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

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The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award of left ankle surgery for applicant Marsha Criswell.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
Case No. ADJ6955370
Regular
Nov 06, 2014

JOHN DELVA vs. ANDREW INTERNATIONAL aka ADVANCED TECH SECURITY, ARCH INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) rescinded a prior award finding industrial injury to the applicant's right ankle. This decision followed the defendant's petition for reconsideration, arguing against the ankle injury finding. The WCAB gave significant weight to the Agreed Medical Evaluator's (AME) final opinion, which, after further review and deposition, concluded the applicant did not sustain an industrial injury to his ankle. Consequently, the WCAB found no industrial injury to any body part and awarded nothing to the applicant.

WORKERS' COMPENSATION APPEALS BOARDINDUSTRIAL INJURYRIGHT ANKLEAGREED MEDICAL EVALUATORCONTINUOUS TRAUMASPECIFIC TRAUMARECONSIDERATIONFINDINGS AND AWARDWCJSUPPLEMENTAL REPORT
References
0
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. MISSING
Regular Panel Decision
Oct 02, 2003

Claim of Johnson v. OCM Boces

Claimant suffered a work-related ankle injury in 1999 and subsequently received workers’ compensation benefits. In 2001, while using crutches necessitated by ankle surgeries, the claimant slipped and sustained a consequential shoulder injury. The Workers’ Compensation Board established this additional claim, which was challenged on appeal by the employer and carrier. The appellate court found substantial evidence to support the Board’s determination that the shoulder injury was a consequence of the earlier compensable ankle injury. The court also affirmed the Board’s decision not to apportion the shoulder injury, noting the absence of medical evidence supporting such apportionment and distinguishing conflicting precedent.

Workers' CompensationAnkle InjuryShoulder InjuryConsequential InjuryApportionmentPreexisting ConditionCrutchesMedical EvidenceSubstantial EvidenceAppellate Review
References
4
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. SAL 0107786
Regular
Oct 16, 2007

MOLLY KIRKPATRICK vs. DOMINICAN SANTA CRUZ HOSPITAL, PSI ADMINISTERED BY OCTAGON RISK SERVICES

This case concerns an injured worker who had cervical spine surgery involving diskectomy, vertebrectomy, decompression, and fusion. The defendant sought reconsideration of an award granting temporary disability benefits beyond the statutory 104-week limit, arguing the surgery was not an amputation. The Appeals Board rescinded the prior award and returned the matter for further proceedings, as the definition of "amputation" in precedent excludes internal body parts like those removed during spinal fusion.

Workers' Compensation Appeals BoardDominican Santa Cruz HospitalOctagon Risk ServicesMolly KirkpatrickIndustrial InjuryCervical Spine SurgeryTemporary Disability IndemnityLabor Code Section 4656(c)AmputationDiskectomy
References
1
Case No. STK 188722
Regular
Dec 19, 2008

RICHARD JAMES vs. KRC HOLDINGS, INC. dba DSS COMPANY and CALIFORNIA INSURANCE GUARANTEE ASSOCIATION on behalf of RELAINCE INSURANCE, in liquidation, KRC HOLDINGS, INC. dba DSS COMPANY and ZURICH NORTH AMERICA INSURANCE COMPANY

The Workers' Compensation Appeals Board denied CIGA's petition for reconsideration, upholding the original award. The WCJ correctly determined that while applicant's 1999 knee injury and 2001 ankle injury shared some overlapping disability factors, the ankle injury's unique limitation to half-time weight-bearing constituted a separate compensable disability. Therefore, CIGA remains liable for the 1999 injury's permanent disability, and Zurich for the 2001 injury's.

CIGAReliance InsuranceZurich North AmericaKRC HoldingsDSS Companypermanent disabilityoverlappsyche injuryright kneeleft ankle
References
6
Case No. MISSING
Regular Panel Decision
Jul 14, 1971

Claim of Brewer v. Thomas Foundry, Inc.

The claimant, who sustained a left foot and ankle injury in 1966 while employed by Aetna Window Cleaning Company, experienced a second incident in 1970. While working for Thomas Foundry, Inc., his left ankle gave out, causing him to fall and injure his back. The Workmen's Compensation Board found that this fall and back injury constituted an accidental injury under the law, resulting in disability. This finding was supported by substantial evidence. The appellate court affirmed the Board's decision.

Workers' CompensationAnkle InjuryBack InjuryAccidental InjuryEmployment InjuryPre-existing ConditionAppellate ReviewSubstantial EvidenceFoundry WorkerWindow Cleaning
References
3
Case No. POM 273393
Regular
Jul 16, 2007

ERIC GREATHOUSE vs. COUNTY SANITATION DISTRICT NO. 2 OF LOS ANGELES COUNTY

The Workers' Compensation Appeals Board granted reconsideration to address the applicant's contention that the administrative law judge erred in denying further medical treatment for his right shoulder and ankles. While the judge correctly found no need for ankle treatment based on medical reports and applicant testimony, the Board found the record unclear regarding the shoulder, citing a need for further development. The case is returned to the trial level for a decision on shoulder treatment, potentially requiring a supplemental medical report.

Workers' Compensation Appeals BoardReconsiderationFurther Medical TreatmentRight ShoulderAnklesQualified Medical EvaluatorSupplemental ReportIndustrial InjuryTreatment Plant OperatorCounty Sanitation District
References
4
Case No. ADJ7322440, ADJ7322436, ADJ7322441
Regular
Aug 27, 2013

Richard Sanchez vs. American Building Supply, The Hartford Insurance

The Appeals Board granted the defendant's petition for removal, rescinding the WCJ's May 2, 2013 orders. These orders had allowed further discovery regarding the applicant's right ankle surgery and continued the matter for a settlement conference. The Board found these actions inconsistent with its prior February 15, 2013 decision which had specifically determined the applicant was not entitled to any future medical care for the right ankle. Allowing further proceedings on this issue after the Board's final determination constituted good cause for removal.

Petition for RemovalWorkers' Compensation Appeals BoardRescinded OrdersFurther DiscoveryMandatory Settlement ConferenceRight Ankle InjuryIrreparable HarmSubstantial PrejudiceReconsiderationOpinion and Order
References
5
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