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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
Jun 02, 2008

Claim of Laezzo v. New York State Thruway Authority

The claimant suffered a work-related slip and fall in 2002, leading to injuries including his head, neck, back, and knees. His morbid obesity contributed to his back and knee issues, prompting him to seek authorization for gastric bypass surgery. The Workers’ Compensation Law Judge approved the surgery, a decision affirmed by the Workers’ Compensation Board, which found the surgery causally related to the compensable injuries. The employer and its carrier appealed, challenging the causal link. The court affirmed the Board's decision, noting substantial evidence that the claimant's weight gain was a result of the sedentary lifestyle imposed by his injuries, and that the surgery would aid in his recovery.

Workers' CompensationConsequential InjuryGastric Bypass SurgeryMorbid ObesityMedical Treatment AuthorizationCausationKnee InjuryBack InjurySedentary LifestyleBoard Decision Appeal
References
2
Case No. ADJ2496250
Regular
Dec 15, 2008

PATRICIA A. ORTIZ vs. SALINAS UNION HIGH SCHOOL DISTRICT, MONTEREY COUNTY SCHOOLS, WCJPA, administrator

This case involves a workers' compensation applicant who sustained a low back injury in 1999, initially awarded 15% permanent disability. After reopening her case, an award of 23% permanent disability was issued, but the board clarified that gastric bypass surgery was not considered reasonably necessary treatment for the industrial injury. Both applicant and defendant sought reconsideration, but the Appeals Board ultimately affirmed the WCJ's findings and awards.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent DisabilityIndustrial InjuryLow Back InjurySubstitute Health TechnicianPetition to ReopenGastric Bypass SurgerySelf-Procured Medical Treatment
References
0
Case No. ADJ1609633 (POM 0277100)
Regular
May 28, 2014

DAVID WILSON (Deceased), PATRICIA WILSON (Widow) vs. POMONA UNIFIED SCHOOL DISTRICT

This case concerns a widow's claim for workers' compensation death benefits following her husband's fatal myocardial infarction. The applicant argued cumulative occupational stress caused his cardiovascular condition and death. However, the Administrative Law Judge and the Appeals Board found the decedent's death resulted from diverticular bleeding leading to a heart attack, a condition deemed not work-related by the chosen medical expert. The Board affirmed the decision denying the claim, finding the medical evidence supporting a non-industrial cause to be more persuasive.

WCABIndustrial InjuryCardiovascular SystemHypertensionHypertensive Ventricular HypertrophyMyocardial InfarctionCumulative Occupational StressDiverticular BleedingColectomyCausation
References
0
Case No. ADJ2162178 (FRE 0200410) ADJ972133 (FRE 0197989)
Regular
Jun 22, 2011

SANDRA LAPLANTE vs. WALMART ASSOCIATES, INC., AMERICAN HOME ASSURANCE

This case involves applicant Sandra Laplante's claim for workers' compensation benefits from Walmart. The initial award found industrial injuries to her right knee, elbow, ankle, and psyche, resulting in 70% permanent disability for one claim and 10% for another, with no apportionment. Upon reconsideration, the Board found a potential for 10% apportionment of psychiatric disability to non-industrial causes, pending further review of whether gastric bypass surgery was industrially related. The applicant's petition for reconsideration of this apportionment, arguing the medical evidence was unsubstantiated, has been denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationGranting ReconsiderationDecision After ReconsiderationJoint Findings Award and OrderAgreed Medical ExaminerApportionmentPsychiatric DisabilityNon-Industrial CausesGastric Bypass Surgery
References
0
Case No. MISSING
Regular Panel Decision

Claim of Berland ex rel. Berland v. P. Mackner & Co.

The Workers' Compensation Board disallowed a claim for benefits, ruling that the death of the claimant's decedent was not causally related to a prior accident. The decedent died on January 27, 1997, due to cardiopulmonary arrest, cardiac arrest, and atherosclerotic heart disease, with cerebrovascular accident and gastrointestinal bleeding as contributing conditions. The prior accident, on December 11, 1952, had resulted in leg injuries. The claimant failed to provide prima facie medical evidence establishing a causal connection between the 1952 accident and the 1997 death from a heart condition. The court affirmed the Board's determination, finding substantial evidence to support the lack of causal relationship.

Causal RelationshipWorkers' Compensation BenefitsDeath ClaimHeart DiseasePrior AccidentMedical EvidenceBurden of ProofSubstantial EvidenceBoard DeterminationAppellate Review
References
2
Case No. MISSING
Regular Panel Decision
Mar 18, 1987

Claim of Brush v. New York University Medical Center

The claimant, an animal research technician for New York University Medical Center, was exposed to toxic chemicals and mice, developing several health issues including bleeding dyscrasia, thrombocytopenia, and later viral meningeal encephalitis. Her physician testified that her condition was causally related to exposure to mice and their droppings. Despite conflicting medical testimony, the Workers’ Compensation Board reversed an Administrative Law Judge's denial, finding a work-related disability. The self-insured employer appealed this decision, arguing a lack of substantial evidence. The Appellate Division, however, affirmed the Board's decision, deferring to its province to resolve conflicting medical testimony.

Workers' CompensationOccupational DiseaseViral Meningeal EncephalitisThrombocytopeniaAnimal Research TechnicianExposure to AnimalsCausal RelationshipMedical TestimonySubstantial EvidenceAppellate Review
References
2
Case No. MISSING
Regular Panel Decision

Byfield v. Chapman

Plaintiff, proceeding pro se, initiated a lawsuit against prison officials under 42 U.S.C. § 1983, alleging that he was subjected to a beating on February 16, 2011, which he claims led to him observing blood in his urine five days later. Defendants subsequently filed a Motion in Limine, seeking to prevent the plaintiff from testifying about his observation of blood in his urine without expert medical testimony to establish causation. Defendants argued that the injury was complex and cited their own expert's opinion attributing the bleeding to benign prostatic hypertrophy. The court, after reviewing arguments and relevant case law, denied the defendants' motion, ruling that the observation of blood in urine following a beating is not an injury so complex that a lay jury cannot assess causation based on common knowledge and the presented evidence, including conflicting expert opinions.

Motion in LimineExpert TestimonyCausationLay Witness Testimony42 U.S.C. § 1983Prison OfficialsPhysical InjuryBlood in UrineFederal Rules of EvidencePro Se Plaintiff
References
12
Case No. MISSING
Regular Panel Decision

Brewerton v. Barnhart

This is an action brought under 42 U.S.C. § 405(g) to review the Commissioner of Social Security's final determination denying the plaintiff's application for disability insurance and SSI benefits. The plaintiff claimed inability to work due to premenstrual dysthymic disorder, panic attacks, major depression, and anxiety, alongside physical issues and alcoholism. After an Administrative Law Judge (ALJ) denied benefits, and the Appeals Council upheld this, the plaintiff sought judicial review. The District Court, presided over by Judge Siragusa, considered the defendant's motion for judgment on the pleadings and the plaintiff's cross-motion for remand based on new medical evidence (post-hearing psychiatric reports, surgery for abnormal menstrual bleeding, and knee surgery). The court found the new evidence material and good cause for its late submission. Consequently, the court denied the Commissioner's motion and granted the plaintiff's motion, remanding the case for further administrative proceedings.

Social SecurityDisability BenefitsSupplemental Security Income (SSI)Disability Insurance BenefitsMental ImpairmentDepressionAnxietyPanic AttacksPremenstrual Dysphoric DisorderAlcoholism
References
11
Case No. MISSING
Regular Panel Decision

Twin City Bakery Workers & Welfare Fund v. Astra Aktiebolag

Plaintiffs allege that defendants monopolized and attempted to monopolize the market for the gastric acid inhibiting drug Prilosec through "sham" litigation, violating Section 2 of the Sherman Antitrust Act and various state laws. The core allegation is that defendants listed numerous later-obtained patents in the Orange Book, knowing they would not proscribe generic versions, solely to trigger automatic 30-month stays on generic drug approvals by initiating infringement lawsuits. Defendants moved to dismiss the Amended Complaint based on the Noerr-Pennington doctrine, which provides antitrust immunity for attempts to influence governmental action. The court, presided over by District Judge Rakoff, found that because claims of infringement for four of the six asserted patents had proceeded beyond summary judgment and two to trial, the litigation was not objectively baseless and thus enjoyed Noerr-Pennington immunity. Allegations of fraud in obtaining or listing patents were dismissed due to lack of particularity as required by Fed.R.Civ.P. 9(b). The court also determined that merely listing the patents did not cause the monopoly extension; rather, it was the subsequent infringement lawsuits. Consequently, the court granted the defendants' motion to dismiss, dismissing the federal claims with prejudice and the state-law claims without prejudice due to a lack of supplemental jurisdiction.

Antitrust LawSherman ActNoerr-Pennington DoctrineSham LitigationPatent InfringementFDA RegulationsOrange BookGeneric Drug ApprovalMonopolizationMotion to Dismiss
References
19
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