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

Case No. ADJ114638 (VNO 0364765)
Regular
Apr 13, 2009

Adriana Modlin vs. CEDARS-SINAI MEDICAL CENTER

The Workers' Compensation Appeals Board rescinded a prior decision regarding Adriana Modlin's claim against Cedars-Sinai Medical Center. Defendant Cedars-Sinai sought reconsideration, arguing the judge incorrectly applied the Permanent Disability Rating Schedule, failed to account for indemnity overpayments and commutations, and miscalculated indemnity rates. The Board remanded the case to the trial level for further proceedings to address these issues, including clarifying indemnity payment records and potentially re-evaluating the correct rating schedule.

Workers' Compensation Appeals BoardReconsiderationTemporary Total DisabilityPermanent Total DisabilityPermanent Disability Rating ScheduleIndemnityCommutationCreditThird Party RecoveryAttorney's Fees
References
0
Case No. ADJ114638
Regular
May 05, 2010

ADRIANA MODLIN vs. CEDARS SINAI MEDICAL CENTER

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding 100% permanent disability for an executive secretary's back and extremity injuries. The defendant argued the WCJ erred in awarding temporary disability post-permanency, in the commutation calculation, and in failing to issue an opinion and apply the correct rating schedule. The Board adopted the WCJ's recommendation to rescind the original decision and return the case to the trial level for further proceedings. The defendant is instructed to pay uncontested permanent disability indemnity and other benefits due during this period.

Workers' Compensation Appeals BoardAdriana ModlinCedars Sinai Medical CenterFindings and AwardPermanent DisabilityTemporary DisabilityCommutationPermanent Disability Rating SchedulePetition for ReconsiderationReport and Recommendation
References
0
Case No. CV-23-0963
Regular Panel Decision
May 29, 2025

In the Matter of the Claim of Adriana Alzate

In this appeal, the claimant, Adriana Alzate, challenged a decision by the Workers' Compensation Board. The Board ruled that Alzate violated Workers' Compensation Law § 114-a by knowingly making false statements regarding prior injuries to her neck and back during testimony and to medical providers, and consequently disqualified her from receiving future indemnity benefits. This decision reversed a Workers' Compensation Law Judge's finding of insufficient evidence. The Supreme Court, Appellate Division, Third Judicial Department, affirmed the Board's decision, concluding it was supported by substantial evidence. The court found no abuse of discretion in the imposition of permanent disqualification from wage replacement benefits due to the egregious nature of the claimant's repeated material omissions and misrepresentations.

Workers' CompensationFalse StatementMisrepresentationIndemnity BenefitsPrior InjuriesMedical DisclosureCredibilityAppellate ReviewAbuse of DiscretionPenalty
References
10
Case No. ADJ7040828
Regular
Aug 14, 2018

ADRIANA SOLERA vs. SODEXHO, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA, GALLAGHER BASSETT SERVICES

The Workers' Compensation Appeals Board affirmed an award of 100% permanent disability for Adriana Solera, finding her vocational expert's opinion substantial evidence of her inability to return to gainful employment due to the extensive effects of her industrial injury. The Board also granted reconsideration to amend a finding regarding self-procured medical treatment, acknowledging the applicant withdrew that issue and noting a lack of evidence to support the original finding. The Board adopted the Workers' Compensation Judge's reasoning for the permanent disability award, emphasizing credible medical and applicant testimony.

Permanent total disabilityVocational expertSelf-procured medical treatmentReconsiderationFindings of Fact and AwardWCJDEU ratingGainful employmentVocational rehabilitationBurns
References
2
Case No. No. 11, No. 12
Regular Panel Decision
Mar 26, 2019

Lilya Andryeyeva v. New York Health Care , Adriana Moreno v. Future Care Health Services

The New York Court of Appeals addressed a common issue in two joint appeals: whether home health care aides on 24-hour shifts must be paid for each hour. The Department of Labor (DOL) interpreted its Wage Order (12 NYCRR part 142) to allow payment for at least 13 hours if the employee receives at least 8 hours for sleep (with 5 uninterrupted) and 3 hours for meals. The Appellate Division rejected this, but the Court of Appeals reversed, deferring to DOL's interpretation as rational and consistent with the Wage Order's plain language. The cases were remitted for lower courts to evaluate class certification issues in accordance with DOL's interpretation.

Home Health Care24-Hour ShiftsMinimum Wage ActWage OrderDepartment of Labor InterpretationClass CertificationAppellate ReviewLabor Law ViolationsSleep BreaksMeal Breaks
References
49
Case No. ADJ6616949
Regular
Jan 18, 2011

ADRIANA GOMEZ vs. COUNTY OF LOS ANGELES/D.P.S.S.#140, ACCLAMATION INSURANCE MANAGEMENT SERVICES

This case concerns a dispute over temporary disability indemnity for applicant Adriana Gomez. The defendant employer sought reconsideration of a prior award finding total temporary disability from February 16, 2009, to May 23, 2010. The defendant argued this award was based on a mutual mistake as the applicant returned to work on April 1, 2010. The Appeals Board granted reconsideration, amending the award to clarify that temporary disability payments are only for periods of actual wage loss, allowing for credit to the defendant for any earnings the applicant received during that period.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardTemporary Total DisabilityStipulations with Request for AwardMutual Mistake of FactCredit for EarningsWage LossLabor Code Section 4653Labor Code Section 4909
References
2
Case No. 2025 NY Slip Op 03229 [238 AD3d 1437]
Regular Panel Decision
May 29, 2025

Matter of Alzate v. Quality Bldg. Servs. Corp.

Adriana Alzate appealed a Workers' Compensation Board decision that found she violated Workers' Compensation Law § 114-a and disqualified her from receiving future indemnity benefits. Alzate sustained a work injury in October 2019, leading to a claim for benefits. During subsequent hearings and independent medical examinations (IMEs), she denied having prior injuries to her neck and back, despite a significant medical history of such injuries. The Board found these denials constituted knowing false statements of material fact, imposing mandatory and discretionary penalties. The Appellate Division, Third Department, affirmed the Board's decision, concluding it was supported by substantial evidence and that the discretionary penalty of permanent disqualification was not an abuse of discretion.

Workers' Compensation Law § 114-aFalse RepresentationDisqualification from BenefitsPrior Injuries DisclosureCredibility AssessmentSubstantial EvidenceAppellate Division Third DepartmentIndemnity BenefitsMedical History OmissionsWage Replacement Benefits
References
10
Case No. ADJ8965574, ADJ8974974
Regular
Aug 08, 2014

Adriana Godoy vs. Destination Shuttle Services, Tower Castlepoint Insurance

The Workers' Compensation Appeals Board granted reconsideration and rescinded an order that dismissed Crenshaw Multi Specialty Medical Group's lien. The Board found that the Administrative Law Judge erred in dismissing the lien for failure to pay a filing fee because Crenshaw had not yet formally filed its lien claim. Therefore, the fee requirement was not applicable at the time of the lien trial, and the dismissal order was invalid. The Board affirmed that Crenshaw qualified as a "person aggrieved" and its petition for reconsideration was timely filed.

Workers Compensation Appeals BoardPetition for ReconsiderationLien TrialLien Filing FeeDue ProcessLabor Code 4903.05Compromise and Release AgreementDeclaration of ReadinessLien ClaimantAdministrative Law Judge
References
0
Case No. ADJ8915041, ADJ9546715
Regular
Nov 28, 2017

ADRIANA MARTINEZ DE ANAYA vs. QUIKSILVER, INC., ACE AMERICAN INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to address an applicant's petition regarding an improperly issued award. The Board affirmed the prior findings but amended the decision to defer the issue of attorney's fees and the issuance of a formal award. The case is returned to the administrative law judge for further proceedings to address these deferred issues.

WCABPetition for ReconsiderationJoint Findings of Fact and AwardWCJADJ8915041ADJ9546715low back injuryright shoulder injuryneck injuryleft elbow injury
References
0
Case No. ADJ11861160
Regular
Oct 25, 2019

ADRIANA MARTINEZ vs. AVITUS, AMERICAN ZURICH INSURANCE COMPANY, GALLAGHER BASSETT SERVICES

This case involves a dispute over the selection of Qualified Medical Evaluator (QME) panels for an applicant with claimed injuries to multiple body parts. The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for removal, rescinded the prior decision, and found that the applicant's chiropractic QME panel request was proper while the defendant's orthopedic surgery panel request was improper. The WCAB determined that chiropractic medicine is the appropriate specialty and struck the orthopedic surgery panel, ordering the parties to proceed with the chiropractic QME. The WCAB clarified that while chiropractors cannot perform surgery or prescribe medication, they are qualified to evaluate injuries within their scope of practice.

QME panel disputeremoval petitionchiropractic specialtyorthopedic surgery specialtyLabor Code 4062.2Medical Directoradministrative law judgeWorkers' Compensation Appeals Boardproper panel selectioninvalid panel request
References
9
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