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

Case No. 13-ev-3288; 13-cv-4244
Regular Panel Decision

Alzheimer's Disease Resource Center, Inc. v. Alzheimer's Disease & Related Disorders Ass'n

This case involves two related lawsuits stemming from the disaffiliation of the Alzheimer’s Disease Resource Center, Inc. (ADRC) from the Alzheimer’s Disease and Related Disorders Association (the Association). In case 13-ev-3288, ADRC alleged unfair competition, false advertising, and other claims. The Court denied dismissal for false advertising under the Lanham Act, New York General Business Law § 349, and unjust enrichment, but granted dismissal for trademark infringement, common law unfair competition, UCC violations, conversion, tortious interference, and fraud. In case 13-cv-4244, ADRC alleged breach of contract and misappropriation of trade secrets related to donor lists. The Court granted the Association's motion to dismiss this complaint in its entirety. Punitive damages were stricken for Lanham Act and unjust enrichment claims.

Unfair CompetitionLanham ActFalse AdvertisingTrademark InfringementNew York General Business Law § 349Unjust EnrichmentMotion to DismissBreach of ContractTrade Secret MisappropriationConversion
References
55
Case No. 04-09-00401-CV
Regular Panel Decision
Jul 21, 2010

Texas Mutual Insurance Company v. Sarah Ochoa

Sarah Ochoa sustained a lumbar sprain injury at work and filed a workers' compensation claim. Texas Mutual Insurance Company, the carrier, initially accepted the lumbar sprain but disputed later claims of extensive lumbar disc pathology as an ordinary disease of life. The hearing officer found a sprain/strain injury superimposed on pre-existing degenerative conditions but also ruled that Texas Mutual waived its right to contest the extent of injury by not timely disputing it within 60 days, making the degenerative conditions compensable. Texas Mutual appealed to the state district court, which granted Ochoa's no-evidence motion for summary judgment. This appellate court reverses and remands the trial court's judgment, holding that the 60-day waiver rule in the Texas Labor Code does not apply to extent-of-injury disputes, citing Texas Supreme Court precedent.

Workers' CompensationSummary JudgmentWaiver RuleExtent of Injury DisputeLumbar SprainDegenerative Disc DiseasePre-existing ConditionAppellate ReviewTexas Labor CodeJudicial Precedent
References
7
Case No. MISSING
Regular Panel Decision

Rice v. Commissioner of Social Security

Plaintiff Tammy Rice sought judicial review of the Commissioner of Social Security's final decision denying her application for disability benefits. The District Court considered the Commissioner's motion for judgment on the pleadings. The Administrative Law Judge (ALJ) found that Plaintiff had severe impairments of mild degenerative disc disease of the lumbar spine and mild degenerative joint disease of the knees but did not meet or equal a listed impairment. The ALJ determined Plaintiff could perform light work with restrictions, concluding she was not disabled. The Court found the Commissioner's decision supported by substantial evidence and in accordance with applicable legal standards. Consequently, the Commissioner's motion for judgment on the pleadings was granted, and Plaintiff's complaint was dismissed with prejudice.

Social SecurityDisability BenefitsALJ DecisionSubstantial EvidenceMedical EvidenceResidual Functional CapacityTreating Physician RuleFederal Rules of Civil ProcedureRule 12(c)Lumbar Spine
References
28
Case No. 531582
Regular Panel Decision
May 13, 2021

Matter of Matteliano v. Trinity Health Corp.

Caitlyn Matteliano, a nurse assistant, suffered work-related back, knee, and leg injuries in 2015 and 2018. Her treating orthopedic surgeon, Franco Vigna, requested authorization for multi-level lumbar fusion surgery and an external bone growth stimulator due to persistent pain and degenerative disc disease, despite conservative treatments. The employer denied this request based on an independent medical examination by Anthony Leone, who deemed the surgery aggressive and inappropriate given the lack of instability. A Workers' Compensation Law Judge initially denied the request, but the Workers' Compensation Board approved it. The employer appealed, and the Appellate Division, Third Department, affirmed the Board's decision, finding substantial evidence in Vigna's testimony to support the surgery's authorization under medical treatment guidelines for degenerative disc disease where non-surgical management has failed.

Workers' CompensationLumbar Fusion SurgeryMedical Treatment GuidelinesDegenerative Disc DiseaseDiscogenic Back PainIndependent Medical ExaminationPrior AuthorizationAppellate ReviewNurse AssistantWork Injury
References
9
Case No. ADJ3649169
Regular
Feb 14, 2013

BRUCE LIBERTY vs. LOS ANGELES UNIFIED SCHOOL DISTRICT; Permissibly Self-Insured

This case concerns an applicant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) order denying his claim for lumbar spine injury. The applicant alleged a lumbar injury from a physical therapy incident following a compensable cervical and shoulder injury. The WCAB denied reconsideration, adopting the WCJ's report which relied on the Agreed Medical Examiner's (AME) opinion. The AME found no industrial injury to the lumbar spine, citing a lack of contemporaneous evidence and a history of degenerative disc disease. The WCAB determined the applicant's presented "new" evidence was either previously reviewed or unpersuasive, upholding the original award.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedBruce LibertyLos Angeles Unified School DistrictPermissibly Self-InsuredCase Number ADJ3649169Workers' Compensation Administrative Law JudgeAgreed Medical ExaminerLumbar Spine Injury
References
0
Case No. 2018-06-0018
Regular Panel Decision
Jul 26, 2018

Coon, Gerald v. Commercial Warehouse and Cartage, Inc.

Gerald C. Coon, an employee, filed a request for temporary disability and medical benefits after an alleged back injury on September 22, 2017, due to a malfunctioning safety lanyard at Commercial Warehouse and Cartage, Inc. (CWC). Mr. Coon claimed continuous pain and denial of medical treatment by CWC. However, CWC witnesses testified Mr. Coon did not exhibit pain or request medical care until November 19, 2017. The Court found Mr. Coon's testimony not credible. Medical opinions varied, with Dr. Robert Carver, a panel physician, determining Mr. Coon's conditions (degenerative disc disease and lumbosacral radiculopathy) were not work-related. Dr. William M. Gavigan diagnosed a work-related lumbar strain but a non-work-related disc herniation. The Court credited Dr. Gavigan's opinion as most persuasive, confining the compensable injury to a lumbar strain, and found Mr. Coon unlikely to prevail on entitlement to additional medical treatment or temporary disability benefits, as no doctor took him off work for the strain. The Court, therefore, denied Mr. Coon's request for benefits.

Workers' CompensationBack InjuryLumbar StrainDegenerative Disc DiseaseLumbosacral RadiculopathyMedical CausationCredibility AssessmentExpedited HearingTemporary Disability BenefitsMedical Benefits
References
4
Case No. MISSING
Regular Panel Decision
Mar 23, 2000

Ramnarine v. Memorial Center for Cancer & Allied Diseases

Jagdeo Ramnarine, an employee of Memorial Sloan-Kettering Cancer Center, suffered a laceration at the Memorial Center for Cancer and Allied Diseases. He subsequently filed a negligence lawsuit. The defendant, Memorial Center, moved for summary judgment, arguing that the plaintiff's claim was barred by the Workers’ Compensation Law § 11, as both the Center and the Hospital operate as a single integrated employer despite their separate legal entities. The Supreme Court initially denied this motion. However, the appellate court reversed the decision, granting summary judgment to the defendant. The court found substantial evidence supporting the integrated employer argument, thereby limiting the plaintiff's remedy to workers' compensation benefits and dismissing the complaint and all cross-claims against the defendant.

Workers' Compensation ExclusivityIntegrated Employer DoctrineSummary Judgment ReversalNegligence ClaimCross Claims DismissedCorporate Alter EgoCommon ControlBronx CountyAppellate DivisionLabor Law
References
11
Case No. MISSING
Regular Panel Decision

Elaine W. v. Joint Diseases North General Hospital, Inc.

Plaintiffs, including Elaine W., sued Joint Diseases North General Hospital for unlawful sexual discrimination due to its policy of excluding pregnant women from its drug detoxification program. The hospital defended its blanket exclusion on medical grounds, citing a lack of specialized equipment, obstetricians, and licensing for obstetrical care. After conflicting rulings in lower courts, with the Appellate Division siding with the hospital, the New York Court of Appeals reversed the Appellate Division's decision. The Court ruled that the hospital must prove its blanket exclusion is medically warranted at trial, rejecting the idea that a mere medical explanation, when disputed, validates a discriminatory policy. The case emphasizes that distinctions based on pregnancy constitute sexual discrimination under New York's Human Rights Law, requiring individual assessment unless a complete medical impossibility of safe treatment is demonstrated.

Sexual DiscriminationPregnancy DiscriminationDrug Detoxification ProgramHospital PolicyMedical JustificationHuman Rights LawExecutive LawAppellate ReviewSummary JudgmentBurden of Proof
References
11
Case No. Index No. 161136/17 Appeal No. 15141 Case No. 2021-02236
Regular Panel Decision
Feb 22, 2022

Quiroz v. Memorial Hosp. for Cancer & Allied Diseases

Jose Alfonso Perez Quiroz, a construction worker, sustained injuries after falling from an unstable scaffold at a site managed by Memorial Hospital for Cancer and Allied Diseases and general contractor Turner Construction Company. He initiated legal action under Labor Law §§ 200, 240 (1), and 241 (6). The Supreme Court initially denied his motion for partial summary judgment on the Labor Law § 240 (1) claim and dismissed his Labor Law § 241 (6) claim. However, the Appellate Division, First Department, reversed the Supreme Court's decision, granting Quiroz's motion for summary judgment on liability under Labor Law § 240 (1), finding the unsecured scaffold to be a proximate cause of his fall. The appellate court subsequently dismissed the Labor Law § 241 (6) claim as academic.

Construction AccidentScaffold FallLabor Law Section 240(1)Labor Law Section 241(6)Industrial Code ViolationsSummary Judgment AppealPlaintiff LiabilityDefendant LiabilityProximate CausationRecalcitrant Worker Defense
References
17
Case No. MISSING
Regular Panel Decision
Sep 16, 2002

Claim of Gandolfo v. MTK Electronics

Claimant, employed by MTK Electronics, developed Hodgkin’s disease due to exposure to trichloroethylene and trichloroethane. A Workers’ Compensation Law Judge found a causally related occupational disease and awarded benefits, a decision affirmed by the Workers’ Compensation Board. The Board emphasized the claimant's treating physician's expert testimony, which established a link between the disease and chemical exposure at work. The employer's requests for reconsideration or full Board review were denied. The appellate court affirmed the Board's decision, finding substantial evidence supported the causal link between claimant's employment and her occupational disease.

Workers' CompensationOccupational DiseaseHodgkin's DiseaseChemical ExposureTrichloroethyleneTrichloroethaneCausalityExpert TestimonyMedical OpinionBoard Review
References
11
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