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

Case No. 2021 NY Slip Op 00606 [191 AD3d 1074]
Regular Panel Decision
Feb 04, 2021

Matter of Pisarski v. Accurate Plumbing & Heating Co.

Claimant Michael Pisarski established a workers' compensation claim for occupational bilateral knee and shoulder injuries after retiring as a union plumber. The Workers' Compensation Board ultimately set the date of disablement as July 12, 2016, and a Worker's Compensation Law Judge ruled Norguard Insurance Company, which covered the employer during Pisarski's last employment, was the liable carrier, as no active policy was found on the disablement date. Norguard appealed, distinguishing its case from Matter of Cammarata, where the employer had ceased business. The Appellate Division, Third Department, found that the Board erred by not determining the business status of Accurate Plumbing and Heating Co. on the date of disablement. This determination is crucial to establish whether Accurate Plumbing was required to maintain an insurance policy or if the Uninsured Employers Fund should be responsible. Consequently, the court reversed the Board's decision and remitted the matter for further proceedings.

Workers' CompensationOccupational DiseaseDate of DisablementInsurance Carrier LiabilityUninsured Employers FundAppellate ReviewRemittalBusiness Status DeterminationPolicy CoverageKnee Injury
References
6
Case No. ADJ3491750
Regular
Jun 19, 2009

MARK RIDER vs. RHO BETA CORPORATION, dba BOB'S MARKET, STATE FARM FIRE AND CASUALTY COMPANY

The Board granted reconsideration to address the defendant's contention that the WCJ erred in failing to apportion 96% of the applicant's bilateral shoulder disability to non-industrial causes. Dr. Miller's opinions on apportionment were deemed unclear and contradictory regarding the applicant's employment history and the extent of pre-existing conditions. Consequently, the Board rescinded the previous Findings and Award and returned the matter for further development of the medical record on apportionment. The parties and WCJ must clarify the applicant's employment history before any physician can accurately apply Labor Code section 4663.

Cumulative TraumaApportionmentPermanent DisabilityMedical OpinionWorkers' Compensation JudgeReconsiderationFindings and AwardLabor Code Section 4663Panel QMEDegenerative Disease
References
6
Case No. ADJ3755232 (VNO0493072)
Regular
Aug 29, 2013

AKHMADMIR ABDULMIR vs. MED-PHARMEX, INC., EVEREST NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior award, finding that the applicant sustained industrial injury to his low back but not his kidneys or abdomen, and his occupation was a material handler/machine loader (group 460). The WCAB found that the opinions of the applicant's Qualified Medical Evaluator (QME) were not substantial evidence due to numerous discrepancies and an inadequate history. The WCAB also found the primary treating physician's (PTP) reports insufficient as they were stale, not based on an accurate history, and lacked review of all medical records. The case was returned to the WCJ for further proceedings on all other deferred issues.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderPrimary Treating PhysicianTemporary DisabilityFurther Medical TreatmentApportionmentLabor Code section 4658(d)(2)Permanent DisabilityAttorney's Fees
References
0
Case No. 2024 NY Slip Op 04848 [231 AD3d 1213]
Regular Panel Decision
Oct 03, 2024

Matter of DiPippo v. Accurate Signs & Awnings

Michael DiPippo sustained work-related injuries in an August 2006 fall, leading to an established claim later amended to include consequential right leg deep vein thrombosis and obesity. He underwent amputations of both legs in 2014 and 2018. DiPippo sought to amend his claim to include the consequential amputation of his right leg, arguing it was caused by conditions linked to his initial injury. The Workers' Compensation Board disallowed the amendment, finding insufficient medical proof of a causal connection. The Appellate Division affirmed the Board's decision, ruling that DiPippo did not qualify as a medical expert and his independent analysis or generalized statements of possibility were inadequate to establish the required causal nexus.

Workers' CompensationAmputationCausal NexusMedical EvidenceExpert TestimonyBoard DecisionAppellate ReviewSubstantial EvidenceWork-Related InjuryClaimant Burden of Proof
References
12
Case No. MISSING
Regular Panel Decision

Santos v. American Museum of Natural History

Guaquin Garcia died after a scaffold fall during renovations at a building leased by the American Museum of Natural History. His estate sued the Museum and the general contractor for wrongful death. The Museum moved for summary judgment, arguing it lacked Labor Law liability as it didn't own, contract for, or supervise the work. The Supreme Court denied this motion, but on appeal, the order was reversed. The appellate court found the Museum, as a lessee, was not liable under Labor Law § 240, having neither contracted for nor supervised the renovation work, and thus lacked authority over safety measures.

Wrongful DeathScaffold AccidentLabor Law Section 240Summary Judgment AppealPremises LiabilityLessee LiabilityRenovation ProjectWorksite SafetyAppellate CourtBuilding Owner Responsibility
References
2
Case No. ADJ10266335
Regular
Sep 15, 2017

LANESHA RICE vs. ACCURATE PERSONNEL, LLC, ZURICH NORTH AMERICA

Defendant Accurate Personnel sought reconsideration of a workers' compensation award, arguing a mutual mistake in calculating the applicant's permanent disability rate. The Workers' Compensation Appeals Board denied the petition, affirming the original award. The Board found no evidence of mutual mistake, noting that the applicant denied it and the defendant failed to prove the applicant knew of and benefited from any alleged error. The Board concluded the defendant's claim stemmed from a unilateral mistake due to neglect, which does not constitute good cause to set aside a stipulation.

Petition for ReconsiderationStipulations with Request for AwardPermanent Disability Indemnity RateMutual Mistake of FactUnilateral MistakeGood CauseLabor Code Section 5702Workers' Compensation Appeals BoardWCJ Report and RecommendationApplicant's Answer
References
8
Case No. ADJ6713503
Regular
May 16, 2014

MATTHEW JENSON vs. PEPSI BOTTLING GROUP, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board denied the Petition for Reconsideration filed by South Lake Medical Center and its associated entities. The Board also dismissed the successive Petition for Reconsideration filed by Accurate Medical Assessment Rating Center (AMARC). AMARC's prior petition was already denied, and successive petitions are not permitted, requiring review by the Court of Appeals instead. The Board adopted the WCJ's Report and Recommendation in support of these decisions.

WCABLien ClaimantPetition for ReconsiderationLabor Code section 5813California Code of Regulations title 8 section 10561WCJSanctionsSuccessive PetitionOrder Denying Petitions for ReconsiderationWrit of Review
References
2
Case No. ANA 0369239 ANA 0369240 ANA 0369241
Regular
Oct 03, 2007

STEVEN A. BANKS vs. COCO'S RESTAURANT, CNA

The Workers' Compensation Appeals Board granted reconsideration because the administrative law judge's finding of 100% total disability was based on a legally deficient medical record and an improper application of the *LeBoeuf* doctrine. The Board found the Agreed Medical Examiner's report failed to properly address apportionment and accurate medical history, necessitating further medical development. Consequently, the prior decision was rescinded and the case returned to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardReconsiderationJoint Findings and AwardIndustrial InjuryLow BackPsycheTotal DisabilityVocational RehabilitationCommutationAttorney's Fees
References
2
Case No. ADJ106846 (VNO 0536976)
Regular
Apr 28, 2011

SARKIS INDOIAN (Dec'd), BETTY INDOIAN (Widow) vs. ON THE WHEELS, SUCCESS DELIVERY, NOUNE SOMOKRANIAN, VIGEN GABOUCHIAN, ROUZZANA ARCHAKOUNI, UNINSURED EMPLOYERS FUND

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding the decedent sustained a fatal cumulative trauma injury due to his employment with Success Delivery. The Board found the medical evidence, particularly the Qualified Medical Evaluator's report, lacked sufficient factual basis and an accurate employment history to establish a causal link. Consequently, the case was remanded to the trial level for further development of the medical record to determine if the employment with Success Delivery contributed to the injury.

Cumulative traumaIndustrial injuryDeath benefitsEmployment relationshipSubstantial shareholderPartnershipUninsured employerMedical evidenceCausationApportionment
References
4
Case No. ADJ10312949
Regular
Oct 17, 2018

REGINALD WILSON vs. UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER

This case involves an applicant claiming injury to his right shoulder and psyche, with the defendant seeking reconsideration of the initial award. The Appeals Board found that the psychiatric QME's opinion was not substantial evidence due to an inadequate and incorrect work history provided to the physician. Furthermore, the Board determined that the orthopedic QME's report lacked sufficient information on key issues and that the record needed further development. Therefore, the Board rescinded the award and returned the case to the WCJ for further proceedings, including requesting supplemental reports from the QMEs with accurate information.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactAward and OrdersQualified Medical ExaminerOrthopedicPsychiatricInjury AOE/COERegular PhysicianLabor Code Section 5701
References
6
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