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

Case No. BAK 145900; BAK 146234 BAK 146235
Regular
Sep 26, 2007

AMALIA DIAZ vs. MCDONALDS/GAVINO MANAGEMENT CORPORATION, UNITED STATES FIDELITY & GUARANTEE COMPANY, LWP CLAIMS SOLUTIONS, INC.

The applicant sustained an industrial knee injury and was awarded continuing temporary disability (TDI) based on an amputation exception. Defendant sought reconsideration, arguing knee surgery is not an amputation under Labor Code section 4656(c)(2)(C). The Appeals Board granted reconsideration to apply the recent en banc decision in *Cruz*, which clarified that "amputation" refers to severance of external body parts. The prior award was rescinded and the matter remanded for a new decision consistent with *Cruz*.

Labor Code section 4656subdivision (c)(2)(C)amputation exceptiontotal knee arthroplastytemporary disability indemnitypermanent and stationaryreconsiderationen banc decisionCruz v. Mercedes Benz of San Franciscorescinded
References
1
Case No. SDO 0354449
Regular
Sep 20, 2007

ADAM PERRY vs. HAMMOND \& MASING CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed a prior award denying additional temporary disability payments beyond the statutory 104-week limit. The applicant sought to extend payments based on his knee surgeries, arguing they constituted "amputations" under Labor Code section 4656(c)(2)(C). The Board held that the term "amputation" in this context refers to the severance of external body parts, not the surgical removal of internal knee fragments or cartilage.

Workers' Compensation Appeals BoardIndustrial InjuryPsyche InjuryTemporary Total DisabilityLabor Code Section 4656(c)(1)Labor Code Section 4656(c)(2)(C)AmputationsOsteochondral FragmentChondroplastyACL Reconstruction
References
1
Case No. MISSING
Regular Panel Decision

Matter of Lichten v. New York City Transit Authority

Claimant, a bus driver, filed for workers' compensation benefits due to an occupational disease stemming from repetitive stress injuries to his legs, including his hips, knees, and feet, caused by his employment. The Workers’ Compensation Law Judge established the case for bilateral hips but disallowed the claim for bilateral knees. This disallowance was upheld by the Workers’ Compensation Board. Claimant appealed this decision. Medical testimony presented conflicting opinions regarding the causal relationship of claimant's knee condition to his work activities. The Board's decision to discredit the treating orthopedist's opinion was found to be supported by substantial evidence and was within its authority concerning credibility determinations. The appellate court affirmed the Board's decision.

Workers' CompensationOccupational DiseaseRepetitive Stress InjuryBilateral KneesCausal RelationshipMedical EvidenceCredibility DeterminationAppellate ReviewAffirmed DecisionBus Driver
References
6
Case No. MISSING
Regular Panel Decision

Claim of Simpson v. New York City Transit Authority

The claimant, identified as a bus driver who retired in 2011, applied for workers’ compensation benefits, alleging an occupational disease due to repetitive stress on his knees. The Workers’ Compensation Board initially disallowed the claim, crediting an independent medical examination by orthopedic surgeon Carl Wilson, who concluded the knee condition was not causally related to work, but rather due to age-related wear and tear and degenerative changes. This Court previously reversed and remitted the case due to the Board's misinterpretation of MRI results. On remittal, the Board again disallowed the claim, reaffirming Wilson's credible testimony. The Appellate Division now affirms the Board’s decision, finding Wilson's medical opinion, which was based on an examination and review of medical records, to be supported by a rational basis and substantial evidence.

occupational diseaseknee injuryrepetitive stressbus driverindependent medical examinationMRI resultsdegenerative changesosteoarthritiscausal relationshipsubstantial evidence
References
6
Case No. LAO 0850067
Regular
Sep 24, 2007

JULIE RAMIREZ vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, PAROLE COMMUNITY SERVICES, Legally Uninsured, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and reversed a prior WCJ finding, ruling that total knee replacement surgery does not constitute an "amputation" for the purpose of extending temporary disability indemnity beyond the 104-week statutory limit. The Board clarified that "amputation" under Labor Code section 4656(c)(2)(C) applies only to the severance or removal of external limbs or appendages, not internal body parts. Therefore, the applicant's claim for additional temporary disability indemnity was denied.

Labor Code section 4656(c)(2)(C)Amputation exceptionTemporary disability indemnity104-week capReconsiderationRemovalInterim Findings and AwardKnee replacement surgeryBilateral kneesIndustrial injury
References
3
Case No. CV-24-0652
Regular Panel Decision
May 29, 2025

Matter of Cahill v. New York State Dept. of Mental Hygiene

Claimant Lynn Cahill sustained a work-related knee injury in 1992, which led to a total knee replacement in 2012 and subsequent revision surgeries. In October 2020, she was diagnosed with a periprosthetic infection, managed with antibiotics. Her condition acutely worsened in September 2022, leading her orthopedic surgeon, Dr. Frank Lombardo, to recommend and perform immediate cement spacer surgery on October 4, 2022, due to risks of sepsis and amputation. The employer and carrier disputed liability, arguing the surgery lacked prior authorization. However, the Workers' Compensation Board, affirmed by the Appellate Division, Third Department, ruled that the surgery was performed on an emergency basis, thereby waiving the authorization requirement under Workers' Compensation Law § 13-a (5) and holding the carrier responsible for the costs.

Knee InjuryPeriprosthetic InfectionEmergency Medical CareSurgical AuthorizationAppellate DivisionWorkers' Compensation Board ReviewMedical NecessityChronic InfectionSepsisAmputation Risk
References
6
Case No. MISSING
Regular Panel Decision
Feb 01, 1978

Claim of Goss v. Hornblower & Weeks

Claimant, a stockbroker, sustained a compensable left knee injury in 1974, leading to surgery and a 10% schedule loss award. Subsequently, the claimant sought to have a right knee injury, sustained in 1975 after being struck by a bicycle while en route to a medical examination for his left knee, deemed a consequential injury. While the referee initially found the right knee injury compensable, the Workers' Compensation Board reversed this decision, concluding that the evidence did not establish a direct and natural link between the industrial left knee injury and the subsequent right knee injury. The appellate court affirmed the Board's determination, citing substantial evidence in the record to support the disallowance of the claim.

Workers' CompensationKnee InjuryConsequential InjurySchedule LossBoard ReversalAffirmationStockbrokerAccidentMedical ExaminationAppellate Review
References
1
Case No. ADJ3023725 (STK 0186210) ADJ 6853419
Regular
Mar 03, 2016

IGNACIO ROA vs. ROHRER BROTHERS/GENERAL PRODUCE; FREMONT COMPENSATION INSURANCE COMPANY, in liquidation CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, administered by SEDGWICK; XL SPECIALTY/BROADSPIRE; STATE COMPENSATION INSURANCE FUND

This case concerns applicant Ignacio Roa's petition for reconsideration of a workers' compensation award finding 20% permanent disability for a right knee injury with 50% apportionment to nonindustrial factors. Roa also sought to establish an industrial injury to his left knee as a consequence of the right knee injury and a cumulative trauma injury to both knees, which the Workers' Compensation Appeals Board denied. The Board affirmed the judge's findings, relying on Dr. Henrichsen's opinion that Roa's left knee symptoms were due to the natural progression of prior surgery and wear, not industrial factors. A dissenting opinion argued for further medical development, finding persuasive evidence of industrial contribution to the left knee condition.

Workers' Compensation Appeals BoardIgnacio RoaRohrer BrothersFremont Compensation Insurance CompanyCIGAXL SpecialtyState Compensation Insurance Fundpermanent disabilityapportionmentnonindustrial factors
References
5
Case No. MISSING
Regular Panel Decision

Claim of LaClaire v. Birds Eye Foods, Inc.

Claimant sustained work-related injuries to her left and right knees in 2007. The Workers' Compensation Board subsequently determined that her condition warranted a marked permanent partial disability classification, entitling her to continuing disability benefits rather than a schedule loss of use award. The employer and its workers' compensation carrier appealed this determination. The court affirmed the Board's decision, finding substantial evidence, including the claimant's orthopedic surgeon's testimony regarding crepitus, swelling, and severe pain, supported the marked permanent partial disability classification. Furthermore, the court concluded that the Board did not abuse its discretion in requiring additional proof concerning any overpayments made to the claimant.

Workers' CompensationPermanent Partial DisabilitySchedule Loss of UseKnee InjuriesAppellate ReviewSubstantial EvidenceMedical OpinionCredibility AssessmentOverpaymentsDisability Benefits
References
6
Case No. ADJ8336436
Regular
Mar 25, 2016

CARMEN NAVARRO vs. VENICE COMMUNITY HOUSING CORPORATION, ATHENS ADMINISTRATORS

Here's a summary for a lawyer: The Workers' Compensation Appeals Board (WCAB) denied Carmen Navarro's petition for reconsideration. Navarro sought to establish her right knee injury as a compensable consequence of a prior admitted left knee injury. The WCJ's report, adopted by the WCAB, found the right knee injury to be non-industrial. Medical evidence, particularly from QME Dr. Williamson, indicated the right knee pain arose independently in August 2013, distinct from the earlier left knee injury and treatment period. The Board specifically rejected any consideration of "rashly undertaken" activity as irrelevant to the legal analysis.

WCABPetition for ReconsiderationWorkers' Compensation Appeals BoardVenice Community Housing CorporationAthens AdministratorsADJ8336436Los Angeles District OfficeWCJcompensable consequenceleft knee injury
References
1
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