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

Case No. SAL SJO 252436 (MF); SJO 246192
Regular
Jul 02, 2007

NIHAL HORDAGODA vs. State Compensation Insurance Fund

This case involves an employer's petition for reconsideration of an order authorizing medical treatment and admitting the Qualified Medical Examiner's (QME) reports. The employer argued the QME reports were inadmissible due to an alleged ex parte communication between the applicant and the QME, and that the awarded treatments were improper. The report recommends denying the petition, finding the communication was permissible under LC § 4062.3(h) and that the QME's opinions and awarded treatments for chronic pain were reasonable and not governed by ACOEM guidelines.

Workers' Compensation Appeals BoardPetition for ReconsiderationQualified Medical EvaluatorLabor Code Section 4062.3Ophthalmological evaluationFunctional capacity evaluationUtilization ReviewACOEM GuidelinesChronic spinal conditionTreating physician
References
0
Case No. MISSING
Regular Panel Decision
Feb 15, 2001

Daniel v. Safir

Plaintiff Elridge Daniel, Jr., proceeding pro se, initiated a civil rights lawsuit alleging constitutional violations stemming from his 1995 arrest and criminal harassment prosecution. The action named several defendants, including judicial officers, private attorneys, a law firm, and corporations. Magistrate Judge Steven M. Gold recommended dismissing claims against all defendants for reasons such as judicial immunity for judges and law clerks, lack of state action for private entities, and inadmissibility of criminal statutes as private rights of action. District Judge Nina Gershon adopted this report entirely, granting motions to dismiss all federal claims against most defendants with prejudice, and state law claims against Robert Friedman without prejudice. All motions for sanctions by both parties were also denied.

Civil RightsPro Se LitigantMotion to DismissJudicial ImmunityState Action DoctrineEleventh AmendmentConspiracy ClaimsPrivate ActorsSupplemental JurisdictionRule 11 Sanctions
References
55
Case No. MISSING
Regular Panel Decision
Jan 27, 1965

Rivera v. Hellman

This case involves a motion to confirm a Special Referee's report concerning the amounts and priorities of various liens. The Special Referee conducted a hearing and reported on claims from an attorney for the plaintiff ($793.50), Roosevelt Hospital ($846.53), and the Millinery Health Fund ($641.00, later adjusted to $528). The report established the amounts of each lien and recommended priorities, placing the attorney's lien first, followed by the hospital lien (except for a $12 outpatient service), and then the compensation lien. The court concurred with the Special Referee's report and recommendations, granting the motion to confirm.

Lien PriorityAttorney's LienHospital LienDisability BenefitsWorkmen's Compensation LawSpecial Referee ReportMotion GrantedNew York Supreme CourtLien LawMotion Practice
References
2
Case No. MISSING
Regular Panel Decision

Colindres v. Carpenito

Plaintiff Rochelle Colindres sought a protective order to deny defendants' demand for a medical report from her former treating psychologist, Diane Henry, or alternatively, relief from compliance with Uniform Rules for Trial Courts § 202.17(b)(1). Colindres argued that the defendants waived their right to the report as the independent medical examination (IME) already occurred, and that obtaining the report would be an undue hardship since Henry ceased treatment due to Colindres' attendance issues. Defendants Mario Carpenito, Jr., City of White Plains, and White Plains Parking Department opposed, asserting that the report was necessary to clarify alleged injuries, prepare for cross-examination, and facilitate settlement, highlighting Colindres' complex medical history predating the incident. The court denied both branches of Colindres' motion, finding that the rule applies broadly to personal injury actions, defendants did not waive their entitlement, and Colindres failed to prove it was impossible to obtain the report. The court ordered Colindres to exchange a compliant medical report from Diane Henry by March 27, 2017.

protective ordermedical report disclosurediscovery disputepsychological treatmentindependent medical examinationCPLR 310322 NYCRR 202.17waiver of discoveryundue hardshippersonal injury damages
References
12
Case No. ADJ8691809
Regular
Apr 14, 2017

NICOLE BORAGNO vs. STATE OF CALIFORNIA, CDCR - CENTRAL CALIFORNIA WOMEN'S FACILITY CHOWCHILLA, STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

This case involves Nicole Boragno's workers' compensation claim against the State of California, CDCR. The applicant sought reconsideration of a decision denying the admission of a supplemental medical report. The WCAB denied reconsideration, adopting the WCJ's report which found the supplemental report inadmissible. This was because discovery had closed at the mandatory settlement conference, and the defendant failed to establish good cause for introducing evidence not previously disclosed. The WCJ noted there was no change in circumstances to warrant the late-filed report, distinguishing it from precedent that allows such reports.

WORKERS' COMPENSATION APPEALS BOARDPetition for Reconsiderationmandatory settlement conferencediscovery closureLabor Code section 5502(d)(3)good causesupplemental reportPQMEapportionmenttimeliness
References
2
Case No. MISSING
Regular Panel Decision

Chaplin v. Pathmark Supermarkets

This case addresses a motion by defendants, including Supermarkets General Corp., for a protective order to vacate the plaintiff Mimi Chaplin's notice for discovery and inspection of accident reports. Mimi Chaplin sought these reports after sustaining personal injuries from a fall at the defendant's premises. The court, presided over by Justice James F. Niehoff, analyzed the newly enacted CPLR 3101 (g), which mandates full disclosure of accident reports prepared in the regular course of business. The court found that the accident report in question was prepared in Supermarkets General Corp.'s regular course of business, rendering it discoverable regardless of its potential use in litigation, thus denying the defendants' motion.

DiscoveryProtective OrderAccident ReportsCPLR 3101(g)Litigation PreparationRegular Course of BusinessPersonal InjuryNegligenceDisclosureEvidence
References
10
Case No. ADJ9467074; ADJ9468922
Regular
Jul 15, 2018

THEODORE DAVIS vs. CITY OF MODESTO, Permissibly Self-Insured, administered by YORK INSURANCE SERVICES GROUP, INC.

This case involves applicant Theodore Davis's claims of industrial injury to his prostate. The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for removal and dismissed their petition for reconsideration. The WCAB rescinded the judge's finding that Dr. Besses' inadmissible report could be reviewed by the PQME, citing Labor Code section 4061(i) and Regulation 35(e). The Board affirmed that inadmissible medical-legal reports, obtained outside statutory procedures, cannot be reviewed by the PQME.

WCABRemovalReconsiderationPetitionAdmissibilityMedical-legal reportPQMELabor CodeBattenQualified Medical Evaluator
References
9
Case No. ADJ7699696
Regular
Apr 06, 2020

George Ramirez, Jr vs. Preston Pipelines, Subsequent Injuries Benefits Trust Fund

This case concerns the applicant's claim for Subsequent Injuries Benefits Trust Fund (SIBTF) benefits, which was initially denied by the WCJ who excluded Dr. Chen's medical reports as inadmissible "doctor shopping." The applicant appealed, arguing Dr. Chen's reports were admissible and not duplicative of Dr. Lockwood's initial, incomplete report. The Appeals Board rescinded the prior order, finding the applicant should not be denied benefits solely due to the exclusion of Dr. Chen's reports, and returned the matter to the trial level to allow the applicant to obtain supplemental reporting from Dr. Lockwood to address his SIBTF eligibility.

Subsequent Injuries Benefits Trust FundSIBTFLabor Code section 4751inadmissible evidencedoctor shoppingQME evaluationsLabor Code section 5703examining physiciancumulative traumaCompromise and Release
References
1
Case No. ADJ7062572
Regular
Apr 28, 2011

ANA LILIA RODRIGUEZ vs. COUNTRY VILLA HEALTH SERVICES, ZURICH AMERICAN INSURANCE CO. administered by TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board granted reconsideration of an award of temporary disability indemnity to an applicant who received treatment outside a valid Medical Provider Network (MPN). The Board overturned the original award, ruling that reports from physicians outside the MPN are inadmissible under current case law, *Valdez v. Warehouse Demo Services*. Consequently, the applicant is not entitled to temporary disability indemnity, reimbursement to the EDD, or attorney's fees based on those inadmissible reports. However, the applicant's unauthorized departure from the MPN was not deemed an unreasonable refusal of medical treatment.

Workers' Compensation Appeals BoardMedical Provider Network (MPN)Labor Code Section 4616.6Unauthorized Medical TreatmentAdmissibility of Medical ReportsTemporary Disability IndemnityEmployment Development Department (EDD)Attorney's FeesUnreasonable Refusal of Medical TreatmentLabor Code Section 4056
References
2
Case No. ADJ16773219; ADJ16653843
Regular
Jun 03, 2025

LAKEISHA HOWARD vs. OPTUM 360 SERVICES, A UNITED HEALTH GROUP COMPANY; TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The applicant, Lakeisha Howard, sought reconsideration after the WCJ denied her claims for cumulative injury to her left knee and ankle, and deemed Dr. Granado's reports inadmissible. The Appeals Board affirmed the WCJ's decision, finding that Dr. Granado's reports were obtained to rebut the panel QME's opinion rather than for medical treatment and were therefore inadmissible. The Board also upheld the finding that the applicant failed to prove a cumulative injury arising out of her employment, citing Dr. Welborn's opinion that her sedentary job would not cause such trauma. Consequently, the Petition for Reconsideration was denied.

Labor Code Section 5909Petition for ReconsiderationAdmissibility of Medical ReportsCumulative Trauma InjuryCompensable Consequence InjurySubstantial EvidenceCausationPanel Qualified Medical EvaluatorTreating PhysicianMedical-Legal Evaluation
References
10
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