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

Case No. 2017 NY Slip Op 07437 [154 AD3d 932]
Regular Panel Decision
Oct 25, 2017

Matter of Awe v. D'Alessandro

Margaret Awe, a dual employee of both New York State and New York City, sought to have her combined salaries aggregated for pension benefit calculations upon retirement. The New York City Employees' Retirement System (NYCERS) declined, considering only her City salary. Awe initiated a CPLR article 78 proceeding, which the Supreme Court granted, annulling NYCERS's determination. However, the Appellate Division reversed this judgment, confirming NYCERS's original determination. The court ruled that NYCERS's refusal to aggregate salaries from state and city employment was not arbitrary and capricious, citing statutory requirements that aggregated salaries must stem from 'city-service,' which her state employment was not.

Retirement benefitsPublic employeesDual employmentPension calculationCPLR article 78 proceedingStatutory interpretationCity-serviceNew York City Employees' Retirement SystemAppellate DivisionAdministrative Code
References
6
Case No. ADJ3576959 (OAK 0336251)
Regular
Oct 22, 2008

Miguel Vilela vs. Jerry Thompson and Sons Painting, Inc., Zurich North America Insurance Company

The Workers' Compensation Appeals Board granted reconsideration to address the defendant's contention that the applicant's Average Weekly Earnings (AWE) and resultant Temporary Disability Indemnity (TDI) rate were improperly determined. The Board found that the applicant's intermittent employment history meant his AWE should be calculated based on his earning capacity under Labor Code section 4453(c)(4), rather than a simple weekly rate. Consequently, the previous Findings and Award were rescinded, and the case was returned for further proceedings to redetermine the applicant's AWE accordingly.

Workers' Compensation Appeals BoardMiguel VilelaJerry Thompson and Sons PaintingZurich North America Insurance CompanyADJ3576959OAK 0336251Opinion and Order Granting ReconsiderationDecision After ReconsiderationFindings and Awardindustrial injury
References
0
Case No. ADJ8820335
Regular
Apr 17, 2017

RAHSHON LOYD vs. DOLAN CONCRETE CONSTRUCTION, OLD REPUBLIC CONTRACTORS INSURANCE GROUP, GALLAGHER BASSETT SERVICES, INC.

This case concerns the calculation of applicant Rahshon Loyd's average weekly earnings (AWE) for temporary disability indemnity following a $100\%$ permanent and total industrial injury. The defendant argued the WCJ erred by calculating AWE based on a presumed 40-hour work week, instead of applicant's actual irregular earnings history. The Appeals Board granted reconsideration, finding that while applicant's earning capacity was relevant, his historical earnings as a union cement mason, even after attaining journeyman status, did not consistently reflect a 40-hour work week. Consequently, the Board amended the decision to calculate AWE as an average of his weekly wage over the three years prior to injury, resulting in a reduced temporary disability rate.

Workers' Compensation Appeals BoardAverage Weekly EarningsTemporary Disability IndemnityLabor Code Section 4453Earning CapacityUnion Cement MasonJourneymanPermanent and Total DisabilityVocational EvaluatorPetition for Reconsideration
References
4
Case No. ADJ1054155 (LAO 0854446) ADJ1247741 (LAO 0854447) ADJ1895803 (LAO 0854448)
Regular
May 03, 2011

HIRITI OKUAMICHAEL vs. PAUL OWENS SHOES INC., STATE FARM FIRE AND CASUALTY COMPANY, STATE COMPENSATION INSURANCE FUND

This amended order clarifies that the Workers' Compensation Appeals Board has granted the applicant's petition for reconsideration of the February 8, 2011 Findings and Awards. This reconsideration aims to allow the Board to thoroughly study the factual and legal issues, including those to be raised in the applicant's supplemental petition. The applicant's request to file a supplemental petition has also been granted and reaffirmed. All future communications regarding these cases should be directed to the Office of the Commissioners of the WCAB.

Supplemental PetitionReconsiderationAppeals Board Rule 10848Findings and AwardsDecision After ReconsiderationOffice of the CommissionersWCABADJ1054155ADJ1247741ADJ1895803
References
0
Case No. ADJ9016733
Regular
May 03, 2016

TYSON CONGER vs. CARE AMBULANCE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration of a prior award concerning industrial injuries to his low back and psyche. The applicant argues the original findings did not properly weigh evidence and support a higher permanent disability rating. The Board also permitted the applicant to file a supplemental petition to address new information, allowing defendants an opportunity to respond. Reconsideration was granted to ensure a complete review of the record and a just decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationSupplemental PetitionEmergency Medical TechnicianLow Back InjuryPsyche InjuryTemporary DisabilityFuture Medical TreatmentPermanent DisabilityApportionment
References
1
Case No. ADJ8429152
Regular
Sep 02, 2014

ROBERT HURLEY vs. CARMEL DEVELOPMENT COMPANY, STATE COMPENSATION INSURANCE FUND

The defendant sought reconsideration of the WCJ's award, arguing the calculation of applicant's average weekly earnings (AWE) was incorrect. The WCJ based the AWE on applicant's recent 40-hour work weeks at $46.00 per hour, totaling $1,840.00. The Board denied reconsideration, upholding the WCJ's calculation based on Labor Code § 4453(c)(1), as applicant was demonstrably working full-time hours immediately prior to injury. Furthermore, the Board noted that even under § 4453(c)(4), considering earning capacity, the applicant's overall circumstances supported the finding.

Average Weekly EarningsLabor Code § 4453(c)Petition for ReconsiderationWCJJourneyman Heavy Equipment OperatorCumulative TraumaTemporary Partial DisabilityEarning CapacityMaximum EarnerSporadic Employment
References
4
Case No. VNO 0438915
Regular
Oct 23, 2008

Applicant vs. University of Southern California

This case concerns an applicant's Petition for Reconsideration of a WCAB decision denying injury claims against the University of Southern California (USC). The applicant alleged a physical altercation with his supervisor, Mr. Pickering, during a meeting on September 20, 2001, which he claims caused various injuries. However, the WCJ found the applicant lacked credibility due to inconsistencies in his testimony and failure to report the incident promptly. The WCJ relied on testimony from witnesses who stated Mr. Pickering merely touched the applicant's shoulders and noted the applicant's history of prior injuries and medical issues not fully disclosed.

WCABPetition for ReconsiderationUniversity of Southern CaliforniaBiological Safety Specialistspecific injuryanimositycredibility issuesshoulder touchingprior injurieshypertension
References
0
Case No. ADJ6958416
Regular
May 19, 2011

Norma Zell vs. ALAMEDA COUNTY, SEDGWICK CMS

The Workers' Compensation Appeals Board granted the applicant's first petition for reconsideration, amending the original award to increase her permanent disability rating from 20% to 24% based on corrected medical calculations. The Board denied the applicant's second petition for reconsideration regarding her left wrist injury, adopting the judge's reasoning that it was not a compensable industrial injury. The original finding of a cumulative industrial injury to the right wrist during her employment as a deputy sheriff was affirmed. The award was amended to reflect the 24% permanent disability rating and adjusted attorney fees.

Workers' Compensation Appeals BoardCumulative Industrial InjuryRight Wrist InjuryDeputy SheriffPermanent Disability RatingAMA GuideWhole Person ImpairmentPetition for ReconsiderationFindings and AwardDecision After Reconsideration
References
0
Case No. ADJ6729105
Regular
Sep 16, 2009

, ## Applicant, vs. , ## Defendant(s).

The Workers' Compensation Appeals Board denied reconsideration of a ruling that utilization review for the applicant's shoulder surgery was timely. The applicant argued she did not receive the denial letter within the required timeframe, but the Board found that the denial was properly sent to the treating physician and carbon-copied to the applicant within the statutory period. The Board clarified that WCAB Rule 10505(d) regarding official address records did not apply at the time of the denial because no claim application was yet filed. Therefore, the carrier's obligation was to communicate the denial in writing within the specified time, which they did.

Workers' Compensation Appeals BoardCadbury SchweppesGallagher Bassett ServicesUtilization ReviewPetition for ReconsiderationApplication for Adjudication of ClaimWCAB Rule 10505(d)Labor Code Section 4610ArthroscopyBiceps Tenodesis
References
0
Case No. ADJ1812731 (LBO 0352930), ADJ4306876 (LBO 0297758)
Regular
Mar 19, 2014

Applicant vs. Defendant

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration. The dismissal was based on the applicant's failure to file proof of service with the petition, a mandatory procedural requirement. Even if the merits were considered, the WCAB would have denied the petition based on the Judge's report. The applicant had sought reconsideration of a denial for a Petition to Reopen and claimed new and further disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition to ReopenFindings and OrderAgreed Medical EvaluatorNew and Further DisabilityTemporary DisabilityBad FaithProof of ServiceDismissal
References
0
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