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

Case No. ADJ367164 (AHM 0084399)
Regular
May 15, 2017

GUILLERMINA BALDWIN vs. DELPHI ENERGY & ENGINE MANAGEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For RELIANCE INSURANCE, In Liquidation

The Workers' Compensation Appeals Board granted reconsideration of a prior award of permanent total disability. The Board found that the applicant did not meet the criteria for a conclusive presumption of total disability under Labor Code section 4662(a)(4) as there was no evidence of a qualifying brain injury resulting in severe cognitive impairment. Therefore, the case was returned to the trial level for further proceedings on permanent disability and apportionment, including the development of the record on work functions and vocational rehabilitation.

Workers' Compensation Appeals BoardGUILLERMINA BALDWINDELPHI ENERGY & ENGINE MANAGEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONRELIANCE INSURANCELiquidationADJ367164Permanent Total DisabilityApportionmentLabor Code section 4662(a)(4)
References
2
Case No. ADJ2616452
Regular
Feb 19, 2009

Alicia Montgomery vs. Tip Top Meats European Deli, Commercial Casualty Insurance Company

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award. The Board found the medical record insufficient to support the finding of permanent total disability, specifically lacking evidence on how applicant's medications affected her cognitive function. The case was returned to the trial level for further development of the medical record to address this deficiency. The Board also noted that pre-existing non-industrial factors cannot be solely relied upon for vocational rehabilitation non-feasibility.

Permanent Total DisabilityVocational RehabilitationMedical Record DevelopmentMedication EffectsCognitive FunctioningIntellectual AbilitiesPain BehaviorsFunctional Capacity EvaluationApportionmentLeBoeuf
References
6
Case No. MISSING
Regular Panel Decision

Colegrove v. Colvin

Plaintiff Scott Wilbur Colegrove seeks judicial review of the denial of disability insurance benefits by the Commissioner of Social Security, alleging the Administrative Law Judge's decision lacked substantial evidence. The Court denied the Commissioner's motion and partially granted Plaintiff's motion, remanding the case for further administrative proceedings. The remand is primarily due to the ALJ's failure to properly weigh the opinions of treating physician Dr. Walters and neuropsychologist Dr. Fleeman, particularly concerning cognitive impairments and functional limitations from seizures and back pain. The court also ordered a reevaluation of Plaintiff's credibility and the Step 5 determination regarding available jobs in the national economy.

Disability Insurance BenefitsSocial Security ActAdministrative Law JudgeResidual Functional CapacityTreating Physician RuleCredibility AssessmentVocational Expert TestimonySeizure DisorderDepressionChronic Back Pain
References
18
Case No. MISSING
Regular Panel Decision

In re Adam NN.

The case involves an appeal from an order of the Family Court of Chemung County that terminated the parental rights of Jennifer NN. (mother) and Frederick NN. (father) to their child, Adam NN., pursuant to Social Services Law § 384-b, on the grounds of mental retardation. Adam was removed from his parents' care shortly after birth. Despite respondents' consistent attendance at supervised visitations, their parenting skills showed limited improvement. Psychological evaluations indicated both parents had subaverage intellectual functioning; the father's IQ was 50 (moderately mentally retarded), and the mother's was 63 (mildly mentally retarded). Experts testified that due to their cognitive deficiencies and impaired adaptive behavior, neither parent could provide proper and adequate care for Adam, who also has special needs, without significant risk of neglect. The appellate court affirmed the Family Court's decision, concluding there was clear and convincing evidence to support the termination of parental rights.

Parental rights terminationmental retardationchild neglectSocial Services LawIQ assessmentchild welfarespecial needs childFamily Court appealparental fitness
References
4
Case No. MISSING
Regular Panel Decision

Fox News Network, LLC v. Tveyes, Inc.

Fox News Network, LLC filed a copyright infringement lawsuit against TVEyes, Inc., a media-monitoring service. The district court previously upheld TVEyes' core service as fair use but reserved judgment on four specific features: archiving, e-mailing, downloading, and date-time search. In this renewed decision, the court ruled that TVEyes' archiving function is fair use. The e-mailing function can also be fair use, provided TVEyes implements adequate protective measures. However, the court found that the downloading and date-time search functions are not fair use, concluding they go beyond TVEyes' transformative purpose and pose undue risks to Fox News' copyrights and derivative businesses.

Copyright InfringementFair Use DefenseMedia MonitoringTransformative UseSummary JudgmentArchivingEmail SharingVideo DownloadingDate-Time SearchDigital Rights
References
23
Case No. MISSING
Regular Panel Decision

Guttierez v. Berryhill

Betsy Lee Guttierez applied for disability insurance benefits and Supplemental Security Income, alleging disability due to various mental health impairments. Her applications were denied by an Administrative Law Judge and the Appeals Council. Guttierez sought judicial review, arguing that the ALJ failed to properly assess her residual functional capacity (RFC) by rejecting the only medical opinion on her mental ability to work without providing adequate reasons or a function-by-function analysis. The Court agreed, finding the ALJ's RFC assessment unsupported by substantial evidence, as the ALJ, a non-medical professional, made a determination of Guttierez's mental capacity without relying on a medical opinion. Consequently, the Court granted Guttierez's motion, denied the Commissioner's motion, and remanded the case for further administrative proceedings.

Social Security ActDisability BenefitsSSIALJ Decision ReviewRFC AssessmentMedical EvidenceMental Health ImpairmentsBipolar DisorderAnxiety DisorderTreating Physician Rule
References
13
Case No. MISSING
Regular Panel Decision
Jun 27, 2013

Karabinas v. Colvin

Dimitrios N. Karabinas challenged the Commissioner of Social Security's denial of his Disability Insurance Benefits application, arguing the Administrative Law Judge (ALJ) committed several legal errors. The court identified flaws in the ALJ's Residual Functional Capacity (RFC) assessment, including failure to accommodate Karabinas's moderate difficulties in concentration, persistence, and pace, and an incomplete function-by-function analysis of his work abilities. Furthermore, the court found the ALJ improperly weighed medical opinions, specifically downplaying the detailed report from Karabinas's chiropractor, and based its credibility determination on a circular logic. Concluding that the ALJ's errors led to an unsupported denial of benefits, the District Court reversed the Commissioner's decision. The case was remanded for the sole purpose of calculating and providing benefits to Karabinas for the specified period.

Disability Insurance BenefitsSocial Security ActRFC AssessmentMedical OpinionCredibility AssessmentVocational ExpertCervical Disc ProblemsPain ManagementChiropractic TreatmentWork Limitations
References
34
Case No. MISSING
Regular Panel Decision

Matejka v. Barnhart

Plaintiff, Ms. Matejka, alleging disability since March 31, 2000, applied for Disability Insurance Benefits, which was denied by an Administrative Law Judge (ALJ). The plaintiff sought review in District Court, arguing the ALJ's decision lacked sufficient inquiry into past relevant work, a reasoned finding on credibility, a proper residual functional capacity assessment, and a correct determination of the severity of her depression. The District Court found the ALJ's conclusions not supported by substantial evidence due to these deficiencies, particularly regarding the exertional requirements of past work, the evaluation of the plaintiff's credibility, the lack of a function-by-function RFC analysis, and the failure to adequately assess the severity of her depression, especially in light of uncontradicted medical opinions. Consequently, the Court reversed the Commissioner's decision and remanded the case for a new hearing consistent with its findings.

Disability Insurance BenefitsAdministrative Law JudgeResidual Functional CapacityCredibility AssessmentMedical EvidencePsychological AssessmentSpinal StenosisChronic Back PainDepressionRemand
References
24
Case No. CV-22-2032
Regular Panel Decision
Mar 14, 2024

In the Matter of the Claim of John Deliso

This case involves an appeal from decisions of the Workers' Compensation Board regarding a claim filed by John Deliso, a maintenance supervisor, for work-related repetitive stress injuries. The claim for bilateral carpal tunnel syndrome and repetitive stress injuries to wrists and shoulders was established. However, the employer alleged a violation of Workers' Compensation Law § 114-a, providing surveillance videos that contradicted Deliso's reported functional abilities during permanency evaluations by his treating physician, Christopher Kyriakides. An independent medical examination by Sean Lager also found no functional impairment and symptom magnification. The Workers' Compensation Law Judge, affirmed by the Board, found that Deliso made material misrepresentations regarding his functional abilities, thus violating Workers' Compensation Law § 114-a. The Appellate Division affirmed the Board's decision, concluding that substantial evidence supported the finding of material misrepresentations and upholding the discretionary disqualification from future wage replacement benefits due to the egregious nature of the deception.

Workers' CompensationFraudMisrepresentationSurveillance EvidenceMedical EvaluationSchedule Loss of UseDisqualificationOccupational DiseaseAppellate ReviewMaterial Fact
References
12
Case No. MISSING
Regular Panel Decision

Claim of Giudi v. New Paltz Fire Department

The Workers' Compensation Board's finding that the claimant remains unable to perform their prior employment duties as a chef, or those of a reasonable substitute, due to cognitive impairments, is supported by substantial evidence. This evidence includes the claimant's testimony and the opinion of a clinical neuropsychologist, who stated that the cognitive impairments prevent the claimant from working as a chef or military police officer. The Board's crediting of this evidence, which justified the finding of over 75% earning capacity loss, was upheld. The employer's argument that the Board applied an incorrect legal standard was rejected. The decision is affirmed.

cognitive impairmentsearning capacity lossdisability benefitsneuropsychologyoccupational injurymedical opinionappellate reviewsubstantial evidenceworkers' compensation lawemployment duties
References
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