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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

Claim of Estrada v. Peepels Mechanical Corp.

The claimant's case was established for occupational disease resulting in bilateral hearing loss. A Workers’ Compensation Law Judge (WCLJ) determined the date of disablement and, after initial discharge, reinstated the State Insurance Fund (Fund) to produce an apportionment report between occupational disease and traumatic hearing loss. The Fund appealed this decision. The Workers’ Compensation Board subsequently found the Fund was not the proper party as it did not cover the employer on the date of disablement and reversed the order for the apportionment report. The employer and its workers’ compensation carrier then appealed the Board's decision. The higher court affirmed the Board’s decision, noting that a claim for traumatic hearing loss was never formally made or pending before the Board.

Occupational DiseaseBilateral Hearing LossApportionmentDate of DisablementWorkers' Compensation CarrierState Insurance FundBoard DecisionAppellate ReviewTraumatic Hearing LossWCLJ Decision
References
1
Case No. MISSING
Regular Panel Decision
Aug 18, 1995

Miller v. Chater

Plaintiff initiated this action to seek review of the Secretary of Health and Human Services' decision establishing June 1, 1992, as the onset date for Supplemental Security Income (SSI) benefits due to alleged disability from mental retardation. Magistrate Judge Carol E. Heckman issued a Report and Recommendation, advising denial of the Secretary's motion for judgment on the pleadings and remand for reconsideration. The Magistrate Judge found errors in the Administrative Law Judge's (ALJ) assessment of the plaintiff's functional limitations, particularly regarding social domain, and noted the ALJ's failure to consider the retroactivity inference from the Zebley class action stipulation. District Judge Arcara reviewed the Report and Recommendation, and with no objections filed, adopted its findings. Consequently, the defendant's motion for judgment on the pleadings was denied, and the case was remanded to the Secretary for further reconsideration, emphasizing a misapplication of post-Zebley requirements for adjudicating children’s SSI benefits claims.

Supplemental Security Income (SSI)Disability BenefitsMental RetardationChild Disability ClaimsAdministrative ReviewSocial Security ActAge-appropriate functioningMedical EvidenceFunctional LimitationsOnset Date
References
12
Case No. MISSING
Regular Panel Decision

Boyd v. Perales

The petitioner sought to expunge a 1976 child abuse report from the State Central Register, which alleged that her children were left bound and unsupervised, arguing it was irrelevant to her current child care employment. This challenge was initiated via a CPLR article 78 petition and transferred to the Appellate Division. An Administrative Law Judge had previously expunged two later reports but maintained the 1976 report. The court confirmed the respondents' determination, finding substantial evidence supported the ALJ's conclusion that the petitioner's serious lack of judgment in 1976 remained relevant to child care. Furthermore, the court dismissed the petitioner's due process argument as it was raised for the first time on appeal.

Child Abuse ReportState Central RegisterExpungementChild Care EmploymentAdministrative Law JudgeDue ProcessCPLR Article 78Social Services LawAppellate ReviewRehabilitation
References
1
Case No. ADJ7357973
Regular
Apr 18, 2012

Pete Rios vs. Peppertree Distributors, Inc., FirstComp Omaha for Southern Insurance Company

This case concerns Pete Rios' workers' compensation claim, where the Appeals Board denied his petition for reconsideration. The applicant argued that temporary disability benefits should not be terminated based on a narrow interpretation of Labor Code Section 4656(c)(2). However, the Board adopted the WCJ's report, finding that the applicant's injury date of April 24, 2009, falls under LC 4656(c)(2), which limits benefits to 104 weeks within five years from the injury date. The Board noted that jurisdiction remains open for penalties and sanctions regarding delayed temporary disability payments.

Workers Compensation Appeals BoardPete RiosPeppertree DistributorsInc.FirstComp OmahaSouthern Insurance CompanyOrder Denying ReconsiderationPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeTemporary Disability
References
0
Case No. MISSING
Regular Panel Decision
Oct 12, 1978

Claim of Falcone v. Western Electric Co.

The case involves an appeal of a Workers' Compensation Board decision that set the claimant's date of disablement as July 30, 1973. The claimant, an employee of Western Electric Company, Inc., developed chronic obstructive pulmonary disease due to polyurethane exposure, initially experiencing symptoms in 1966. While a medical report from Dr. Ehret in 1966 identified bronchial asthma, the condition was not considered disabling until July 30, 1973, when the claimant first lost work time due to respiratory issues. The Board's decision, which also discharged the Special Fund from liability under section 25-a of the Workers’ Compensation Law, was affirmed by the appellate court, finding substantial evidence to support the determination of the disablement date.

Occupational DiseaseChronic Obstructive Pulmonary DiseaseBronchial AsthmaPolyurethane ExposureToluene Diisocyanate (TD1)Date of DisablementWorkers' Compensation LawSpecial FundsSubstantial EvidenceMedical Testimony
References
3
Case No. ADJ10885080
Regular
Aug 21, 2019

ALMA PADRON vs. MODESTO CITY SCHOOLS

The Workers' Compensation Appeals Board affirmed a judge's finding that the applicant's Qualified Medical Evaluator (QME) report was not untimely. The applicant argued the report was late because she did not receive it until after her objection date, but the Board found her objection was filed after the QME's proof of service date. The Board also determined that the timeliness of the QME report was an interlocutory issue not subject to reconsideration and that the applicant failed to demonstrate irreparable harm. Therefore, the Board denied the applicant's petition for reconsideration.

AOE/COEQME panelreplacement QMEPetition for ReconsiderationPetition for RemovalWCJMedical Unitproof of serviceEvidence Code § 641presumption of receipt
References
14
Case No. ANA 0385112
Regular
Feb 15, 2008

LIANA SAENZ vs. ORANGE COUNTY DEPARTMENT OF EDUCATION, Permissibly Self-Insured, Adjusted By SOUTHERN CALIFORNIA RISK MANAGEMENT ASSOCIATES, INC.

This case involves a dispute over which workers' compensation permanent disability rating schedule to apply. The applicant sustained injury before January 1, 2005, but the defense QME report determining her permanent and stationary status was dated November 2004 but not signed until February 2005. The Appeals Board granted reconsideration to apply the 1997 Schedule, finding that the date of the physician's evaluation, not the signing date of the report, should control when an exception to the 2005 Schedule is invoked for pre-2005 injuries.

Workers' Compensation Appeals BoardCumulative trauma injuryPermanent disability rating2005 Schedule1997 ScheduleLabor Code section 4660(d)Qualified Medical EvaluatorComprehensive medical-legal reportPermanent and stationary statusDate of evaluation
References
3
Case No. 531438
Regular Panel Decision
Feb 18, 2021

Matter of Chrostowski v. Pinnacle Envtl. Corp.

Claimant Miroslaw Chrostowski, an asbestos handler, appealed a Workers' Compensation Board decision that found his claim for benefits for repetitive stress injuries to be time-barred. The Board had set the date of disablement as March 17, 2009, based on a medical report by Laura Bienenfeld. The Appellate Division, Third Department, reversed this decision, ruling that the Board's determination of the disablement date was not supported by substantial evidence. The court noted that the relied-upon March 17, 2009 medical report did not address all of the claimant's alleged injuries, specifically his shoulder and knee, making it insufficient to establish the disablement date for all claims. The matter was remitted to the Board for further proceedings consistent with the court's decision.

Workers' Compensation BenefitsOccupational DiseaseTime Barred ClaimDate of DisablementRepetitive Stress InjuryAsbestos ExposureWorld Trade Center SiteMedical EvidenceSubstantial Evidence ReviewAppellate Review
References
5
Case No. MISSING
Regular Panel Decision
Jan 27, 1965

Rivera v. Hellman

This case involves a motion to confirm a Special Referee's report concerning the amounts and priorities of various liens. The Special Referee conducted a hearing and reported on claims from an attorney for the plaintiff ($793.50), Roosevelt Hospital ($846.53), and the Millinery Health Fund ($641.00, later adjusted to $528). The report established the amounts of each lien and recommended priorities, placing the attorney's lien first, followed by the hospital lien (except for a $12 outpatient service), and then the compensation lien. The court concurred with the Special Referee's report and recommendations, granting the motion to confirm.

Lien PriorityAttorney's LienHospital LienDisability BenefitsWorkmen's Compensation LawSpecial Referee ReportMotion GrantedNew York Supreme CourtLien LawMotion Practice
References
2
Case No. MISSING
Regular Panel Decision

Colindres v. Carpenito

Plaintiff Rochelle Colindres sought a protective order to deny defendants' demand for a medical report from her former treating psychologist, Diane Henry, or alternatively, relief from compliance with Uniform Rules for Trial Courts § 202.17(b)(1). Colindres argued that the defendants waived their right to the report as the independent medical examination (IME) already occurred, and that obtaining the report would be an undue hardship since Henry ceased treatment due to Colindres' attendance issues. Defendants Mario Carpenito, Jr., City of White Plains, and White Plains Parking Department opposed, asserting that the report was necessary to clarify alleged injuries, prepare for cross-examination, and facilitate settlement, highlighting Colindres' complex medical history predating the incident. The court denied both branches of Colindres' motion, finding that the rule applies broadly to personal injury actions, defendants did not waive their entitlement, and Colindres failed to prove it was impossible to obtain the report. The court ordered Colindres to exchange a compliant medical report from Diane Henry by March 27, 2017.

protective ordermedical report disclosurediscovery disputepsychological treatmentindependent medical examinationCPLR 310322 NYCRR 202.17waiver of discoveryundue hardshippersonal injury damages
References
12
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