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

Case No. ADJ7186535, ADJ8480044
Regular
Feb 05, 2019

America Guandique vs. State of California, Department of Motor Vehicles

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding of permanent total disability for the applicant. The defendant argued that the administrative law judge erred in combining two separate injuries and in relying on medical opinions. However, the Board found substantial evidence supported the conclusion that the applicant's injuries were inextricably intertwined and that her disabilities should be added, not combined. The Board affirmed that the finding of permanent total disability under Labor Code Section 4660 was well-supported, rendering other arguments moot.

Permanent Total DisabilityInextricably IntertwinedPetition for ReconsiderationJoint Findings of Fact and AwardAdministrative Law JudgePanel Qualified Medical EvaluatorAgreed Medical EvaluatorCombined vs. Added ImpairmentsVocational ExpertPermanent Disability Rating Schedule
References
12
Case No. ADJ10490434 (MF), ADJ10419398, ADJ10490429, ADJ10419507, ADJ8677936
Regular
Jun 23, 2025

Javier Hernandez vs. Richmar Farms, Zenith Insurance Co.

The Workers' Compensation Appeals Board denied defendant Zenith Insurance Co.'s petition for reconsideration. The defendant challenged a WCJ's decision to issue a single, joint and several award of 82% permanent partial disability to applicant Javier Hernandez, arguing that the hypertension-related disability should be apportioned to a single injury date. The Board affirmed the WCJ's finding that the permanent disability due to hypertension was inextricably intertwined across the applicant's multiple industrial injuries and therefore could not be parceled out, aligning with established legal precedents regarding apportionment.

Permanent Partial DisabilityApportionmentJoint and Several AwardInextricably IntertwinedMultiple Industrial InjuriesHypertensionBenson DecisionQualified Medical EvaluatorPhysician's ReportCumulative Injury
References
15
Case No. MISSING
Regular Panel Decision

Smith v. New York State & Local Retirement Systems

Petitioner, a taxpayer services representative, sustained a back injury in March 1981 while lifting forms, leading to a decline in attendance and eventual termination in November 1989. She applied for accidental and ordinary disability retirement benefits, both of which were denied by the Comptroller. The accidental disability claim was denied because the incident was not deemed an 'accident' under Retirement and Security Law § 63. The ordinary disability claim was denied as untimely, having been filed approximately six months after her termination, exceeding the 90-day limit stipulated by Retirement and Social Security Law § 62. The Supreme Court dismissed the challenge to the ordinary disability denial due to untimeliness and transferred the accidental disability challenge to this Court. This Court confirmed the Comptroller's determination on both counts, rejecting the petitioner's estoppel argument regarding the untimely ordinary disability application and finding substantial evidence to support the finding that the injury did not constitute an 'accident' within the meaning of the relevant law, as it resulted from ordinary employment duties without an unexpected event.

Disability Retirement BenefitsAccidental DisabilityOrdinary DisabilityUntimely ApplicationEstoppel Against GovernmentWork-Related InjuryBack InjuryDefinition of AccidentOrdinary Employment DutiesSubstantial Evidence Review
References
16
Case No. MISSING
Regular Panel Decision
May 15, 2012

Hamzik v. Office for People with Developmental Disabilities

Plaintiff John J. Hamzik sued the Office for People with Developmental Disabilities (OPWDD) and several individual employees, alleging discrimination based on sex, age, and disability, as well as equal protection, due process, and retaliation claims under federal and state laws, including Title VII, ADEA, and ADA. Defendants moved to dismiss the amended complaint, and plaintiff cross-moved to file a second amended complaint. The District Court, finding that many claims were barred by Eleventh Amendment immunity or failure to exhaust administrative remedies, and that the remaining claims failed to state a plausible cause of action, granted the defendants' motion to dismiss. All federal claims were dismissed with prejudice, the cross-motion was denied as futile, and the remaining state law claims were dismissed without prejudice.

DiscriminationRetaliationDue ProcessEqual ProtectionTitle VIIADEAADAEleventh Amendment ImmunityAdministrative ExhaustionMotion to Dismiss
References
50
Case No. 2020 NY Slip Op 02301 [182 AD3d 821]
Regular Panel Decision
Apr 16, 2020

Matter of Community, Work, & Independence, Inc. v. New York State Off. for People with Dev. Disabilities

This case involves a CPLR article 78 proceeding initiated by Community, Work, and Independence, Inc. (petitioner) to challenge a determination affirming the objection to its proposed discharge of M.D., an individual with developmental disabilities, from day habilitation services. M.D.'s parents objected to the discharge, and an administrative hearing sustained their objection, a decision later affirmed by the Commissioner of the Office for People with Developmental Disabilities. The Appellate Division, Third Department, confirmed the Commissioner's determination, finding that the burden of proof was appropriately placed on the service provider. The court concluded that substantial evidence supported the finding that discharging M.D. was not reasonable, considering his needs, the lack of suitable alternative programs, and despite the petitioner's financial concerns. The court suggested that financial issues for service providers should be addressed by seeking increased funding rather than by discharging individuals.

Developmental DisabilityHCBS WaiverDischarge ServicesAdministrative HearingBurden of ProofSubstantial EvidenceFinancial ConcernsService ProviderMedicaid FundingAutism Spectrum
References
7
Case No. ADJ1299341 (MON 0210486), ADJ1360926 (MON 0210487), ADJ2178726 (MON 0210488), ADJ3724105 (MON 0213769)
Regular
Oct 10, 2013

CARTIS SPILLMAN vs. MCDONNEL DOUGLAS AIRCRAFT, CALIFORNIA INSURANCE GUARANTEE ASSN., FREMONT INDEMNITY CO

This case involves multiple industrial injuries sustained by the applicant from 1990 to 1993. The Workers' Compensation Appeals Board (WCAB) reconsidered the original award, amending it to remove findings of injury to certain body parts like the left knee and neck due to insufficient evidence. The WCAB affirmed the finding of 100% permanent disability, as the applicant's orthopedic and psychiatric conditions were deemed inextricably intertwined and not reasonably apportionable. The periods for temporary total disability indemnity were adjusted, and the Board deferred to the WCJ's credibility determination regarding the applicant's average weekly wage.

CIGAFremont IndemnitySedgwick ClaimsReconsiderationFindings of FactAward and OrderWCJPermanent DisabilityTemporary DisabilityAgreed Medical Evaluator
References
0
Case No. ADJ158556 (MON 0206719) ADJ1611743 (MON 0222554) ADJ137665 (MON 0271624) ADJ1710332 (MON 0247216) ADJ716421 (MON 0222553)
Regular
Jun 27, 2011

Neil M. Lamont vs. BOEING, AIG/CHARTIS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INSURANCE COMPANY

This case involves apportionment of permanent disability benefits for multiple industrial injuries sustained by the applicant, Neil M. Lamont. The defendant, Chartis, sought reconsideration of an award finding them liable for reimbursement from CIGA, arguing the medical evidence was insufficient. The Appeals Board denied reconsideration, adopting the arbitrator's report. The Board found that due to the "inextricably intertwined" nature of the applicant's disabilities, as testified by the agreed medical examiner, apportionment of causation was impossible. Therefore, a joint and several award was justified, making the solvent defendant (Chartis) solely liable, thus relieving CIGA.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderArbitratorSubstantial EvidenceInextricably Intertwined DisabilityApportionment of LiabilityCalifornia Insurance Guarantee Association (CIGA)Insolvent Insurance CarrierCovered Claims
References
9
Case No. ADJ 924444 (LAO 0841815) ADJ 7065158
Regular
May 09, 2018

CESAR ESPINOZA vs. FLOWSERVE CORPORATION, TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board affirmed a joint award of 100% permanent disability for an applicant who sustained a specific injury to his right shoulder, left knee, and back, and a cumulative trauma injury to his bilateral shoulders, knees, back, and right knee. The Board found the applicant's industrial injuries were "inextricably intertwined," justifying an unapportioned award as per *Benson*. Furthermore, the Board relied on the vocational expert's opinion that the applicant was unable to find and sustain gainful employment due to his injuries, without considering non-industrial factors. The defendant's arguments regarding erroneous permanent total disability findings and the need for separate apportionment were rejected.

ApportionmentInextricably IntertwinedCumulative TraumaSpecific InjuryPermanent Total DisabilityAgreed Medical Examiner (AME)Vocational ExpertJoint AwardBenson v. WCABDiminished Future Earning Capacity
References
4
Case No. MISSING
Regular Panel Decision

Bullard v. St. Mary's Hospital

Claimant, a secretary at St. Mary's Hospital, developed rheumatoid arthritis, resulting in a permanent partial disability. The Workers' Compensation Board ruled it an occupational disease and awarded compensation. Liability was apportioned among three employers: Rochester Savings Bank, Woodward Health Center, and St. Mary's Hospital. The Special Disability Fund (SDF) was deemed liable for benefits after the initial 104-week disability period. SDF appealed, contending its reimbursement should be limited to St. Mary's Hospital's one-third share. The court affirmed the Board's decision, holding that Workers' Compensation Law § 44 makes the last employer (St. Mary's) responsible for total compensation, and Workers' Compensation Law § 15 (8) (d) requires SDF to fully reimburse the employer's carrier, Sedgwick James, for benefits paid after 104 weeks.

Occupational DiseaseRheumatoid ArthritisPermanent Partial DisabilityApportionmentSpecial Disability FundReimbursementWorkers' Compensation LawLast Employer LiabilityInsurance CarrierWorkers' Compensation Board
References
0
Case No. MISSING
Regular Panel Decision

Forsyth v. Staten Island Developmental Disabilities Services Office

The claimant, a lifeguard, sustained head and shoulder injuries in an automobile accident while working for the Staten Island Developmental Disabilities Services Office. His workers' compensation benefits were calculated based on concurrent employment, including seasonal work for the City of New York. The Workers’ Compensation Board affirmed the finding of concurrent employment, a decision which was subsequently appealed by the employer and its carrier. The appellate court affirmed the Board's determination, finding substantial evidence to support the finding of concurrent employment under Workers’ Compensation Law § 14 [6], given the claimant's long history of working for both employers during the same periods.

concurrent employmentaverage weekly wageworkers' compensationlifeguard injuryseasonal employmentappellate reviewNew York labor law
References
3
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