicant's thumb injury based on factors not explicitly covered by the AMA Guides. Consequently, the applicant's permanent disability was increased to 51%, and their attorney's fee was adjusted accordingly. The decision highlights the principle that medical opinions may deviate from strict AMA Guides application when clinical judgment and comparable impairments are warranted.

Permanent Disability RatingReconsiderationPanel Qualified Medical Evaluator (PQME)Almaraz/GuzmanAMA GuidesWhole Person Impairment (WPI)Substantial EvidenceMedical Expert OpinionGrip StrengthThumb Deformity
References
11
Case No. MISSING
Regular Panel Decision

Claim of Martone v. Niagara Frontier Transportation Authority-Metro

In 2005 and 2007, a bus driver (claimant) suffered work-related neck and back injuries. Initially, a Workers’ Compensation Law Judge found him permanently totally disabled. However, the Workers’ Compensation Board modified this, determining he had a permanent partial disability with a 75% loss of wage-earning capacity based on medical evidence and other factors. The claimant appealed this decision, arguing a lack of substantial evidence for the partial disability finding. The Appellate Division affirmed the Board's decision, noting medical reports indicating submaximal efforts, high medication dosages, symptom magnification, and the ability to ambulate, which supported the finding of partial disability. The court also upheld the 75% loss of wage-earning capacity, finding it supported by substantial evidence after considering the claimant's impairment, work restrictions, age, education, and work experience.

Permanent Partial DisabilityWage-Earning CapacityChronic Pain SyndromeLumbar Spine SurgeryMedical EvidenceSubmaximal EffortsSymptom MagnificationAppellate ReviewBoard DecisionMedical Treatment Guidelines
References
2
Case No. ADJ3566412 (OAK 0340812)
Regular
Oct 04, 2010

JESUS RAMIREZ vs. NILES MACHINE & TOOL WORKS, INC., PACIFIC COMPENSATION INSURANCE COMPANY

The Appeals Board granted reconsideration to address the defendant's claim that the WCJ erred in awarding permanent disability without a specific finding on injury to the applicant's neck. The Board noted that the WCJ's permanent disability rating appeared to incorporate factors related to the cervical spine, despite no finding of industrial injury to that body part. Consequently, the Board rescinded the Amended Findings and Award and returned the case to the trial level for further proceedings and a decision on industrial injury to the neck and the proper permanent disability rating. The Board did not rule on the defendant's other arguments regarding the AMA Guides and the appropriateness of the rating.

AMENDED FINDINGS AND AWARDINDUSTRIAL INJURYUPPER EXTREMITIESSHOULDERPERMANENT DISABILITY51%RECONSIDERATIONWCJALMARAZAMA GUIDES
References
2
Case No. ADJ798960
Regular
May 22, 2009

JUAN NAVARRO vs. MARANTZ COOPERATIVE PURCHASERS, EMPLOYERS COMPENSATION INSURANCE GROUP

The Workers' Compensation Appeals Board granted reconsideration to address the applicant's claim that the wrong permanent disability rating schedule was applied. The Board affirmed the use of the 2005 PDRS, finding no comprehensive medical report predating January 1, 2005, indicating permanent disability. However, the Board rescinded the prior award and returned the matter for further medical development regarding the applicant's permanent disability factors, as required by the recent *Almarez/Guzman* en banc decision. A dissenting opinion argued that the applicant waived the issue of AMA Guides impairment rating by not raising it at trial.

WORKERS COMPENSATION APPEALS BOARDMARANTZ COOPERATIVE PURCHASERSEMPLOYERS COMPENSATION INSURANCE GROUPJUAN NAVARRO2005 PERMANENT DISABILITY RATING SCHEDULEALMAREZ/GUZMANAMA GUIDES TO THE EVALUATION OF PERMANENT IMPAIRMENTLABOR CODE SECTION 4660(D)PERMANENT AND STATIONARY STATUSMEDICAL-LEGAL REPORT
References
12
Case No. MISSING
Regular Panel Decision

Smith v. New York State & Local Retirement Systems

Petitioner, a taxpayer services representative, sustained a back injury in March 1981 while lifting forms, leading to a decline in attendance and eventual termination in November 1989. She applied for accidental and ordinary disability retirement benefits, both of which were denied by the Comptroller. The accidental disability claim was denied because the incident was not deemed an 'accident' under Retirement and Security Law § 63. The ordinary disability claim was denied as untimely, having been filed approximately six months after her termination, exceeding the 90-day limit stipulated by Retirement and Social Security Law § 62. The Supreme Court dismissed the challenge to the ordinary disability denial due to untimeliness and transferred the accidental disability challenge to this Court. This Court confirmed the Comptroller's determination on both counts, rejecting the petitioner's estoppel argument regarding the untimely ordinary disability application and finding substantial evidence to support the finding that the injury did not constitute an 'accident' within the meaning of the relevant law, as it resulted from ordinary employment duties without an unexpected event.

Disability Retirement BenefitsAccidental DisabilityOrdinary DisabilityUntimely ApplicationEstoppel Against GovernmentWork-Related InjuryBack InjuryDefinition of AccidentOrdinary Employment DutiesSubstantial Evidence Review
References
16
Case No. MISSING
Regular Panel Decision

Matter of Franklin v. New England Motor Freight

Claimant, a tractor-trailer truck driver, suffered work-related back injuries in 2012 and 2013, leading to disability benefits. A Workers' Compensation Law Judge initially determined a 75% loss of wage-earning capacity, factoring in vocational considerations. However, the Workers' Compensation Board reduced the award, ruling that vocational factors are not applicable for temporary disability determinations. The Appellate Division affirmed the Board's decision, emphasizing that Workers’ Compensation Law § 15 (5-a) does not permit consideration of vocational factors for temporary partial disabilities, reserving such considerations for the duration of permanent partial disability benefits.

Workers' Compensation LawWage-earning capacityTemporary partial disabilityPermanent partial disabilityVocational factorsAppellate reviewBack injuryTractor-trailer truck driverInjury recurrenceCompensation rate
References
7
Case No. MISSING
Regular Panel Decision
May 15, 2012

Hamzik v. Office for People with Developmental Disabilities

Plaintiff John J. Hamzik sued the Office for People with Developmental Disabilities (OPWDD) and several individual employees, alleging discrimination based on sex, age, and disability, as well as equal protection, due process, and retaliation claims under federal and state laws, including Title VII, ADEA, and ADA. Defendants moved to dismiss the amended complaint, and plaintiff cross-moved to file a second amended complaint. The District Court, finding that many claims were barred by Eleventh Amendment immunity or failure to exhaust administrative remedies, and that the remaining claims failed to state a plausible cause of action, granted the defendants' motion to dismiss. All federal claims were dismissed with prejudice, the cross-motion was denied as futile, and the remaining state law claims were dismissed without prejudice.

DiscriminationRetaliationDue ProcessEqual ProtectionTitle VIIADEAADAEleventh Amendment ImmunityAdministrative ExhaustionMotion to Dismiss
References
50
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