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Case Law Database

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

Case No. ADJ4216095 (BAK 0149327)
Regular
Oct 25, 2010

ALICIA NUNEZ ARREOLA vs. SUNTREAT PACKING, STATE COMPENSATION INSURANCE FUND

This case concerns a seasonal worker who sustained an industrial injury to her right shoulder and cervical spine. The defendant sought reconsideration of the permanent disability rate awarded by the WCJ, arguing it was miscalculated for a seasonal employee. The Appeals Board granted reconsideration, finding the WCJ erred in calculating the rate by focusing solely on in-season earnings. The Board amended the award, establishing the permanent disability rate based on the applicant's actual annual earnings, which resulted in a lower rate than initially awarded.

WCABPetition for ReconsiderationFindings and AwardSeasonal workerTemporary disabilityPermanent disabilityStipulationLabor Code section 4453(c)(4)Earning capacityMontana
References
2
Case No. ADJ2440985 (EUR 0037746)
Regular
Mar 03, 2014

FRANK MCCOVEY vs. WAYNE BARE TRUCKING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to amend the applicant's temporary disability rate. The applicant, a truck driver, sustained bilateral knee injuries in August 2003. The Board corrected the applicant's average weekly earnings during the logging season to $947.08, resulting in a temporary disability rate of $631.39 per week. Additionally, the off-season temporary disability rate was adjusted to the statutory minimum of $126.00 per week based on the applicant's limited off-season earnings. The established dates for the logging season, March 15 to December 15, were affirmed.

Wayne Bare TruckingState Compensation Insurance FundFrank McCoveyADJ2440985EUR 0037746Petition for ReconsiderationFindings and Awardbilateral kneestemporary disabilityaverage weekly earnings
References
4
Case No. ADJ4258585 (OXN 0130492) ADJ220258 (OXN 0130487)
Regular
Apr 17, 2018

ENRIQUE HERRERA vs. MAPLE LEAF FOODS, U.S. FIRE INSURANCE COMPANY, ALEA NORTH AMERICAN INSURANCE COMPANY

This notice informs parties that the Workers' Compensation Appeals Board (WCAB) intends to admit its rating instructions and a disability rater's recommended permanent disability rating into evidence. The WCAB previously granted reconsideration for further study. Parties have seven days to object to the rating instructions or the recommended rating, with specific procedures for addressing objections. If no timely objection is filed, the matters will be submitted for decision thirty days after service.

WORKERS' COMPENSATION APPEALS BOARDPermanent Disability RatingDisability Evaluation UnitRating InstructionsRecommended Permanent Disability RatingJoint RatingReconsiderationObjectionRater Cross-ExaminationRebuttal Evidence
References
0
Case No. FRE 0147567
En Banc
Jan 24, 2002

Maria Yolanda Jimenez vs. San Joaquin Valley Labor, Superior National Insurance Company

The Board holds that an industrially injured seasonal employee is entitled to two separate temporary disability indemnity rates based on their in-season and off-season earning capacity, and consequently, their Vocational Rehabilitation Maintenance Allowance (VRMA) should also be a two-tiered award corresponding to those rates.

Workers' Compensation Appeals BoardEn Banc DecisionReconsiderationFindings and AwardSeasonal Farm LaborerTemporary Disability IndemnityVocational Rehabilitation Maintenance Allowance (VRMA)Average Weekly EarningsEarning CapacityIn-Season Rate
References
37
Case No. 2025 NY Slip Op 02569 [237 AD3d 1160]
Regular Panel Decision
Apr 30, 2025

Delcid-Funez v. Seasons at E. Meadow Home Owners Assn.

The plaintiff, Edwin Delcid-Funez, suffered personal injuries after falling approximately 30 feet from a condominium roof while shoveling snow, which he was doing for his employer in response to a leak complaint. He initiated an action against Seasons at East Meadow Home Owners Association, Inc., and Einsidler Management, Inc., alleging a violation of Labor Law § 240 (1). Both the plaintiff and the defendants moved for summary judgment on the issue of liability. The Supreme Court denied both motions. The Appellate Division affirmed the Supreme Court's order, concluding that triable issues of fact remain regarding whether the plaintiff was engaged in an enumerated activity under Labor Law § 240 (1) and whether his actions constituted the sole proximate cause of his injuries.

Labor LawSafe Place to WorkSnow ShovelingRoof FallPersonal InjurySummary JudgmentLiabilityElevated Work SiteProximate CauseAppellate Review
References
9
Case No. MISSING
Regular Panel Decision

People v. Young

An attorney representing an indigent defendant in Monroe County filed an application seeking reimbursement for legal services at a rate of $200 per hour, mirroring the rate charged by the Special Prosecutor, rather than the statutory rates under County Law § 722-b. The attorney argued that the significant disparity in hourly compensation violated the defendant's right to equal protection and that his qualifications justified the requested rate. The New York State Association of Criminal Defense Lawyers supported the application as amicus curiae, while Monroe County opposed it, arguing the request was untimely and lacked extraordinary circumstances. Presiding Judge Donald J. Mark, J., acknowledged the court's authority to grant compensation in excess of statutory limits under extraordinary circumstances but ultimately denied the application. The denial was based on the court's reasoning that an analogous argument was previously rejected, that linking assigned counsel rates to prosecutor rates would render County Law § 722-b ineffective, and that extraordinary circumstances could not be demonstrated prior to the conclusion of the criminal action. The court, however, reserved the right to reconsider an increased hourly fee upon the case's termination if such circumstances are then proven.

Assigned CounselLegal Aid CompensationCounty Law Section 722-bHourly Rate DisputeSpecial Prosecutor FeesIndigent RightsJudicial DiscretionExtraordinary CircumstancesMonroe County LawEqual Protection Challenge
References
16
Case No. FRE 0147567
Significant
Jan 24, 2002

MARIA YOLANDA JIMENEZ vs. SAN JOAQUIN VALLEY LABOR, SUPERIOR NATIONAL INSURANCE COMPANY

The Board holds that an industrially injured seasonal employee's vocational rehabilitation maintenance allowance (VRMA) should be calculated at two-tiered rates, reflecting in-season and off-season earning capacity, similar to temporary disability indemnity. The case is remanded to determine the applicant's off-season earning capacity.

Seasonal farm laborerVocational Rehabilitation Maintenance Allowance (VRMA)Temporary Disability Indemnity (TDI)In-season earnings capacityOff-season earnings capacityAverage weekly earningsLabor Code section 139.5En banc decisionEarning capacity benchmarkTwo-tiered award
References
38
Case No. ADJ20699429
Regular
Sep 15, 2025

VICENTE RAMIREZ vs. FAMILY RANCH, ZENITH INSURANCE COMPANY

Applicant Vicente Ramirez sought reconsideration of a Findings of Fact and Award (F&A) issued by a Workers' Compensation Judge, challenging the findings regarding his employment status and the calculation of his average weekly wage and temporary disability rate. The Appeals Board denied the petition for reconsideration, upholding the WCJ's conclusion that the applicant was not a seasonal employee and had a reasonable expectation of continued employment. The Board found that the evidence presented by the defendant did not support the claim of seasonal employment, affirming the WCJ's calculations for average weekly wage and temporary disability rate.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardSeasonal EmployeeReasonable Expectation of Continued EmploymentAverage Weekly WageTemporary Disability IndemnityLabor Code section 5909Electronic Adjudication Management SystemFarm Laborer
References
10
Case No. MISSING
Regular Panel Decision

Claim of Perrin v. Builders Resource, Inc.

The case concerns an appeal from a Workers' Compensation Board decision regarding the reimbursement rate for home health aide services provided to a claimant by their sister. Initially, the carrier denied payment but was later directed to pay. The Workers’ Compensation Law Judge set the reimbursement rate at $12 per hour for services starting in 2011, which the Board affirmed. The claimant appealed, solely challenging this rate. The court dismissed the appeal, ruling that the claimant was not an aggrieved party concerning the reimbursement rate, as the dispute was between the care provider (the sister) and the carrier. The court affirmed that the claimant received the care sought and could not raise issues on behalf of the care provider.

Workers' CompensationHome Health Aide ServicesReimbursement RateAppeal DismissalAggrieved PartyCare ProviderWorkers' Compensation BoardAppellate ProcedureNew York LawCarrier Liability
References
4
Case No. MISSING
Regular Panel Decision

Anthony L. Jordan Health Corp. v. Axelrod

The Anthony L. Jordan Health Center, a not-for-profit corporation, challenged the New York State Department of Health's recalculation of its Medicaid reimbursement rates for the 1983-1984 and 1984-1985 periods. Following an appeal, the parties entered into a stipulation agreement. However, the Department, while recalculating the rates in accordance with the stipulation, unilaterally changed the group composition, resulting in a significant negative adjustment and recoupment from Jordan. The court determined that this regrouping constituted an 'error of judgment,' not a permissible correction for mathematical error or an audit finding. Consequently, the court found that the Department did not have the right to retroactively adjust the rates based on this discretionary change. The petition was granted.

Medicaid ReimbursementRate RecalculationAdministrative ReviewStipulation AgreementError of JudgmentGroup CompositionRetroactive AdjustmentHealth Care LawJudicial ReviewDepartment of Health
References
5
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