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

Case No. MISSING
Regular Panel Decision
Apr 17, 2006

D.I.S., LLC v. Sagos

This case concerns an appeal by a mortgagee from an order of the Supreme Court, Nassau County, which granted the mortgagor's petition to direct the mortgagee to accept a specific sum in full satisfaction of the mortgage debt and issue a satisfaction of mortgage. The appellate court affirmed the lower court's order, ruling that the mortgagor's tender of payment of the entire mortgage principal plus interest, in response to the mortgagee's acceleration of debt, did not constitute a 'prepayment' within the meaning of the mortgage's prepayment clause. Consequently, the mortgagee was precluded from assessing a prepayment penalty as no such provision was specified in the mortgage. Additionally, the court declined to consider the mortgagee’s remaining contention regarding the acceleration clause because it was raised for the first time in her reply brief.

Mortgage LawPrepayment PenaltyMortgage Debt SatisfactionAcceleration of DebtRPAPL 1921Appellate ProcedureCivil ProcedureNassau County Supreme CourtContractual ProvisionsTender of Payment
References
7
Case No. OXN 126995
Regular
Nov 07, 2007

CHARLES DURHAM vs. MISSION LINEN SUPPLY, SECURITY INSURANCE COMPANY OF HARTFORD, FIDELITY AND CASUALTY COMPANY OF CONNECTICUT, ACCELERATED CLAIMS SERVICES, INC

This case involves a workers' compensation claim where the applicant sustained a low back injury. The core dispute centers on whether cognitive behavioral therapy is a compensable medical treatment for the applicant's chronic pain resulting from a failed surgery, despite the defendant's arguments about a non-industrial psychiatric component. The Workers' Compensation Appeals Board denied reconsideration, adopting the Administrative Law Judge's report that emphasized the treating physician and Qualified Medical Examiner recommendations supporting the therapy as essential to relieve the effects of the orthopedic injury.

Cognitive behavioral therapyFailed back surgeryPain managementQualified Medical ExaminerUtilization ReviewLabor Code § 3208.3Labor Code § 4600Labor Code § 4610Labor Code § 4062Compensable psychiatric injury
References
5
Case No. ADJ11130965
Regular
Jan 15, 2020

SUSAN ADAMS vs. KAISER FOUNDATION HEALTH PLAN

The Appeals Board affirmed the WCJ's finding that the applicant did not sustain a cumulative trauma injury to her neck, upper extremities, or back. This decision relied heavily on the WCJ's credibility determination of the applicant. While a PQME opined that work activities likely caused a lumbar spine cumulative trauma, the Board found this opinion lacked substantiality. The PQME's report failed to adequately explain how work activities accelerated or aggravated the applicant's numerous pre-existing back conditions and prior injuries.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaCredibility DeterminationQualified Medical EvaluatorOrthopedicsLumbar SpinePreexisting ConditionIndustrial InjurySubstantial Evidence
References
2
Case No. ADJ6675568
Regular
May 01, 2015

GERALD KEYES vs. B&L MECHANICAL, LINCOLN GENERAL INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, affirming the finding of industrial injury to the applicant's teeth. This injury was found to be a consequence of medications prescribed for a prior industrial back injury, which caused dry mouth and accelerated tooth decay. While the apportionment of industrial versus non-industrial causation was debated, the Board found substantial medical evidence supporting that the industrial medications contributed to the dental condition. The decision focused on causation of injury, not permanent disability apportionment.

Workers' Compensation Appeals BoardGerald KeyesB&L MechanicalLincoln General Insurance CompanyADJ6675568dental injuryhyposalivationPQMEDr. Gregory StephensDr. Dennis Shamlian
References
1
Case No. ADJ9638094
Regular
Apr 04, 2016

ALEJANDRO GONZALEZ CEJA vs. TREASURY WINE ESTATES, SENTRY INSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration, rescinded findings on permanent disability, and returned the case for further proceedings. The Board found the Qualified Medical Evaluator's (PQME) apportionment of 25% permanent disability to pre-existing arthritis lacked substantial evidence. Specifically, the PQME failed to adequately explain the basis and causation for this apportionment, particularly when also stating the job duties likely aggravated and accelerated the condition. The matter was returned to clarify the PQME's apportionment determination before a new decision is issued.

ApportionmentPQMECumulative traumaVineyard workerLeft shoulderLeft elbowPermanent disabilitySubstantial evidencePre-existing conditionAcromioclavicular joint arthritis
References
6
Case No. ADJ11320525
Regular
Jul 01, 2019

LOURDES OCAMPO vs. SWEETWATER UNION HIGH SCHOOL DISTRICT

The Workers' Compensation Appeals Board granted reconsideration of the initial decision, finding the orthopedic QME's opinions did not constitute substantial evidence. Applicant contended the QME's opinions were inconsistent with medical literature regarding the acceleration of pre-existing conditions. The Board agreed that the QME seemed to conflate causing arthritis with aggravating a pre-existing condition. Therefore, the Board rescinded the original findings and returned the case for further development of the record, specifically regarding the extent of applicant's walking and a clearer medical opinion on causation.

AOE/COEQualified Medical Examiner (QME)Petition for ReconsiderationFindings and Order (F&O)substantial evidenceorthopedichip arthritisdegenerative joint diseaseindustrial causationacceleration of condition
References
9
Case No. MISSING
Regular Panel Decision

Claim of Nardo v. Rheinstein Construction Co.

The claimant, an electrician, developed Dupuytren's Contracture after years of work involving pressure on his hands. The Workmen's Compensation Board awarded him compensation, finding the disease to be occupational. Appellants argued that the disease's cause is unknown, it affects the general population, and the claimant had a constitutional defect predisposing him to it, thus preventing an award. The court rejected this rigid test, stating that medical opinion supported the finding that the claimant's work accelerated and adversely affected the disease. The court noted Dupuytren's Contracture has been frequently linked to repeated heavy hand use in occupations like brewery workers. The award was unanimously affirmed.

Occupational DiseaseDupuytren's ContractureWorkmen's Compensation BoardMedical OpinionCausal ConnectionAppellate ReviewEmployer LiabilityWork-Related InjuryConstitutional DefectHand Injuries
References
2
Case No. MISSING
Regular Panel Decision
Aug 01, 1983

Dowling v. Consolidated Carriers Corp.

This dissenting opinion addresses a case where a truck driver lost control due to a stuck accelerator and crashed into two illegally parked buses on the shoulder of the Long Island Expressway, injuring a passenger. The dissent argues against the majority's finding of a triable issue regarding proximate cause, asserting that the buses' improper parking merely provided a condition for the accident, and the sole proximate cause was the truck driver's negligence. Citing several legal precedents, the opinion supports the Trial Term's decision to grant summary judgment, dismissing the complaint against the bus defendants. The dissent emphasizes that the accident, given the circumstances, was not reasonably foreseeable from the buses' position.

Proximate CauseSuperseding CauseIntervening CauseSummary JudgmentNegligence LawTraffic AccidentVehicle Law ViolationForeseeability DoctrineDissenting OpinionPersonal Injury Claim
References
13
Case No. MISSING
Regular Panel Decision
Oct 04, 2004

In re the Claim of Ziegler

The claimant's employment with Valeo Electrical Systems, Inc. ended through a company-funded 'Retirement Acceleration Program' providing monthly payments. Despite receiving these payments, the claimant applied for unemployment insurance benefits. The Unemployment Insurance Appeal Board ruled that the claimant's benefit rate should be reduced to zero under Labor Law § 600 (7) (b) because the claimant was receiving employer-financed payments based on previous work. This decision was upheld on appeal. The court also rejected the claimant's argument that Labor Law § 600 conflicted with the Federal Trade Act of 1974, clarifying that trade adjustment allowances are supplemental and do not prohibit the application of state labor law.

Unemployment InsuranceBenefit ReductionRetirement Acceleration ProgramEmployer Funded PensionLabor Law § 600Federal Trade Act of 1974Trade Adjustment AssistancePeriodic PaymentsAppeal DecisionUnemployment Insurance Appeal Board
References
10
Case No. MISSING
Regular Panel Decision
Jan 17, 1980

People v. Hoppe

This case involves an appeal from a judgment convicting the defendant of arson in the third degree. The fire destroyed the residence of James Wahl on June 23, 1979. Witnesses testified that the fire started in a bedroom near a partially opened window and an accelerant was used. The defendant, a former boyfriend of Sandra Wahl (one of the residents), had a history of harassment, threats to burn down her house, and suspicious statements made just hours before the fire. During his arrest, charcoal lighter fluid and other flammable substances were found in his vehicle. The appellate court affirmed the judgment, finding the circumstantial evidence sufficiently strong to exclude all reasonable hypotheses of innocence and upholding the admission of evidence regarding the defendant's prior bad acts.

ArsonCircumstantial EvidenceSufficiency of EvidenceOther Criminal ActsAppellate ReviewHarassmentThreatsAccelerantJury InstructionsIndictment Validity
References
5
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