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Case Law Database

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

Case No. ADJ10013104
Regular
Sep 19, 2018

MARIA GARCIA vs. TATUNG COMPANY OF AMERICA, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of a prior order that stayed Mesa Pharmacy's lien based on Labor Code section 4615. This case was consolidated with over 19,000 others to address common issues regarding whether Mesa Pharmacy's liens fall under section 4615. The Board rescinded the prior findings regarding Mesa's lien and returned the matter to the trial level for further proceedings within the consolidated case. This ensures Mesa has an opportunity to be heard on the section 4615 issue in conjunction with the broader litigation.

Labor Code section 4615Lien claimantPetition for ReconsiderationOrder of ConsolidationWCAB Rule 10589Master fileCommon issues of fact and lawOwnership and controlCriminal proceedingsStipulation
References
6
Case No. ADJ9971330
Regular
Nov 13, 2017

MARIA ROCHIN vs. DIANA'S MEXICAN FOOD PRODUCTS INC, CARL WARREN \& COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address disputes over temporary and permanent disability, apportionment, and further medical treatment. The WCAB found that the trial judge's reliance on medical reports was not substantial evidence due to incomplete medical histories, incorrect dates of injury, and lack of explanation for the delayed onset of disability. Consequently, the WCAB rescinded the findings on these issues and returned the case for further development of the medical record and new findings. The EDD lien determination was also deferred to be revisited in conjunction with the new findings on disability.

Workers' Compensation Appeals BoardADJ9971330Opinion and Decision After ReconsiderationTemporary Total DisabilityPermanent DisabilityApportionmentFurther Medical TreatmentEmployment Development Department (EDD) lienAttorney's FeeStatute of Limitations
References
6
Case No. ADJ4418771 (FRE 0242974)
Regular
Oct 08, 2019

FIDELA GARCIA vs. GCA PRODUCTION SERVICES, EMPLOYERS INSURANCE OF WAUSAU

The Workers' Compensation Appeals Board (WCAB) rescinded the trial judge's order denying a Petition for Determination of Non-IBR Medical-Legal Dispute. The WCAB found the trial judge's decision lacked supporting evidence regarding the fee schedule's applicability to petitioner's copy services performed in 2016. Additionally, the WCAB noted that WCAB Rule 10451.1(c)(3)(D) does not require medical-legal providers to file a lien in conjunction with such a petition. The case is returned to the trial level for further proceedings and development of the record.

Petition for Non-IBR DisputeWCAB Rule 10451.1(c)(3)(D)medical-legal providercopy servicesfee scheduleLabor Code section 5313Report and Recommendation on Petition for ReconsiderationrescindedAD Rules 9980-9983petition for removal
References
3
Case No. ADJ8875115
Regular
Nov 26, 2013

PHAEDRA SERRANO vs. SKYWEST AIRLINES, ACE AMERICAN INSURANCE, SEDGWICK CLAIMS MANAGEMENT

The applicant, Phaedra Serrano, sought temporary disability indemnity for the period from May 29, 2013, to September 19, 2013. The Workers' Compensation Appeals Board denied her petition for reconsideration of the original finding that she was not entitled to this indemnity. The Board adopted the judge's report, which found that Serrano tacitly refused an offer of modified employment by failing to promptly notify her employer of her inability to access her work due to badge and parking issues. This failure to communicate, in conjunction with her prior "no-show" instances, was deemed equivalent to a refusal of employment, thus precluding temporary disability benefits.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary Disability IndemnityModified EmploymentRefusal of EmploymentNo Call/No ShowSIDA BadgeParking PassJob AbandonmentTermination
References
7
Case No. MISSING
Regular Panel Decision
Apr 03, 1986

Soto v. City of New York

Wilfredo Soto, an epileptic, participated in the Public Works Program in conjunction with the New York City Department of Social Services, working for the Department of Transportation. In May 1979, he suffered a seizure on a work bus, fell out, and sustained a fractured spine, rendering him paraplegic. Soto appealed a judgment, claiming errors in jury instructions regarding comparative fault, where he was found 70% at fault and the City of New York 30%. The court affirmed the judgment, finding the jury instructions on comparative fault were proper and Soto's remaining contentions were without merit. The City of New York's cross-appeal for dismissal of Soto's cause of action was also denied.

Personal InjuryComparative FaultJury InstructionsParaplegiaEpilepsyPublic Works ProgramNegligenceAppellate ReviewKings CountyNew York City
References
1
Case No. 2018 NY Slip Op 08400 [167 AD3d 1128]
Regular Panel Decision
Dec 06, 2018

Matter of Byrnes v. New Is. Hosp.

Claimant Jenmarie Byrnes suffered work-related injuries to her back, right shoulder, and left hip in 2000, receiving workers' compensation benefits. Her claim was later amended to include consequential injuries. In 2016, the employer and its carrier challenged the medical necessity of her continued, long-term use of the prescription medication Amrix, citing recommendations for short-term use. Claimant's treating physician testified that Amrix, in conjunction with other therapies, had positively impacted her ability to perform daily activities and continue working. A Workers' Compensation Law Judge and subsequently the Workers' Compensation Board affirmed the medical necessity. The Appellate Division affirmed the Board's decision, finding it was supported by substantial evidence, as the Board was empowered to resolve conflicting medical evidence.

Workers' CompensationMedical NecessityPrescription Drug UseAmrixConflicting Medical EvidenceTreating Physician OpinionEmployer ChallengeAppellate ReviewBoard DecisionMuscle Relaxant
References
4
Case No. MISSING
Regular Panel Decision
Jun 07, 1984

People v. Charles

The defendant, a court clerk in New York City, was convicted of bribe receiving in the second degree after an undercover agent, posing as a taxi driver, sought help with traffic summonses. The defendant allegedly accepted $100 to dismiss an "uninsured" vehicle ticket, which was later found to be invalid regardless of his actions. The appeal addresses whether the evidence sufficiently established the bribe influenced his actions "as a public servant" and if the jury instructions, which varied from the indictment's conjunctive language, prejudiced the defense. The court affirmed the conviction, holding that "colorable authority" is sufficient for the crime and that the instructions correctly allowed for a finding of guilt based on any one of the charged acts (solicitation, agreement, or acceptance). The court also upheld its prior ruling against required hearings for peremptory challenges to jurors.

bribe receivingpublic servantcourt clerktraffic summonsescolorable authorityjury instructionsindictment varianceappellate reviewNew York Court of Appealscriminal procedure
References
19
Case No. 2017-913 K C
Regular Panel Decision
Aug 02, 2019

Oriental Health Acupuncture, P.C. v. State Farm Mut. Auto. Ins. Co.

This case concerns an appeal initiated by Oriental Health Acupuncture, P.C., acting as the assignee of Carrington, Earnel, against State Farm Mutual Automobile Ins. Co. The appeal originated from an order by the Civil Court of the City of New York, Kings County, which had granted State Farm's motion for summary judgment and dismissed the plaintiff's complaint seeking first-party no-fault benefits. The Civil Court's decision was predicated on the finding that the amounts claimed by the plaintiff exceeded the limits established by the workers' compensation fee schedule. The Appellate Term, Second Department, affirmed the lower court's order. This decision was made in conjunction with a related case, BQE Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co., decided concurrently.

No-fault benefitsSummary judgmentAppellate reviewWorkers' compensation fee scheduleAutomobile insuranceFirst-party benefitsMedical provider claimAssigned benefitsCivil Court appealAppellate Term decision
References
1
Case No. MISSING
Regular Panel Decision

People v. Fratt

The defendant, charged with second-degree murder, provided notice of intent to present psychiatric evidence from Dr. Martha Rosen, a defense-retained psychologist, who would testify about dependent personality disorder and 'battered woman's syndrome.' The prosecution subsequently moved for an order compelling Dr. Rosen to prepare a report outlining her findings and evaluations, and for the discovery of her notes. The court granted the prosecution's motion, ruling that the defendant waived psychologist-patient privilege by placing her mental state at issue. The court further held that CPL 250.10, read in conjunction with CPLR 3101(d), requires the defense to provide a detailed notice of psychiatric evidence, including expert qualifications, examination details, relied-upon materials, diagnostic opinions, and the bases for those opinions. The court denied the motion for a pretrial hearing as premature.

Psychiatric EvidenceDiscoveryExpert TestimonyPsychologist-Patient PrivilegeWaiver of PrivilegeCriminal Procedure LawCivil Practice Law and RulesMental StateBattered Woman's SyndromeForensic Evaluation
References
14
Case No. MISSING
Regular Panel Decision
Jul 25, 2001

Claim of Multari v. Keenan Oil Co.

The claimant appealed a Workers' Compensation Board decision from July 25, 2001, which found that a section 32 waiver agreement included his major depression condition. The claimant had settled two compensation cases from 1972 and 1994 for $93,000, closing both. He later argued the agreement failed to cover his major depression, established in 1996 in conjunction with the 1994 accident. The Board affirmed its jurisdiction and rejected the claimant's contention that the major depression was excluded. The appellate court agreed the Board had jurisdiction to determine if a condition was included in a section 32 agreement. On the merits, the court found the Board correctly concluded the major depression condition was subsumed in the settlement, citing the agreement's unequivocal terms and the claimant's hearing testimony. The agreement stated cases could not be reopened "for any purpose whatsoever" and permanently discontinued weekly benefits that included compensation for depression.

Workers' CompensationSettlement AgreementWaiver AgreementMajor DepressionPsychiatric ConditionJurisdictionSection 32 AgreementAppealBoard ReviewScope of Agreement
References
4
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