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Case Law Database

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

Case No. ADJ3776077 (ANA 0409837) ADJ1854171 (ANA 0409862) ADJ310640 (ANA 0409836)
Regular
Sep 08, 2009

MARIA O'CAMPO vs. MICHAEL D. COOPER, D.D.S., INC.; STATE FARM FIRE AND CASUALTY COMPANY

This case involves applicant Maria O'Campo's petition for reconsideration of findings regarding industrial injuries to her knee, spine, and upper extremities. The Workers' Compensation Appeals Board denied reconsideration, affirming the WCJ's decision that applicant sustained industrial injuries but awarding only 2% permanent disability for upper extremity injuries, finding no permanent disability for the knee and spine. The WCJ properly relied on substantial medical evidence, particularly Dr. Mandel's reports, and found Dr. Einbund's report to be unreliable due to an apparent misinterpretation of an MRI. The Appeals Board found no requirement to further develop the record, as applicant failed to request it and the existing evidence supported the WCJ's findings.

Workers' Compensation Appeals BoardIndustrial InjuryFindings and AwardsPetition for ReconsiderationQualified Medical ExaminerCumulative TraumaSpecific InjuryPermanent DisabilityMedical EvidenceRecord Development
References
12
Case No. ADJ9176746, ADJ10288149
Regular
Jan 05, 2018

ANA MARIA ROCHA vs. GREEN VALLEY CHRISTIAN CENTER, CHURCH MUTUAL INSURANCE COMPANY

This case involves Ana Maria Rocha's petition for reconsideration of a Workers' Compensation Appeals Board decision. The Board denied reconsideration, adopting the Administrative Law Judge's report. The applicant's primary contentions involved a separate psychological injury, her CRPS classification, apportionment of disability, and future medical treatment for her neck and back. The Judge found no separate psychological injury, that medical opinions on CRPS classification were for physicians, that apportionment was supported by substantial evidence regarding pre-existing conditions, and that further medical treatment was not warranted for her neck and back.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedAdministrative Law JudgePsychological InjuryPermanent DisabilityApportionmentCRPSWhole Person ImpairmentAMA Guides
References
3
Case No. ADJ3685689 (ANA 0335527) ADJ1125665 (ANA 0345901) ADJ1288486 (ANA 0345902) ADJ3581550 (ANA 0345904) ADJ2369046 (ANA 0335528) MF ADJ2208312 (ANA 0349503)
Regular
Nov 16, 2012

MARIA WENCES vs. JC RESORTS, INC., dba SAND & SURF HOTEL, et. al.; CALIFORNIA INSURANCE GUARANTEE ASSOCIATION; by BROADSPIRE, for CALIFORNIA COMPENSATION and HIH, in liquidation, EBIC, administered by ARROWWOOD INDEMNITY COMPANY

The Appeals Board granted reconsideration of a WCJ's decision, amending the date of cumulative injury to the applicant's lower extremities to September 21, 1998, through February 18, 2000. The Board affirmed the finding that EBIC, as a solvent carrier, must administer the claim and reimburse CIGA for payments made. This reimbursement amount is to be adjusted by the parties. The Board found the Agreed Medical Examiner's opinions constituted substantial evidence supporting the cumulative trauma finding.

Workers' Compensation Appeals BoardMaria WencesJC ResortsSand and Surf HotelCalifornia Insurance Guarantee AssociationCIGABroadspireHIHEBICArrowpoint Capital
References
9
Case No. MISSING
Regular Panel Decision

In re Maria A.

This case involves an appeal from an order of disposition by the Family Court, Kings County, dated April 19, 1979, which found appellant Maria to be a juvenile delinquent and placed her with the Division for Youth, Title III, for 18 months. Maria argued that her placement was not supported by a preponderance of the evidence and that less coercive alternatives were not considered. The delinquency finding stemmed from Maria's admission to acts constituting second-degree robbery and second-degree manslaughter. At the dispositional hearing, conflicting expert opinions were presented regarding the appropriate placement, with court-appointed experts favoring a more secure facility due to concerns about Maria's impulse control, while appellant's experts suggested an open residential setting. The appellate court affirmed the order, finding no basis for reversal after balancing the child's needs and community protection.

Juvenile DelinquencyFamily CourtOrder of DispositionPlacementDivision for YouthRobberyManslaughterPreponderance of EvidenceDispositional HearingResidential Facility
References
1
Case No. CV-23-1577
Regular Panel Decision
Nov 14, 2024

In the Matter of the Claim of Miguel Maria Santos

Miguel Maria Santos, a pizza delivery person, appealed a Workers' Compensation Board decision denying his claim for benefits. Santos alleged injuries from a fall off his electric bicycle on June 14, 2021, while working for 77 GP, Inc. However, 77 GP, Inc. and its carrier controverted the claim, asserting no employer-employee relationship existed at the time of the accident. The Workers' Compensation Law Judge credited the employer's testimony that Santos was discharged on June 2, 2021, for drinking on the job, prior to his injuries. The Workers' Compensation Board affirmed this decision, and the Appellate Division also affirmed, finding the Board's determination supported by substantial evidence.

Workers' compensationEmployer-employee relationshipSubstantial evidenceCredibility assessmentPizza deliveryDischarged employeeBicycle accidentAppellate reviewClaim denial
References
5
Case No. ADJ7917765
Regular
Mar 16, 2018

ANA MARIA GRAJEDA vs. TRISTAR STAFFING, Dba QUALITY STAFFING SERVICES, LUMBERMEN'S UNDERWRITING ALLIANCE

The Workers' Compensation Appeals Board denied reconsideration of a $500 lien settlement. The lien claimant sought to overturn the stipulation, alleging due process violations and entitlement to reimbursement for self-procured medical care. The Board found no good cause to set aside the stipulation, as petitioner was represented and failed to demonstrate mistake, inadvertence, or new evidence. Therefore, the stipulation and order approving the $500 payment remain in effect.

Workers' Compensation Appeals BoardAna Maria GrajedaTristar StaffingLumbermen's Underwriting AllianceOptimal Health InstituteJie Ci DingStipulation and OrderCompromise And Releaseindustrial injuryback injury
References
3
Case No. 2018 NY Slip Op 08980
Regular Panel Decision
Dec 27, 2018

Matter of Ricci v. Maria Regina Residence

This case involves an appeal by the Special Disability Fund from a Workers' Compensation Board decision. The Board had ruled that the workers' compensation carrier for Maria Regina Residence was entitled to reimbursement from the Special Disability Fund for a claim related to Cyndia Ricci's work-related knee injury, asserting Ricci had pre-existing heart and arthritis conditions. The Appellate Division, Third Department, found that the record lacked substantial evidence to support the Board's finding that Ricci's preexisting conditions hindered her employment potential. The court concluded that the medical opinion relied upon was based on generalities and speculation, and that conditions controlled by medication do not, without more, constitute a hindrance to employability. Consequently, the Board's decision was reversed, and the matter was remitted for further proceedings.

Workers' CompensationSpecial Disability FundReimbursement ClaimPreexisting ImpairmentEmployabilityMaterially and Substantially Greater DisabilityMedical OpinionOrthopedic SurgeonAppellate ReviewSubstantial Evidence
References
11
Case No. 532851
Regular Panel Decision
Jul 07, 2022

In the Matter of the Claim of Maria Fierro-Switzer (William Switzer, Dec'd)

Claimant Maria Fierro-Switzer appealed a Workers' Compensation Board decision that disallowed her claim for death benefits. Her deceased spouse, William Switzer, a retired New York City firefighter, volunteered at Ground Zero after the September 2001 terrorist attacks and later died from metastatic kidney cancer. Claimant alleged that his death was caused by toxic exposure during his volunteer work. A Workers' Compensation Law Judge (WCLJ) and the Board disallowed the claim, finding that Article 8-A of the Workers' Compensation Law, which covers volunteers in World Trade Center rescue efforts, requires the participant to file a WTC-12 registration form during their lifetime. As the decedent did not file this form, the claim under Article 8-A was denied. The court affirmed the Board's decision, stating that despite the independence of a death benefits claim from the decedent's potential compensation claim, there must be a legal basis for the claim and an entity upon which liability may be imposed. Since the decedent was a volunteer at the time of exposure, no claim could lie under Workers' Compensation Law § 16, which requires injuries to arise out of and in the course of employment. The decedent's sole potential avenue for recovery would have been under Article 8-A, which was precluded by the failure to file the required WTC-12 form during his lifetime.

World Trade Center9/11 AttacksGround ZeroVolunteer BenefitsDeath Benefits ClaimWorkers' Compensation Law Article 8-AWTC-12 Registration FormToxic ExposureRenal Cell CarcinomaAppellate Division
References
9
Case No. ADJ4435696 [ANA 0406876] ADJ1243268 [ANA 0406877]
Regular
Sep 02, 2008

ANN JOHNSON vs. SANTA ANA UNIFIED SCHOOL DISTRICT

The School District failed to provide proper notice of its Medical Provider Network (MPN) to the applicant at the time of injury. The District is liable for reasonable medical treatment self-procured by the applicant.

Workers' Compensation Appeals BoardMedical Provider Network (MPN)Santa Ana Unified School Districtnotice requirementsAdministrative Director Rule 9767.12(a)Knight v. United Parcel Serviceburden of proofself-procured treatmentliabilityreconsideration
References
1
Case No. ADJ2363674 (ANA 0405865) ADJ2676561 (ANA 0405866)
Regular
Oct 15, 2008

MARIA OCAMPO vs. GREER COMPANY, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a Joint Findings and Award and Order where the employer and insurer disputed the judge's findings on MPN notices, treatment with a specific doctor, and liability for psychological treatment. The Board found reconsideration necessary to fully study the factual and legal issues before issuing a final decision. The order also redirected all future communications to the Board's reconsideration unit.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings and AwardIndustrial InjuryNeck InjuryShoulder InjuryUpper Extremity InjuryAssemblerMPN NoticesMedical Treatment
References
0
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