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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
Mar 28, 1985

Gay v. American Janitor Service

This case concerns an appeal from a Workers’ Compensation Board decision affirming that the claimant sustained an accidental injury during the course of employment. The claimant, an employee of American Janitor Service, was injured in a company vehicle while being transported to work. Although transportation was not contractually mandated or compensated, it was a regular accommodation provided by the employer. The court affirmed the Board's decision, citing Matter of Holcomb v Daily News, which established that workers' compensation benefits can be awarded for transportation-related injuries if an employer knowingly acquiesces to a long-established practice of providing transport. The record supported the finding of such a common practice.

Workers' CompensationTransportation InjuryCourse of EmploymentEmployer LiabilityImplied AgreementAcquiescenceAppellate ReviewBoard DecisionAccident
References
1
Case No. ADJ1925946 (VNO 0473346)
Regular
Feb 02, 2012

ELIZABETH GONIA vs. ROBIN, CARMACK & GONIA LLP, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board reversed an award for housekeeping services, finding the applicant failed to properly object to the utilization review denial for services requested after January 29, 2009. For services prior to that date, the Board found the applicant did not present sufficient medical evidence demonstrating the housekeeping was "medically necessary and reasonable" to treat her industrial injury. The applicant sustained multiple injuries in 1996, resulting in 100% permanent disability, and sought reimbursement for increased housekeeping due to her condition.

Workers' Compensation Appeals BoardElizabeth GoniaRobin Carmack & Gonia LLPState Compensation Insurance FundFindings and AwardReconsiderationPermanent DisabilityMedical TreatmentHousekeeping ServicesUtilization Review
References
11
Case No. MISSING
Regular Panel Decision
Jul 19, 1996

Claim of Rochel v. Gardiner Manor Mall

A claimant, injured in 1982 as a general manager, was initially classified with a permanent partial disability. Due to a worsened condition, she was reclassified as permanently totally disabled in 1991, receiving ordinary compensation and housekeeping services. This determination was affirmed by the Workers' Compensation Board. The employer appealed, but the court found substantial medical evidence supported the Board's decision on the worsened disability. The court also upheld the award for housekeeping services under Workers’ Compensation Law § 13 (a), as the claimant's inability to perform household tasks was medically established.

permanent total disabilitypermanent partial disabilityworkers' compensation benefitshousekeeping servicesmedical evidencetreating physiciansindependent medical examinationstatutory interpretationdisability reclassificationjudicial review
References
6
Case No. MISSING
Regular Panel Decision

Kenton v. Wyman

Petitioner, a 35-year-old father of five, was enrolled full-time in the SEEK program at college. His public assistance grant was reduced, and housekeeping services discontinued, because he refused to seek employment that interfered with his schooling. The court examined whether the hearing officer should have disqualified herself (found she was qualified), whether the petitioner was entitled to public assistance while in the SEEK program (found he was not as he wasn't a minor or in an approved vocational program), and whether he required notice for discontinuance of housekeeping services (found he did, but he had a fair hearing). The court ultimately directed that the petitioner be reimbursed for welfare allowances deducted during the period leading up to the State's fair hearing decision, acknowledging a new regulation requiring continued payments during that time, but upheld the other decisions.

Public AssistanceWelfareSEEK ProgramFull-Time StudentEmployabilityFair HearingHousekeeping ServicesGrant ReductionArticle 78 ProceedingSocial Services Law
References
4
Case No. MISSING
Regular Panel Decision
Dec 13, 1999

White v. Marriott Management Services

The plaintiff, a building service housekeeper at the New York Hospital Medical Center of Queens, allegedly sustained personal injuries while operating a "windblower" machine. The defendant, responsible for managing the hospital's housekeeping department, sought summary judgment, contending that the plaintiff was its special employee, limiting his remedy to Workers' Compensation benefits. The Supreme Court initially agreed and dismissed the complaint. However, the appellate court reversed the decision, asserting that the Workers' Compensation Board holds primary jurisdiction over determinations concerning the applicability of the Workers' Compensation Law. The case was subsequently remitted to the Supreme Court with instructions to defer ruling on the summary judgment motion until the Workers' Compensation Board makes a final determination regarding the parties' rights.

Personal InjuryWorkers' Compensation LawSummary JudgmentPrimary JurisdictionSpecial EmployeeAppellate ReviewKings CountyRemittalHospital EmployeeHousekeeping
References
7
Case No. MISSING
Regular Panel Decision

In re the Claim of Augustine

This case involves an appeal by the Industrial Commissioner from a decision of the Unemployment Insurance Appeal Board. The Board had ruled that the claimant, a full-time student at the University of Buffalo working as a janitor, was entitled to unemployment insurance credit. The claimant attended university from approximately 9:30 A.M. to 2:20 P.M. daily, pursuing a Bachelor of Arts degree to qualify for law school, and worked as a janitor from 4:30 P.M. to 1:00 A.M. five days a week. The central question was whether his janitorial work fell under the "Day student" exception in Labor Law § 511(9), which excludes certain part-time student employment from the definition of "employment" for unemployment insurance purposes. Citing precedents like *Matter of Renee (Gorsi)* and *Matter of Moslcowitz (Gorsi)*, the court concluded that the claimant's work fit the statutory exception, viewing it as a temporary job subordinate to his education rather than a permanent livelihood. Consequently, the court unanimously reversed the Appeal Board's decision and reinstated the Industrial Commissioner's initial determination.

Unemployment InsuranceStudent EmploymentLabor Law ExceptionPart-time WorkAppeal BoardJudicial ReviewEducational PursuitTemporary EmploymentStatutory InterpretationJanitor
References
2
Case No. LAO 0778165
Regular
Jul 29, 2008

ROBERTO REYES vs. DRAKE OFFICE OVERLOAD, RELIANCE NATIONAL INSURANCE, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ADVO, INC, ST. PAUL TRAVELERS

This case involved a janitor injured while employed by both a general employer (Drake) and a special employer (Advo). The Workers' Compensation Appeals Board denied Advo's petition for reconsideration, upholding the finding of joint and several liability for the injury. The Board affirmed that Advo's agreement with Drake did not absolve Advo of liability, the statute of limitations did not bar the claim against Advo, and the neurologist's opinion constituted substantial medical evidence.

Workers Compensation Appeals BoardSpecial EmployeeGeneral EmployerJoint and Several LiabilityCIGAInsurance Code section 1063.1Labor Code section 5405Statute of LimitationsLachesSubstantial Medical Evidence
References
19
Case No. VNO 0411435
Regular
Dec 27, 2007

REBECA WISE vs. CALIFORNIA STATE UNIVERSITY NORTHRIDGE, permissibly self-insured, administered by OCTAGON RISK SERVICES

The applicant sought reconsideration of a decision that denied an industrial psychiatric injury claim, arguing that the psychiatrist's opinion was not substantial evidence. The Appeals Board denied reconsideration, finding the psychiatrist's opinion to be substantial medical evidence that supported the finding of non-industrial causation for the psychiatric injury. The Board also noted that the issue of housekeeping services was not ripe for reconsideration and a clerical error regarding apportionment would be corrected at the trial level.

Workers' Compensation Appeals BoardRebeca WiseCalifornia State University NorthridgeOctagon Risk ServicesVNO 0411435Opinion and Order Denying Petition for ReconsiderationFindings and AwardAdministrative Law JudgeIndustrial InjuryLumbar Spine
References
4
Case No. ADJ2088268 (MON0341079)
Regular
Dec 07, 2012

ERNESTINA MORALES (Deceased), MARIO R. CHAVARRIA, DEATH WITHOUT DEPENDENTS UNIT vs. SHEILA HARTMAN, ALLSTATE INSURANCE CO., SHEILA HARTMAN MANAGEMENT CO., BENEDICT CANYON PRODUCTIONS, STATE COMPENSATION INSURANCE FUND

This case concerns the compensability of a housekeeper's death that occurred on her employer's premises. The appellate board granted reconsideration but affirmed the WCJ's decision finding the death arose out of and in the course of employment under the "bunkhouse rule," despite the decedent not working weekends. It also clarified that the decedent was employed by Sheila Hartman individually, not by related production companies. The board found no error in dismissing the other companies and their insurer, as this was a determination of employment status, not a coverage dispute.

Workers' Compensation Appeals BoardPetition for ReconsiderationErnestina MoralesSheila HartmanAllstate Insurance Co.Specialty Risk ServicesSheila Hartman Management Co.Benedict Canyon ProductionsState Compensation Insurance FundWCJ
References
3
Case No. ADJ7498085 ADJ7264010
Regular
Dec 03, 2012

SANDRA CATLIN vs. JC PENNEY, INC., AMERICAN HOME ASSURANCE COMPANY

The Appeals Board granted reconsideration, rescinded the WCJ's award, and returned the matter to the trial level. While not finding the Agreed Medical Examiner's (AME) report inadmissible due to a procedural violation, the Board determined it lacked substantial medical evidence. The AME's report was deemed cursory and not based on adequate examination or reasoning to support the award of housekeeping services. Further proceedings are required to develop the record, potentially including a re-evaluation by the AME and cross-examination.

Workers Compensation Appeals BoardJoint Findings and AwardAgreed Medical Examiner (AME)Supplemental ReportLabor Code Section 4062.3Treating Physician ReportHousekeeping ServicesSubstantial Medical EvidenceReconsiderationRescind Decision
References
10
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