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

Case No. 533089
Regular Panel Decision
Oct 07, 2021

Matter of Barden v. General Physicians PC

Claimant, a patient services representative, sought to amend her workers' compensation claim to include left shoulder aggravation after a work-related injury to her right shoulder. The Workers' Compensation Board disallowed this request, finding that claimant failed to provide sufficient credible medical evidence to establish a causal relationship between her employment and the left shoulder condition. The Appellate Division, Third Department, affirmed the Board's decision. The court noted that the claimant's treating physician opined the left shoulder pathology was largely preexisting and unrelated to the work injury, and other medical opinions either lacked sufficient weight or were based on inaccurate information, providing no basis to disturb the Board's finding.

Workers' CompensationShoulder InjuryCausationMedical EvidencePreexisting ConditionAppellate ReviewBoard DecisionClaim AmendmentPatient Services Representative
References
10
Case No. MISSING
Regular Panel Decision
Apr 07, 1988

De Coste v. Champlain Valley Physicians Hospital

Decedent, Darwin A. De Coste, experienced chest pain and elevated blood pressure, leading him to Champlain Valley Physicians Hospital where he was seen by Dr. William Amsterlaw. Amsterlaw diagnosed reflux esophagitis despite an abnormal electrocardiogram, discharging De Coste, who subsequently suffered a fatal cardiopulmonary arrest 12 hours later. The administrator of De Coste's estate filed a wrongful death action, alleging medical malpractice and that the misdiagnosis was the proximate cause of death. A jury awarded pecuniary damages and funeral expenses, which the defendants appealed. The appellate court affirmed the verdict, finding rational support for the jury's malpractice finding and rejecting the defendants' argument to reduce the award by Social Security benefits due to the effective date of CPLR 4545 (c).

Medical MalpracticeWrongful DeathProximate CauseCollateral Source RuleCPLR 4545Jury VerdictEmergency Room CareMisdiagnosisArteriosclerosisMyocardial Infarction
References
3
Case No. MISSING
Regular Panel Decision

World Trading Corp. v. Kolchin

The plaintiff sought to permanently enjoin the defendant from arbitrating disputes, arguing that the defendant union's change in affiliation from the American Federation of Labor to the Committee for Industrial Organization, along with a name change, altered its legal entity and invalidated their contract. The court disagreed, holding that a union's identity, structure, operation, constitution, by-laws, officers, and membership remain the same despite changes in affiliation and name. The court affirmed that such changes do not affect the union's rights or responsibilities under existing contracts. Therefore, the court found no basis to support the plaintiff's contention.

union affiliationarbitration disputeinjunctioncontract validityorganizational identitylabor lawname changelegal entitytrade unionsAmerican Federation of Labor
References
2
Case No. MON 094741 MON 124794
Regular
Mar 25, 2008

ANA SAMI vs. HUGHES AIRCRAFT, HARTFORD ACCIDENT as administered by SPECIALTY RISK SERVICES

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, affirming the prior decision that denied the defendant's petition to change the primary treating physician. While the Board amended the order to correct a clerical error as recommended by the WCJ, it did not specifically rule on the applicant's arguments for attorney fees and subpoena costs, referencing the WCJ's report. The Board's decision ultimately upholds the denial of the defendant's request to change physicians.

Petition for ReconsiderationJoint Findings of FactPrimary Treating PhysicianAdministrative DirectorWCJLabor Code section 5814.5Labor Code section 4607attorney feessubpoena costsHIPPA violation
References
0
Case No. ADJ9762825
Regular
Feb 29, 2016

MARIA OLGA BARAJAS vs. BARRETT BUSINESS SERVICES, CORVEL

This case involves Maria Olga Barajas's workers' compensation claim against Barrett Business Services and Corvel. The applicant was injured on July 20, 2014, and her attempts to change her treating physician within the employer's Medical Provider Network (MPN) were unsuccessful. The Workers' Compensation Appeals Board denied the defendants' Petition for Reconsideration, upholding the original award. This award allowed the applicant to seek treatment outside the MPN at the defendants' expense due to the failure to facilitate a timely change of physician.

Medical Provider NetworkMPNPetition for ReconsiderationFindings and Awardremovalchange of treating physicianinterim orderLabor Code § 4616.3(b)Title 8Regulations
References
2
Case No. ADJ8890109 ADJ8890125
Regular
Jan 09, 2017

ELIZABETH BURGOS vs. IMAGEFIRST HEALTHCARE LAUNDRY SPECIALIST; TRAVELERS

The applicant sought removal from a Workers' Compensation Appeals Board decision finding no denial of care. The applicant argued a 43-day delay in authorizing a change to a new treating physician within the defendant's MPN constituted denial of care. The Board denied removal, finding the applicant did not prove denial of care, as there was no evidence of inability to obtain treatment or refusal by the defendant. Furthermore, the applicant's requested change of physician occurred after the initial 30-day window, thus not falling under Labor Code section 4601(a).

Workers' Compensation Appeals BoardPetition for RemovalJoint Findings and AwardStipulations with Request for AwardPrimary Treating Physician (PTP)Medical Provider Network (MPN)Denial of CareLabor Code section 4601(a)Labor Code section 4600Cal. Code Regs.
References
10
Case No. ADJ7938670
Regular
Jun 20, 2012

ROSALINDA MAGANA vs. FIRST ALARM, INC., LIBERTY MUTUAL INSURANCE COMPANY

This case concerns an employer and insurer's unsuccessful petition for reconsideration to prevent an injured worker from changing her primary treating physician. The applicant injured her back and, after postponing recommended surgery, sought to switch to a pain management specialist within the employer's medical network. The Workers' Compensation Appeals Board denied reconsideration, adopting the judge's report which found the applicant could change physicians as the requested specialist's treatment was consistent with the original orthopedic surgeon's recommendations. The Board also admonished the defendants for delaying medical treatment.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedMedical treatmentPrimary treating physicianMedical Provider Network (MPN)Orthopedic surgeonChronic pain managementLabor CodeFindings Award and Orders
References
0
Case No. 2022 NY Slip Op 07102
Regular Panel Decision
Dec 15, 2022

Matter of Kingston v. New York City Fire Dept.

In this workers' compensation case, claimant Donnay Kingston appealed two decisions of the Workers' Compensation Board. Kingston had established a claim in 2008 for bilateral carpal tunnel syndrome, later amended for DeQuervain's tenosynovitis, and received a schedule loss of use (SLU) award in 2014, affirmed in 2016. In 2019, her treating physician sought to reopen the claim, alleging a material change in her medical condition. Both a Workers' Compensation Law Judge and the Board denied the request, finding no sufficient change to warrant reopening or rescinding the SLU award, despite the physician noting a worsening of symptoms that was deemed anticipated. The Appellate Division, Third Department, affirmed both decisions, concluding that the Board did not abuse its discretion in denying the reopening and found claimant's remaining contentions without merit.

Workers' Compensation ClaimBilateral Carpal Tunnel SyndromeDeQuervain's TenosynovitisSchedule Loss of UseClaim Reopening DenialMedical Condition ChangeAppellate Division Third DepartmentBoard DiscretionTreating Physician TestimonyWrist Pain
References
6
Case No. ADJ7760130
Regular
Nov 22, 2011

MARILOU YOUNG vs. DEPARTMENT OF FORESTRY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted the applicant's Petition for Removal to overturn the denial of a change of venue. The WCAB found good cause to change venue from San Luis Obispo to Salinas, where the employer, treating physicians, and applicant's attorney are located. The applicant's initial venue designation in her county of residence appeared to be a clerical error, especially since the defendant stipulated to the change. Therefore, venue was officially changed to the Salinas district office.

Petition for RemovalChange of VenueLabor Code section 5501.6(a)StipulationIndustrial InjuryBreast CancerFirefighterApplication for Adjudication of ClaimVenue ShoppingJudge Shopping
References
0
Case No. MISSING
Regular Panel Decision

Claim of Ceselka v. Kingsborough Community College

Claimant, a custodian, sustained a lower back injury in September 1996 while at work, leading to temporary total disability benefits until September 1997. A Workers’ Compensation Law Judge (WCLJ) determined no causally related permanent disability existed after September 5, 1997, a finding affirmed by the Workers’ Compensation Board. The claimant appealed this decision. The Appellate Division affirmed the Board’s ruling, stating that the resolution of conflicting medical testimony—between the employer's physician, who attributed the herniated disc to degenerative changes, and the claimant's treating physician—is within the Board's authority. The court also dismissed the claimant's argument that her attorney being denied access to the employer's physician's notes warranted reversal, noting that ample opportunity for cross-examination was provided, and the physician's report sufficiently addressed the claimant’s complaints and job duties. Objective medical tests did not support a permanent disability claim.

Workers' Compensation Lawpermanent disabilitycausally related injurymedical evidenceconflicting medical testimonylumbar spine injuryherniated discsubjective complaintsobjective medical testsevidentiary rulings
References
6
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