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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

Lyublinsky v. Barnhart

A 73-year-old disabled plaintiff, who has received Social Security Disability (SSD) benefits since 1993, brought this action to review the Commissioner's final determination concerning his benefit rate calculation. The plaintiff argued that his benefit rate was improperly calculated, citing discrepancies in earnings records and claims of discrimination. The case has a lengthy procedural history, including multiple remands from the District Court due to issues like denial of a fair hearing and lack of legal representation. The Court conducted a de novo review of the Social Security Administration's (SSA) benefit calculations, utilizing the Average Indexed Monthly Earnings (AIME) method, and found no mathematical errors. Ultimately, the plaintiff failed to present compelling evidence to disprove the SSA's records, which are considered conclusive after a statutory period. Consequently, the Commissioner's motion for judgment on the pleadings was granted, the complaint was dismissed, and the Administrative Law Judge's (ALJ) decision was affirmed.

Social Security DisabilityBenefit CalculationAIME MethodAdministrative Law JudgePro Se PlaintiffFederal Court ReviewEarnings RecordsBurden of ProofRemandJudgment on the Pleadings
References
3
Case No. MISSING
Regular Panel Decision

Romero v. Albany Medical Center Hospital

The case involves an appeal from a Workers' Compensation Board decision concerning a claimant's wage expectancy calculation. The employer challenged the Board's consideration of the claimant's potential earnings as a physician, rather than a part-time nursing aide, given her age and career aspirations. The court affirmed the Board's decision, emphasizing that the rule limiting wage expectancy to similar employment does not apply in atypical situations, especially when a claimant is actively pursuing a higher-earning career path like medicine, with their current job being secondary.

Wage ExpectancyFuture EarningsWorkers' Compensation BoardAppellate ReviewCareer ProgressionAtypical EmploymentAverage Weekly WageMedical CareerPart-time WorkUnder 25 Claimant
References
3
Case No. ADJ8820335
Regular
Apr 17, 2017

RAHSHON LOYD vs. DOLAN CONCRETE CONSTRUCTION, OLD REPUBLIC CONTRACTORS INSURANCE GROUP, GALLAGHER BASSETT SERVICES, INC.

This case concerns the calculation of applicant Rahshon Loyd's average weekly earnings (AWE) for temporary disability indemnity following a $100\%$ permanent and total industrial injury. The defendant argued the WCJ erred by calculating AWE based on a presumed 40-hour work week, instead of applicant's actual irregular earnings history. The Appeals Board granted reconsideration, finding that while applicant's earning capacity was relevant, his historical earnings as a union cement mason, even after attaining journeyman status, did not consistently reflect a 40-hour work week. Consequently, the Board amended the decision to calculate AWE as an average of his weekly wage over the three years prior to injury, resulting in a reduced temporary disability rate.

Workers' Compensation Appeals BoardAverage Weekly EarningsTemporary Disability IndemnityLabor Code Section 4453Earning CapacityUnion Cement MasonJourneymanPermanent and Total DisabilityVocational EvaluatorPetition for Reconsideration
References
4
Case No. MISSING
Regular Panel Decision

Claim of Reasoner v. New York State Department of Motor Vehicles

This appellate decision addresses whether the Workers' Compensation Board correctly calculated the claimant's average weekly wage. The employer and carrier argued that due to the claimant's limited employment as an MVRSAB member, the compensation rate should be based on actual earnings, not the 200 multiple outlined in Workers’ Compensation Law § 14 (3). The Board determined that neither Workers’ Compensation Law § 14 (1) nor (2) was applicable, thus applying Workers’ Compensation Law § 14 (3). It also found no evidence that the claimant voluntarily limited participation in the labor market, based on testimony of availability and continued business operation. The court affirmed the Board's calculation.

average weekly wageworkers' compensation lawcompensation rateemployment limitationlabor marketstatutory interpretationappellate reviewMVRSAB member
References
8
Case No. MISSING
Regular Panel Decision
Feb 17, 1977

Orbinati v. Utica Mutual Insurance

A claimant, employed as a physical education teacher and track/football coach by the Utica City School District, sustained an injury in August 1970. His average weekly wage was calculated to include his coaching stipend. Following his injury, he returned to his teaching role with restrictions that prevented him from coaching. Despite subsequent salary increments resulting in a higher overall salary than his pre-injury average weekly wage, the claimant contended he was experiencing reduced earnings due to the loss of his coaching allowance. The Workers’ Compensation Board and the referee affirmed there were no reduced earnings, concluding that his teaching and coaching constituted a single, integrated employment. This decision was subsequently affirmed without costs.

Workers' CompensationReduced EarningsAverage Weekly Wage CalculationDual EmploymentSingle EmploymentCoaching StipendUtica City School DistrictWorkers' Compensation LawAppellate DecisionInjury in Course of Employment
References
1
Case No. ADJ8517780
Regular
Jun 03, 2013

DEANNA ROBBINS vs. SUSANVILLE ELEMENTARY SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied the defendant school district's petition for reconsideration. The district challenged the calculation of the applicant's average weekly earnings, arguing her probationary status should reduce the figure. However, the Board affirmed the administrative law judge's finding, determining that the applicant's earnings capacity was properly calculated based on her actual earnings from multiple employers prior to the injury. The Board emphasized that earning capacity is a dynamic assessment, not limited to the applicant's immediate employment status.

Workers' Compensation Appeals BoardSusanville Elementary School DistrictDeanna RobbinsPetition for ReconsiderationFindings and Awardcumulative injuryupper extremitiesaverage weekly earningsearning capacityLabor Code section 4453(c)(4)
References
7
Case No. ADJ12393038
Regular
Mar 07, 2023

CRISTIAN AVILA GARCIA (Deceased) SINTIA YANETH GARCIA (Guardia Ad Litem) vs. BAYVIEW ENVIRONMENTAL SERVICES INCORPORATED, GREAT DIVIDE INSURANCE COMPANY, BERKELEY ENTERTAINMENT

In this workers' compensation case, the applicant's average weekly wage (AWW) was determined based on his higher earnings during the four weeks prior to his death on a special project. The defendant sought reconsideration, arguing the AWW should have been based on his entire tenure, but the Appeals Board affirmed the original award. The Board held that AWW is calculated based on earnings "at the time of injury" to reflect earning capacity, not necessarily the entire earnings history. Therefore, the calculation using the prevailing wage during the Santa Monica project was upheld.

Workers' Compensation Appeals BoardCristan Avila GarciaSintia Yaneth GarciaBayview Environmental Services IncorporatedGreat Divide Insurance CompanyBerkeley EntertainmentAdjudication NumberFindings and AwardAverage Weekly WageTemporary Disability Indemnity
References
6
Case No. MISSING
Regular Panel Decision

Claim of Sneyd v. Joy-Kar Taxi

The Workmen’s Compensation Board awarded death benefits to the widow of William Sneyd, who died in a work-related accident, by calculating his average weekly wage based on his combined earnings from concurrent similar employments with Joy-Kar Taxi and County School Service, Inc. Appellants challenged this method, arguing that only wages from the employer at the time of injury should be considered, as Sneyd's employment with County School Service, Inc. had ceased shortly before his death. The court affirmed the Board's decision, interpreting Section 14 of the Workmen’s Compensation Law to prioritize an employee’s total annual earning capacity when determining average weekly wage in cases of concurrent similar employments. It clarified that the phrase "at the time of the injury" in the statute serves as a temporal marker for examining past and potential future earnings rather than restricting wage calculation to a single employer. Consequently, the court upheld the use of total wages from both employments to ensure a fair assessment of the deceased's earning potential.

Death benefitsAverage weekly wageConcurrent employmentsWorkmen's Compensation LawStatutory interpretationEarning capacityAppellate reviewWage calculationSimilar employmentsWorkmen's Compensation Board decision
References
7
Case No. ADJ3871980 (SBR 0332495) ADJ1578450 (SBR 0333829) ADJ7125261
Regular
Nov 05, 2010

ANITA BAKER vs. SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP, PSI, Adjusted and Administered By KAISER PERMANENTE MEDICAL GROUP

This case involves Anita Baker's workers' compensation claim against Southern California Permanente Medical Group. The Workers' Compensation Appeals Board denied reconsideration of the judge's decision. The primary dispute centered on the calculation of diminished future earning capacity, with the applicant arguing for a calculation based on actual lost earnings and the defendant relying on statutory guidelines and expert testimony. The Board adopted the judge's report, which found in favor of the applicant regarding the calculation of permanent disability, incorporating aspects of both expert opinions and considering the applicant's specific circumstances.

Workers Compensation Appeals BoardSouthern California Permanente Medical GroupKaiser Permanente Medical GroupPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeOgilvie v. City and County of San Franciscodiminished future earning capacityFindings and Awardcontinuous traumabilateral upper extremities
References
1
Case No. ADJ11991362
Regular
Mar 13, 2023

EDEN BOJORQUEZ GERARDO vs. METAL SUPPLY, INC., FEDERAL INSURANCE COMPANY, GALLAGHER BASSETT

The Workers' Compensation Appeals Board (WCAB) affirmed a prior decision finding the applicant's average weekly earnings to be $1,492.25, resulting in a temporary disability rate of $994.83. The WCAB gave great weight to the workers' compensation judge's (WCJ) credibility determinations, finding no substantial evidence to warrant rejection. The WCJ relied on the applicant's W2 information for 2018 and 2019 to calculate earnings due to inconsistencies and lack of clarification in the provided pay stub evidence. The WCJ's calculation closely approximated the defendant's calculation, which was adopted by the WCAB.

WCABReconsiderationFindings and OrderCredibility DeterminationsGarza v. Workmen's Comp. Appeals Bd.Petition for ReconsiderationStatutory GroundsTemporary DisabilityAverage Weekly EarningsPrevailing Wage
References
4
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