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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
Dec 30, 2015

Matter of Curcio v. Sherwood 370 Management LLC

The claimant, a building engineer, sustained a work-related back and neck injury, initially classified as a permanent total disability by a Workers' Compensation Law Judge (WCLJ) with awarded counsel fees. The Workers' Compensation Board (Board) modified this, finding a permanent partial disability with a 90% loss of wage-earning capacity and reduced counsel fees due to an improperly completed application. The appellate court affirmed the Board's decision, citing substantial medical evidence supporting a partial disability and a 90% loss of wage-earning capacity based on the claimant's age, education, work history, and functional abilities. The court also upheld the reduction of counsel fees due to the attorney's failure to accurately complete the required fee application form.

Permanent Partial DisabilityWage-Earning Capacity LossWorkers' Compensation BenefitsCounsel FeesMedical EvidenceVocational FactorsOC-400.1 ApplicationAdministrative AppealAppellate DivisionMedical Impairment Guidelines
References
12
Case No. 00-CV-1598
Regular Panel Decision
May 28, 2003

Jenkins v. NORTHWOOD REHAB. & EXTENDED CARE FACIL.

Plaintiff Pamela Joan Jenkins sued her prospective employer for discrimination under the Americans with Disabilities Act (ADA), alleging failure to accommodate her back problems which limited her lifting capacity as a physical therapist. The employment offer was rescinded after a health questionnaire revealed her inability to perform maximum assist lifts, a job requirement. Highgate considered and rejected various accommodations, deeming them impractical, unsafe, or requiring the elimination of essential job functions. The court applied the McDonnell Douglas Corp. v. Green burden-shifting test and found that Jenkins could not establish a prima facie case of discrimination because she was not a "qualified individual" under the ADA, unable to perform the essential functions of the job even with accommodation. Consequently, the court granted the defendants' motion for summary judgment, dismissing the federal claims with prejudice and the state law claims without prejudice.

ADA discriminationDisability employmentReasonable accommodationEssential job functionsSummary judgmentPhysical therapistBack injuryMcDonnell Douglas testQualified individualEEOC claim
References
24
Case No. MISSING
Regular Panel Decision

Guttierez v. Berryhill

Betsy Lee Guttierez applied for disability insurance benefits and Supplemental Security Income, alleging disability due to various mental health impairments. Her applications were denied by an Administrative Law Judge and the Appeals Council. Guttierez sought judicial review, arguing that the ALJ failed to properly assess her residual functional capacity (RFC) by rejecting the only medical opinion on her mental ability to work without providing adequate reasons or a function-by-function analysis. The Court agreed, finding the ALJ's RFC assessment unsupported by substantial evidence, as the ALJ, a non-medical professional, made a determination of Guttierez's mental capacity without relying on a medical opinion. Consequently, the Court granted Guttierez's motion, denied the Commissioner's motion, and remanded the case for further administrative proceedings.

Social Security ActDisability BenefitsSSIALJ Decision ReviewRFC AssessmentMedical EvidenceMental Health ImpairmentsBipolar DisorderAnxiety DisorderTreating Physician Rule
References
13
Case No. MISSING
Regular Panel Decision

Ortiz Torres v. Colvin

Luz Leida Ortiz Torres appealed the denial of her Supplemental Security Income (SSI) benefits by the Commissioner of the Social Security Administration. The District Court found that the Administrative Law Judge (ALJ) improperly discounted the treating physician's opinion regarding Ortiz's physical limitations based on a conservative treatment regimen. Consequently, the court vacated the Commissioner's decision in part and remanded the case for a more comprehensive physical residual functional capacity assessment. However, the court affirmed the ALJ's findings on Ortiz's mental residual functional capacity and credibility, deeming them supported by substantial evidence.

Supplemental Security Income (SSI)Disability BenefitsSocial Security Administration (SSA)Residual Functional Capacity (RFC)Degenerative Disc DiseaseDepressionMedical-Vocational Guidelines (Grid)Treating Physician RuleCredibility DeterminationRemand Order
References
26
Case No. MISSING
Regular Panel Decision
Dec 31, 2015

Drake v. SRC, Inc.

The claimant appealed a Workers’ Compensation Board decision from December 31, 2015, which ruled he sustained a permanent partial disability and a 15% loss of wage-earning capacity after a December 2010 work injury. The claimant argued for a 32% loss of wage-earning capacity, which would extend benefit duration, based on post-injury wages. The court affirmed the Board's decision, distinguishing between calculating loss of wage-earning capacity for benefit duration based on vocational factors and wage-earning capacity based on actual earnings. It found substantial evidence supported the 15% loss of wage-earning capacity, considering the claimant's functional abilities, impairment severity, age, education, and language proficiency.

Permanent Partial DisabilityLoss of Wage-Earning CapacityWorkers' Compensation BenefitsVocational FactorsAppellate ReviewSubstantial EvidenceBenefit DurationWork InjuryNeck InjuryBack Injury
References
10
Case No. MISSING
Regular Panel Decision

Matter of Williams v. Preferred Meal Systems

Claimant, a driver, suffered injuries to his right knee and back in 2009 while making a delivery, leading to an established workers' compensation claim. The claim was later amended to include consequential adjustment disorder, and the Workers' Compensation Board ultimately found that claimant had sustained a permanent total disability from May 2012 onward. The employer, workers’ compensation carrier, and policy administrator appealed this decision, arguing that further proof was needed regarding claimant's vocational and functional capacity. The court affirmed the Board's decision, holding that extensive evidence of vocational and functional capacity is not required when medical proof demonstrates a permanent total disability and inability to engage in any gainful employment, as benefits continue for life in such cases. The court found substantial evidence in the opinions of treating and independent medical examination orthopedists to support the finding of permanent total disability.

Workers' CompensationPermanent Total DisabilityWage-Earning CapacityMedical ProofVocational CapacityFunctional CapacityAppellate ReviewNew York LawDisability BenefitsClaimant Rights
References
4
Case No. ADJ11148584, ADJ11607816
Regular
Dec 31, 2018

BRIDGETT LE BOY vs. KAISER PERMANENTE

The applicant sought reconsideration of an Order Approving Compromise and Release (OACR) for $\$28,000.00$ related to back and lower extremity injuries. She argued she would not have settled if she had known her functional capacity test, crucial for her return to work, was approved on the same day as the settlement. The Appeals Board granted reconsideration due to the applicant's allegations and the Board's broad discretion. The OACR was rescinded, and the case was returned to the trial level for further proceedings to determine if the stipulations should be set aside.

Order Approving Compromise and ReleasePetition for ReconsiderationIndustrial InjuryPharmacy TechnicianFunctional Capacity TestMandatory Settlement ConferenceAppeals BoardWorkers' Compensation JudgeGood CauseFraud
References
10
Case No. MISSING
Regular Panel Decision
May 26, 2000

Snyder v. Barnhart

Sharon Snyder applied for Supplemental Security Income disability benefits due to severe back pain and carpal tunnel syndrome, which was denied by the Commissioner of Social Security. The Administrative Law Judge (ALJ) found Snyder capable of "medium" work, but not her past work as a maid, and deemed her ineligible for benefits. This decision was affirmed by the Appeals Council. On appeal, the Court found the ALJ erred by not waiting for a detailed response from Snyder's treating physician, Dr. Richard Dobson, regarding her condition and Spinoscope test results, thus failing to fully develop the record. The case is remanded for the ALJ to consider this additional medical information, carefully weigh the treating physician's opinion, reassess Snyder's residual functional capacity (RFC), and re-evaluate her credibility concerning subjective complaints of pain.

Social Security DisabilityChronic Back PainCarpal Tunnel SyndromeSpinoscope TestAdministrative Law JudgeResidual Functional CapacityTreating Physician RuleCredibility AssessmentRemandMedical Evidence
References
12
Case No. MISSING
Regular Panel Decision
Jun 22, 2015

Claim of Barrett v. New York City Department of Transportation

The case involves an appeal from a Workers’ Compensation Board decision regarding a claimant injured in a 2011 work-related motor vehicle accident. A WCLJ classified the claimant with a permanent partial disability and a 25% loss of wage-earning capacity, ruling that he would be entitled to 250 weeks of benefits if his full wages ceased. The Board affirmed this, leading the employer to appeal, arguing that the claimant's current full wages meant a 100% wage-earning capacity, rendering the 25% loss finding unlawful. The court affirmed the Board’s decision, distinguishing between 'loss of wage-earning capacity' (fixed, for benefit duration) and 'wage-earning capacity' (fluctuating, for weekly rates).

Workers' CompensationPermanent Partial DisabilityWage-Earning CapacityLoss of Wage-Earning CapacityBenefit DurationAppellate ReviewStatutory InterpretationMotor Vehicle AccidentNew York Workers' Compensation BoardDisability Classification
References
2
Case No. MISSING
Regular Panel Decision

Bennett v. Secretary of United States Depatment of Health & Human Services

Charles Bennett ("plaintiff") is appealing a final decision by the Secretary of the United States Department of Health and Human Services, which denied his application for disability insurance and supplemental security income benefits. Bennett, a 41-year-old with a history of heart issues and a December 1986 back injury, claims disability, which was initially denied by an Administrative Law Judge and upheld by the Appeals Council. The court's review examines whether the Secretary's decision is supported by substantial evidence, specifically evaluating the "treating physician rule" concerning the opinions of Dr. Blum and Dr. Gold versus consulting physicians like Dr. Massoff. While objective tests confirm a bulging disc and treating physicians noted decreased range of motion, the court found their cursory "total disability" conclusion for Workers' Compensation purposes insufficient under the Act. Consequently, the court remands the case to the Secretary, requiring further information on Bennett's current residual functional capacity for sedentary or light work.

Social Security ActDisability Insurance BenefitsSupplemental Security IncomeResidual Functional CapacityLumbosacral Spine StrainBulging DiscTreating Physician RuleRemandAdministrative Law JudgeAppeals Council
References
11
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