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

Case No. ADJ6776516
Regular
May 30, 2017

FRANCIS HARGREAVES vs. SOUTHWEST AIRLINES, ACE USA INSURANCE CO.

This case involves an applicant seeking workers' compensation benefits for injuries sustained on the job, including to his back, left shoulder, left wrist, and psyche, as well as complex regional pain syndrome, coronary artery disease, and a sleep disorder. The defendant sought reconsideration of the initial award, arguing that the medical evidence did not support the $90\%$ permanent disability finding. The Appeals Board granted reconsideration, affirming the findings of injury and treatment for Complex Regional Pain Syndrome but reducing the permanent disability to $88\%$ by excluding the sleep disorder impairment due to insufficient objective evidence. The applicant's permanent disability payments were recalculated and ordered to commence from January 21, 2011.

Workers' Compensation Appeals BoardFrancis HargreavesSouthwest AirlinesACE USA Insurance Co.Sedgwick CMSADJ6776516Opinion and Order Granting Petition for ReconsiderationFindings Award and OrderAOE/COEback injury
References
1
Case No. 524271
Regular Panel Decision
Sep 06, 2018

Matter of Kemraj v. Garelick Farms

Claimant Balram Kemraj sustained a work-related injury to his left shoulder in 2005. He was initially awarded workers' compensation benefits, but his schedule loss of use was later rescinded, and the claim was amended to include complex regional pain syndrome. A Workers' Compensation Law Judge found no further causally-related disability after September 16, 2013, a decision affirmed by the Workers' Compensation Board. On appeal, the Appellate Division affirmed the Board's decision, finding substantial evidence to support it. The court relied on the opinion of neurologist Sheldon Staunton, who conducted an independent medical examination and concluded that the claimant had no objective neurological problems, was exaggerating symptoms, exhibited no signs of complex regional pain syndrome, and could return to work immediately.

Workers' Compensation BenefitsCausally-Related DisabilityIndependent Medical Examination (IME)Complex Regional Pain SyndromeSchedule Loss of UseSubstantial EvidenceAppellate ReviewMedical CredibilityShoulder InjuryReturn to Work
References
7
Case No. MISSING
Regular Panel Decision

Ley v. Rochester Regional Joint Board, Local 14A

Rhonda P. Ley, Regional Director of the National Labor Relations Board, filed a petition against the Rochester Regional Joint Board, Local 14A (Union) seeking a preliminary injunction. Ley alleged that Article XXII of the collective bargaining agreement between the Union and Xerox Corporation (Employer) constituted an unlawful 'union signatory' agreement under Section 8(e) of the National Labor Relations Act. Furthermore, Ley claimed that the Union's continued attempts to enforce Article XXII violated Sections 8(b)(4)(ii)(A) and (B) of the Act. The Union argued that Article XXII was a lawful work preservation provision. The Court found reasonable cause to believe the Union was violating the Act and that a preliminary injunction was just and proper to prevent further statutory violations and maintain public interest. Consequently, the preliminary injunction was granted, enjoining the Union from enforcing Article XXII.

Labor LawPreliminary InjunctionUnfair Labor PracticeNational Labor Relations ActUnion Signatory AgreementWork PreservationCollective Bargaining AgreementSubcontractingArbitrationDistrict Court
References
11
Case No. ADJ3361459
Regular
Oct 15, 2012

Christiane Flynn vs. YOLANDA'S OF VENTURA, AMERICAN HOME ASSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration and amended its prior decision regarding Christiane Flynn's injury. The applicant sustained injuries including right shoulder, brachial nerve, upper extremities, thoracic outlet syndrome, complex regional pain syndrome, psyche, and fibromyalgia. Her permanent disability was found to be 100% total, entitling her to weekly indemnity payments. A substantial attorney fee of $47,451.89 was deemed reasonable and ordered payable.

Christiane FlynnYolanda's of VenturaAmerican Home AssuranceAIG Claim ServicesADJ3361459VEN 0112129ReconsiderationAdministrative Law JudgeWaitressOccupational Group 322
References
0
Case No. ADJ8731635
Regular
Apr 02, 2019

Daissy Contreras vs. CRESTWOOD BEHAVIORAL HEALTH, UNION FIRE INSURANCE COMPANY

The Appeals Board granted reconsideration and rescinded the prior award, finding the medical record inadequate to determine applicant's claim of Complex Regional Pain Syndrome (CRPS). While some physicians noted symptoms consistent with CRPS, the Agreed Medical Examiner (AME) found no objective evidence. The Board ordered the matter returned to the trial level for further development of the medical record by appointing a pain management specialist. This new evaluation will aim to diagnose the applicant's right upper extremity condition and determine its industrial causation.

Complex Regional Pain SyndromeCRPSskin injuryrashcumulative traumaAgreed Medical ExaminerAMEskin conditionright upper extremitypain management specialist
References
4
Case No. ADJ8376717
Regular
Apr 12, 2019

SOOHYUN KIM vs. VALENTINO, Permissibly Self-Insured, Administered By GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board (WCAB) affirmed the finding of industrial injury for Complex Regional Pain Syndrome (CRPS) but rescinded the finding of chronic pain. The WCAB also rescinded the finding of permanent and total disability, finding the medical evidence supported a scheduled disability rating between 64-81%. The vocational expert's opinion was deemed insufficient to rebut the scheduled rating or establish permanent total disability. The case was returned to the trial level for further proceedings and a new permanent disability finding based on the medical reports.

Complex Regional Pain SyndromeCRPSIndustrial InjuryPermanent and Total DisabilityReconsiderationVocational ExpertMedical EvidencePermanent Disability RatingAMA GuidesLabor Code
References
14
Case No. ADJ9870934, ADJ9870932
Regular
Mar 13, 2019

Julio Espana vs. STOCKTON UNIFIED SCHOOL DISTRICT, YORK RISK SERVICES GROUP

The Workers' Compensation Appeals Board rescinded the previous award and returned the case for further development of the record. The applicant claims his post-surgery disability, resembling Complex Regional Pain Syndrome, arose directly from treatment for his industrial injuries, arguing for an unapportioned award per *Hikida*. Medical evidence suggests a possible complication from the surgery caused increased pain and disability, but the extent to which this surgery directly caused the applicant's permanent disability requires further evaluation. Therefore, the case is remanded for an Agreed Medical Examiner to determine causation, diagnosis, and apportionment.

Workers' Compensation Appeals BoardPetition for ReconsiderationIndustrial InjuryPermanent Disability RatingUnapportioned AwardComplex Regional Pain SyndromeAMA GuidesQualified Medical EvaluatorMedical Malpractice LawsuitSpinal Surgery Complication
References
2
Case No. 2018 NY Slip Op 04413 [162 AD3d 1286]
Regular Panel Decision
Jun 14, 2018

Matter of Tobin v. Finger Lakes DDSO

Kristi M. Tobin, a support aide, sustained injuries in April 2012 after being assaulted by a client, leading to a workers' compensation claim established for various injuries including reflex sympathetic dystrophy (RSD)/complex regional pain syndrome (CRPS) of her right face. A Workers' Compensation Law Judge initially awarded schedule loss of use for vision loss and facial disfigurement. The Workers' Compensation Board reversed this decision, classifying claimant's RSD/CRPS and ptosis as a nonschedule permanent partial disability under Workers' Compensation Law § 15 (3) (w), rescinding the prior awards, and remitting the case for further record development regarding loss of wage-earning capacity. The Appellate Division, Third Department, affirmed the Board's determination, finding substantial medical evidence supported the nonschedulable permanent partial disability classification due to the claimant's ongoing chronic pain and worsening ptosis, consistent with not receiving both schedule loss of use and nonschedule permanent partial disability awards for the same work-related accident.

Workers' Compensation LawPermanent Partial DisabilitySchedule Loss of UseReflex Sympathetic Dystrophy (RSD)Complex Regional Pain Syndrome (CRPS)Facial DisfigurementWage-Earning CapacityAppellate ReviewMedical EvidenceSubstantial Evidence
References
9
Case No. ADJ7069357
Regular
Dec 19, 2013

CHERYL MCMILLIN, MERYL MCMILLIN vs. MONSANTO COMPANY – SEMINIS, ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Monsanto's petition for reconsideration. The Board adopted the Administrative Law Judge's report, which found that the applicant sustained injury arising out of and in the course of employment, including Complex Regional Pain Syndrome, and was permanently and totally disabled. The Board also admonished defense counsel for citing unpublished cases and failing to properly reference the record, and denied their accompanying petition for a stay.

Petition for ReconsiderationWCAB Rule 10856WCAB Rule 10846WCAB Rule 10842Petition for StayPetition for Removalsurveillance filmsnewly discovered evidencefraudcumulative trauma
References
1
Case No. ADJ3516579 (VNO 0523127)
Regular
Jan 30, 2012

KELLY WHELIHAN vs. CBS RADIO, MURPHY AND BEANE (TPA)

This case involved a defendant seeking reconsideration of a workers' compensation award for an industrial injury including bilateral wrists, neck, psyche, and complex regional pain syndrome. The defendant argued the administrative law judge erred by relying on one medical opinion over another for temporary disability benefits. However, both the Petition for Reconsideration and the Petition for Removal were dismissed. The Appeals Board found both petitions to be untimely filed based on the dates of service and filing.

Workers' Compensation Appeals BoardReconsiderationRemovalFindings and AwardTemporary DisabilityIndustrial InjuryBilateral WristsNeckPsycheComplex Regional Pain Syndrome
References
2
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