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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Antonetti v. Barnhart

This case involves Eliabnel Antonetti's appeal of the Commissioner of Social Security's final determination that he is not disabled, seeking Supplemental Security Income benefits. The Commissioner conceded legal errors by the Administrative Law Judge (ALJ) in evaluating Antonetti's mental retardation and speech impairment, moving for a remand for a new hearing and reevaluation. Antonetti, while agreeing on the need for reversal, sought remand solely for the calculation and payment of benefits due to what he believed was substantial evidence of disability. The District Court granted the Commissioner's motion, denied Antonetti's, and remanded the case for further administrative proceedings, directing the ALJ to properly assess IQ tests, speech impairments, and their impact on work-related functional limitations using the "severity test" under Section 12.05C of the Listing of Impairments. The court also highlighted the need to develop a complete administrative record due to inaudible portions in the prior hearing transcript.

Disability BenefitsSupplemental Security IncomeSocial Security ActMental RetardationSpeech ImpairmentIQ TestsALJ ErrorRemandAdministrative RecordSeverity Test
References
16
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
5
Case No. ADJ1880234 (GOL 0097047)
Regular
Oct 06, 2014

HSING TEREK vs. EMBASSY SUITES/WINDSOR CAPITAL GROUP

In this workers' compensation case, the applicant suffered an admitted industrial injury from a slip and fall as a housekeeper. The defendant sought reconsideration of the findings of total permanent disability and injury to the "psyche, head, internal, and neurological/cognitive impairment." The Appeals Board granted reconsideration to address the ambiguity of the "internal" injury finding, which they found insufficiently specified. While affirming the total permanent disability finding and injury to psyche, head, and neurological/cognitive impairment, the Board rescinded the "internal" injury finding and returned the case for further proceedings to clarify the specific internal systems or conditions injured.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardIndustrial InjuryPsycheNeurological/Cognitive ImpairmentTotal Permanent DisabilityApportionmentHousekeeperSlip and Fall
References
1
Case No. 2014-1493 W CR
Regular Panel Decision
Aug 01, 2016

People v. Oliva (Edward)

Edward P. Oliva appealed convictions for driving while ability impaired and two counts of passing a red signal. The Appellate Term, Second Department, dismissed the appeal concerning passing a red signal as abandoned due to lack of raised issues. The judgment convicting Oliva of driving while ability impaired was affirmed. The court found sufficient evidence to support the conviction, noting that Oliva consumed alcohol, exhibited signs of impairment such as glassy eyes and slurred speech, fled an accident scene at high speed, and refused a breath test. Oliva's defense, attributing his condition to fatigue and shock, was deemed meritless by the court.

Driving While Ability Impaired (DWAI)Vehicle and Traffic Law ViolationsAppellate Review of ConvictionSufficiency of EvidenceRefusal to Submit to Chemical TestConsciousness of GuiltLesser-Included OffensePolice ChaseOperating a Motor Vehicle Under InfluenceTraffic Accident
References
19
Case No. ADJ10558753
Regular
Apr 25, 2018

DIANE SCHRADER vs. THE HETTENA LAW FIRM, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The applicant sought to set aside a Compromise and Release (C&R) settlement, alleging severe cognitive impairment at the time of signing. The Workers' Compensation Appeals Board (WCAB) denied reconsideration of the original decision. The WCAB found that the physician's report, which formed the basis of the applicant's claim of impairment, was speculative as the physician was not present at the settlement. Furthermore, the WCAB deferred to the administrative law judge's credibility determination, who found the claims of incompetence not credible.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact & OrderCompromise and ReleaseOrder Approving Compromise and ReleaseSet AsideGood CauseCognitive ImpairmentSubstantial EvidencePrimary Treating Physician
References
3
Case No. ADJ6619965 ADJ9843987
Regular
Jul 16, 2018

JESUS ZARAGOZA vs. KOOL KOUNTRY, LLC, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Board granted reconsideration to review the finding of injury to the bladder, sleep disorder, sexual dysfunction, and cognitive disability/headaches, as well as the applicant's earnings. The Board affirmed the finding of injury to the bladder, sleep disorder, and sexual dysfunction but reversed the finding of injury related to cognitive impairment/headaches, finding insufficient medical evidence. Additionally, the Board amended the applicant's earnings to $270.00 per week, based on the parties' stipulation regarding the permanent disability rate, and affirmed the overall award except for these specific modifications.

Workers' Compensation Appeals BoardReconsiderationFindings of FactAwardAdministrative Law JudgePermanent DisabilityAverage Weekly EarningsStipulationAgreed Medical ExaminerQualified Medical Examiner
References
0
Case No. ADJ7449576
Regular
May 11, 2016

MANNY WINNINGHAM vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS

This case concerns an applicant seeking total permanent disability benefits based on a brain injury. The applicant argued for conclusive total disability under Labor Code section 4662(a)(4) due to permanent mental incapacity. The Board affirmed the WCJ's finding that while the applicant suffered serious psychiatric impairments leading to overall total disability, the specific cognitive impairments did not meet the threshold for the *conclusive* presumption of total disability under section 4662(a)(4). Therefore, apportionment was still applicable, and the previous award of $84\%$ permanent disability was upheld.

Permanent total disabilityLabor Code section 4662(a)(4)Conclusive presumptionApportionmentBrain injuryPermanent mental incapacityGlobal Assessment of Functioning ScaleCognitive impairmentPsychiatric impairmentCorrectional officer
References
1
Case No. MISSING
Regular Panel Decision

the Claim of Brigandi v. Town & Country Linoleum & Carpet

This case involves an appeal by an employer and its compensation carrier against decisions made by the Workers’ Compensation Board. The decedent, a carpet layer, died from cardiac arrest during work, with an autopsy revealing underlying coronary atherosclerotic disease. His widow was awarded death benefits. The employer’s carrier sought reimbursement from the Special Disability Fund under Workers’ Compensation Law § 15 (8), asserting a preexisting permanent physical impairment. However, the Board determined that there was no evidence that the decedent’s heart condition hindered his job potential before his death, thus releasing the Special Disability Fund from liability and holding the compensation carrier responsible. The employer's subsequent application for reconsideration was denied by the Board, leading to these appeals. The appellate court affirmed the Board's decisions, concluding that the Board rationally found no proof that the decedent's heart disease impaired his job potential, a necessary condition for reimbursement under WCL § 15 (8) (d).

Special Disability FundPreexisting Permanent ImpairmentCardiac ArrestCoronary Atherosclerotic DiseaseDeath Benefits ClaimEmployer ReimbursementCarrier LiabilityBoard Decision ReviewAppellate AffirmationMedical Evidence Interpretation
References
2
Case No. ADJ11269770
Regular
Mar 08, 2023

RYAN GASKINS vs. WET DIRT INC., NATIONAL FIRE AND LIABILITY INSURANCE COMPANY, GALLAGHER BASSETT

The Workers' Compensation Appeals Board affirmed the original finding of 100% permanent total disability for the applicant, Ryan Gaskins, due to a work-related brain injury. Despite the defendant's contention that medical evidence did not explicitly state "permanent mental incapacity," the Board adopted the WCJ's reasoning that the physicians' reports detailing severe cognitive impairment and need for continuous 24/7 care constituted substantial evidence. The Board amended the award to correctly identify the insurer as National Liability and Fire Insurance Company and removed the administrator Gallagher Bassett. The defendant's arguments regarding the AMA Guides impairment rating were rejected as inconsistent with the medical findings of total disability.

Permanent mental incapacityLabor Code section 4662(a)(4)Permanent total disabilityTraumatic brain injuryPanel Qualified Medical EvaluatorAMA GuidelinesVocational rehabilitationAOE/COECraniotomySeizure disorder
References
2
Case No. MISSING
Regular Panel Decision

Claim of Milner v. Country Developers, Inc.

The Special Disability Fund appealed decisions by the Workmen’s Compensation Board which imposed liability on the Fund for a claimant's injuries. The Board found that the employer, Country Developers, continued to employ the claimant, a carpenter, with knowledge of his pre-existing permanent physical impairment, triggering liability under subdivision 8 of section 15 of the Workmen’s Compensation Law. The claimant suffered a fracture of the nose and a hip dislocation in 1964, having a history of three ruptured disc surgeries and other conditions. The appeal centered on whether the employer had sufficient knowledge of the claimant’s permanent condition. Testimony from the employer’s foreman, Mr. Pahlck, indicated awareness of the claimant's back issues, including wearing a back brace and being favored by co-workers. The court affirmed the Board’s decision, reiterating that employer knowledge is a question of fact for the Board, and its findings, if supported by substantial evidence, will not be disturbed.

Workers' Compensation LawSpecial Disability FundEmployer LiabilityPre-existing Permanent ImpairmentEmployer KnowledgeSubstantial EvidencePermanent Partial DisabilityFracture of NoseHip DislocationRuptured Discs
References
3
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