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

Case No. MISSING
Regular Panel Decision

Claim of Pulos v. Asplundh Tree

Claimant, a tree trimmer, had an existing claim for bilateral carpal tunnel syndrome and later sought to include a cervical spine condition as an occupational disease. A workers' compensation law judge initially disallowed this amendment, but the Workers' Compensation Board reversed, finding the cervical condition was dormant and non-disabling, and that the claimant's work activities aggravated it. The employer appealed this decision. The court affirmed the Board's ruling, concluding there was substantial evidence to support the finding that the claimant's preexisting cervical condition was activated by the distinctive features of his employment.

Occupational DiseaseCervical Spine InjuryCarpal Tunnel SyndromePreexisting ConditionAggravation of InjuryWorkers' Compensation LawJudicial ReviewAppellate DecisionTree TrimmingWork Activities
References
3
Case No. 526688
Regular Panel Decision
Dec 27, 2018

Matter of Bufearon v. City of Rochester Bur. of Empl. Relations

Claimant Kamren Bufearon sustained work-related injuries in a motor vehicle collision on March 4, 2016, for which his workers' compensation claim was established for injuries to his left shoulder, left hip, and lower back. Subsequently, he sought to amend his claim to include a causally-related cervical spine injury, which was initially approved by a Workers' Compensation Law Judge. However, the Workers' Compensation Board reversed this decision, finding that the claimant failed to sufficiently demonstrate a causal relationship between his cervical spine condition and the March 4, 2016 incident. The Appellate Division affirmed the Board's decision, noting that the medical testimony from two physicians contained conflicting findings and equivocal narratives regarding causation. The court concluded that the Board was entitled to reject the physicians' opinions as speculative, particularly since neither physician had reviewed the claimant's prior medical records for a pre-existing cervical spine fusion surgery.

Cervical spine injuryCausal relationshipMedical evidenceSubstantial evidence reviewAppellate DivisionWorkers' Compensation BoardPre-existing conditionCredibility of physiciansBurden of proofMotor vehicle accident
References
13
Case No. 533683
Regular Panel Decision
Apr 21, 2022

In the Matter of the Claim of Alexandra Minichino

Claimant, a picker for Amazon.com DEDC LLC, experienced symptoms including loss of feeling in her right arm and shoulder while working on December 20, 2018. She initially filed a workers' compensation claim for an occupational/repetitive stress injury. The Workers' Compensation Law Judge (WCLJ) disallowed the claim due to inconsistencies. However, the Workers' Compensation Board modified this, ruling that she sustained an accidental and causally-related injury to her cervical spine. The Appellate Division affirmed the Board's decision, finding substantial evidence supported the Board's determination regarding both the occurrence of an accidental injury arising out of employment and its causal relationship to the claimant's cervical spine condition, deferring to the Board's resolution of conflicting medical testimony.

Workers' Compensation BoardAppellate DivisionAccidental InjuryCausally Related InjuryCervical Spine InjuryOccupational Disease ClaimRepetitive Stress InjuryIndependent Medical ExaminationWitness CredibilitySubstantial Evidence
References
16
Case No. 2024 NY Slip Op 03080 [228 AD3d 426]
Regular Panel Decision
Jun 06, 2024

DiMaggio v. Port Auth. of N.Y. & N.J.

Plaintiffs Salvatore DiMaggio et al. alleged that Salvatore was struck in the face by a metal rod during a construction project, resulting in injuries to his face, head, and spine, as well as aggravation of prior asymptomatic conditions. Defendants Port Authority of New York and New Jersey et al. subsequently sought authorizations for records related to 19 prior incidents involving an individual named "Salvatore DiMaggio" and moved to compel discovery or dismiss the case. The Supreme Court initially granted defendants' motion to the extent of compelling plaintiffs to provide a Jackson affidavit and authorizations. However, the Appellate Division modified this order, ruling that the requirement for a Jackson affidavit was improper, as that procedure applies when documents are claimed to be missing, not when seeking authorizations from third parties, and CPLR 3130 prohibits interrogatories upon a party served with a demand for a bill of particulars. The Appellate Division affirmed the compulsion for plaintiffs to provide authorizations for records related to claims made by Salvatore and incidents in which he was involved, given his acknowledgement of involvement in some prior incidents and failure to timely object to the demands. The court further limited the scope of these authorizations to records relating to injuries to or treatment of Salvatore DiMaggio's face, mouth, head, cervical spine, and/or thoracolumbar spine, due to the nature of the alleged injuries and the principle that general anxiety/depression from physical injuries does not place entire mental health into contention, while allowing them to be unrestricted by date due to allegations of exacerbated preexisting injuries.

DiscoveryAuthorizationsMedical RecordsPreexisting InjuriesJackson AffidavitCPLR 3126CPLR 3130Waiver of ObjectionAppellate ProcedurePersonal Injury
References
11
Case No. ADJ7924562
Regular
Sep 19, 2014

RAUL HERNANDEZ vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

The applicant sought reconsideration of a WCJ decision that found an industrial injury to the low back but not the cervical spine or left ankle, with no permanent disability or further medical treatment. The applicant argued the QME's reports were insubstantial and that prior permanent disability was not considered. The Appeals Board granted reconsideration to amend the original award to include injury to the cervical spine, affirming the remainder of the decision. Therefore, the applicant sustained injury to his low back and cervical spine.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryLow Back InjuryCervical Spine InjuryPermanent DisabilityFurther Medical TreatmentPanel Qualified Medical EvaluatorLabor Code Section 4664(b)
References
0
Case No. ADJ1337074 (GRO 0034564) ADJ1286218 (GRO 0034565)
Regular
Jun 24, 2009

Dave Gerletti vs. SANTA MARIA AIRPORT DISTRICT, GREGORY BRAGG STOCKTON

The Workers' Compensation Appeals Board denied Dave Gerletti's petition for reconsideration of an award for a cumulative trauma injury to his cervical spine and lungs. The original award found 35% permanent disability, apportioning 50% of the cervical spine disability to non-industrial factors based on a Qualified Medical Evaluator's opinion of degenerative changes. The majority affirmed the WCJ's reliance on this opinion, finding it adequately explained. A dissenting opinion argued the QME's apportionment was speculative and improperly based on age and genetics, recommending an unapportioned award for the cervical spine injury.

Workers' Compensation Appeals Boardcumulative traumacervical spinelungspermanent disabilityapportionmentQualified Medical EvaluatorAgreed Medical Examinerarthritic degenerationnon-industrial factors
References
1
Case No. 2024 NY Slip Op 00599 [224 AD3d 428]
Regular Panel Decision
Feb 06, 2024

Matter of New Millennium Pain & Spine Medicine, P.C. v. Garrison Prop. & Cas. Ins. Co.

This case involves two appeals by New Millennium Pain & Spine Medicine, P.C. against Garrison Property & Casualty Insurance Company and GEICO Casualty Company. New Millennium sought to vacate master arbitration awards that denied its claims for no-fault benefits for medical services. The Supreme Court denied these applications. The Appellate Division, First Department, affirmed the Supreme Court's decisions, stating that an arbitrator's award will not be set aside unless it is irrational. The court also addressed the argument regarding a 20% wage offset in no-fault benefits, finding it unavailing under Insurance Law § 5102 (b). Ultimately, New Millennium was not entitled to attorneys' fees as it was not the prevailing party.

No-fault benefitsarbitration awardvacaturinsurance lawwage offsetappellate reviewmedical servicesno-fault policy exhaustionattorneys' feesCPLR Article 75
References
8
Case No. ADJ7288330
Regular
Oct 03, 2016

GLORIA BENITEZ vs. NEWPORT SUBACUTE HEALTH CARE CENTER, ALASKA NATIONAL INSURANCE COMPANY

The applicant, Gloria Benitez, sought to reopen her workers' compensation claim to include injury to additional body parts beyond her cervical spine and psyche. The original award found injury only to the cervical spine and psyche, with a 19% permanent disability rating for the cervical spine. While the WCJ's initial decision denied injury to additional body parts, the Board granted reconsideration. The Board amended the original findings to defer the issue of injury to the alleged additional body parts, while affirming other aspects of the WCJ's order, including the appointment of a regular physician to evaluate new and further disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderNew and Further DisabilityAgreed Medical ExaminerRegular PhysicianLabor Code Section 5410Petition to ReopenIndustrial InjuryCervical Spine
References
4
Case No. MISSING
Regular Panel Decision

Claim of Fonda v. Norton Co.

Claimant suffered serious injuries to his right leg, hip, and spine in February 1988, necessitating two laminectomies for a herniated disc. The employer and its insurer challenged the Workers’ Compensation Board's determination that the claimant's permanent disability resulted solely from his back injury, arguing that a preexisting dormant heart condition contributed. The court affirmed the Board's decision, finding substantial evidence that the claimant's disability was not materially or substantially greater due to the heart condition. The Board's prerogative to resolve conflicting medical opinions was upheld. Furthermore, the court found the employer's argument regarding a contractually based reimbursement claim could not be raised for the first time on appeal, as it was not addressed administratively.

Workers' CompensationBack InjuryPreexisting ConditionHeart ConditionDisabilityLaminectomyCausationMedical EvidenceFactual DisputeAppellate Review
References
2
Case No. ADJ8457042
Regular
Nov 04, 2014

ALICE JEFFRES vs. ARROYO GRANDE COMMUNITY HOSPITAL

This case involves a dispute over the extent of an industrial injury sustained by an applicant. The Workers' Compensation Appeals Board (WCAB) affirmed the administrative law judge's finding that the applicant suffered industrial injuries to her shoulders, cervical spine, right knee, thoracic spine, upper extremities, and hands. However, the WCAB granted reconsideration to clarify that while the industrial incident temporarily aggravated the applicant's pre-existing fibromyalgia, it did not necessitate ongoing industrial medical treatment for that condition. The WCAB found the opinions of treating physicians to constitute substantial evidence, outweighing defendant's reliance on a panel QME.

Fibromyalgia aggravationQualified Medical EvaluatorTreating PhysiciansSubstantial Medical EvidenceApportionmentPermanent DisabilityIndustrial InjuryWorkers' Compensation Appeals BoardReport and RecommendationPetition for Reconsideration
References
0
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