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

Case No. ADJ1 44848 (GRO 0032874)
Regular
Apr 26, 2016

BILLY BRANHAM vs. ARROYO GRANDE GLASS, STATE COMPENSATION INSURANCE FUND

The Appeals Board rescinded the Workers' Compensation Judge's (WCJ) decision granting a 63% permanent disability award. This was because the WCJ improperly rejected the vocational expert's opinion regarding the impact of industrial medications on the applicant's ability to compete in the labor market. The Board remanded the case for further development of both medical and vocational records, specifically requesting updated opinions on the side effects of the applicant's medications. This is to ensure a more thorough investigation into the cognitive effects of prescribed drugs on the applicant's work capacity.

Workers' Compensation Appeals BoardReconsiderationPetition to ReopenPermanent Disability AwardVocational ExpertCognitive EffectsIndustrially-Prescribed MedicationsMedical Record DevelopmentApportionmentDiminished Future Earning Capacity
References
8
Case No. MISSING
Regular Panel Decision

Moskal v. Fleet Bank

Plaintiff Mark Moskal, a jeweler, was robbed in Fleet Bank's basement vault area after being directed by a security guard to use a stairwell due to elevator renovations. Moskal and his wife sued Fleet Bank, the building owner (UOB Realty), managing agent (Axiom Real Estate), security company (Effective Security Systems, Inc.), and contractor (Interior Construction Company), alleging negligence for failure to protect him from foreseeable danger. The court granted summary judgment to UOB, Axiom, Security, and Interior, finding the attack unforeseeable by them and no duty owed. However, Fleet Bank's cross-motion for summary judgment was denied, as the court found questions of fact for a jury regarding Fleet's potential duty to Moskal, given its awareness of the stairwell's danger and its specific policy prohibiting customer use, which was allegedly disregarded.

ForeseeabilityNegligencePremises LiabilitySummary JudgmentDuty of CareCriminal Act of Third PersonsBank SecurityStairwell DangerConstruction NegligenceRobbery
References
18
Case No. MISSING
Regular Panel Decision
Aug 13, 1995

Brier v. City University

The respondent City University of New York's determination, dated August 13, 1995, to dismiss the petitioner from his role as Administrative Superintendent of Campus Buildings and Grounds at Lehman College, effective September 8, 1995, was unanimously confirmed. The petition was denied, and the CPLR article 78 proceeding, transferred from the Supreme Court, New York County, was dismissed. The court found that respondent's conclusions regarding the petitioner's failure to report lost keys, ensure proper facility cleaning and maintenance, and general incompetence were supported by substantial evidence, including testimony from the petitioner, superiors, and co-workers. No grounds were found to overturn the respondent's credibility assessments, and the penalty of dismissal was deemed appropriate, especially considering the petitioner's prior disciplinary history.

Public EmploymentAdministrative LawEmployee MisconductWorkplace DisciplineJudicial ReviewArticle 78 ProceedingLehman CollegeCity University of New YorkTermination of EmploymentSubstantial Evidence
References
1
Case No. ADJ8110632, ADJ8110825
Regular
Apr 26, 2019

DOMINGO HERNANDEZ vs. WMLS, INC., and TWIN CITY FIRE INSURANCE/THE HARTFORD, and SOUTHERN INSURANCE COMPANY, adjusted by MAKEL SERVICES, INC.

Defendant sought reconsideration of an award of future medical treatment for a 2010 back injury, arguing it was erroneous. The Workers' Compensation Appeals Board denied reconsideration, finding the award supported by evidence. Medical evaluations recommended continued home exercises, over-the-counter medication for the back, and cognitive behavioral therapy for the psyche. Labor Code section 4600 mandates provision of all treatment reasonably required to cure or relieve the effects of an industrial injury, which includes recommended conservative care.

Workers Compensation Appeals BoardJoint Findings and AwardPetition for ReconsiderationPanel Qualified Medical EvaluatorPQMEPermanent DisabilityFurther Medical TreatmentLabor Code Section 4600Low Back InjuryPsyche Injury
References
2
Case No. OXN 126995
Regular
Nov 07, 2007

CHARLES DURHAM vs. MISSION LINEN SUPPLY, SECURITY INSURANCE COMPANY OF HARTFORD, FIDELITY AND CASUALTY COMPANY OF CONNECTICUT, ACCELERATED CLAIMS SERVICES, INC

This case involves a workers' compensation claim where the applicant sustained a low back injury. The core dispute centers on whether cognitive behavioral therapy is a compensable medical treatment for the applicant's chronic pain resulting from a failed surgery, despite the defendant's arguments about a non-industrial psychiatric component. The Workers' Compensation Appeals Board denied reconsideration, adopting the Administrative Law Judge's report that emphasized the treating physician and Qualified Medical Examiner recommendations supporting the therapy as essential to relieve the effects of the orthopedic injury.

Cognitive behavioral therapyFailed back surgeryPain managementQualified Medical ExaminerUtilization ReviewLabor Code § 3208.3Labor Code § 4600Labor Code § 4610Labor Code § 4062Compensable psychiatric injury
References
5
Case No. ADJ2593762 (SAC 0363364)
Regular
Jul 13, 2012

RICHARD HODGE vs. DEPENDABLE HIGHWAY EXPRESS, ZURICH NORTH AMERICA INSURANCE

The Workers' Compensation Appeals Board denied reconsideration, upholding the WCJ's decision to provide psychiatric treatment. Even if the need for psychiatric treatment stems from a potentially non-compensable psychiatric injury, the employer remains liable if the treatment is reasonably required to cure or relieve the effects of a compensable industrial injury. In this case, the applicant's psychiatric treatment was deemed necessary to address cognitive impairment caused by a compensable traumatic brain injury. Therefore, the employer is liable for this treatment under established case law, regardless of the nuances of the six-month employment rule.

Labor Code section 3208.3(d)sudden and extraordinary exceptionsix-month employment rulemedical treatmentLabor Code section 4600reasonably requiredcure or relievenon-compensable injurypsychiatric treatmenttraumatic brain injury
References
6
Case No. MISSING
Regular Panel Decision

Claim of Chirino v. Sanitary Controls, Inc.

This case concerns appeals from Workers’ Compensation Board decisions that upheld the State Insurance Fund's cancellation of a workers’ compensation policy for Sanitary Controls, Inc. due to nonpayment. The Fund sent a cancellation notice on November 23, 1976, effective December 11, 1976. Sanitary received it eight days before the effective date. Concurrently, Sanitary filed for bankruptcy, and a court order stayed proceedings against it but did not explicitly stop the policy cancellation. The appeals court affirmed the Board’s decision, holding that service of cancellation is effective upon mailing, not receipt, as per Workers’ Compensation Law § 54, subd 5, and that the bankruptcy filing did not negate Sanitary’s insurance obligations.

Policy CancellationNonpayment of PremiumBankruptcy LawService of NoticeInsurance LiabilityAppellate ProcedureStatutory InterpretationEmployer ObligationsInsurer ObligationsBoard Decisions
References
4
Case No. MISSING
Regular Panel Decision

Textile Workers Pension Fund v. Standard Dye & Finishing Co.

Plaintiff Textile Workers Pension Fund sued Defendant Standard Dye & Finishing Co., Inc. to collect withdrawal assessments under the Multiemployer Pension Plan Amendments Act of 1980 (MPPAA). Standard Dye ceased its primary business operations in June 1980, prior to the MPPAA's effective date of September 26, 1980, but retained a few employees for clean-up and dismantling work through October 1980, for whom pension contributions were made. The core legal issue is whether Standard Dye "completely withdrew" from the pension plan before September 26, 1980, which would eliminate liability due to the Tax Reform Act of 1984. The Court analyzed the meaning of "permanently ceases all covered operations" under 29 U.S.C. § 1383(a), considering similar precedents. The Court found that the retention of a skeleton crew for liquidation activities did not prevent a complete cessation of covered operations. Therefore, Standard Dye effected a complete withdrawal prior to the MPPAA's effective date.

Multiemployer Pension Plan Amendments ActWithdrawal LiabilityPension PlanComplete WithdrawalCovered OperationsTax Reform Act of 1984Retroactive ApplicationSummary JudgmentStatutory InterpretationCollective Bargaining Agreement
References
11
Case No. MISSING
Regular Panel Decision
Apr 10, 1998

Browning v. County Fence Co.

The Supreme Court of Westchester County erred in applying Workers' Compensation Law § 11, as amended, to a third-party action. The appellate court determined that the amendment should be applied prospectively to actions commenced by employees after its effective date. Although the third-party action itself was commenced after the amendment's effective date, the main action by the employee predated it. Consequently, the amendment was deemed inapplicable, leading to the reversal of the order that had dismissed the third-party complaint. The third-party complaint was therefore reinstated.

Personal Injury DamagesThird-Party ClaimsWorkers' Compensation Law § 11Statutory AmendmentsProspective ApplicationAppellate ProcedureMotion to DismissIndemnificationNew York Supreme CourtCase Precedent
References
2
Case No. ADJ3861984
Regular
Sep 23, 2010

GUADALUPE SANTA CRUZ vs. PEP BOYS, GALLAGHER BASSETT ROSEVILLE

This case involves a lien claim by a chiropractor for over $67,000 for treatment provided to an injured worker. The Workers' Compensation Appeals Board (WCAB) affirmed a prior finding that only $66.94 was owed, disallowing the balance of the lien. The WCAB ruled that a statutory amendment effective in 2008 did not apply retroactively to services rendered prior to its effective date. Additionally, the lien claimant failed to prove licensure for physical and occupational therapy, and the stipulated medical treatment and AME opinions did not cover the disputed past services.

Labor Code section 4604.5(d)(3)retrospective applicationmedical treatment utilizationchiropractic visitsphysical therapy visitsoccupational therapy visitslumbar surgerystipulated awardAME reportsACOEM Guidelines
References
2
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