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

Case No. ADJ9344211
Regular
Dec 01, 2017

Patricia Preston vs. Los Angeles Unified School District, SEDGWICK CLAIMS MANAGEMENT SERVICES

The applicant sought reconsideration of a workers' compensation award, challenging the permanent disability rating primarily based on the chosen medical evaluation method. The applicant argued the Range-of-Motion (ROM) method, favored by her treating physician, should have been used instead of the Diagnosis-Related Estimates (DRE) method employed by a Qualified Medical Evaluator (QME). Additionally, she contended that her vocational expert's opinion supported a finding of total permanent disability. The Board denied reconsideration, affirming the administrative law judge's decision, finding the QME's DRE rating supported by substantial evidence and the applicant's vocational evidence insufficient to prove total disability. A dissenting opinion argued that findings of multi-level spinal involvement supported the use of the ROM method for a potentially higher rating and questioned the QME's justification for choosing DRE.

Workers' Compensation Appeals BoardPatricia PrestonLos Angeles Unified School DistrictSedgwick Claims Management ServicesADJ9344211Permanent Disability RatingRange-of-Motion MethodDiagnosis-Related Estimates MethodApportionmentDr. Fenton
References
6
Case No. ADJ10489999
Regular
Feb 01, 2019

Sean Lawson vs. Zenith Insurance Company

This case involves a dispute over the permanent disability rating for applicant Sean Lawson's low back injury. The defendant, Zenith Insurance Company, argues that the Range of Motion (ROM) method used by the Qualified Medical Evaluator (QME) was inappropriate, and the Diagnosis-Related Estimates (DRE) method should have been applied as there was only one level of radiculopathy. The Workers' Compensation Appeals Board (WCAB) affirmed the WCJ's finding that the ROM method was appropriate based on the QME's expert opinion and the AMA Guides' provision for its use with multi-level involvement. However, one Commissioner dissented, believing the DRE method was mandated given the lack of evidence for multi-level radiculopathy.

WCABPetition for ReconsiderationPermanent DisabilityApportionmentNon-industrial factorsDiagnosis-Related Estimates (DRE) methodRange of Motion (ROM) methodQualified Medical Evaluator (QME)AMA GuidesMultilevel radiculopathy
References
1
Case No. MON 0339411
Regular
Jul 21, 2008

Dionisio Jimenez vs. NUPAC APARTMENTS, STATE COMPENSATION INSURANCE FUND

This case involves a dispute over the proper method used to rate the applicant's permanent disability following a back and leg injury. The defendant contends the Agreed Medical Examiner improperly used the Range of Motion (ROM) method instead of the Diagnosis-Related Estimate (DRE) method per the AMA Guides. The Appeals Board rescinded the prior award and returned the case to the trial level for further development of the record. This development will address why the ROM method was used and clarify the appropriate rating methodology.

Workers' Compensation Appeals BoardDionisio JimenezNupac ApartmentsState Compensation Insurance FundMON 0339411Opinion and Decision After ReconsiderationFindings and AwardIndustrial InjuryBack InjuryRight Leg Injury
References
2
Case No. ADJ6820630
Regular
Mar 19, 2018

MARK COLLINS vs. ENTERTAINMENT PARTNERS, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

The WCAB dismissed the Defendant's Petition for Reconsideration because it was not filed from a final order. The Board granted the Defendant's Petition for Removal to rescind the WCJ's order vacating submission and appointing a new physician. The WCJ erred by refusing to accept the AME's rating based on the Diagnosis-Related Estimate (DRE) method, as physicians have discretion to use the most accurate method. However, the AME's own deposition testimony indicated that the Range of Motion (ROM) method, mandated by the WCJ, would yield a higher impairment rating. Therefore, the matter is returned to the trial level for the WCJ to obtain a permanent disability rating using the existing record and potentially consulting a DEU rater.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalAgreed Medical Examiner (AME)Range of Motion (ROM) methodDiagnosis-Related Estimates (DRE) methodAmerican Medical Association's Guides (AMA Guides)Whole Person Impairment (WPI)cumulative traumaspinal injury
References
6
Case No. MISSING
Regular Panel Decision

Sutton Area Community v. Board of Estimate

This case addresses a challenge by petitioners against the Board of Estimate's approval of a major private development in Manhattan. The core issue revolves around a last-minute change in the designated sewage treatment plant from Ward's Island to Newtown Creek, the latter lacking secondary treatment and operating over capacity. The court found that this eleventh-hour correction, three days before the Board's vote, deprived the public and relevant agencies of a meaningful opportunity to review and comment on the significant environmental impacts related to sewage disposal. Citing violations of the New York State Environmental Quality Review Act (SEQRA), the court emphasized the necessity of strict compliance with environmental review procedures. Consequently, the judgment confirming the Board of Estimate's determination was reversed, and the Board's approval of the project was nullified.

Environmental LawSEQRASewage DisposalAdministrative Agency ActionPublic ParticipationEnvironmental Impact StatementJudicial Review of Agency DecisionsUrban PlanningRegulatory ComplianceWater Pollution
References
6
Case No. MISSING
Regular Panel Decision

Coca-Cola Bottling Co. v. Board of Estimate

This case concerns an Article 78 proceeding initiated by The Coca-Cola Bottling Company of New York, Inc. against the Board of Estimate of the City of New York and other city entities, along with Con-Agg Recycling Corp. Coca-Cola challenged the Board of Estimate's approval of Con-Agg's concrete recycling business in The Bronx and an amendment to the urban renewal plan, alleging violations of the State Environmental Quality Review Act (SEQRA). The core issue was whether the Department of Environmental Protection (DEP) or the Board of Estimate was the proper 'lead agency' responsible for assessing the environmental impact. The trial court and Appellate Division found that DEP's issuance of a conditional negative declaration, rather than the Board of Estimate making the final environmental policy decision, violated SEQRA. The Court of Appeals affirmed, holding that the 'lead agency' with principal responsibility for approving an action must also determine its significant environmental effect, and Mayoral Executive Order No. 91 was invalidly applied to the extent it diminished this responsibility.

Environmental ReviewSEQRALead AgencyConditional Negative DeclarationUrban Renewal PlanArticle 78 ProceedingGovernmental Decision MakingEnvironmental Impact StatementPolicy DecisionMayoral Executive Order No. 91
References
4
Case No. ADJ1475903
Regular
Jun 10, 2011

JEFFREY SMITH vs. COAST MACHINERY MOVERS, STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the defendant sought reconsideration of an award finding the applicant sustained an industrial injury and $87\%$ permanent disability. The defendant argued the administrative law judge erred by relying on the primary treating physician's opinions and using a Diagnosis Related Estimates method instead of Range of Motion. The Appeals Board denied reconsideration, agreeing that the physician's reports constituted substantial medical evidence and the judge did not err in their application. Although the Board found the judge incorrectly stated the defendant waived its objection to the evidence, the core findings were upheld.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and AwardSteam and PipefitterIndustrial InjuryPermanent DisabilityPrimary Treating PhysicianSubstantial Medical EvidenceDiagnosis Related EstimatesRange of Motion
References
7
Case No. MISSING
Regular Panel Decision

New York State Employment Relations Board v. Christ the King Regional High School

The New York State Employment Relations Board initiated a proceeding to enforce its order against Christ the King Regional High School, which mandated good-faith bargaining with the Lay Faculty Association and reinstatement of teachers. The School challenged this order on First Amendment grounds, specifically citing the Free Exercise and Establishment Clauses, arguing for an absolute exemption from the New York State Labor Relations Act. The Supreme Court and Appellate Division ruled in favor of the Board. The Court of Appeals affirmed these decisions, concluding that the Act, being a neutral and generally applicable regulatory measure, did not violate the First Amendment rights of the religious school in its labor relations with lay faculty. The court also upheld the reinstatement of teacher Gaglione, finding insufficient evidence of religious entanglement to preclude it.

First AmendmentFree Exercise ClauseEstablishment ClauseLabor LawCollective BargainingReligious SchoolsLay Faculty RightsEmployment DisputesJudicial ReviewAdministrative Order Enforcement
References
19
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. MISSING
Regular Panel Decision
Jun 12, 1996

In Re Ralph Lauren Womenswear, Inc.

Stuart L. Kreisler, the debtor's former chief executive officer, moved to have his claim against Ralph Lauren Womenswear, Inc. (RLW) estimated for voting purposes in RLW's plan of reorganization. Kreisler argued most of his claim, arising from postpetition termination, was an administrative expense, with a smaller unsecured claim. The debtor, RLW, denied any claim. Chief Judge Tina L. Brozman conducted an evidentiary hearing to estimate the claim due to time constraints before the confirmation hearing. The court determined that Kreisler's severance claim would likely be allowed as a postpetition quantum meruit administrative expense, estimating his prepetition unsecured claim related to unpaid bonus at $279,000, and the severance portion of his prepetition claim at zero. The ruling also addressed disputes concerning EBIT calculation for bonus determination and the allocation of the bonus between pre- and post-petition periods.

BankruptcyClaim EstimationSeverance PayAdministrative ExpenseQuantum MeruitEmployment AgreementDebtor ReorganizationPostpetition ClaimPrepetition ClaimBonus Calculation
References
13
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