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

Case No. ADJ2308109 (OAK 0275439) ADJ01058712 (OAK 0275438)
Regular
Apr 29, 2011

LINDA BURT-FOSS vs. CHILDREN'S FAIRYLAND, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation claim for a zoo keeper injured in 1999. The applicant sustained a left foot and ankle injury that led to a Charcot foot condition, resulting in total permanent disability. The defendant argued for apportionment of disability, citing a medical opinion suggesting pre-existing conditions contributed to the Charcot foot. However, the Board affirmed the applicant's total permanent disability, finding the industrial injury was a contributing cause and therefore not subject to apportionment. The Board also found that the defendant waived issues regarding the overlap of disabilities from prior knee injuries by failing to raise them in their petition for reconsideration.

Workers' Compensation Appeals BoardJoint Findings and AwardReconsiderationPermanent Total DisabilityApportionmentAgreed Medical EvaluatorCharcot footIndustrial InjuryInciting EventCompensable Consequence
References
11
Case No. MISSING
Regular Panel Decision
Mar 25, 2004

Foote v. Lyonsdale Energy Limited Partnership

Glenn A. Foote, Jr., an employee, sustained injuries when a wood chip stacker collapsed at the Lyonsdale Cogeneration Facility. He and his wife filed a lawsuit alleging negligence and violations of Labor Law §§ 200, 240, and 241 against the facility owners (Lyonsdale Energy Limited Partnership and Moose River Energy, Inc.), the stacker designer (American Bin & Conveyor), and the procurer (Wolf & Associates). The Supreme Court partially granted summary judgment to Lyonsdale and Wolf, dismissing the Labor Law § 240(1) claim against Lyonsdale and the negligence claim against Wolf. On cross-appeals, the Appellate Division affirmed the lower court's decision, concluding that Labor Law § 240(1) was inapplicable as the injury resulted from the structure's collapse rather than the failure of a safety device. The court also upheld the dismissal of the negligence claim against Wolf due to the absence of a duty to the plaintiff, and found a question of fact existed regarding Lyonsdale's supervisory control, thus denying summary judgment to Lyonsdale on other claims.

Labor LawWorkplace InjurySummary JudgmentNegligenceElevated Work SiteScaffold LawWood Chip StackerDesign DefectSupervisory ControlContractual Obligation
References
19
Case No. 01-07-00193-CV
Regular Panel Decision
Oct 23, 2008

Rosa Schwartz v. the Insurance Company of the State of Pennsylvania, Gallagher Bassett Services, Inc., and Belinda Ybarra

Rosa Schwartz sued The Insurance Company of the State of Pennsylvania, Gallagher Basset Services, Inc., and Belinda Ybarra (collectively, “Gallagher”) for damages stemming from alleged unreasonable delay and denial in authorizing her requested foot surgery. The trial court granted Gallagher's plea to the jurisdiction, ruling Schwartz failed to exhaust administrative remedies and dismissing her claims. Schwartz appealed, contending the trial court erred in its exhaustion of remedies ruling and in granting the plea regarding claims for a neuroma deformity. The appellate court affirmed the trial court's decision, finding that Schwartz failed to exhaust administrative remedies regarding the foot surgery preauthorization dispute and that her petition did not adequately allege claims related to the neuroma deformity denial. The court concluded that the impediment to jurisdiction regarding the foot surgery could not be cured due to untimely requests for reconsideration.

Workers' CompensationJurisdictionAdministrative RemediesMedical NecessityFoot SurgeryNeuroma DeformityInsurance DenialPlea to the JurisdictionAppellate ReviewTexas Law
References
15
Case No. MISSING
Regular Panel Decision

Schwartz v. Insurance Co. of Pennsylvania

Rosa Schwartz sued The Insurance Company of the State of Pennsylvania, Gallagher Basset Services, Inc., and Belinda Ybarra (collectively, "Gallagher") for damages due to alleged unreasonable delay and denial in authorizing her requested foot surgery. The trial court granted Gallagher's plea to the jurisdiction, which Schwartz appealed. The appellate court affirmed the trial court's decision, holding that Schwartz failed to exhaust administrative remedies regarding the medical necessity dispute for her foot surgery. The court determined that the jurisdictional impediment was incurable as no timely reconsideration request was made following the initial denial. Furthermore, the appellate court ruled that Schwartz's petition did not provide fair notice for claims concerning her neuroma deformity.

Administrative RemediesPlea to JurisdictionMedical Necessity DisputeInsurance CodeDeceptive Trade Practices ActBreach of DutyExhaustion of RemediesNeuroma DeformityFoot SurgeryPreauthorization Denial
References
16
Case No. 07 Civ. 1358(DAB)
Regular Panel Decision
Sep 29, 2009

Osberg v. Foot Locker, Inc.

Plaintiff Geoffrey Osberg filed a class action against Foot Locker, Inc. and its Retirement Plan, alleging violations of ERISA due to the 1996 conversion of the plan to a cash balance system. The complaint included claims for age discrimination, insufficient notice of benefit reduction, misleading summary plan descriptions (SPDs), and breach of fiduciary duties. Defendants moved to dismiss all counts, but the court denied dismissal on grounds of standing and statute of limitations for all claims. The court granted the motion to dismiss for age discrimination (Count One) and insufficient notice under the 1996 ERISA § 204(h) (Count Two), aligning with precedents that found cash balance plans not inherently age discriminatory and that the notice provided met the then-current requirements. However, the court denied the motion to dismiss regarding the misleading SPD (Count Three) and breach of fiduciary duty (Count Four), concluding that the SPD might have been insufficiently clear about the "wear-away" effect and benefit reductions, thereby supporting the breach of fiduciary duty claim.

ERISApension plancash balance planbenefit conversionage discriminationfiduciary dutysummary plan descriptionnotice requirementsmotion to dismissstatute of limitations
References
15
Case No. MISSING
Regular Panel Decision

Collins v. Liberty Mutual Insurance Co.

This case concerns an action for workmen's compensation death benefits initiated by the widow of Douglas S. Collins against Foote Mineral Company, the insured employer. Mr. Collins died following an automobile accident, with his death certificate indicating an 'apparent heart attack' as the cause. The plaintiff argued for an inference that the death arose out of and in the course of employment, referencing Milstead v. Kaylor. However, the court emphasized that merely being found dead at work in Tennessee does not automatically establish a prima facie case; additional evidence, such as exertion or an accident aggravating a pre-existing condition, is required. Given the plaintiff's insufficient proof to connect Mr. Collins' death directly to his employment, the trial court's dismissal of the action was affirmed.

Workmen's CompensationDeath BenefitsCourse of EmploymentArising Out of EmploymentBurden of ProofInference of Death CauseApparent Heart AttackAutomobile AccidentInsufficient EvidenceAffirmed Decision
References
10
Case No. ADJ350092 (LBO 0372531)
Regular
Apr 23, 2010

PATRICK FOOTE vs. MEDADENT BIOMEDICAL; SCIF INSURED SANTA ANA

The Workers' Compensation Appeals Board dismissed Patrick Foote's petition for reconsideration because it was unverified and lacked proof of service, violating Labor Code sections 5902 and 5905. The Board noted that the applicant had ample opportunity to cure these defects but failed to do so. Even if the procedural defects were overlooked, the Board would have denied the petition based on the original administrative law judge's findings. Ultimately, the petition was dismissed for non-compliance with procedural requirements.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissalIndustrial InjuryPsycheUpper BackNeckHeadIn Pro PerUnverified Petition
References
1
Case No. MISSING
Regular Panel Decision

Burns v. Union Standard Insurance Co.

Mrs. Ruby Burns, an employee of Freddie Burns General Construction Company, sustained an injury to her left ankle and foot on September 30, 1974. She filed a worker's compensation claim, alleging a general injury to her ankle, leg, hip, and back. The compensation carrier contended it was a specific injury limited to her left ankle and foot. The jury found the injury was confined to her left foot and leg below the knee and determined a 10% permanent partial loss of use of her left foot. Mrs. Burns appealed the judgment, citing errors in the jury charge and a lack of evidentiary support for the verdict. The appellate court affirmed the trial court's decision, finding no reversible error in the submission of special issues or the jury's findings.

Worker's CompensationSpecific InjuryGeneral InjuryJury VerdictPermanent Partial DisabilityAnkle SprainNerve Root IrritationAppellate ReviewJury ChargeSufficiency of Evidence
References
3
Case No. MISSING
Regular Panel Decision

Claim of Jweid v. Vicks Lithograph & Printing

Claimant injured his back at work in February 1999, leading to multiple diagnoses and back surgeries. Following surgeries, he developed a consequential left foot drop injury. A workers' compensation claim was established and later amended to include the foot drop. Medical evidence supported a 40% loss of use of the left foot and a permanent partial disability of his back, with the claimant having reached maximum medical improvement. The Workers’ Compensation Law Judge made a schedule loss award for the 40% loss of use of the left foot, which the Workers’ Compensation Board affirmed. The employer and carrier appealed, arguing against a schedule loss award. The court affirmed the Board's decision, finding it supported by substantial evidence, as a schedule loss of use award is appropriate when there is no continuing need for medical treatment and the condition is stable.

Workers' CompensationSchedule Loss of UseBack InjuryFoot DropMedical ImprovementPermanent Partial DisabilityAppellate ReviewSubstantial EvidenceMedical OpinionCausal Relationship
References
5
Case No. MISSING
Regular Panel Decision

Claim of Hughes v. Indian Valley Industries, Inc.

In October 1996, the claimant sustained a work-related injury while lifting a 500-pound tarpaulin, leading to claims of left foot, leg, low back injuries, and nerve damage. Initially, a Workers’ Compensation Law Judge (WCLJ) recognized causal relationship only for the left foot injury, later amending the findings to include the back injury and left foot drop. The Workers’ Compensation Board subsequently rescinded the portion regarding the left foot drop for further medical evaluation but affirmed the causal relationship for the back injury and rejected the carrier's fraud allegations. The employer and its carrier appealed this Board decision. The Appellate Division affirmed the Board’s determination, noting that resolving conflicting expert medical testimony falls within the Board’s authority and concluding that the Board’s findings on the back injury and fraud issue were supported by substantial evidence.

CausationBack InjuryLeft Foot DropMedical EvidenceConflicting TestimonyWorkers' Compensation FraudPreexisting ConditionSubstantial Evidence ReviewAppellate AffirmationJudicial Review of Administrative Decision
References
4
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