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Case Law Database

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

Case No. MISSING
Regular Panel Decision
May 11, 1990

Claim of Johnson v. New York City Board of Education

This case involves an appeal from a decision and an amended decision of the Workers’ Compensation Board. The Board had ruled that the claimant sustained a consequential injury and subsequently restored the case to the trial calendar. The appellate court affirmed the Board's decision, finding that the claimant's physician's testimony, despite some lack of clarity, met the requirement of signifying a probability as to the cause of the injury and was supported by a rational basis. Specifically, the determination that the claimant’s left ankle fracture was a consequence of an earlier work-related ankle fracture, which left the ankle in a weakened condition, was supported by substantial evidence.

Workers' CompensationAppealConsequential InjuryAnkle FractureMedical EvidencePhysician TestimonySubstantial EvidenceAppellate AffirmationWork-Related InjuryMedical Causation
References
3
Case No. 533068
Regular Panel Decision
Jun 23, 2022

In the Matter of the Claim of Robert Diamond Jr.

Claimant, a building maintenance mechanic, sustained a right ankle fracture in a 2018 work-related slip and fall. His claim for workers' compensation benefits was established. Medical examiners, Adam Suslak and Dominic Belmonte, agreed on a 30% schedule loss of use (SLU) of the right ankle, but differed on apportionment for a prior ankle injury from 40 years ago. A WCLJ initially apportioned the award, attributing only 10.5% to the 2018 injury, but the Workers' Compensation Board modified this, finding insufficient evidence for apportionment. The Appellate Division affirmed the Board's decision, reiterating that apportionment is generally not applicable where a preexisting non-compensable condition did not hinder job performance, and the medical evidence lacked documentation for the prior injury to support an SLU finding.

Workers' CompensationSchedule Loss of UseApportionmentAnkle InjuryPreexisting ConditionMedical EvidenceMaximum Medical ImprovementJudicial ReviewAppellate DivisionNew York Law
References
12
Case No. MISSING
Regular Panel Decision

Elliott v. American Motorists Insurance Co.

This workers' compensation case involves appellant Elliott, who sustained comminuted fractures to both heels after falling twenty or thirty feet. A jury found he suffered a total and permanent loss of the use of both feet. Elliott contended that this injury entitled him to lifetime weekly compensation payments under Tex.Rev.Civ.Stat.Ann. art. 8306, § 11a, arguing that the 'at or above the ankle' language in the statute applied only to amputations. The trial court, however, awarded compensation based on 250 weeks, representing the maximum allowable periods for specific injuries to each foot. The appellate court affirmed the trial court's judgment, concluding that the statutory language 'at or above the ankle' applies to both total loss and total loss of use of a member, and since Elliott's injury was confined below the ankle, he did not meet the criteria for conclusive total and permanent incapacity for lifetime benefits.

workers' compensationfoot injurycalcaneus fracturestotal permanent disabilitylifetime benefitsstatutory interpretationat or above the ankleloss of usespecific member injuryTexas law
References
3
Case No. 534831
Regular Panel Decision
Oct 12, 2023

In the Matter of the Claim of Susan Zuhlke

Susan Zuhlke appealed two decisions by the Workers' Compensation Board concerning a schedule loss of use (SLU) award for her right leg injuries. Zuhlke, a teacher, suffered right ankle and knee/tibia fractures in October 2018, later including fibular neuropathy. While a 25.8% SLU for her right foot was stipulated, a dispute arose over the right knee, with the Board ultimately affirming a 15% SLU based on the carrier's medical consultant's opinion and denial of reconsideration. The Appellate Division affirmed the Board's determination, finding substantial evidence supported the 15% SLU award for the right knee, consistent with impairment guidelines and prior Board decisions regarding tibial plateau fractures.

Workers' CompensationSchedule Loss of UseSLURight Leg InjuryTibial Plateau FractureFibular NeuropathyMaximum Medical ImprovementImpairment GuidelinesMedical OpinionsAppellate Review
References
9
Case No. 534831
Regular Panel Decision
Oct 12, 2023

Matter of Zuhlke v. Lake George Cent. Sch. Dist.

Claimant, a teacher, suffered right ankle and knee/tibia fractures in October 2018, later amended to include causally-related fibular neuropathy. She underwent evaluations by two independent medical examiners to determine a schedule loss of use (SLU) award. While an agreement was reached for the right ankle (25.8% SLU), the parties disputed the SLU for the right knee. A Workers' Compensation Law Judge awarded a 15% SLU for the right knee, a decision affirmed by the Workers' Compensation Board. Claimant's subsequent application for reconsideration and/or full Board review was denied. The Appellate Division, Third Department, affirmed the Board's decisions, finding substantial evidence to support the 15% SLU award based on the carrier's consultant's interpretation of impairment guidelines, and upheld the denial of reconsideration.

Schedule Loss of Use (SLU)Tibial Plateau FractureFibular NeuropathyRight Knee InjuryRight Ankle InjuryMedical Impairment GuidelinesIndependent Medical Examination (IME)Workers' Compensation Board AppealAppellate ReviewConflicting Medical Opinions
References
11
Case No. MISSING
Regular Panel Decision

Reagan v. Tennessee Municipal League

The employer and its insurance carrier appealed a permanent partial disability award to an employee in a worker’s compensation case. Appellants argued that the employee's injuries were confined to a scheduled member (right leg and foot) and therefore, the disability rating should be based on statutory schedules, not apportioned to the body as a whole. The court found that the employee sustained a severe fracture to the right leg and ankle, rated by an orthopedic surgeon as 50% permanent partial disability to the foot/ankle, or 35% to the leg, or 14% to the whole person per medical guidelines. However, the appellate court ruled that statutory schedules for scheduled member injuries must control over medical impairment ratings that translate to a body as a whole disability. Consequently, the trial court's judgment was reversed, and the case remanded for a redetermination of the disability rating based solely on the injury to the right leg as a scheduled member.

Permanent Partial DisabilityScheduled Member InjuryBody as a WholeStatutory SchedulesMedical Impairment RatingRemandLeg InjuryFoot InjuryAnkle InjuryTennessee Law
References
2
Case No. MISSING
Regular Panel Decision
Mar 04, 1977

Bellamy v. County of Nassau

The Workers’ Compensation Board decision, filed March 4, 1977, found claimant’s phlebitis causally related to a September 23, 1973 accident. Additionally, the claimant suffered a consequential accident on January 1, 1975, fracturing her left ankle due to weakness in her right foot. This determination was based on Dr. F. Hudak’s medical testimony and was found to have substantial support in the record. The appellate court affirmed the board's decision.

Workers CompensationPhlebitisAnkle FractureCausal RelationConsequential AccidentMedical TestimonyBoard DecisionAppealAffirmed
References
0
Case No. Docket No. 2015-06-0677, State File No. 60024-2015
Regular Panel Decision
Mar 31, 2016

Navyac, Laury v. Universal Health Services

In this interlocutory appeal, the employee sustained a fractured ankle after slipping at a fast-food restaurant while traveling to a work-related event. The employer initially accepted the claim but later denied it. The trial court ruled the injury occurred in the course and scope of employment but not primarily out of employment. The Appeals Board affirmed the 'course and scope' finding but reversed the 'arising primarily out of employment' conclusion, determining the employment contributed more than fifty percent to the injury. The case was remanded for further proceedings.

Workers' CompensationInterlocutory AppealCourse of EmploymentScope of EmploymentArising Out of EmploymentSpecial Errand RuleDeviation from RouteFractured AnkleEmployer LiabilityMedical Benefits
References
14
Case No. ADJ8160941
Regular
Apr 13, 2015

DANIEL BROWN vs. GOLDEN GATE BRIDGE\/HIGHWAY AND TRANSPORTATION DISTRICT

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The Board adopted the Administrative Law Judge's (WCJ) report, which found the applicant's right ankle fracture to be a compensable consequence of his prior industrial right knee injury. The WCJ's credibility determination regarding the applicant's testimony that his knee buckled before his fall was given great weight, as is standard practice. The Board found no substantial evidence to overturn this determination, despite minor inconsistencies in testimony regarding the exact surface of the fall.

Compensable consequenceCredibility determinationWorkers' Compensation Appeals BoardWCJPetition for ReconsiderationIndustrial injuryRight kneeRight ankleCausation of injuryMedical treatment
References
2
Case No. ADJ417505 (STK 173008)
Regular
Oct 07, 2008

MARSHA CRISWELL vs. COUNTY OF STANISLAUS

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award of left ankle surgery for applicant Marsha Criswell. The Board found no substantial medical evidence connecting Criswell's current ankle condition to her 2000 industrial injury, noting the ankle injury resolved and a new injury occurred in 2005. Therefore, the applicant failed to meet her burden of proof for industrial causation of the current ankle problem.

Workers' Compensation Appeals BoardReconsiderationMedical CausationIndustrial InjuryLeft Ankle SurgeryAgreed Medical ExaminerTreating PhysicianPreponderance of the EvidenceReasonable Medical ProbabilityLay Testimony
References
8
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