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

Case No. ADJ9733920
Regular
Feb 26, 2020

SYLVERIA VILLALOBOS vs. GIUMARRA VINEYARDS, ESIS

The Workers' Compensation Appeals Board affirmed the Administrative Law Judge's decision disallowing a photocopy lien claim. The Board found the lien claimant failed to prove they actually provided the billed "page capture/conversion and processing" services, as the records were provided on CD-ROM by the defendant. Furthermore, the defendant issued a timely and valid Explanation of Review (EOR) with a reduced payment, which the lien claimant did not object to within the statutory period. Consequently, the Board ruled the defendant was not liable for the denied portion of the lien.

Workers' Compensation Appeals BoardLien claimantReconsiderationFindings of Fact and OrderExplanation of ReviewSection 4903.8(d)Declaration of Custodian of RecordsCD-ROMInvoicePage capture/conversion
References
1
Case No. MISSING
Regular Panel Decision

Great American Insurance v. Canandaigua National Bank & Trust Co.

This case involves an appeal and cross-appeal concerning a dispute over a $300,000 certificate of deposit (CD) held in escrow. Great American Insurance Company (GAIC) provided workers' compensation insurance to Transit Group, Inc., secured by a CD held by Canandaigua National Bank and Trust Company (CNB) as an escrowee. Following Transit's bankruptcy filing, CNB released the CD funds to Transit without notifying GAIC, leading GAIC to sue CNB for breach of fiduciary duty. The Supreme Court granted summary judgment to GAIC. The appellate court affirmed this decision, agreeing that CNB breached its fiduciary duty by improperly releasing the funds. However, the appellate court reversed the Supreme Court's denial of Transit's cross-motion, ruling that CNB was not entitled to common-law indemnification or claims for fraud and negligent misrepresentation against Transit, as CNB's liability stemmed from its own breach of duty and it could not justifiably rely on Transit's attorney's representations.

Escrow AgreementBreach of Fiduciary DutySummary JudgmentWorkers' Compensation InsuranceCommon-Law IndemnificationNegligent MisrepresentationBankruptcy LawAppellate ReviewCertificate of DepositInsurer Liability
References
16
Case No. CV-23-1451
Regular Panel Decision
Nov 07, 2024

Matter of Amato v. Patchogue Supermarkets LLC

Domenico Amato, a claimant, sustained work-related injuries to his bilateral shoulders and biceps in May 2019, leading to two arthroscopic surgeries. Following these, medical evaluations for permanency by two orthopedic specialists, Frank Hudak and Lee Kupersmith, yielded differing schedule loss of use (SLU) percentages for Amato's arms. A Workers' Compensation Law Judge initially found a bilateral 42.5% SLU. However, the Workers' Compensation Board subsequently rejected both physicians' permanency opinions, deeming them unreliable due to inconsistent range of motion (ROM) measurements. Instead, the Board relied on earlier ROM measurements from Dr. Kupersmith, taken before Amato reached maximum medical improvement (MMI), to determine a 20% SLU for each arm. Amato appealed this decision. The Appellate Division, Third Department, modified the Board's decision, finding that it was improper for the Board to determine SLU percentages based on premature medical reports that did not confirm MMI or adhere to proper ROM measurement guidelines. Consequently, the matter was remitted to the Workers' Compensation Board for further consideration.

Workers' CompensationSchedule Loss of UseMaximum Medical ImprovementRange of MotionAppellate DivisionThird DepartmentMedical EvidenceBoard ReviewRemittalOrthopedic Surgery
References
8
Case No. MON 0339411
Regular
Jul 21, 2008

Dionisio Jimenez vs. NUPAC APARTMENTS, STATE COMPENSATION INSURANCE FUND

This case involves a dispute over the proper method used to rate the applicant's permanent disability following a back and leg injury. The defendant contends the Agreed Medical Examiner improperly used the Range of Motion (ROM) method instead of the Diagnosis-Related Estimate (DRE) method per the AMA Guides. The Appeals Board rescinded the prior award and returned the case to the trial level for further development of the record. This development will address why the ROM method was used and clarify the appropriate rating methodology.

Workers' Compensation Appeals BoardDionisio JimenezNupac ApartmentsState Compensation Insurance FundMON 0339411Opinion and Decision After ReconsiderationFindings and AwardIndustrial InjuryBack InjuryRight Leg Injury
References
2
Case No. ADJ10489999
Regular
Feb 01, 2019

Sean Lawson vs. Zenith Insurance Company

This case involves a dispute over the permanent disability rating for applicant Sean Lawson's low back injury. The defendant, Zenith Insurance Company, argues that the Range of Motion (ROM) method used by the Qualified Medical Evaluator (QME) was inappropriate, and the Diagnosis-Related Estimates (DRE) method should have been applied as there was only one level of radiculopathy. The Workers' Compensation Appeals Board (WCAB) affirmed the WCJ's finding that the ROM method was appropriate based on the QME's expert opinion and the AMA Guides' provision for its use with multi-level involvement. However, one Commissioner dissented, believing the DRE method was mandated given the lack of evidence for multi-level radiculopathy.

WCABPetition for ReconsiderationPermanent DisabilityApportionmentNon-industrial factorsDiagnosis-Related Estimates (DRE) methodRange of Motion (ROM) methodQualified Medical Evaluator (QME)AMA GuidesMultilevel radiculopathy
References
1
Case No. ADJ9344211
Regular
Dec 01, 2017

Patricia Preston vs. Los Angeles Unified School District, SEDGWICK CLAIMS MANAGEMENT SERVICES

The applicant sought reconsideration of a workers' compensation award, challenging the permanent disability rating primarily based on the chosen medical evaluation method. The applicant argued the Range-of-Motion (ROM) method, favored by her treating physician, should have been used instead of the Diagnosis-Related Estimates (DRE) method employed by a Qualified Medical Evaluator (QME). Additionally, she contended that her vocational expert's opinion supported a finding of total permanent disability. The Board denied reconsideration, affirming the administrative law judge's decision, finding the QME's DRE rating supported by substantial evidence and the applicant's vocational evidence insufficient to prove total disability. A dissenting opinion argued that findings of multi-level spinal involvement supported the use of the ROM method for a potentially higher rating and questioned the QME's justification for choosing DRE.

Workers' Compensation Appeals BoardPatricia PrestonLos Angeles Unified School DistrictSedgwick Claims Management ServicesADJ9344211Permanent Disability RatingRange-of-Motion MethodDiagnosis-Related Estimates MethodApportionmentDr. Fenton
References
6
Case No. M2023-01588-CCA-R3-CD
Regular Panel Decision
Dec 20, 2024

State of Tennessee v. Jeremy James Dalton

Defendant Jeremy James Dalton was convicted of attempted first-degree murder for stabbing his neighbor, Luther Byrd, and sentenced to forty years. Representing himself at trial and on appeal, Dalton raised seventeen issues, including challenges to the sufficiency of evidence, the admission of the deceased victim's preliminary hearing testimony, denial of a motion to suppress his statements, and claims of prosecutorial misconduct and denial of access to courts. The appellate court affirmed the trial court's judgment, finding no reversible error in any of the issues raised by Dalton. The court upheld the trial court's rulings on evidence admissibility, jury instructions, and sentencing.

Criminal LawAttempted MurderFirst Degree MurderSelf-RepresentationSufficiency of EvidencePreliminary Hearing TestimonyHearsay ExceptionMotion to SuppressMiranda RightsJury Instructions
References
86
Case No. M2016-01980-CCA-R3-CD
Regular Panel Decision
Aug 16, 2018

State of Tennessee v. Timothy A. Crowell

Timothy A. Crowell appealed his conviction for aggravated robbery and an eighteen-year sentence from Davidson County Criminal Court. His appeal contended errors by the trial court regarding the admission of partial surveillance video, hearsay evidence, and a photograph lineup during jury deliberations, as well as questioning the sufficiency of the evidence and the excessiveness of his sentence. The Court of Criminal Appeals of Tennessee affirmed the trial court's judgment, finding no reversible error in the evidence's admission or its sufficiency, and upholding the trial court's sentencing discretion. The court determined the state had no duty to acquire a complete surveillance video and that any hearsay admission was harmless. Additionally, the positive identification by the victim and the application of various enhancement factors justified the conviction and sentence.

Aggravated RobberyEyewitness IdentificationSufficiency of EvidenceHearsay EvidenceSurveillance VideoDue ProcessSentencing ReviewEnhancement FactorsCriminal ProcedureAppellate Review
References
44
Case No. W1999-01512-CCA-R3-CD
Regular Panel Decision
Oct 25, 2000

State v. John Vengrin

The defendant, John Joseph Vengrin, appealed his 25-year sentence for second-degree murder, arguing the trial court improperly considered testimony from another case for enhancement factors. The appellate court found that while the trial court erred in relying on matters outside the record, the defendant waived the objection by also advocating for the consideration of external evidence for mitigating factors. Despite the error in judicial notice, the appellate court affirmed the trial court's judgment, concluding that the imposed sentence was proper after a de novo review, as the identified enhancement factors significantly outweighed the mitigating factors.

Sentencing ErrorJudicial NoticeAppellate ReviewWaiver of ObjectionEnhancement FactorsMitigating FactorsSecond Degree MurderCriminal LawTennessee Appellate ProcedureRecord on Appeal
References
10
Case No. W2004-02375-CCA-R3-CD
Regular Panel Decision
Dec 13, 2005

State of Tennessee v. Victor L. Powell

Victor L. Powell appealed his convictions for vehicular homicide and vehicular assault, arguing insufficient evidence and the trial court's refusal to grant a second mental evaluation. Powell was found guilty of causing a multi-vehicle accident resulting in one death and severe injuries to several passengers while driving under the influence. The appellate court reviewed the evidence, including witness testimony, accident reconstruction, and forensic toxicology reports, which supported the jury's finding of Powell's impairment and recklessness. The court also upheld the trial court's decision regarding competency, finding that Powell understood the proceedings. Consequently, the judgments of the trial court were affirmed.

Vehicular HomicideVehicular AssaultDUISufficiency of EvidenceMental CompetencyAccident ReconstructionForensic ToxicologyCriminal AppealConsecutive SentencesMerged Convictions
References
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