CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. MISSING
Regular Panel Decision

Main Evaluations, Inc. v. State

The claimant, Main Medical Evaluations, entered into contracts with the New York State Office of Temporary and Disability Assistance (OTDA) to perform consultative medical evaluations. OTDA terminated these contracts, alleging the claimant failed to disclose professional disciplinary proceedings against its chief medical officer, Arvinder Sachdev, and submitted false information during the bidding process. Following the dismissal of its claim in the Court of Claims, the claimant appealed. The appellate court affirmed the lower court's judgment, concluding that OTDA had legitimate grounds for termination due to the claimant's misrepresentations and failure to report substantial contract-related issues concerning Sachdev's integral role. Additionally, the court rejected the claimant's equal protection argument, finding no evidence of selective enforcement based on impermissible considerations.

Contract TerminationProfessional MisconductFalse RepresentationEqual ProtectionGovernment ContractsAppellate ReviewBreach of ContractMedical LicensingAdministrative ProceedingsDue Diligence
References
5
Case No. ADJ2167155 (VNO 0443514)
Regular
Oct 17, 2013

Thomas David Williams vs. MAKENZIE ELECTRICAL INC., STATE COMPENSATION INSURANCE FUND

The Appeals Board remanded the case for further development of the record concerning the applicant's claimed injury to psyche/PTSD. The prior findings were not based on substantial evidence due to an inadequate medical history and stale opinions from the evaluating physician, Dr. Glaser. The Board ordered a new evaluation by an Agreed Medical Evaluator or a regular physician to address the complex psychological issues, including PTSD, substance abuse, and potential organic brain injury. After this evaluation, the matter will return to the judge for a new decision incorporating all relevant findings.

Workers' Compensation Appeals BoardReconsiderationPsyche/PTSDSubstantial EvidenceAgreed Medical EvaluatorLabor Code section 5701Findings and AwardWCJPermanent DisabilityApportionment
References
0
Case No. ADJ10024436
Regular
May 13, 2019

JUAN FRANCISCO HERNANDEZ vs. CITI STAFF SOLUTIONS, INC., OLD REPUBLIC INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior decision, finding potential issues with the adequacy of the primary treating physician's medical reports. Specifically, the Board noted that the applicant required a Spanish interpreter for other evaluations and at trial, yet the physician's reports did not mention an interpreter or his own Spanish proficiency. Consequently, the Board rescinded the previous award and remanded the case for further proceedings to clarify these issues regarding the physician's evaluation and communication with the applicant.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPrimary Treating PhysicianQualified Medical EvaluatorSpanish Language InterpreterMedical HistorySubstantial EvidenceInadequate Medical HistoryRescind
References
3
Case No. ADJ7109314
Regular
Apr 22, 2011

YESIKA LEON vs. CREATIVE WOOD PRODUCTS INC., ILLINOIS MIDWEST SPRINGFIELD

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration because the challenged order compelling a medical evaluation was not a final decision. The Board also denied the applicant's petition for removal, finding no showing of significant prejudice or irreparable harm justifying this extraordinary remedy. The applicant had sought to compel a chiropractic evaluation instead of an orthopedic one based on their interpretation of physician specialties and a prior physician's opinion. The Board found no basis to deviate from the administrative law judge's order for an orthopedic evaluation.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalWCJmedical evaluationchiropractic QMEorthopedic evaluationfinal ordersubstantive rightsirreparable harm
References
5
Case No. ADJ10474797
Regular
Nov 13, 2017

Hernan Fuentes vs. STAFFMARK INVESTMENT, LLC, ACE AMERICAN INSURANCE COMPANY, CANNON COCHRAN

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior Findings and Order, and returned the case for further medical record development. The Board found the Qualified Medical Evaluator's (QME) report lacked substantial evidence due to the physician's apparent misunderstanding of workers' compensation principles and conflicting dates of maximum medical improvement. The applicant's primary treating physician's reports were also insufficient as they did not address a significant MRI finding of a re-tear. Therefore, a new medical evaluation from an Agreed Medical Examiner or a WCJ-selected physician is required to determine the applicant's entitlement to temporary disability indemnity.

Workers' Compensation Appeals BoardHernan FuentesStaffmark Investment LLCACE AMERICAN INSURANCE COMPANYCannon CochranADJ10474797San BernardinoPetition for ReconsiderationTemporary Disability IndemnityPrimary Treating Physician
References
0
Case No. ADJ11995067
Regular
Jul 25, 2025

ADELINA PEREZ vs. KYONG AE YUN, CHONG MYON YUN, ZENITH INSURANCE COMPANY

Applicant Adelina Perez sought removal of a May 9, 2022, Findings & Order (F&O) by a workers’ compensation administrative law judge (WCJ), which found Dr. Marcel Ponton's medical-legal report inadmissible and ordered his replacement, arguing Dr. Ponton was a treating physician to whom Labor Code section 4062.3 did not apply. The Workers' Compensation Appeals Board (WCAB) treated the petition as one for reconsideration and found that Dr. Ponton was indeed a treating physician, not a panel-selected medical-legal evaluator, rendering section 4062.3 inapplicable. Consequently, the WCAB rescinded the WCJ's F&O, substituted new findings affirming Dr. Ponton's role as a treating physician, and ordered his continuation as the medical-legal neuropsychological evaluator.

RemovalReconsiderationLabor Code section 4062.3Ex parte communicationMedical-legal evaluatorTreating physicianMPNNeuropsychological assessmentTraumatic brain injuryAdmissibility of evidence
References
17
Case No. 533089
Regular Panel Decision
Oct 07, 2021

Matter of Barden v. General Physicians PC

Claimant, a patient services representative, sought to amend her workers' compensation claim to include left shoulder aggravation after a work-related injury to her right shoulder. The Workers' Compensation Board disallowed this request, finding that claimant failed to provide sufficient credible medical evidence to establish a causal relationship between her employment and the left shoulder condition. The Appellate Division, Third Department, affirmed the Board's decision. The court noted that the claimant's treating physician opined the left shoulder pathology was largely preexisting and unrelated to the work injury, and other medical opinions either lacked sufficient weight or were based on inaccurate information, providing no basis to disturb the Board's finding.

Workers' CompensationShoulder InjuryCausationMedical EvidencePreexisting ConditionAppellate ReviewBoard DecisionClaim AmendmentPatient Services Representative
References
10
Case No. MISSING
Regular Panel Decision
Apr 07, 1988

De Coste v. Champlain Valley Physicians Hospital

Decedent, Darwin A. De Coste, experienced chest pain and elevated blood pressure, leading him to Champlain Valley Physicians Hospital where he was seen by Dr. William Amsterlaw. Amsterlaw diagnosed reflux esophagitis despite an abnormal electrocardiogram, discharging De Coste, who subsequently suffered a fatal cardiopulmonary arrest 12 hours later. The administrator of De Coste's estate filed a wrongful death action, alleging medical malpractice and that the misdiagnosis was the proximate cause of death. A jury awarded pecuniary damages and funeral expenses, which the defendants appealed. The appellate court affirmed the verdict, finding rational support for the jury's malpractice finding and rejecting the defendants' argument to reduce the award by Social Security benefits due to the effective date of CPLR 4545 (c).

Medical MalpracticeWrongful DeathProximate CauseCollateral Source RuleCPLR 4545Jury VerdictEmergency Room CareMisdiagnosisArteriosclerosisMyocardial Infarction
References
3
Case No. MISSING
Regular Panel Decision

55th Management Corp. v. Goldman

This case addresses whether an out-of-court statement made to a court evaluator in an Article 81 guardianship proceeding is protected by absolute privilege, thereby defeating a defamation claim. The defendant, a tenant, made allegedly defamatory remarks about a landlord to a court evaluator during the evaluator's investigation for a guardianship proceeding. The court considered if the remarks were pertinent, if a statement to a court evaluator is considered part of a judicial proceeding, and if the speaker had standing. The court found the remarks pertinent, extended the absolute privilege to statements made to court evaluators given their role as court agents, and affirmed the defendant's standing as a potential witness. Consequently, the defendant's motion to dismiss the defamation complaint was granted.

DefamationAbsolute PrivilegeJudicial ProceedingsCourt EvaluatorGuardianshipMental Hygiene Law Article 81Tenant-Landlord DisputeMotion to DismissCPLR 3211 (a) (7)Scope of Privilege
References
44
Case No. ADJ519728
Regular
Aug 08, 2011

LOWELL BAPTISTE vs. METROPOLITAN TRANSIT AUTHORITY

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding industrial injury and temporary total disability dating back to 2000. The Board found that the medical opinion relied upon by the workers' compensation judge was not substantial evidence due to staleness, lack of complete records, and insufficient specialization. To ensure a fair resolution, the Board ordered new evaluations by independent orthopedic and psychiatric physicians, who will report on all outstanding medical issues.

Workers' Compensation Appeals BoardReconsiderationCompelling Medical EvaluationsTemporary Total DisabilityIndustrial InjuryOrthopedicsPsychiatrySubstantial EvidenceMedical OpinionWCJ
References
2
Showing 1-10 of 3,337 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational