CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. MISSING
Regular Panel Decision

Abreo v. URS Greiner Woodward Clyde

A plaintiff sustained personal injuries while working on a scaffold during a renovation project, alleging violations of Labor Law §§ 200, 240 (1), and 241 (6). Defendants Colgate Scaffolding and URS Greiner Woodward Clyde (now URS Corporation-New York), the alleged general contractor and scaffolding provider, respectively, moved for summary judgment to dismiss the complaint. The Supreme Court denied their motions in part. On appeal, the denial of summary judgment for URS concerning Labor Law § 240 (1) and § 241 (6) claims was affirmed, as triable issues of fact existed and the cited Industrial Code provisions were deemed specific. Colgate's appeal from one order was dismissed as they were not aggrieved, and their motion for summary judgment was also found to lack a prima facie case. The plaintiff was awarded costs.

Personal InjuryLabor LawScaffolding AccidentSummary JudgmentAppellate DecisionConstruction AccidentElevation-Related RiskIndustrial Code ViolationsNegligenceWorkers' Safety
References
14
Case No. 2022 NY Slip Op 00941 [202 AD3d 505]
Regular Panel Decision
Feb 10, 2022

Locke v. URS Architecture & Eng'g-N.Y., P.C.

Plaintiff Michael Locke sustained injuries after slipping on soapy water in a designated restroom at a construction site managed by URS. Locke had repeatedly notified URS of an overflowing sink causing water to pool, but URS attributed responsibility to prime general contractor Tri-Rail. The Supreme Court granted summary judgment to plaintiffs on common-law negligence and Labor Law claims against URS, while denying URS's motion to dismiss and for contractual indemnification against Tri-Rail, and denying Crescent's motion to dismiss. The Appellate Division modified the Supreme Court's order, dismissing the common-law negligence and Labor Law § 200 claims against Crescent and granting URS conditional contractual indemnification against Tri-Rail, pending liability apportionment. The court found URS liable under Labor Law §§ 241(6) and 200 due to its control over the injury-producing activity and notice of the dangerous condition.

Workers' CompensationConstruction Site AccidentSlip and FallPremises LiabilityLabor Law §200Labor Law §241(6)Industrial Code ViolationSummary JudgmentContractual IndemnificationCommon-Law Negligence
References
9
Case No. ADJ2172104 (SAC 0326562)
Regular
Jan 15, 2015

THOMAS MEEKER vs. OREGON PACIFIC BUILDING PRODUCTS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT COMPENSATION INSURANCE COMPANY

This case involves a dispute over the validity of a utilization review (UR) denial for an applicant's requested prescription medication. Initially, the administrative law judge found the UR denial invalid because the reviewing physician did not examine all relevant medical reports. However, following the en banc decision in *Dubon II*, the Appeals Board reversed this finding. The Board ruled that under *Dubon II*, only untimely UR decisions are invalid; other defects, like incomplete medical review, must be addressed through the Independent Medical Review (IMR) process. Therefore, the UR denial was deemed valid as it was timely.

Utilization ReviewRequest for AuthorizationProvigilDubon IIIndustrial InjuryPermanent DisabilityFuture Medical TreatmentPetition for ReconsiderationAdministrative Law JudgeWorkers' Compensation Appeals Board
References
14
Case No. ADJ6755122
Regular
Jan 22, 2014

Kimberly Bigham vs. Epic Management, Oak Insurance Co., Bershire Hathaway

This case concerns the validity of a utilization review (UR) and subsequent Independent Medical Review (IMR) denial by defendants. The WCJ found the UR invalid for procedural defects, specifically improper service on the applicant's counsel. Defendants sought reconsideration, arguing the WCJ erred by deeming the UR invalid based on service rules and by issuing a vague award. The Appeals Board granted reconsideration, adopting the WCJ's reasoning and affirming the decision, while correcting a typographical error in the award.

WORKERS' COMPENSATION APPEALS BOARDEPIC MANAGEMENTOAK INSURANCE CO.BERSHIRE HATHAWAYFINDINGS AND AWARDPETITION FOR RECONSIDERATIONUTILIZATION REVIEWINDEPENDENT MEDICAL REVIEWWCJCALIFORNIA CODE OF REGULATIONS
References
0
Case No. ADJ3685938 (WCK 0066506)
Regular
Dec 02, 2014

EMMETT BOONE vs. DREYER'S GRAND ICE CREAM, FIREMAN'S FUND INSURANCE COMPANY

In this workers' compensation case, the Appeals Board affirmed a prior award finding defendant's utilization review (UR) denials for prescription refills invalid. The Board agreed with the WCJ that the UR denials were untimely because the defendant failed to communicate the decisions to the treating physician within the statutory 24-hour timeframe. Consequently, the Board found the UR invalid, allowing the WCAB to determine medical necessity based on substantial evidence. This decision upholds the applicant's right to ongoing prescription refills.

Workers' Compensation Appeals BoardUtilization ReviewReconsiderationFindings and AwardPrescription RefillsMedical TreatmentDefective DenialTimeliness RequirementsLabor Code § 4610Dubon v. World Restoration
References
8
Case No. ADJ8454101
Regular
Dec 18, 2014

Joshua Desmarias vs. California Highway Patrol

The Appeals Board rescinded the original WCJ's decision, finding the applicant's appeal of the UR denial for spinal surgery is denied. The Board clarified that a procedural defect in a UR report, such as an illegible signature, does not invalidate the UR determination unless the UR itself was untimely. Since the parties stipulated the UR was timely, the Board lacked jurisdiction to determine the medical necessity of the surgery. Therefore, the IMR decision upholding the UR denial stands, and the applicant's request for surgery is denied.

Workers' Compensation Appeals BoardCalifornia Highway Patrollegally uninsuredState Compensation Insurance FundFindings of Fact and Orderindustrial injuryutilization reviewUR denialspinal surgeryorthopedic surgeon
References
3
Case No. ADJ896085
Regular
Nov 07, 2014

VALERIO FLORES vs. HVOLVOLL-JOHNSON CONSTRUCTION, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INDEMNITY COMPANY

This case involves a workers' compensation applicant seeking authorization for analgesic medications. The applicant's physician submitted requests, which the employer's utilization reviews (URs) denied as untimely. The Administrative Law Judge found the URs untimely and ordered authorization, disallowing the employer's UR denial documents as evidence. The employer sought reconsideration, arguing the Appeals Board lacked authority over UR timeliness and medical necessity. The Board affirmed the ALJ's decision, citing precedent that the Board retains authority over untimely URs and can determine medical necessity based on evidence when URs are invalid. The employer waived their right to challenge the timeliness finding or the medical evidence by not raising these points in their petition.

Workers' Compensation Appeals BoardUtilization ReviewRequest For AuthorizationUntimelyIndependent Medical ReviewMedical NecessityFindings And AwardPetition For ReconsiderationEn Banc DecisionDubon v. World Restoration
References
4
Case No. ADJ795505 (LAO 0794863)
Regular
Feb 13, 2014

VICTORIA SHANLEY vs. HENRY MAYO NEWHALL MEMORIAL HOSPITAL, TRAVELERS INSURANCE CO.

The Appeals Board reconsidered a WCJ's decision upholding utilization review (UR) denials for an MRI and EMG. While other contentions regarding the UR physician's qualifications and licensing were dismissed based on precedent, the Board found the UR decisions invalid due to untimely communication. Specifically, the defendant failed to prove by substantial evidence that the UR decisions were communicated by phone, fax, or email within 24 hours of being made. The matter is returned to the trial level to determine medical necessity, as the UR denials are void.

Utilization ReviewLabor Code Section 4610Administrative Director Rule 9792.9Physician QualificationLicensing RequirementsCommunication TimeframesTimely CommunicationMedical NecessityIndependent Medical ReviewInvalid UR Decision
References
2
Case No. MISSING
Regular Panel Decision

Haygood v. Hardwick

Andrew Hardwick appealed a Supreme Court order that denied his motion to dismiss a petition to invalidate his independent nominating petition and subsequently granted the petition, invalidating his nomination. The petitioners had alleged widespread fraud and forgery in the signatures collected for Hardwick's independent nominating petition. Hardwick contended that these allegations lacked sufficient specificity, a claim the court rejected, finding that the petition to invalidate adequately incorporated specific objections filed with the Nassau County Board of Elections. The Supreme Court's decision to invalidate was affirmed on appeal, as the court found Hardwick to be chargeable with knowledge of the fraudulent methods employed to gather signatures. Evidence showed subscribing witnesses were paid for collecting signatures before being registered to vote, and dates on petitions were altered, further substantiating the fraud. Additionally, the non-appearance of key subscribing witnesses led to an adverse inference against Hardwick.

Election LawIndependent Nominating PetitionPetition InvalidationFraudulent SignaturesForgeryVoter RegistrationCampaign FinanceAppellate DecisionNassau County ElectionCounty Executive
References
15
Case No. ADJ7286862, ADJ7604060
Regular
Sep 14, 2015

Kelly Tinsley vs. VERTIS COMMUNICATIONS, ACE USA INSURANCE

This case involves a denial of a defendant's petition for reconsideration regarding a workers' compensation award. The defendant's Utilization Review (UR) of the applicant's requested continued treatment at a residential rehabilitation center was deemed invalid by the Administrative Law Judge (ALJ) due to untimeliness in communication. The Workers' Compensation Appeals Board (WCAB) affirmed the ALJ's decision, finding the UR invalid because the defendant failed to prove timely communication to the physician as required by statute. Consequently, the WCAB upheld the award of continued treatment, deeming it reasonable and supported by substantial medical evidence.

Workers' Compensation Appeals BoardPetition for ReconsiderationUtilization ReviewUntimelinessRequest for AuthorizationTransitional Living CenterResidential ProgramPost-Acute Physical RehabilitationPsychiatric InjuryIndependent Medical Review
References
14
Showing 1-10 of 576 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational