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

Case No. ADJ4718149 (GRO 0034104) ADJ708995 (GRO 0034105)
Regular
Jul 03, 2012

ART QUIROS vs. SUPERIOR TANK COMPANY, INC., SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded an earlier order awarding reimbursement to the Employment Development Department (EDD). The Board found that EDD's claim for reimbursement was invalid because EDD failed to provide the defendant with proper written notice of the lien claim and its extent, as required by Labor Code section 4904(a). Although EDD argued oral notice was given at hearings, the Board held that statutory law mandates written notification for a lien to be valid. Therefore, EDD's claim for reimbursement was disallowed.

Workers' Compensation Appeals BoardSuperior Tank CompanySeabright Insurance CompanyEmployment Development Departmentlien claimCompromise and Releasewritten noticeLabor Code section 4904(a)actual or constructive noticetemporary disability benefits
References
0
Case No. MISSING
Regular Panel Decision

Angulo v. City of New York

In a personal injury action, the defendant City of New York appealed an order from the Supreme Court, Queens County. The original order denied the City's motion to dismiss the complaint for failure to timely serve a notice of claim and granted the plaintiff's cross-motion to deem his notice of claim timely served nunc pro tunc. The plaintiff, injured in May 2005, served his notice of claim in August 2005, which the City rejected as untimely. The Appellate Division reversed the lower court's order, granting the City's motion to dismiss the complaint and denying the plaintiff's cross-motion. The court held that timely service of a notice of claim is a condition precedent to suing the City and that the plaintiff failed to make a timely application for leave to serve a late notice of claim. Furthermore, the court ruled that the plaintiff could not rely on the workers' compensation carrier's notice of claim.

Personal InjuryNotice of ClaimTimelinessCondition PrecedentCPLR 3211(a)(7)General Municipal Law § 50-eDismissal of ComplaintLate Notice of ClaimNunc Pro TuncWorkers' Compensation Carrier
References
7
Case No. AHM 0097551
Regular
Jan 22, 2008

THE IRON MULE vs. STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration, rescinded the prior award, and returned the case for further proceedings. The Board found Dr. Eroshevich's psychiatric reports inadmissible due to violations of Labor Code section 4628 and gave notice of intent to impose a civil penalty against her. The matter was remanded to reconsider TDI rates, EDD's lien claim, and potential sanctions against the defendant for their delayed denial of liability.

Workers' Compensation Appeals BoardReconsiderationFindings & Award & OrderIndustrial InjuryNeck InjuryBack InjuryPsyche InjuryTemporary Total DisabilityPermanent DisabilityMedical-Legal Report
References
0
Case No. ADJ739750 (FRE 0217695), ADJ3422922 (FRE 0217696), ADJ4620151 (FRE 0217213)
Regular
Aug 26, 2010

JERRY WILLIAMS vs. GOLDEN STATE VINTNERS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded prior findings, returning the case to the trial level for further proceedings due to insufficient documentation regarding credit for benefits paid and resolution of EDD liens. The Board also issued a notice of intention to impose a $250 sanction on SCIF for failing to comply with the mandatory rule requiring a computer printout of benefits paid. This failure to provide essential information caused unnecessary delay and appeared to be a bad-faith tactic. The matter requires clarification of calculations and a clear record for review.

WCABGolden State VintnersState Compensation Insurance FundJerry Williamsmaintenance mechanicwinery workerforemancumulative traumabilateral kneeshearing loss
References
0
Case No. ADJ1975641 (SRO 0139288)
Regular
Nov 15, 2010

LETEBRHAN BERHE vs. DLK VENTURES INC. dba HANNA HOUSE, RIDLEY NURSING HOME; VIRGINIA, SURETY INSURANCE COMPANY as, administered by FIRSTCOMP OMAHA

Defendant seeks reconsideration of an award finding applicant sustained a work injury and granted benefits, including reimbursement to EDD from applicant's permanent disability award. The defendant contends the WCJ erred by not ordering applicant to reimburse EDD directly. The Appeals Board granted reconsideration, rescinded the decision, and returned the matter to the trial level. This action was taken to allow the WCJ to determine EDD's entitlement to reimbursement directly from the defendant, given the defendant's failure to notify EDD of permanent disability payments after receiving EDD's lien notice.

WORKERS' COMPENSATION APPEALS BOARDDLK VENTURES INC.HANNA HOUSERIDLEY NURSING HOMEVIRGINIA SURETY INSURANCE COMPANYFIRSTCOMP OMAHAADJ1975641SRO 0139288LETEBRHAN BERHEFindings and Award
References
0
Case No. MISSING
Regular Panel Decision

Isereau v. Brushton-Moira School District

This case concerns consolidated appeals from Supreme Court orders granting petitioners Darrell Isereau and Jason K. Houghton leave to file late notices of claim against Brushton-Moira School District. The petitioners, employees of Bette & Cring, LLC, were injured in a construction accident in August 2002, sustaining falls of approximately 15 feet. They sought to file late notices of claim based on alleged incapacitation and the District's actual knowledge of the accident. The respondent District argued prejudice due to late notice and a subsequent insurance disclaimer. The Appellate Division affirmed the Supreme Court's orders, finding no abuse of discretion as the District had actual notice of the essential facts, and the insurance disclaimer was attributed to the District Superintendent's failure, not the petitioners' delay.

Late Notice of ClaimGeneral Municipal LawLabor Law ViolationsPersonal InjurySchool District LiabilityConstruction AccidentFall AccidentActual KnowledgePrejudiceInsurance Disclaimer
References
5
Case No. ADJ5814563
Regular
Nov 19, 2012

MARIA VILLEGAS vs. BURKE WILLIAMS, INC., TRAVELERS SACRAMENTO

The Appeals Board dismissed the lien claimant's Petition for Reconsideration as untimely, unverified, and unserved. The Board also initiated removal and a notice of intention to impose a $250 sanction against the lien claimant and its representative for frivolous conduct, including filing a petition with willful misrepresentations of the record. The lien claimant failed to appear at a lien conference, leading to a Notice of Intention to Dismiss, which formed the basis of the dismissed petition. The Board found the lien claimant's assertion of lack of notice contradicted the record, which showed service of the conference notice.

Notice of Intention to Dismiss LienPetition for ReconsiderationLien claimantRemovalSanctionsLabor Code § 5813Due processVerificationServiceUntimely
References
9
Case No. ADJ9258192
Regular
Aug 03, 2015

Thomas Senczakiewicz vs. Boeing Company, Sedgwick Claims Management Services, Inc.

The Appeals Board granted reconsideration to address the applicant's attorney fee claim under Labor Code § 4903.2, related to EDD lien reimbursement. The Board affirmed the original award of temporary total disability but deferred the issue of attorney fees against the EDD lien. They found the applicant's attorney instrumental in securing EDD's reimbursement, as EDD had notice of hearings but did not participate. The matter is returned to the WCJ for further proceedings on the attorney's fee.

Workers' Compensation Appeals BoardPetition for ReconsiderationAmended Findings Award and OrderAdministrative Law JudgeProduction Operation SpecialistThoracic SpineLumbar SpineRight ShoulderTemporary Total DisabilityPost-Retirement Period
References
0
Case No. VNO 0413963
Regular
Dec 26, 2007

KATHLEEN FREEMAN vs. FOTO-KEM INDUSTRIES, CNA INSURANCE COMPANY

This case involves the Employment Development Department's (EDD) lien claim. The Appeals Board initially dismissed EDD's petition for reconsideration as untimely, but upon review of new evidence, found it was timely filed. Despite the timely filing, the Appeals Board denied EDD's petition on its merits, affirming the WCJ's decision to disallow EDD's lien due to improper notice to the administering defendant, resulting in a double recovery for the applicant.

Workers' Compensation Appeals BoardReconsiderationEmployment Development DepartmentPetition for ReconsiderationWCJ DecisionLienReimbursementDouble RecoveryMisdirected NoticeStipulation
References
1
Case No. MISSING
Regular Panel Decision

Claim of Miller v. North Shore University Hospital

Claimant, a registered nurse, allegedly exacerbated an abdominal injury in September 1994 while at work, but did not file a workers' compensation claim until May 1996, after undergoing surgery. The workers' compensation carrier subsequently controverted the claim, citing untimely notice. Both a Workers' Compensation Law Judge and the Workers' Compensation Board determined that the claimant failed to provide timely notice to the employer as mandated by Workers’ Compensation Law § 18. On appeal, the court affirmed the Board's decision, concluding that the emergency room report was insufficient to constitute proper notice. Furthermore, the claimant did not meet his burden of proving that the employer was not prejudiced by the delay in notice, as the delay prevented an investigation prior to his surgery.

Timely NoticeEmployer KnowledgePrejudiceAbdominal InjuryRegistered NurseAccident ReportEmergency RoomSurgeryAppellate ReviewWorkers' Compensation Law § 18
References
5
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