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Case Law Database

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

Case No. ADJ3193987 (RIV 0037219)
Regular
Feb 26, 2009

DOUGLAS CRAWFORD vs. COUNTY OF SAN BERNARDINO FIRE DEPARTMENT, COUNTY OF SAN BERNARDINO

This case involves a lien claimant, Forensic Psychiatric Services, whose lien was initially slated for disallowance due to an unprepared representative at a conference. The lien claimant petitioned for the Workers' Compensation Administrative Law Judge's (WCJ) disqualification, alleging bias and an unwarranted opinion. The Appeals Board denied the disqualification petition, finding insufficient grounds. However, they granted the lien claimant's objection to the disallowance notice, rescinded it, and returned the matter to the trial level for further proceedings.

Workers' Compensation Appeals BoardForensic Psychiatric ServicesPetition for DisqualificationNotice of Intention to Disallow Lien ClaimWorkers' Compensation Administrative Law Judgeunprepared lien representativeunqualified opinionevinced enmityWCAB Rule 10452objection to NOI
References
0
Case No. MISSING
Regular Panel Decision

Matter of Waddy v. Barnard College

The case concerns an appeal from a Workers’ Compensation Board decision affirming the disallowance of a claimant's application for benefits. The claimant, an employee in a mail room, alleged that exposure to dust and mold due to poor ventilation at her workplace caused her to develop disabling asthma. The Workers’ Compensation Law Judge initially disallowed the claim, finding no causal relationship between her asthma and employment, a decision subsequently affirmed by the Board. The Board's determination was based on the medical opinions of the treating pulmonologist, William Marino, who could not establish work-related causation, and an independent medical examiner, Carl Friedman, who concluded that the asthma was not workplace-induced, referencing a negative indoor air quality test. While the claimant's family physician, Rajesh Patel, suggested a probable work-related allergen exposure, the Board resolved the conflicting medical evidence. The Appellate Division affirmed the Board's decision, finding substantial evidence to support the ruling that the claimant did not sustain a causally related injury.

Workers' CompensationAsthmaOccupational DiseaseCausationMedical EvidenceIndependent Medical Examination (IME)Treating PhysicianEnvironmental IrritantsWorkplace ConditionsAppellate Review
References
5
Case No. MISSING
Regular Panel Decision

Claim of Kendrick v. Mohawk Valley Oil Co.

This case involves an appeal against a Workers' Compensation Board decision, filed on February 26, 1979. The Board had disallowed a claim for death benefits, concluding that the claimant's death was not causally linked to work activities on September 17, 1974. Instead, the Board determined, based on evidence including Dr. Cohen’s testimony, that the death was a result of the natural progression of the claimant’s underlying heart disease. The appellate court found substantial evidence supporting the Board's decision. Consequently, the Board's decision was affirmed, and all other contentions raised by the claimant were deemed without merit.

Death BenefitsCausal RelationshipHeart DiseaseMedical TestimonySubstantial EvidenceAppealAffirmationWorkers' Compensation Board DecisionMedical OpinionWork-Related Injury
References
0
Case No. ADJ6610233
Regular
Nov 18, 2014

WILLIAM WILLIAMS (Deceased) vs. STATE OF CALIFORNIA, CDCR - PLEASANT VALLEY STATE PRISON, Legally Uninsured; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES, Adjusting Agency

This case concerns a deceased correctional officer whose dependent sons were awarded death benefits. The Appeals Board denied reconsideration of its prior order requiring an offset for a CalPERS special death benefit received by the decedent's widow, deeming it consistent with precedent and statutory intent. The Board also issued a notice of intention to disallow the applicant's attorney's requested fee increase due to non-compliance with a rule regarding notice to the client of adverse interests. Compliance with this rule is required for the fee increase to be considered by the trial judge.

CalPERSspecial death benefitoffsetdeath benefitsdependent childrenattorney's feesWCAB Rule 10778adverse interestindependent counselPetiton for Reconsideration
References
4
Case No. Claim No. 134
Regular Panel Decision

In Re Crystal Apparel, Inc.

The Reorganized Debtor, Crystal Apparel, Inc., successfully objected to Claim No. 134 filed by the Amalgamated Cotton Garment and Allied Industries Fund, which sought $689,291.78 for alleged withdrawal liability. The Bankruptcy Court granted the Reorganized Debtor's motion for summary judgment, disallowing the claim. The court determined that the Fund's '1989 Rules' and '1991 Rules' for imposing withdrawal liability on the Social Insurance Fund were not lawfully adopted by the trustees or properly incorporated into the relevant agreements, thereby failing to satisfy the 'written agreement' requirement of 29 U.S.C. § 186(c)(5). The decision emphasized the principles of contract interpretation and cited a prior First Circuit case, Manchester Knitted Fashions, Inc. v. Amalgamated Cotton Garment and Allied Industries Fund, which similarly rejected the Fund's arguments.

Bankruptcy LawSummary Judgment MotionClaim DisallowanceMultiemployer PlansWithdrawal LiabilityEmployee Benefits LawTrust Fund AdministrationContract InterpretationLabor LawFederal Rules of Civil Procedure
References
18
Case No. Proof of Claim No. 149
Regular Panel Decision

In re DeWitt Rehabilitation & Nursing Center, Inc.

The Debtor, DeWitt Rehabilitation and Nursing Center, Inc., moved to expunge the priority portion of a claim filed by United Staffing Registry, Inc. The Claimant sought priority status for social security, Medicare, and unemployment payments made for temporary employees it provided, citing 11 U.S.C. § 507(a)(5). Bankruptcy Judge Allan L. Gropper analyzed the application of § 507(a)(5) in light of case precedents, including Howard Delivery Service, Inc. The Court determined that the priority under § 507(a)(5) is intended to protect contributions for a debtor's direct employees, and the temporary employees were not employees of DeWitt. Consequently, the Debtor's objection was sustained, disallowing the priority and reclassifying the entire claim as a general unsecured claim, while also denying the Debtor's request for legal fees.

Bankruptcy LawPriority ClaimsEmployee Benefit Plans11 U.S.C. § 507(a)(5)Temporary EmployeesUnsecured ClaimsIndemnificationLegal FeesClaim ExpungementStatutory Interpretation
References
9
Case No. 530286
Regular Panel Decision
Oct 29, 2020

Matter of Barton v. Consolidated Edison Co. of New York, Inc.

Claimant Loretta Barton appealed a decision by the Workers' Compensation Board which disallowed her claim for death benefits, arising from her spouse's occupational asbestosis. Initially, a Workers' Compensation Law Judge found a physician's report provided prima facie medical evidence, but the Board later precluded this report for non-compliance with a regulation requiring submission to all parties. Consequently, the Board disallowed the claim due to a lack of admissible evidence and closed the case. The Appellate Division determined that the Board's decision to disallow and close the claim was procedurally improper, as claimant should have been afforded an opportunity to submit additional evidence. The court, therefore, modified the decision by reversing the disallowance and closure of the case, remitting the matter for further proceedings consistent with its decision.

Workers' Compensation Death BenefitsAsbestosis ClaimOccupational DiseaseMedical Evidence PreclusionPrima Facie Medical EvidenceProcedural Due ProcessRemand for Further ProceedingsAppellate Division ReviewNYCRR RegulationsCausally-Related Death
References
5
Case No. ADJ360587
Regular
May 15, 2009

SERGIO VALADEZ vs. LSG SKY CHEFS, LIBERTY MUTUAL INSURANCE

This case involves a lien claimant, Spine Care and Orthopedic Physicians, whose lien was initially disallowed for failure to appear at a hearing. The lien claimant petitioned for reconsideration, arguing they provided medical services and had objected to the disallowance notice. The WCJ acknowledged a timely objection was filed despite initial file confusion. The Appeals Board granted reconsideration, rescinded the disallowance order, and returned the matter for a hearing on the merits of the lien.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationOrder Disallowing LienNotice of Intent to Disallow LienHearing on the meritsRescindedTrial levelMedical servicesWCJ
References
0
Case No. ADJ4274309 (VNO 0537036) ADJ2544417 (VNO 0537037)
Regular
Jul 07, 2009

HIPOLITO GOMEZ vs. HIGHLAND PARK GUEST HOME, INC., NATIONAL LIABILITY AND FIRE INSURANCE COMPANY

This case concerns lien claimants seeking reconsideration of disallowed liens for failure to appear at a lien trial due to a family emergency. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, finding that the prior order disallowing the liens was issued hastily. The WCAB rescinded the disallowance order and returned the matter to the trial level for further proceedings and a new decision. The Board agreed with the WCJ's recommendation that the lien claimants should be allowed to prosecute their claims based on their merit.

Workers' Compensation Appeals BoardLien claimantsReconsiderationOrder Disallowing LiensNotice of Intention to DismissCompromise and ReleaseIndustrial InjuryHearing RepresentativeFamily EmergencyDue Process
References
0
Case No. ADJ3389162 (LAO 0852819)
Regular
Mar 26, 2013

Jin Yu vs. CWCM, INC., Y.C., INC., Zenith Insurance

This case involved a lien claimant, Dr. Gromis, whose claim for medical treatment reimbursement was disallowed. The WCAB granted reconsideration, rescinding a $1,000 sanction previously imposed on Dr. Gromis for frivolous bad faith. The Board found that Dr. Gromis' pursuit of his lien was not frivolous, as the issue of applicant's employment was not clearly raised by the defendant prior to the lien trial, and he lacked proper notice of a prior ruling disallowing employment. The Board upheld the disallowance of Dr. Gromis' lien for medical treatment.

Lien claimantReconsiderationSanctionBad faithFrivolous actionEmployment statusCompromise and ReleasePre-trial conference statementFindings and OrderCollateral estoppel
References
0
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