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

Case No. ADJ6765018
Regular
Nov 13, 2015

MARTIN GUERRERO vs. McKESSON CORPORATION, OLD REPUBLIC INSURANCE

The Appeals Board reversed the WCJ's decision, holding that the statutory timeframes for Independent Medical Review (IMR) determinations are directory, not mandatory. Therefore, IMR decisions issued late are still valid and binding on the applicant. The Board concluded that the Legislature's intent was for IMR to be the sole avenue for resolving medical treatment disputes post-utilization review, ensuring consistent application of evidence-based standards. The case was returned to the trial level for further proceedings consistent with this decision.

Independent Medical ReviewIMRAdministrative DirectorLabor Code Section 4610.6Directory vs. Mandatory TimeframesMedical Treatment DisputesUtilization ReviewMedical NecessityWorkers' Compensation Appeals BoardSB 863
References
22
Case No. MISSING
Regular Panel Decision

Catapano v. Jow, Inc.

The Board affirmed its prior decision regarding the waiver of a carrier's right to reimbursement from the Fund under Workers’ Compensation Law § 15 (8) (d). The principle states that a carrier waives its right to reimbursement if it fails to obtain the Fund’s consent to a settlement. The Board found the current case factually indistinguishable from previous rulings and applied the precedent consistently. The court upheld the Board's decision, deeming it a rational and consistent interpretation and application of the relevant statute, specifically referencing Workers’ Compensation Law § 29.

Workers' CompensationReimbursement WaiverFund ConsentSettlement AgreementBoard DecisionStatutory InterpretationCarrier LiabilityPrior PrecedentJudicial ReviewAdministrative Law
References
4
Case No. ADJ8492547
Regular
Oct 18, 2019

HECTOR ACEVEDO vs. SUN HO CORPORATION dba TREIU CHAU RESTAURANT, FARMERS TRUCK INSURANCE EXCHANGE

The Workers' Compensation Appeals Board rescinded the prior findings that National Script Pharmacy's lien was stayed under Labor Code section 4615. This case, along with others involving National Script Pharmacy, has been consolidated into a master file to address common factual and legal issues regarding the applicability of section 4615. The matter is returned to the trial level for further proceedings consistent with the consolidation order, allowing all parties to be heard. This decision ensures consistent rulings and judicial economy given the complex ownership and criminal proceeding issues surrounding the lien claimant.

Workers' Compensation Appeals BoardReconsiderationLien ClaimantLabor Code Section 4615ConsolidationMaster FileNational Script PharmacyBahar Danesh GharibCriminal ProceedingsJudicial Economy
References
2
Case No. MISSING
Regular Panel Decision
Aug 31, 1992

Matter of P.

The appellant, Rashmi P., appealed a Family Court's finding that he sexually abused his daughter, Parul. The Appellate Division affirmed the order of disposition, dismissing the appeal from the superseded October 12, 1990 order. The court found that the Family Court's determination of abuse was supported by a preponderance of the evidence. This was based on consistent out-of-court statements made by the child to a social worker and a caseworker, corroborated by the testimony of a psychologist. The psychologist, an expert in child sexual abuse, stated that the child's allegations and behavior were consistent with the inter-familial, child sex-abuse syndrome. The appellant did not testify or present any evidence.

sexual abusechild abusefamily courtappellate reviewcorroborationexpert testimonyout-of-court statementschild sex-abuse syndromepreponderance of evidenceparental rights
References
2
Case No. ADJ2295331 (ANA 0397551)
Regular
Mar 17, 2014

WESLEY CARROLL vs. NEW ORLEANS SAINTS, LOUISIANA WORKERS' COMPENSATION CORPORATION, TRAVELERS INSURANCE

This case concerns a former professional football player seeking workers' compensation for cumulative industrial injury against the New Orleans Saints. The applicant argues California has jurisdiction because prior proceedings conclusively determined injury occurred in California and the *Johnson* precedent was misapplied. However, the Appeals Board affirmed the WCJ's finding that California lacks a substantial interest to justify jurisdiction, as the applicant's California work activities were de minimis, consisting of only five games played in the state over his career. The Board found that California's connection to the injury was insufficient to warrant applying its workers' compensation law, consistent with *Johnson*.

WCABPetition for ReconsiderationFindings And OrderTake NothingFindings Of FactSubstantial InterestJurisdictionCumulative Industrial InjuryProfessional Football PlayerWide Receiver
References
10
Case No. ADJ1646469 (VNO 0550706)
Regular
Apr 19, 2013

ANDREW HERNANDEZ vs. STATE OF CALIFORNIA - CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

This case concerns the defendant's petition for reconsideration of an award for industrial injury to the applicant's low back and cervical spine. The defendant argued the applicant was not temporarily disabled as they offered a modified position consistent with AME Dr. Sew Hoy's restrictions, and that sub rosa videos should have been admitted. The Board denied reconsideration, finding Dr. Sew Hoy's report was qualified and did not preclude temporary disability, especially when contrasted with the applicant's treating physician's consistent findings. The Board also upheld the exclusion of the sub rosa videos due to late disclosure, as required by Labor Code section 5502(d)(3).

Workers' Compensation Appeals BoardAndrew HernandezState Compensation Insurance FundFindings and Awardindustrial injurylow backcervical spinetemporary disabilitypermanent disabilityfuture medical treatment
References
1
Case No. MISSING
Regular Panel Decision
Dec 22, 1995

In re Najam M.

The Family Court's dismissal of a child abuse petition, brought by the Commissioner of Social Services and the Law Guardian for Najam M. against her respondent father, was reversed on appeal. The appellate court reinstated the petition and entered a finding of sexual abuse, remanding the case for further proceedings. Expert medical testimony from Dr. Jamie Hoffman Rosenfeld, a child abuse specialist, detailed physical abnormalities in the child consistent with chronic manipulation and sexual abuse, which she affirmed could not be self-inflicted. The child's consistent allegations of abuse by her father, made to multiple individuals, further supported the medical findings. The court determined that the petitioner had established a prima facie case of child abuse, which the parents' explanation failed to rebut.

Child AbuseSexual AbuseFamily CourtAppellate ReversalExpert Medical TestimonyHymenal InjuryPrima Facie CaseBurden of ProofChild InterviewParental Explanation Rebuttal
References
8
Case No. MISSING
Regular Panel Decision

In re Daniel AA.

This case is an appeal concerning a Family Court order that terminated parental rights due to permanent neglect. The respondents' children, James and Daniel, were placed in petitioner's custody after a finding of neglect. Despite the petitioner's diligent efforts to provide a service plan, including mental health, substance abuse counseling, and parenting classes, the respondents consistently failed to cooperate, resisted change, and denied the existence of problematic behaviors. The court concluded that the petitioner satisfied its statutory obligations under Social Services Law § 384-b, and the mother was capable of planning for the children's future. Given the respondents' unstable lifestyle, characterized by violence and marital separations, the Family Court's decision to terminate parental rights was affirmed, prioritizing the children's needs for consistency, affection, and a stable environment.

Permanent NeglectParental Rights TerminationDiligent EffortsFamily Court AppealChild WelfareSocial Services LawParental ResponsibilityDomestic ViolenceSubstance Abuse CounselingMental Health Counseling
References
6
Case No. MISSING
Regular Panel Decision

Balsam Lake Anglers Club v. Department of Environmental Conservation

The petitioner, Balsam Lake Anglers Club, initiated a hybrid proceeding challenging a Unit Management Plan (UMP) for the Balsam Lake Mountain Wild Forest area. The challenge focused on alleged violations of Article XIV of the New York State Constitution concerning timber removal, infringement on easements, and non-compliance with the State Environmental Quality Review Act (SEQRA). The court determined that the UMP did not violate the State Constitution or the petitioner's property rights as the timber cutting was deemed insubstantial and consistent with public use. However, the court found that the respondents, particularly the Department of Environmental Conservation, failed to adhere to SEQRA's procedural and substantive requirements by issuing a negative declaration without a comprehensive 'hard look' or a reasoned elaboration of environmental impacts. Consequently, the petition was granted in part regarding the SEQRA violation, and the matter was remitted to the Department of Environmental Conservation for further proceedings consistent with the ruling.

Environmental LawSEQRAUnit Management PlanForest PreserveArticle XIVNew York State ConstitutionTimber CuttingEasementsWild Forest LandsJudicial Review
References
16
Case No. MISSING
Regular Panel Decision

Tzolis v. Wolff

The dissent argues that the majority overstepped its bounds by judicially creating a right for Limited Liability Company (LLC) members to bring derivative actions, a right that the New York Legislature explicitly considered and rejected during the enactment of the LLC Law in 1994. Justice Read highlights the legislative history, demonstrating that while the Assembly initially included derivative action provisions in proposed LLC bills, the Senate consistently omitted them, leading to a deliberate legislative compromise that excluded such rights from the final statute. The dissent criticizes the majority's justification based on existing common law and analogies to other business entities, asserting that there is no settled law regarding derivative suits for LLCs, which are a relatively new statutory form. Citing precedents, Justice Read emphasizes the Court's consistent deference to legislative intent, particularly when proposed statutory language is omitted. The dissenting opinion concludes that the majority has effectively rewritten the law, undermining legislative prerogative and providing a remedy unfettered by the safeguards typically imposed by the Legislature.

Limited Liability Companies (LLCs)Derivative SuitsLegislative IntentStatutory InterpretationJudicial ActivismAppellate ProcedureBusiness LawCorporate GovernancePartnership LawCommon Law Equity
References
12
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