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

Case No. ADJ8855485
Regular
Nov 07, 2019

IMELDA SOSA vs. BRAWLEY UNION HIGH SCHOOL DISTRICT, ATHENS ADMINISTRATORS, LIBERTY MUTUAL INSURANCE, SELF-INSURED SCHOOLS OF CALIFORNIA

This case involves an employer's reconsideration request concerning a finding of cumulative trauma injury. The applicant was found to have sustained a cumulative trauma injury through June 13, 2011, resulting in 23% permanent disability and an award for indemnity and future medical treatment. The employer argued against compensable temporary disability for a single day's absence and questioned the applicant's knowledge of the cumulative trauma's industrial cause. The Board affirmed the original award, finding the applicant had knowledge of an industrial injury and suffered disability on June 13, 2011.

Cumulative trauma injuryDate of injuryLabor Code section 5412Compensable temporary disabilityPermanent disabilityIndustrial accident leaveEducation CodeWorkers' Compensation Appeals BoardReconsiderationFindings Award and Order
References
2
Case No. ADJ8070183 ADJ9326618
Regular
Feb 17, 2016

CARLOS VASQUEZ vs. TRINET, AMERICAN HOME ASSURANCE

This case involves a defendant seeking reconsideration of a prior Board decision that found applicant sustained new and further disability from a January 7, 2009 injury and allowed further development of the medical record for a cumulative trauma claim. The defendant argued the treating physicians' reports were not substantial evidence for new and further disability and that there was insufficient evidence to reopen the cumulative trauma claim. The Board denied reconsideration, reaffirming its prior decision based on substantial medical evidence, and noting that the absence of an officially designated primary treating physician does not invalidate the relied-upon medical opinions. The Board further clarified that an Agreed Medical Examiner can be used for further evaluation of the cumulative trauma claim.

Workers' Compensation Appeals BoardPetition for ReconsiderationNew and Further DisabilityCumulative Trauma InjuryJoint Findings of Fact and OrderSubstantial EvidenceAgreed Medical ExaminerQualified Medical EvaluatorPrimary Treating PhysicianNon-Substantial Evidence
References
2
Case No. MISSING
Regular Panel Decision
Feb 11, 1992

Spiegel v. Perales

Petitioner was terminated from State employment after accumulating more than one year of absence due to an occupational injury, receiving workers' compensation benefits. She challenged the termination, arguing that her employer misinterpreted Civil Service Law § 71, contending that the law required a continuous year of absence, not a cumulative one. The court, citing a companion case (Matter of Allen v Howe), deferred to the interpretation of the Civil Service Law by the Department of Civil Service regulations. Consequently, the court found the petitioner's termination was lawful and upheld the dismissal of her petition.

Workers' CompensationEmployment TerminationCivil Service LawStatutory InterpretationCumulative AbsenceContinuous AbsenceAdministrative DeferenceCPLR Article 78Judicial ReviewOccupational Injury
References
1
Case No. ADJ7898288
Regular
Nov 19, 2012

vs. LAMPS PLUS, OLD REPUBLIC INSURANCE

The Workers' Compensation Appeals Board denied reconsideration of a "take nothing" award for an applicant claiming cumulative trauma injury. The Board adopted the WCJ's report, which found the applicant failed to meet his burden of proof due to inconsistent testimony and unreliable medical evidence. The WCJ's credibility findings, based on the applicant's demeanor and conflicting statements regarding his medical history and work absences, were given great weight. Consequently, the Board concluded that the evidence did not demonstrate a cumulative trauma injury arising out of and in the course of employment, and further development of the medical record was not warranted.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedGarza v. Workers' Comp. Appeals Bd.Old Republic Insurance CompanyMilestone Insurance CompanyColdiron v. Compuwave Corp.cumulative trauma injuryAOE/COEtake nothing
References
5
Case No. MISSING
Regular Panel Decision

Allen v. Howe

Petitioners Allen and Spiegel, State employees, challenged their termination by respondents after cumulative one-year absences due to occupational injuries, arguing Civil Service Law § 71 required a continuous one-year absence. Petitioner Allen also alleged equal protection and due process violations, claiming disparate treatment compared to employees with non-occupational injuries under Civil Service Law § 73. The Court upheld the respondents' interpretation of Civil Service Law § 71 as rational and in furtherance of the State's interest in an efficient civil service. It rejected the equal protection and due process claims, finding the distinction between occupational and ordinary injuries to be rational and not in violation of constitutional guarantees. The Appellate Division's orders were affirmed.

Civil Service LawOccupational InjuryDisability LeaveEmployee TerminationEqual ProtectionDue ProcessAdministrative InterpretationStatutory InterpretationWorkers' Compensation BenefitsState Employees
References
17
Case No. MISSING
Regular Panel Decision

Jacobsen v. New York State Department of Labor

Petitioner, a senior stenographer for the Department of Labor, was terminated after cumulative absences due to a work-related injury exceeded one year, pursuant to Civil Service Law § 71. The Department calculated absences including non-workdays. Petitioner challenged the calculation and argued improper termination due to lack of notice regarding the concurrent running of Family and Medical Leave Act (FMLA) leave. The court found respondent's method of calculating Civil Service Law § 71 leave rational. However, it determined that the Department of Labor failed to provide proper notice that petitioner's FMLA leave would run concurrently with her workers' compensation leave. Consequently, the court annulled the termination, granted the petition for reinstatement with back pay and benefits, and remitted the matter for further proceedings.

Workers' Compensation LeaveCivil Service LawFamily and Medical Leave Act (FMLA)Cumulative AbsencesTermination of EmploymentMedical DisabilityNotice RequirementsReinstatementBack Pay and BenefitsAdministrative Review
References
2
Case No. 2020 NY Slip Op 06000 [187 AD3d 1395]
Regular Panel Decision
Oct 22, 2020

Matter of Capraro v. Matrix Absence Mgt.

Claimant, a home-based claims examiner, was injured while moving unassembled new office furniture to his home office after his employer declined to cover the expense. He applied for workers' compensation benefits, but both a Workers' Compensation Law Judge (WCLJ) and the Workers' Compensation Board denied his claim, ruling that the injury did not arise out of and in the course of his employment. The Board had applied a novel, rigid standard for at-home employees, limiting compensability to injuries during regular work hours and active work duties. The Appellate Division, Third Department, found this new standard unsupported by precedent and inconsistent with the remedial nature of the Workers' Compensation Law, emphasizing that a regular pattern of work at home makes the residence a place of employment. The court reversed the Board's decision and remitted the matter, instructing the Board to apply the long-established standard to determine if the activity was "purely personal" or "reasonable and sufficiently work related."

Workers' CompensationArising out of employmentCourse of employmentWork-from-home injuryOffice furniturePersonal activity vs. work-relatedAppellate reviewRemittalBoard decision reversalHome as workplace
References
20
Case No. ADJ878030 (MON 0360260) ADJ3081052 (MON 0358854)
Regular
Dec 17, 2012

Antonio Montero vs. Herrck Corporation, Matrix Absence Management

The Appeals Board affirmed a prior award finding applicant sustained a specific industrial injury to his right knee on March 26, 2003, resulting in five percent permanent disability and further medical treatment. All other claimed injuries, including cumulative trauma to multiple body parts, were found barred by Labor Code section 3600(a)(10). The Board adopted the arbitrator's reasoning for these findings. Applicant's petition for removal regarding the admissibility of a QME's report was also denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact Award and OrderSpecific Industrial InjuryCumulative InjuryLabor Code Section 3600(a)(10)Permanent DisabilityFurther Medical TreatmentPetition for RemovalQualified Medical Examiner (QME)
References
0
Case No. ADJ2317869
Regular
Aug 04, 2009

ALLEN BONET vs. HONDA OF OAKLAND, MATRIX ABSENCE MANAGEMENT

This case involves a Petition for Removal filed by Honda of Oakland and Matrix Absence Management. The Workers' Compensation Appeals Board denied the petition because the defendants failed to demonstrate substantial prejudice or irreparable harm, which are the strict requirements for removal. The Administrative Law Judge recommended denial, citing significant issues with the medical records and the applicant's inconsistent testimony regarding his date of injury. The ALJ had taken the matter out of submission to further develop the record, specifically to determine the correct date of injury, which is crucial for evaluating the defendants' post-termination and statute of limitations defenses.

Petition for RemovalWorkers' Compensation Appeals BoardADJ2317869Allen BonetHonda of OaklandMatrix Absence ManagementOrder Denying Petition for RemovalSubstantial PrejudiceIrreparable InjuryAOE/COE
References
4
Case No. ADJ3434154
Regular
Mar 28, 2011

GARY ZIMMERMAN vs. LEPRINO FOODS, INC., MATRIX ABSENCE MANAGEMENT COMPANY

The Workers' Compensation Appeals Board granted reconsideration, finding that Leprino Foods violated Labor Code section 132a by failing to place the applicant on a required union leave of absence. While the Board affirmed the WCJ's decision that the applicant's termination was lawful based on a doctor's work restrictions, they awarded a 50% increase in compensation up to $10,000, plus costs, due to the Section 132a violation. However, the Board denied back pay, agreeing with the WCJ that lost wages were not caused by the employer's contract violation but by the lawful termination and the applicant's insufficient mitigation efforts. A dissenting commissioner argued for back pay, citing the discriminatory nature of the termination during the mandated leave and the lack of evidence for the WCJ's findings on misleading doctors and failed mitigation.

Labor Code section 132aLeprino FoodsMatrix Absence Management CompanyGary ZimmermanBrian Belanger D.C.permanent and stationary reportunion grievanceArbitratorback payreinstatement
References
3
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