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

Case No. ADJ7939992
Regular
Sep 12, 2017

JORGE AVALOS vs. FINELITE, TRI STATE MALEKO STAFFING, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION (CIGA), SEDGWICK CLAIMS MANAGEMENT SERVICES, LUMBERMEN'S UNDERWRITING ALLIANCE, COMPWEST SAN FRANCISCO

The Workers' Compensation Appeals Board (WCAB) dismissed Jorge Avalos' Petition for Reconsideration and denied his Petition for Removal. The WCAB found that Avalos' petition was not taken from a "final" order as it only addressed an intermediate procedural or evidentiary issue. Furthermore, the WCAB denied removal, finding no showing of substantial prejudice or irreparable harm that would necessitate this extraordinary remedy. Reconsideration was deemed an adequate remedy should a final adverse decision issue.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFinal OrderInterlocutory OrderSubstantive RightLiabilityThreshold IssueExtraordinary RemedySubstantial Prejudice
References
6
Case No. ADJ4648071 (AHM 0111231)
Regular
May 05, 2010

JOYCE SIMON vs. COUNTY OF ORANGE, Permissibly Self-Insured, adjusted by YORK INSURANCE SERVICES GROUP, INC.

The Workers' Compensation Appeals Board (WCAB) dismissed Joyce Simon's petition for reconsideration because it was filed from a non-final interlocutory order, not a final decision that determined substantive rights. The WCAB also denied her petition for removal, finding no showing of substantial prejudice or irreparable harm. The decision relies on established legal definitions of "final" orders in workers' compensation proceedings. Removal was denied as reconsideration would be an adequate remedy if an adverse final decision later issues.

Petition for ReconsiderationFinal OrderSubstantive RightInterlocutory OrderRemovalWCJ's Report and RecommendationSubstantial PrejudiceIrreparable HarmInadequate RemedyWorkers' Compensation Appeals Board
References
8
Case No. ADJ10908468
Regular
Jun 30, 2025

DANIEL DORIS vs. DBI BEVERAGES, ZURICH AMERICAN INSURANCE COMPANY, GALLAGHER BASSETT SERVICES

Defendant filed a Petition for Reconsideration of a Findings and Award, challenging the deferral of issues regarding catastrophic injury and vocational expert fees. The Appeals Board, treating the petition under a removal standard despite a final order, agreed with the WCJ that the record was incomplete concerning applicant's work restrictions and vocational feasibility, thus requiring further development. Concluding that the defendant failed to establish substantial prejudice or irreparable harm, and that reconsideration would be an adequate remedy if an adverse final decision ultimately issues, the Board denied the Petition for Reconsideration.

Petition for ReconsiderationFindings and AwardCervical spineLumbar spinePsychUpper extremitiesLower extremitiesBowelBladderApportionment
References
11
Case No. MISSING
Regular Panel Decision
May 16, 2003

Claim of Isaacs v. Fleet Financial Services

Claimant appealed a Workers’ Compensation Board decision from May 16, 2003, which deemed her application for review untimely. The claimant's initial workers' compensation claim for a compensable back injury was established in 1999, with an average weekly wage set at $258. After the case was reopened in 2000 for further medical treatment and then closed in 2001, claimant sought an explanation for her average weekly wage calculation in March 2003, over three years after the initial decision became final. Her subsequent formal application for Board review of the 1999 administrative decision was denied as untimely because it was filed more than 30 days after the initial decision, as required by 12 NYCRR 313.3 [c] and Workers’ Compensation Law § 23. The court affirmed the Board’s discretionary decision, finding no abuse of discretion given the significant delay and lack of evidence demonstrating erroneous wage computation.

Workers' CompensationAppealTimeliness of ApplicationAdministrative ReviewAverage Weekly WageBoard DiscretionNew York Labor LawJudicial ReviewProcedural IssuesStatutory Interpretation
References
5
Case No. ADJ12548721 (MF); ADJ19393188
Regular
May 23, 2025

JOSE FLORES vs. ALGOS, INCORPORATED, NOVA CASUALTY COMPANY, CYPRESS INSURANCE COMPANY

The Workers' Compensation Appeals Board considered a petition for removal, treating it as a petition for reconsideration. The Board reviewed the WCJ's report and analysis, noting the WCJ's decision was a final order because it resolved a threshold issue regarding employment and jurisdiction. Although the decision was final, the Board applied the removal standard since the petitioner only challenged an interlocutory finding. Ultimately, the Board denied the petition, concluding that no substantial prejudice or irreparable harm would result from denial, and that reconsideration would be an adequate remedy if an adverse final decision were to issue.

Petition for ReconsiderationLabor Code Section 5909Transmission of CaseElectronic Adjudication Management System (EAMS)Petition for RemovalThreshold IssueFinal DecisionInterlocutory IssueRemoval StandardQualified Medical Evaluator (QME)
References
6
Case No. MISSING
Regular Panel Decision

Calabrese v. Astrue

Darlene Calabrese sought judicial review under 42 U.S.C. § 405(g) of a final determination by the Commissioner of Social Security, which found her not disabled. After a prior remand, ALJ Bruce Mazzarella's decision became final, prompting this district court action. Plaintiff moved for judgment on the pleadings, and the Commissioner cross-moved. Presiding District Judge David G. Larimer affirmed the Commissioner's decision, concluding it was supported by substantial evidence from a vocational expert, despite Calabrese's severe impairments including chronic pain, borderline IQ, and depression/anxiety disorder. The court found that the ALJ's hypothetical to the vocational expert adequately accounted for the plaintiff's limitations. Consequently, the plaintiff's complaint was dismissed with prejudice.

Social Security DisabilityMental ImpairmentDepressive DisorderAnxiety DisorderBorderline IQVocational Expert TestimonyResidual Functional CapacitySedentary WorkAppeals CouncilAdministrative Law Judge
References
17
Case No. ADJ7700512
Regular
Jan 27, 2017

John E. Skaff vs. CITY OF STOCKTON

The Workers' Compensation Appeals Board granted reconsideration of a decision denying a police officer's claim for prostate cancer. The applicant sought an adverse inference against the City of Stockton for failing to produce Hazard Awareness Recognition Program (HARP) forms allegedly detailing chemical exposures during methamphetamine lab investigations. The Board rescinded the prior decision, returning the case for further development of the record. This is to determine whether the City had a duty to retain and produce the HARP forms, and if the applicant exercised reasonable diligence in seeking them. The Board will then allow the WCJ to decide if an adverse inference is warranted and issue a new decision.

Hazard Awareness Recognition ProgramHARP formsadverse inferenceindustrial causationprostate cancerchemical exposuremethamphetamine labspolice officerQualified Medical ExaminerDr. Juan Cesar Larach
References
1
Case No. MISSING
Regular Panel Decision

Claim of Murray v. St. Joseph's Hospital

The State Insurance Fund appealed a decision by the Workers’ Compensation Board, filed March 10, 1995. The Board had denied the Fund’s application to transfer a claimant’s workers’ compensation case to the original Workers’ Compensation Law Judge (WCLJ) after a final determination awarding benefits had already been made. The appellate court affirmed the Board’s decision, citing Workers’ Compensation Law § 20, which states that a continued hearing before the same referee is only required until a final determination is reached. Since a final award had been made, the court found no requirement to assign the matter to the original WCLJ, deferring to the Board's interpretation of the statute.

Workers' CompensationAppealWCLJ AssignmentStatutory InterpretationFinal DeterminationAdministrative LawInsurance CarrierJurisdictionBoard Decision
References
1
Case No. 90-cv-279
Regular Panel Decision
Oct 01, 2013

Deno v. Colvin

Michael Deno sought judicial review under section 205(g) of the Social Security Act of the Commissioner of Social Security's final decision denying him Supplemental Security Income (SSI) benefits. Deno challenged the Administrative Law Judge's (hearing officer) decision, requesting a reversal of the finding that he is not disabled. The Commissioner, in turn, sought affirmation of the hearing officer's decision. This Court previously reversed and remanded Deno's claim in 2009, leading to further administrative proceedings where the hearing officer again denied the claim in 2010. Deno appealed this denial, arguing various errors by the hearing officer, including inadequate consideration of medical evidence, improper weight given to providers, unsupported credibility determinations, and erroneous reliance on vocational expert testimony. The Court, however, found the hearing officer's decision to be supported by substantial evidence, affirming the denial of disability benefits and dismissing Deno's complaint.

Social Security ActSupplemental Security Income (SSI)Disability Benefits AppealJudicial Review StandardALJ Decision ReviewTreating Physician Rule ApplicationResidual Functional Capacity AssessmentVocational Expert ReliabilityClaimant CredibilityChronic Back Pain
References
28
Case No. ADJ10708028
Regular

GLADYS MEZA vs. AMERICAN HI-FI INDUSTRIAL 26, INC., GRANITE STATE INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed Gladys Meza's Petition for Reconsideration because it was not filed from a final order, but rather an interlocutory procedural/evidentiary decision. The Board also denied her Petition for Removal, finding no substantial prejudice or irreparable harm and that reconsideration would be an adequate remedy if a final adverse decision ultimately issues. These decisions were based on the reasoning provided in the workers' compensation administrative law judge's report.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFinal OrderInterlocutory OrderProcedural IssueEvidentiary IssueSubstantive LiabilityThreshold IssueExtraordinary Remedy
References
6
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